Nativity, Chronic Health Conditions, and Health Behaviors in Filipino Americans.

Science.gov (United States)

Bayog, Maria L G; Waters, Catherine M

2018-05-01

Nearly half of Americans have a chronic health condition related to unhealthful behavior. One in four Americans is an immigrant; yet immigrants' health has been studied little, particularly among Asian American subpopulations. Years lived in United States, hypertension, diabetes, smoking, walking, adiposity, and fruit/vegetable variables in the 2011-2012 California Health Interview Survey were analyzed to examine the influence of nativity on chronic health conditions and health behaviors in 555 adult Filipinos, the second largest Asian American immigrant subpopulation. Recent and long-term immigrant Filipinos had higher odds of having hypertension and diabetes, but lower odds of smoking and overweight/obesity compared with second-generation Filipinos. Being born in the United States may be protective against chronic health conditions, but not for healthful behaviors among Filipinos. Chronic disease prevention and health promotion strategies should consider nativity/length of residence, which may be a more consequential health determinant than other immigration and acculturation characteristics.

Health conditions and support needs of persons living in residential ...

African Journals Online (AJOL)

Background. Intellectual disability (ID) is a relatively high-incidence disability, with an increased risk of poor physical and mental health. Persons with ID also have lifelong support needs that must be met if they are to achieve an acceptable quality of life. Little is known about these health conditions and support needs in the ...

Changes in working conditions and physical health functioning among midlife and ageing employees.

Science.gov (United States)

Mänty, Minna; Kouvonen, Anne; Lallukka, Tea; Lahti, Jouni; Lahelma, Eero; Rahkonen, Ossi

2015-11-01

The aim this study was to examine the effect of changes in physical and psychosocial working conditions on physical health functioning among ageing municipal employees. Follow-up survey data were collected from midlife employees of the City of Helsinki, Finland, at three time points: wave 1 (2000-2002), wave 2 (2007), and wave 3 (2012). Changes in physical and psychosocial working conditions were assessed between waves 1 and 2. Physical health functioning was measured by the physical component summary (PCS) of the Short-Form 36 questionnaire at each of the three waves. In total, 2784 respondents (83% women) who remained employed over the follow-up were available for the analyses. Linear mixed-effect models were used to assess the associations and adjust for key covariates (age, gender, obesity, chronic diseases, and health behaviors). Repeated and increased exposure to adverse physical working conditions was associated with greater decline in physical health functioning over time. In contrast, decrease in exposures reduced the decline. Of the psychosocial working conditions, changes in job demands had no effects on physical health functioning. However, decreased job control was associated with greater decline and repeated high or increased job control reduced the decline in physical health functioning over time. Adverse changes in physical working conditions and job control were associated with greater decline in physical health functioning over time, whereas favorable changes in these exposures reduced the decline. Preventing deterioration and promoting improvement of working conditions are likely to help maintain better physical health functioning among ageing employees.

Income-related inequalities in diseases and health conditions over the business cycle.

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Ásgeirsdóttir, Tinna Laufey; Jóhannsdóttir, Hildur Margrét

2017-12-01

How business cycles affect income-related distribution of diseases and health disorders is largely unknown. We examine how the prevalence of thirty diseases and health conditions is distributed across the income spectrum using survey data collected in Iceland in 2007, 2009 and 2012. Thus, we are able to take advantage of the unusually sharp changes in economic conditions in Iceland during the Great Recession initiated in 2008 and the partial recovery that had already taken place by 2012 to analyze how income-related health inequality changed across time periods that can be described as a boom, crisis and recovery. The concentration curve and the concentration index are calculated for each disease, both overall and by gender. In all cases, we find a considerable income-related health inequality favoring higher income individuals, with a slight increase over the study period. Between 2007 and 2009, our results indicate increased inequality for women but decreased inequality for men. Between 2009 and 2012 on the contrary, men's inequality increases but women's decreases. The overarching result is thus that the economic hardship of the crisis temporarily increased female income-related health inequality, but decreased that of men.

Preparations for Severe Winter Conditions by Emergency Health Personnel in Turkey.

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Calışkan, Cüneyt; Algan, Aysun; Koçak, Hüseyin; Biçer, Burcu Küçük; Sengelen, Meltem; Cakir, Banu

2014-04-23

Emergency and core ambulance personnel work under all environmental conditions, including severe weather condtions. We evaluated emergency medical personnel in Çanakkale, Turkey, for their degree of preparedness. A descriptive study was conducted in Çanakkale, Turkey, within 112 emergency service units and their 17 district stations. Surveys were developed to measure the level of preparedness for serious winter conditions that individual workers made for themselves, their homes, and their cars. Of the 167 survey participants, the mean age was 29.8 ± 7.9 years; 52.7% were women; more than half (54.75%) were emergency medical technicians; and 53.3% were married. Only 10.4% of those who heated their homes with natural gas had carbon monoxide detectors. Scores relating to household and individual preparation for severe winter conditions increased by participants' age (P tires (P winter conditions (P = .016). Many of the surveyed emergency health personel demonstrated insufficient preparations for serious winter conditions. To increase the safety and efficiency of emergency medical personnel, educational training programs should be rountinely conducted. (Disaster Med Public Health Preparedness. 2014;0:1-4).

Forest health conditions on the Allegheny National Forest (1989-1999): Analysis of forest health monitoring surveys

Science.gov (United States)

R.S. Morin; A.M. Liebhold; K.W. Gottschalk; D.B. Twardus; R.E. Acciavatti; R.L. White; S.B. Horsley; W.D. Smith; E.R. Luzader

2001-01-01

This publication describes the forest vegetation and health conditions of the Allegheny National Forest (ANF). During the past 15 years, the ANF has experienced four severe droughts, several outbreaks of exotic and native insect defoliators, and the effects of other disturbance agents. An increase in tree mortality has raised concerns about forest health. Historical...

Introduction to the Special Section: Sustainability of Work with Chronic Health Conditions

NARCIS (Netherlands)

Shaw, W.S.; Tveito, T.H.; Boot, C.R.L.

2013-01-01

Background The increasing prevalence of older workers and chronic health conditions represents a growing occupational health concern. More research is needed to understand risk factors, apply and adapt theories, and test workplace-focused interventions that might prevent work disability and

Introduction to the special section: Sustainability of work with chronic health conditions

NARCIS (Netherlands)

Shaw, W.S.; Tveito, T.H.; Boot, C.R.L.

2013-01-01

Background The increasing prevalence of older workers and chronic health conditions represents a growing occupational health concern. More research is needed to understand risk factors, apply and adapt theories, and test workplace-focused interventions that might prevent work disability and

[Psychosocial working conditions and mental health status of the German babyboomer generation].

Science.gov (United States)

Tophoven, S; Tisch, A; Rauch, A; Burghardt, A

2015-04-01

The baby boomers are the first to be available to the German labour market up to the age of 67. A crucial premise for a long working life is good health. However, there is evidence that psychosocial working conditions are related to health. More and more employees report psychosocial stress at work. In addition, mental illness has become one of the main reasons for the entry into disability pension. Against this background this study considers the relationship between psychosocial work conditions and mental health exemplarily for two birth cohorts of the German baby boomers. For the analysis of the assumed relationships data of the lidA study "lidA - leben in der Arbeit - German Cohort Study on Work, Age and Health" is used (N=6 057). Mental health is assessed by the mental health scale of the SF-12. In addition, the items and the scales quantitative job requirements, work pace and support from colleagues from the Copenhagen Psychosocial Questionnaire (COPSOQ) are used. As further control variables cohort affiliation, level of education, occupational status and partnership are considered. Multivariate analyses of the relations between quantitative job requirements, work pace and the experienced support from colleagues show significant relationship to mental health. The increasing frequency of the requirement to work quickly and increasing quantitative job demands are negatively associated to mental health. However, support of colleagues shows a positive relationship to mental health. These results are similarly observed for women and men. For the regarded group of the German babyboomers, employees at the threshold to higher working age, it is clearly shown that psychosocial working conditions are related to mental health. Since this group still has to work up to 18 years given a statutory retirement age of 67, psychosocial working conditions should rather be in the focus of occupational safety. © Georg Thieme Verlag KG Stuttgart · New York.

Atopic conditions and mental health problems: a 3-year follow-up study.

Science.gov (United States)

Lien, Lars; Green, Kristian; Thoresen, Magne; Bjertness, Espen

2010-09-01

The aim of this study was to test the hypothesis that atopic conditions at 15/16 years of age affect both internalized and externalized mental health problems 3 years later. Combined school and postal survey was conducted in urban and rural settings. A total of 3,674 adolescents (70.1% response rate) were followed at two time points and interviewed with similar questionnaires at baseline and follow-up. Hopkins Symptoms Checklist (HSCL-10) was used to assess internalized problems, and two subscales (conduct problems and hyperactivity) from the Strength and Difficulties Questionnaire to measure externalized mental health problems. The atopic conditions investigated were asthma, hay fever and eczema by asking the adolescents whether these conditions were present or not. There was an increase in the prevalence of internalized mental health problems from about 17-25% and a decrease in externalized mental health problems and number of atopic conditions in the follow-up period. Of the atopic conditions, hay fever was most prevalent with about 34% at 15 years of age and 20% at 18. The asthma prevalence was at 10 and 5% and eczema at 25 and 10%, respectively. Internalized mental health problems among girls were significantly associated with atopic conditions 3 years earlier, also after controlling for confounding variables. To live with atopic conditions seem to affect the mood and level of anxiety among adolescent girls. This should be kept in mind by health professionals treating young girls with atopic conditions.

Characterisation of mental health conditions in social media using Informed Deep Learning

OpenAIRE

Gkotsis, George; Oellrich, Anika; Velupillai, Sumithra; Liakata, Maria; Hubbard, Tim J P; Dobson, Richard J B; Dutta, Rina

2017-01-01

The number of people affected by mental illness is on the increase and with it the burden on health and social care use, as well as the loss of both productivity and quality-adjusted life-years. Natural language\\ud processing of electronic health records is increasingly used to study mental health conditions and risk behaviours on a large scale. However, narrative notes written by clinicians do not capture first-hand\\ud the patients’ own experiences, and only record cross-sectional, professio...

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.

Impact of ACA Health Reforms for People With Mental Health Conditions.

Science.gov (United States)

Thomas, Kathleen C; Shartzer, Adele; Kurth, Noelle K; Hall, Jean P

2018-02-01

This brief report explores the impact of health reform for people with mental illness. The Health Reform Monitoring Survey was used to examine health insurance, access to care, and employment for 1,550 people with mental health conditions pre- and postimplementation of the Affordable Care Act (ACA) and by state Medicaid expansion status. Multivariate logistic regressions with predictive margins were used. Post-ACA reforms, people with mental health conditions were less likely to be uninsured (5% versus 13%; t=-6.89, df=50, peffects were experienced in both Medicaid expansion and nonexpansion states. Findings underscore the importance of ACA improvements in the quality of health insurance coverage.

Depression and Chronic Health Conditions Among Latinos: The Role of Social Networks.

Science.gov (United States)

Soto, Sandra; Arredondo, Elva M; Villodas, Miguel T; Elder, John P; Quintanar, Elena; Madanat, Hala

2016-12-01

The purpose of this study was to examine the "buffering hypothesis" of social network characteristics in the association between chronic conditions and depression among Latinos. Cross-sectional self-report data from the San Diego Prevention Research Center's community survey of Latinos were used (n = 393). Separate multiple logistic regression models tested the role of chronic conditions and social network characteristics in the likelihood of moderate-to-severe depressive symptoms. Having a greater proportion of the network comprised of friends increased the likelihood of depression among those with high cholesterol. Having a greater proportion of women in the social network was directly related to the increased likelihood of depression, regardless of the presence of chronic health conditions. Findings suggest that network characteristics may play a role in the link between chronic conditions and depression among Latinos. Future research should explore strategies targeting the social networks of Latinos to improve health outcomes.

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.

The evolution of health status and chronic conditions in Catalonia, 1994-2006: the paradox of health revisited using the Blinder - Oaxaca decomposition.

Science.gov (United States)

García-Altés, Anna; Pinilla, Jaime; Ortún, Vicente

2011-05-23

The paradox of health refers to the improvement in objective measures of health and the increase in the reported prevalence of chronic conditions. The objective of this paper is to test the paradox of health in Catalonia from 1994 to 2006. Longitudinal cross-sectional study using the Catalonia Health Interview Survey of 1994 and 2006. The approach used was the three-fold Blinder - Oaxaca decomposition, separating the part of the differential in mean visual analogue scale value (VAS) due to group differences in the predictors (prevalence effect), due to differences in the coefficients (severity effect), and an interaction term. Variables included were the VAS value, education level, labour status, marital status, all common chronic conditions over the two cross-sections, and a variable for non-common chronic conditions and other conditions. Sample weights have been applied. Results show that there is an increase in mean VAS for men aged 15-44, and a decrease in mean VAS for women aged 65-74 and 75 and more. The increase in mean VAS for men aged 15-44 could be explained by a decrease in the severity effect, which offsets the increase in the prevalence effect. The decrease in mean VAS for women aged 65-74 and 75 and more could be explained by an increase in the prevalence effect, which does not offset the decrease in the severity effect. The results of the present analysis corroborate the paradox of health hypothesis for the population of Catalonia, and highlight the need to be careful when measuring population health over time, as well as their usefulness to detect population's perceptions.

Multiple chronic health conditions and their link with wealth assets.

Science.gov (United States)

Schofield, Deborah J; Callander, Emily J; Shrestha, Rupendra N; Passey, Megan E; Kelly, Simon J; Percival, Richard

2015-04-01

There has been little research on the economic status of those with multiple health conditions, particularly on the relationship between multiple health conditions and wealth. This paper will assess the difference in the value and type of wealth assets held by Australians who have multiple chronic health conditions. Using Health&WealthMOD, a microsimulation model of the 45-64-year-old Australian population in 2009, a counterfactual analysis was undertaken. The actual proportion of people with different numbers of chronic health conditions with any wealth, and the value of this wealth was estimated. This was compared with the counterfactual values had the individuals had no chronic health conditions. There was no change in the proportion of people with one health condition who actually had any wealth, compared to the counterfactual proportion had they had no chronic health conditions. Ninety-four percent of those with four or more health conditions had some accumulated wealth; however, under the counterfactual, 100% would have had some accumulated wealth. There was little change in the value of non-income-producing assets under the counterfactual, regardless of number of health conditions. Those with four or more chronic health conditions had a mean value of $17 000 in income-producing assets; under the counterfactual, the average would have been $78 000. This study has highlighted the variation in the value of wealth according to number of chronic health conditions, and hence the importance of considering multiple morbidities when discussing the relationship between health and wealth. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Increasing tobacco taxes : A cheap tool to increase public health

NARCIS (Netherlands)

van Baal, Pieter H. M.; Brouwer, Werner B. F.; Hoogenveen, Rudolf T.; Feenstra, Talitha L.

Introduction: Several studies have estimated health effects resulting from tobacco tax increases. However, studies on the cost effectiveness of tobacco taxes are scarce. The aim of this study was to estimate the cost effectiveness of tobacco tax increases from a health care perspective, explicitly

Health Inequalities among Workers with a Foreign Background in Sweden: Do Working Conditions Matter?

Directory of Open Access Journals (Sweden)

Mikael Rostila

2013-07-01

Full Text Available Employment and working conditions are key social determinants of health, yet current information is lacking regarding relationships between foreign background status, working conditions and health among workers in Sweden. This study utilized cross-sectional data from the 2010 Swedish Level of Living Survey (LNU and the Level of Living Survey for Foreign Born Persons and their Children (LNU-UFB to assess whether or not health inequalities exist between native Swedish and foreign background workers and if exposure to adverse psychosocial and physical working conditions contributes to the risk for poor health among foreign background workers. A sub-sample of 4,021 employed individuals aged 18–65 was analyzed using logistic regression. Eastern European, Latin American and Other Non-Western workers had an increased risk of both poor self-rated health and mental distress compared to native Swedish workers. Exposure to adverse working conditions only minimally influenced the risk of poor health. Further research should examine workers who are less integrated or who have less secure labor market attachments and also investigate how additional working conditions may influence associations between health and foreign background status.

Under-coding of secondary conditions in coded hospital health data: Impact of co-existing conditions, death status and number of codes in a record.

Science.gov (United States)

Peng, Mingkai; Southern, Danielle A; Williamson, Tyler; Quan, Hude

2017-12-01

This study examined the coding validity of hypertension, diabetes, obesity and depression related to the presence of their co-existing conditions, death status and the number of diagnosis codes in hospital discharge abstract database. We randomly selected 4007 discharge abstract database records from four teaching hospitals in Alberta, Canada and reviewed their charts to extract 31 conditions listed in Charlson and Elixhauser comorbidity indices. Conditions associated with the four study conditions were identified through multivariable logistic regression. Coding validity (i.e. sensitivity, positive predictive value) of the four conditions was related to the presence of their associated conditions. Sensitivity increased with increasing number of diagnosis code. Impact of death on coding validity is minimal. Coding validity of conditions is closely related to its clinical importance and complexity of patients' case mix. We recommend mandatory coding of certain secondary diagnosis to meet the need of health research based on administrative health data.

Crisis, Living Conditions and Health in Mexico: New Challenges for Social Policy

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Oliva López Arellano

2010-08-01

Full Text Available In the last 30 years, Mexico has faced major crises in its political, economic, and social life. These crises have affected living conditions and health. With the implementation in the 1980's of structural adjustment and economic stabilization policies, Mexico saw a rapid growth of poverty accelerating trends toward social polarization and social division. The current crisis, fueled by deregulation of the global financial markets, only deepens the tendency towards economic stagnation. It has led to an increase in unemployment, worsening income inequalities, and generalized inflation. The increase in food prices, in particular, has made life more difficult for the Mexican population. The crisis has had a palpable and concrete impact on living conditions, health status, and food security for diverse social groups.

The Role of School Health Services in Addressing the Needs of Students with Chronic Health Conditions: A Systematic Review

Science.gov (United States)

Leroy, Zanie C.; Wallin, Robin; Lee, Sarah

2017-01-01

Children and adolescents in the United States spend many hours in school. Students with chronic health conditions (CHCs) may face lower academic achievement, increased disability, fewer job opportunities, and limited community interactions as they enter adulthood. School health services provide safe and effective management of CHCs, often for…

Frequent Surfing on Social Health Networks is Associated With Increased Knowledge and Patient Health Activation.

Science.gov (United States)

Grosberg, Dafna; Grinvald, Haya; Reuveni, Haim; Magnezi, Racheli

2016-08-10

The advent of the Internet has driven a technological revolution that has changed our lives. As part of this phenomenon, social networks have attained a prominent role in health care. A variety of medical services is provided over the Internet, including home monitoring, interactive communications between the patient and service providers, and social support, among others. This study emphasizes some of the practical implications of Web-based health social networks for patients and for health care systems. The objective of this study was to assess how participation in a social network among individuals with a chronic condition contributed to patient activation, based on the Patient Activation Measure (PAM). A prospective, cross-sectional survey with a retrospective component was conducted. Data were collected from Camoni, a Hebrew-language Web-based social health network, participants in the diabetes mellitus, pain, hypertension, and depression/anxiety forums, during November 2012 to 2013. Experienced users (enrolled at least 6 months) and newly enrolled received similar versions of the same questionnaire including sociodemographics and PAM. Among 686 participants, 154 of 337 experienced and 123 of 349 newly enrolled completed the questionnaire. Positive correlations (Psocial relationships, and chronic disease knowledge. Men surfed longer than women (χ²3=10.104, Psocial health network use were correlated with increased knowledge about a chronic disease. Experienced surfers had higher PAM than newly enrolled, suggesting that continued site use may contribute to increased activation. Web-based social health networks offer an opportunity to expand patient knowledge and increase involvement in personal health, thereby increasing patient activation. Further studies are needed to examine these changes on other aspects of chronic illnesses such as quality of life and costs.

Aridity under conditions of increased CO2

Science.gov (United States)

Greve, Peter; Roderick, Micheal L.; Seneviratne, Sonia I.

2016-04-01

A string of recent of studies led to the wide-held assumption that aridity will increase under conditions of increasing atmospheric CO2 concentrations and associated global warming. Such results generally build upon analyses of changes in the 'aridity index' (the ratio of potential evaporation to precipitation) and can be described as a direct thermodynamic effect on atmospheric water demand due to increasing temperatures. However, there is widespread evidence that contradicts the 'warmer is more arid' interpretation, leading to the 'global aridity paradox' (Roderick et al. 2015, WRR). Here we provide a comprehensive assessment of modeled changes in a broad set of dryness metrics (primarily based on a range of measures of water availability) over a large range of realistic atmospheric CO2 concentrations. We use an ensemble of simulations from of state-of-the-art climate models to analyse both equilibrium climate experiments and transient historical simulations and future projections. Our results show that dryness is, under conditions of increasing atmospheric CO2 concentrations and related global warming, generally decreasing at global scales. At regional scales we do, however, identify areas that undergo changes towards drier conditions, located primarily in subtropical climate regions and the Amazon Basin. Nonetheless, the majority of regions, especially in tropical and mid- to northern high latitudes areas, display wetting conditions in a warming world. Our results contradict previous findings and highlight the need to comprehensively assess all aspects of changes in hydroclimatological conditions at the land surface. Roderick, M. L., P. Greve, and G. D. Farquhar (2015), On the assessment of aridity with changes in atmospheric CO2, Water Resour. Res., 51, 5450-5463

Oral Health Condition of Children Living with HIV

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Natália Spillere Rovaris

2014-01-01

Full Text Available AIDS progression is faster in children than adults. Little is known about the oral health status of children living with HIV. Aim: To carry out a literature review about the oral health conditions of children living with HIV in order to observe if this specific population presents different oral health conditions compared to children without HIV infection. Methods: A documental study of literature review was carried out. Studies were searched at PubMed using “oral health”, “children”, “HIV” and “AIDS” as keywords. Papers published between 2001 and 2011 were included. After applying the exclusion criteria and complete reading of the selected studies, other articles were selected from the references lists of the first ones. Results: Firstly, 24 studies were identified. Among them, 65.5% were excluded according to the exclusion criteria. From the five selected articles, another five from the references of these were included. Only one article compared the oral health conditions of children living with HIV with controls without HIV infection. Conclusions: Only 10 papers contained information on the oral health conditions of children living with HIV, and just one compared the results with controls. The few studies found were insufficient to establish the oral health condition profile of children living with HIV. This lack of information could represent the lack of interest of researchers and health authorities in more integrative care and can result in neglect with this specific population of children.

Chronic health conditions and work ability in the ageing workforce : the impact of work conditions, psychosocial factors and perceived health

NARCIS (Netherlands)

Koolhaas, Wendy; van der Klink, Jac J. L.; de Boer, Michiel R.; Groothoff, Johan W.; Brouwer, Sandra

The aim of this study was to determine the influence of work conditions, psychosocial factors and perceived health on the association between the presence of a chronic health condition and (single-item) work ability among workers aged 45 years and older. In addition, we aimed to examine variables

Chronic health conditions and work ability in the ageing workforce: the impact of work conditions, psychosocial factors and perceived health

NARCIS (Netherlands)

Koolhaas, W.; van der Klink, J.J.L.; de Boer, M.R.; Groothoff, J.W.; Brouwer, S.

2014-01-01

Purpose: The aim of this study was to determine the influence of work conditions, psychosocial factors and perceived health on the association between the presence of a chronic health condition and (single-item) work ability among workers aged 45 years and older. In addition, we aimed to examine

The high price of depression: Family members' health conditions and health care costs.

Science.gov (United States)

Ray, G Thomas; Weisner, Constance M; Taillac, Cosette J; Campbell, Cynthia I

2017-05-01

To compare the health conditions and health care costs of family members of patients diagnosed with a Major Depressive Disorder (MDD) to family members of patients without an MDD diagnosis. Using electronic health record data, we identified family members (n=201,914) of adult index patients (n=92,399) diagnosed with MDD between 2009 and 2014 and family members (n=187,011) of matched patients without MDD. Diagnoses, health care utilization and costs were extracted for each family member. Logistic regression and multivariate models were used to compare diagnosed health conditions, health services cost, and utilization of MDD and non-MDD family members. Analyses covered the 5years before and after the index patient's MDD diagnosis. MDD family members were more likely than non-MDD family members to be diagnosed with mood disorders, anxiety, substance use disorder, and numerous other conditions. MDD family members had higher health care costs than non-MDD family members in every period analyzed, with the highest difference being in the year before the index patient's MDD diagnosis. Family members of patients with MDD are more likely to have a number of health conditions compared to non-MDD family members, and to have higher health care cost and utilization. Copyright © 2017. Published by Elsevier Inc.

Health conditions and role limitation in three European Regions: a public-health perspective.

Science.gov (United States)

Barbaglia, Gabriela; Adroher, Núria D; Vilagut, Gemma; Bruffaerts, Ronny; Bunting, Brentan; Caldas de Almeida, José Miguel; Florescu, Silvia; de Girolamo, Giovanni; de Graaf, Ron; Haro, Josep Maria; Hinkov, Hristo; Kovess-Masfety, Vivianne; Matschinger, Herbert; Alonso, Jordi

To describe the distribution of role limitation in the European population aged 18-64 years and to examine the contribution of health conditions to role limitation using a public-health approach. Representative samples of the adult general population (n=13,666) aged 18-64 years from 10 European countries of the World Mental Health (WMH) Surveys Initiative, grouped into three regions: Central-Western, Southern and Central-Eastern. The Composite International Diagnostic Interview (CIDI 3.0) was used to assess six mental disorders and standard checklists for seven physical conditions. Days with full and with partial role limitation in the month previous to the interview were reported (WMH-WHODAS). Population Attributable Fraction (PAFs) of full and partial role limitation were estimated. Health conditions explained a large proportion of full role limitation (PAF=62.6%) and somewhat less of partial role limitation (46.6%). Chronic pain was the single condition that consistently contributed to explain both disability measures in all European Regions. Mental disorders were the most important contributors to full and partial role limitation in Central-Western and Southern Europe. In Central-Eastern Europe, where mental disorders were less prevalent, physical conditions, especially cardiovascular diseases, were the highest contributors to disability. The contribution of health conditions to role limitation in the three European regions studied is high. Mental disorders are associated with the largest impact in most of the regions. There is a need for mainstreaming disability in the public health agenda to reduce the role limitation associated with health conditions. The cross-regional differences found require further investigation. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Perceived unfairness in working conditions: The case of public health services in Tanzania

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Massay Deodatus

2011-02-01

Full Text Available Abstract Background The focus on the determinants of the quality of health services in low-income countries is increasing. Health workers' motivation has emerged as a topic of substantial interest in this context. The main objective of this article is to explore health workers' experience of working conditions, linked to motivation to work. Working conditions have been pointed out as a key factor in ensuring a motivated and well performing staff. The empirical focus is on rural public health services in Tanzania. The study aims to situate the results in a broader historical context in order to enhance our understanding of the health worker discourse on working conditions. Methods The study has a qualitative study design to elicit detailed information on health workers' experience of their working conditions. The data comprise focus group discussions (FGDs and in-depth interviews (IDIs with administrators, clinicians and nursing staff in the public health services in a rural district in Tanzania. The study has an ethnographic backdrop based on earlier long-term fieldwork in the same part of Tanzania. Results The article provides insights into health workers' understanding and assessment of their working conditions. An experience of unsatisfactory working conditions as well as a perceived lack of fundamental fairness dominated the FGDs and IDIs. Informants reported unfairness with reference to factors such as salary, promotion, recognition of work experience, allocation of allowances and access to training as well as to human resource management. The study also revealed that many health workers lack information or knowledge about factors that influence their working conditions. Conclusions The article calls for attention to the importance of locating the discourse of unfairness related to working conditions in a broader historical/political context. Tanzanian history has been characterised by an ambiguous and shifting landscape of state regulation

[Working conditions, living conditions and physical health problems declared among penitentiary administration personnel in France].

Science.gov (United States)

Goldberg, P; Landre, M F; David, S; Goldberg, M; Dassa, S; Marne, M J

1996-06-01

A cross-sectional epidemiological survey was conducted among prison staff in France to investigate the relationships between working conditions and health. The sample included men and women 20 to 64 years old belonging to all categories of prison personnel: prison guards, administrative staff, socioeducational workers, technicians, health care workers, and managers (n = 4587, response rate 45.7%). A mailed self-administered questionnaire was used to assess sociodemographic characteristics, working conditions, and physical and mental disorders. Multiple logistic regression analyses were conducted to determine the effects of working conditions and social relationships on health of prison staff. However, the results reported here only concern 17 health disorders: body mass index, sick leave, medication use, accidents, digestive disorders, lower extremities and back disorders, hypertension, hemorrhoids, arthritis, skin disorders, urinary infections, chronic bronchitis, cholesterol, gastric ulcer, respiratory infections, ocular disorders. The living non professional conditions mostly associated with health disorders were financial difficulties (OR: 1.9 for digestive disorders, 1.8 for gastric ulcer, 1.7 for medication use) and irregularity of meals (OR = 1.5 for digestive disorders, and hypertension). In the occupational environment, the factors most associated with health disorders are seniority (OR = 4.2 for arthritis, 2.3 for cholesterol) and constraints (OR = 1.7 for lower extremities disorders). In spite of some limits associated to this kind of study, relationships between occupational and non occupational factors and physical health conditions were observed; the results also pointed out the protective role of the social relationships for health conditions.

Health conditions and role limitation in three European Regions: a public-health perspective

Directory of Open Access Journals (Sweden)

Gabriela Barbaglia

2017-01-01

Conclusion: The contribution of health conditions to role limitation in the three European regions studied is high. Mental disorders are associated with the largest impact in most of the regions. There is a need for mainstreaming disability in the public health agenda to reduce the role limitation associated with health conditions. The cross-regional differences found require further investigation.

Conditioning Influences Audio-Visual Integration by Increasing Sound Saliency

Directory of Open Access Journals (Sweden)

Fabrizio Leo

2011-10-01

Full Text Available We investigated the effect of prior conditioning of an auditory stimulus on audiovisual integration in a series of four psychophysical experiments. The experiments factorially manipulated the conditioning procedure (picture vs monetary conditioning and multisensory paradigm (2AFC visual detection vs redundant target paradigm. In the conditioning sessions, subjects were presented with three pure tones (= conditioned stimulus, CS that were paired with neutral, positive, or negative unconditioned stimuli (US, monetary: +50 euro cents,.–50 cents, 0 cents; pictures: highly pleasant, unpleasant, and neutral IAPS. In a 2AFC visual selective attention paradigm, detection of near-threshold Gabors was improved by concurrent sounds that had previously been paired with a positive (monetary or negative (picture outcome relative to neutral sounds. In the redundant target paradigm, sounds previously paired with positive (monetary or negative (picture outcomes increased response speed to both auditory and audiovisual targets similarly. Importantly, prior conditioning did not increase the multisensory response facilitation (ie, (A + V/2 – AV or the race model violation. Collectively, our results suggest that prior conditioning primarily increases the saliency of the auditory stimulus per se rather than influencing audiovisual integration directly. In turn, conditioned sounds are rendered more potent for increasing response accuracy or speed in detection of visual targets.

Job Burnout, Work Engagement and Self-reported Treatment for Health Conditions in South Africa.

Science.gov (United States)

de Beer, Leon T; Pienaar, Jaco; Rothmann, Sebastiaan

2016-02-01

The purpose of the study being reported here was to investigate the relationship of job burnout and work engagement with self-reported received treatment for health conditions (cardiovascular condition, high cholesterol, depression, diabetes, hypertension and irritable bowel syndrome), while controlling for age, gender, smoking and alcohol use. The sample comprised 7895 employees from a broad range of economic sectors in the South African working population. A cross-sectional survey design was used for the study. Structural equation modelling methods were implemented with a weighted least squares approach. The results showed that job burnout had a positive relationship with self-reported received treatment for depression, diabetes, hypertension and irritable bowel syndrome. Work engagement did not have any significant negative or positive relationships with the treatment for these health conditions. The results of this study make stakeholders aware of the relationship between job burnout, work engagement and self-reported treatment for health conditions. Evidence for increased reporting of treatment for ill-health conditions due to burnout was found. Therefore, attempts should be made to manage job burnout to prevent ill-health outcomes. Copyright © 2014 John Wiley & Sons, Ltd.

Women waste pickers: living conditions, work, and health.

Science.gov (United States)

Coelho, Alexa Pupiara Flores; Beck, Carmem Lúcia Colomé; Fernandes, Marcelo Nunes da Silva; Freitas, Natiellen Quatrin; Prestes, Francine Cassol; Tonel, Juliana Zancan

2016-09-29

To know the elements of work, health, and living conditions of women who pick recyclable waste and are members of a waste cooperative in a town of the state of Rio Grande do Sul, Brazil. This is a qualitative, exploratory and descriptive study with seven subjects. Data were collected through participative observation, semi structured interview, and a focus group from July to August of 2013. The data were subjected to content analysis. The following thematic categories emerged: Women's work, informality and precariousness; Experiences of job satisfaction; and Working conditions and health: experiences with accidents, illness and health services. It was concluded that the women who collect recyclable material are exposed to precarious work conditions and potential health risks, such as work overload, accidents, illness, and social insecurity, and that nurses are responsible for promoting actions that ensure the health and inclusion of these workers.

Racial and gender discrimination, early life factors, and chronic physical health conditions in midlife.

Science.gov (United States)

McDonald, Jasmine A; Terry, Mary Beth; Tehranifar, Parisa

2014-01-01

Most studies of perceived discrimination have been cross-sectional and focused primarily on mental rather than physical health conditions. We examined the associations of perceived racial and gender discrimination reported in adulthood with early life factors and self-reported physician diagnosis of chronic physical health conditions. We used data from a racially diverse birth cohort of U.S. women (n = 168; average age, 41 years) with prospectively collected early life data (e.g., parental socioeconomic factors) and adult reported data on perceived discrimination, physical health conditions, and relevant risk factors. We performed modified robust Poisson regression owing to the high prevalence of the outcomes. Fifty percent of participants reported racial and 39% reported gender discrimination. Early life factors did not have strong associations with perceived discrimination. In adjusted regression models, participants reporting at least three experiences of gender or racial discrimination had a 38% increased risk of having at least one physical health condition (relative risk, 1.38; 95% confidence interval, 1.01-1.87). Using standardized regression coefficients, the magnitude of the association of having physical health condition(s) was larger for perceived discrimination than for being overweight or obese. Our results suggest a substantial chronic disease burden associated with perceived discrimination, which may exceed the impact of established risk factors for poor physical health. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Health conditions detected in a comprehensive periodic health evaluation of 558 professional football players

NARCIS (Netherlands)

Bakken, Arnhild; Targett, Stephen; Bere, Tone; Adamuz, Maria-Carmen; Tol, Johannes L.; Whiteley, Rod; Wilson, Mathew G.; Witvrouw, Erik; Khan, Karim M.; Bahr, Roald

2016-01-01

Despite the widespread use of periodic health evaluation (PHE) to detect and prevent injury and illness in athletes, its effectiveness in detecting health conditions and relevant risk factors is still debated. To assess health conditions detected by a comprehensive PHE in professional male football

Work disability resulting from chronic health conditions.

Science.gov (United States)

Lerner, Debra; Allaire, Saralynn H; Reisine, Susan T

2005-03-01

To describe current programs and policies for addressing work disability among adults with chronic health conditions, and to identify opportunities for new research aimed at reducing the problem. The authors conducted secondary data analysis and a literature review. Millions of Americans with a chronic health condition have a work disability or are at risk of developing one. This public health problem is costing hundreds of billions of dollars a year nationally in lost productivity and diminishing the quality of life of millions of Americans. The medical care system, employers, and government--three traditional sources of help for adults with chronic health problems--are not sufficiently oriented toward the primary or secondary prevention of work disability. New research is urgently needed to reduce the burden of work disability on individuals and society.

Suicide and self-injury among children and youth with chronic health conditions.

Science.gov (United States)

Barnes, Andrew J; Eisenberg, Marla E; Resnick, Michael D

2010-05-01

Chronic conditions may be associated with suicide risk. This study aimed to specify the extent to which youth chronic conditions are at risk for suicidality and self-harm. Logistic regression was used to estimate odds of self-harm, suicidal ideation, and suicide attempts in 10- to 19-year-olds with and without chronic physical and/or mental health conditions. Independent of race, socioeconomic status, absent parent, special education status, substance use, and emotional distress, youth with co-occurring chronic physical and mental conditions (n = 4099) had significantly higher odds of self-harm (odds ratio [OR]: 2.5 [99% confidence interval (CI): 2.3-2.8), suicidal ideation (OR: 2.5 [99% CI: 2.3-2.8), and suicide attempts (OR: 3.5 [99% CI: 3.1-3.9]) than healthy peers (n = 106,967), as did those with chronic mental conditions alone (n = 8752). Youth with chronic physical conditions alone (n = 12,554) were at slightly elevated risk for all 3 outcomes. Findings were similar among male and female youth, with a risk gradient by grade. Chronic physical conditions are associated with a slightly elevated risk for self-harm, suicidal thinking, and attempted suicide; chronic mental conditions are associated with an increased risk for all 3 outcomes. Co-occurring chronic physical and mental conditions are associated with an increased risk for self-harm and suicidal ideation that is similar to the risk in chronic mental conditions and with an attempted suicide risk in excess of that predicted by the chronic mental health conditions alone. Preventive interventions for these youth should be developed and evaluated.

Managing the demands of the preregistration mental health nursing programme: The views of students with mental health conditions.

Science.gov (United States)

Ramluggun, Pras; Lacy, Mary; Cadle, Martha; Anjoyeb, Mahmood

2018-05-30

An increasing number of students with a pre-existing mental health condition are enrolling on preregistration mental health nursing programmes. The challenges faced by these students in managing the demands of the programme have not been fully explored. Mental health and well-being is an integral part of providing a healthy university in which students can flourish. The purpose of the study was to explore how students with an underlying mental health issue manage the demands of the mental health nursing programme. The outcomes of the study are aimed at informing inclusive teaching and learning and current student support provision. Ethics approval was given. Students from two universities in South East England who met the criterion of having a pre-existing mental health condition when enrolling on the mental health preregistration nursing programme were invited to take part. Nine students took part in the study. Using an interpretative descriptive design, 1:1 face-to-face, audio-taped, semistructured interviews were undertaken. The data were analysed using a framework approach, and this revealed four main themes: timing of disclosure; managing lived experience in learning environments; students' coping mechanisms, and experience of support. Recommendations for practice was that approved education institutes (AEIs) should ensure they have a robust, inclusive practice by implementing strategies to develop these students' resilience, and enhance their learning and the current support provisions. This will ensure the barriers to disclosing their mental health conditions are recognized and minimized to enable these students to fully contribute to their own learning and teaching experience. © 2018 Australian College of Mental Health Nurses Inc.

[Children's health under the conditions of social differentiation].

Science.gov (United States)

Maksimova, T M; Gaenko, O N; Belov, V B

2004-01-01

Results of social-and-hygienic research of the health condition of children belonging to different social-and-economic population categories are under discussion. The material family status is shown to directly affect the child's life quality, i.e. family life mode, psychological climate, scope and variety of food-stuffs, the possibility to have a regular and valuable recreation, educational regime, and the possibility to satisfy the spiritual demands of a child etc. The morbidity goes up among children as the family income decreases. The social-and-economic conditions are the uttermost and often decisive risk factor that provokes the development of deviations in children's health. The material stratification of society conditions, for children, differing degrees of access to public benefits that are involved in shaping the children's health, thus, entailing the disequilibrium in their health. A realistic pattern of children's health is needed as a data base to define an objective necessity of children in medical care of different types as well as their necessity in medical drugs and equipment.

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

Science.gov (United States)

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

2016-01-01

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. 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, cardiovascular diseases, chronic respiratory diseases, and arthritis. A cluster design with probability proportional to size sampling was used to attain a nationally representative sample of 1550 non-camp Syrian refugee households. Of 1363 cases with a chronic health condition diagnosis, 84.7% had received care in Jordan. Public facilities faced a heavy burden serving over half (53.9%) of care-seekers; the remainder received care in the private (29.6%) and NGO/charity (16.6%) sectors. Individuals with non-communicable diseases (NCDs) in the central region of Jordan and with arthritis had the lowest rates of care-seeking when compared to other regions and conditions. Overall, 31.6% of care-seekers had an out-of-pocket payment for the most recent care-seeking event which averaged 18.8 USD (median = 0 USD), excluding cost of medications. Forced displacement presents major challenges to those with NCDs, which have the potential to seriously impact both the quality of life and life expectancy amongst refugees. NCD patterns among Syrian refugees indicate the importance of continuing support to public sector services in Jordan to adequately meet expanding needs and ensure appropriate prevention and control of priority NCDs.

Crisis in the health sector: Impact on nurses' working conditions.

Science.gov (United States)

Granero-Lázaro, Alberto; Blanch-Ribas, Josep M; Roldán-Merino, Juan Francisco; Torralbas-Ortega, Jordi; Escayola-Maranges, Ana María

In a context of economic crisis and policies to reduce the public deficit, the budgets of the Catalan Health Institute (CHI) were cut by 15.33% between 2010 and 2014. To assess the perceived impact on nurses' work conditions of measures to contain health spending. The study design was descriptive and transversal. A sample of 1,760 nurses from the province of Barcelona answered a questionnaire on the perceived impact of health spending containment measures implemented in their workplace during the early years of the crisis. Among the main aspects of the perceived impact of these measures, 86.6% of the nurses identified a pay cut and an increase in the following relevant parameters of their working conditions: number of hours worked (66.7%), final ratio of treated patients (35.2%), task complexity and workload (75.3%), rotation through various departments (31.5%), work shifts (21.4%) or work areas (23.4%), job insecurity (58.4%) and loss of employment by dismissal (6.6%) or non-renewal of contract (9%). The perceived impact of the crisis showed a triple negative component: Pay cut, work overload and job insecurity. As a combined effect of this multiple trend, the nurses acknowledged a deterioration in their working conditions and quality of working life. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Disability mediates the impact of common conditions on perceived health.

Directory of Open Access Journals (Sweden)

Jordi Alonso

Full Text Available We examined the extent to which disability mediates the observed associations of common mental and physical conditions with perceived health.WHO World Mental Health (WMH Surveys carried out in 22 countries worldwide (n = 51,344 respondents, 72.0% response rate. We assessed nine common mental conditions with the WHO Composite International Diagnostic Interview (CIDI, and ten chronic physical with a checklist. A visual analog scale (VAS score (0, worst to 100, best measured perceived health in the previous 30 days. Disability was assessed using a modified WHO Disability Assessment Schedule (WHODAS, including: cognition, mobility, self-care, getting along, role functioning (life activities, family burden, stigma, and discrimination. Path analysis was used to estimate total effects of conditions on perceived health VAS and their separate direct and indirect (through the WHODAS dimensions effects. Twelve-month prevalence was 14.4% for any mental and 51.4% for any physical condition. 31.7% of respondents reported difficulties in role functioning, 11.4% in mobility, 8.3% in stigma, 8.1% in family burden and 6.9% in cognition. Other difficulties were much less common. Mean VAS score was 81.0 (SD = 0.1. Decrements in VAS scores were highest for neurological conditions (9.8, depression (8.2 and bipolar disorder (8.1. Across conditions, 36.8% (IQR: 31.2-51.5% of the total decrement in perceived health associated with the condition were mediated by WHODAS disabilities (significant for 17 of 19 conditions. Role functioning was the dominant mediator for both mental and physical conditions. Stigma and family burden were also important mediators for mental conditions, and mobility for physical conditions.More than a third of the decrement in perceived health associated with common conditions is mediated by disability. Although the decrement is similar for physical and mental conditions, the pattern of mediation is different. Research is needed on the

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....

Air-conditioning and antibiotics: Demand management insights from problematic health and household cooling practices

International Nuclear Information System (INIS)

Nicholls, Larissa; Strengers, Yolande

2014-01-01

Air-conditioners and antibiotics are two technologies that have both been traditionally framed around individual health and comfort needs, despite aspects of their use contributing to social health problems. The imprudent use of antibiotics is threatening the capacity of the healthcare system internationally. Similarly, in Australia the increasing reliance on air-conditioning to maintain thermal comfort is contributing to rising peak demand and electricity prices, and is placing an inequitable health and financial burden on vulnerable heat-stressed households. This paper analyses policy responses to these problems through the lens of social practice theory. In the health sector, campaigns are attempting to emphasise the social health implications of antibiotic use. In considering this approach in relation to the problem of air-conditioned cooling and how to change the ways in which people keep cool during peak times, our analysis draws on interviews with 80 Australian households. We find that the problem of peak electricity demand may be reduced through attention to the social health implications of air-conditioned cooling on very hot days. We conclude that social practice theory offers a fruitful analytical route for identifying new avenues for research and informing policy responses to emerging health and environmental problems. - Highlights: • Over-use of antibiotics and air-conditioning has social health implications. • Focusing on financial incentives limits the potential of demand management programs. • Explaining peak demand to households shifts the meanings of cooling practices. • Emphasising the social health implications of antibiotics and air-conditioning may resurrect alternative practices. • Analysing policy with social practice theory offers insights into policy approaches

Estimating health state utility values for comorbid health conditions using SF-6D data.

Science.gov (United States)

Ara, Roberta; Brazier, John

2011-01-01

When health state utility values for comorbid health conditions are not available, data from cohorts with single conditions are used to estimate scores. The methods used can produce very different results and there is currently no consensus on which is the most appropriate approach. The objective of the current study was to compare the accuracy of five different methods within the same dataset. Data collected during five Welsh Health Surveys were subgrouped by health status. Mean short-form 6 dimension (SF-6D) scores for cohorts with a specific health condition were used to estimate mean SF-6D scores for cohorts with comorbid conditions using the additive, multiplicative, and minimum methods, the adjusted decrement estimator (ADE), and a linear regression model. The mean SF-6D for subgroups with comorbid health conditions ranged from 0.4648 to 0.6068. The linear model produced the most accurate scores for the comorbid health conditions with 88% of values accurate to within the minimum important difference for the SF-6D. The additive and minimum methods underestimated or overestimated the actual SF-6D scores respectively. The multiplicative and ADE methods both underestimated the majority of scores. However, both methods performed better when estimating scores smaller than 0.50. Although the range in actual health state utility values (HSUVs) was relatively small, our data covered the lower end of the index and the majority of previous research has involved actual HSUVs at the upper end of possible ranges. Although the linear model gave the most accurate results in our data, additional research is required to validate our findings. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Predicting Comorbid Conditions and Trajectories using Social Health Records.

Science.gov (United States)

Ji, Xiang; Ae Chun, Soon; Geller, James

2016-05-05

Many patients suffer from comorbidity conditions, for example, obese patients often develop type-2 diabetes and hypertension. In the US, 80% of Medicare spending is for managing patients with these multiple coexisting conditions. Predicting potential comorbidity conditions for an individual patient can promote preventive care and reduce costs. Predicting possible comorbidity progression paths can provide important insights into population heath and aid with decisions in public health policies. Discovering the comorbidity relationships is complex and difficult, due to limited access to Electronic Health Records by privacy laws. In this paper, we present a collaborative comorbidity prediction method to predict likely comorbid conditions for individual patients, and a trajectory prediction graph model to reveal progression paths of comorbid conditions. Our prediction approaches utilize patient generated health reports on online social media, called Social Health Records (SHR). The experimental results based on one SHR source show that our method is able to predict future comorbid conditions for a patient with coverage values of 48% and 75% for a top-20 and a top-100 ranked list, respectively. For risk trajectory prediction, our approach is able to reveal each potential progression trajectory between any two conditions and infer the confidence of the future trajectory, given any observed condition. The predicted trajectories are validated with existing comorbidity relations from the medical literature.

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

Directory of Open Access Journals (Sweden)

Shannon Doocy

Full Text Available 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.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, cardiovascular diseases, chronic respiratory diseases, and arthritis. A cluster design with probability proportional to size sampling was used to attain a nationally representative sample of 1550 non-camp Syrian refugee households.Of 1363 cases with a chronic health condition diagnosis, 84.7% had received care in Jordan. Public facilities faced a heavy burden serving over half (53.9% of care-seekers; the remainder received care in the private (29.6% and NGO/charity (16.6% sectors. Individuals with non-communicable diseases (NCDs in the central region of Jordan and with arthritis had the lowest rates of care-seeking when compared to other regions and conditions. Overall, 31.6% of care-seekers had an out-of-pocket payment for the most recent care-seeking event which averaged 18.8 USD (median = 0 USD, excluding cost of medications.Forced displacement presents major challenges to those with NCDs, which have the potential to seriously impact both the quality of life and life expectancy amongst refugees. NCD patterns among Syrian refugees indicate the importance of continuing support to public sector services in Jordan to adequately meet expanding needs and ensure appropriate prevention and control of priority NCDs.

Cumulative burden of comorbid mental disorders, substance use disorders, chronic medical conditions, and poverty on health among adults in the U.S.A.

Science.gov (United States)

Walker, Elizabeth Reisinger; Druss, Benjamin G

2017-07-01

The health of individuals in the U.S.A. is increasingly being defined by complexity and multimorbidity. We examined the patterns of co-occurrence of mental illness, substance abuse/dependence, and chronic medical conditions and the cumulative burden of these conditions and living in poverty on self-rated health. We conducted a secondary data analysis using publically-available data from the National Survey on Drug Use and Health (NSDUH), which is an annual nationally-representative survey. Pooled data from the 2010-2012 NSDUH surveys included 115,921 adults 18 years of age or older. The majority of adults (52.2%) had at least one type of condition (mental illness, substance abuse/dependence, or chronic medical conditions), with substantial overlap across the conditions. 1.2%, or 2.2 million people, reported all three conditions. Generally, as the number of conditions increased, the odds of reporting worse health also increased. The likelihood of reporting fair/poor health was greatest for people who reported AMI, chronic medical conditions, and poverty (AOR = 9.41; 95% CI: 7.53-11.76), followed by all three conditions and poverty (AOR = 9.32; 95% CI: 6.67-13.02). For each combination of conditions, the addition of poverty increased the likelihood of reporting fair/poor health. Traditional conceptualizations of multimorbidity should be expanded to take into account the complexities of co-occurrence between mental illnesses, chronic medical conditions, and socioeconomic factors.

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......Human health is the result of the interaction of genetic, nutritional, socio-cultural, economic, physical infrastructure and ecosystem factors. All of the individual, social, cultural and socioeconomic factors are influenced by the environment they are embedded in and by changes in this environment...... 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...

Associations of psychosocial working conditions with self-rated general health and mental health among municipal employees.

Science.gov (United States)

Laaksonen, Mikko; Rahkonen, Ossi; Martikainen, Pekka; Lahelma, Eero

2006-03-01

To examine associations of job demands and job control, procedural and relational organizational fairness, and physical work load with self-rated general health and mental health. In addition, the effect of occupational class on these associations is examined. The data were derived from the Helsinki Health Study baseline surveys in 2001-2002. Respondents to cross-sectional postal surveys were middle-aged employees of the City of Helsinki (n=5.829, response rate 67%). Associations of job demands and job control, organizational fairness and physical work load with less than good self-rated health and poor GHQ-12 mental health were examined. Those with the poorest working conditions two to three times more, often reported poor general and mental health than those with the best working conditions. Adjustment for occupational class weakened the associations of low job control and physical work load with general health by one fifth, but even more strengthened that of high job demands. Adjustment for occupational class clearly strengthened the associations of job control and physical work load with mental health in men. Mutual adjustment for all working conditions notably weakened their associations with both health measures, except those of job control in men. All working conditions except relational organizational fairness remained independently associated with general and mental health. All studied working conditions were strongly associated with both general and mental health but the associations weakened after mutual adjustments. Of the two organizational fairness measures, procedural fairness remained independently associated with both health outcomes. Adjustment for occupational class had essentially different effects on the associations of different working conditions and different health outcomes.

Choir singing and creative writing enhance emotion regulation in adults with chronic mental health conditions.

Science.gov (United States)

Dingle, Genevieve A; Williams, Elyse; Jetten, Jolanda; Welch, Jonathon

2017-11-01

Adults with mental health conditions commonly experience difficulties with emotion regulation which affect their social functioning. Arts-based groups provide opportunities for shared emotional experiences and emotion regulation. This study explores emotion regulation strategies and the emotional effects of arts-based group participation in adults with mental health problems and in controls. The 62 participants included 39 adults with chronic mental health problems who were members of arts-based groups (ABG) and 23 comparison choir (CC) members who were not specifically experiencing mental health problems. The repeated measures design included self-reports of emotion upon waking (T1), the hour before group (T2), end of the group (T3), and evening (T4), as well as participant notes to explain their emotion ratings at each time. They also completed measures of individual and interpersonal emotion regulation. The ABG participants engaged marginally more in affect worsening strategies than CC (p = .057 and .08), but there were no other group differences. All participants reported a significant increase in positive emotions, F (3, 180) = 28.044, p emotions during the arts-based activity: F (2.637, 155.597) = 21.09, p emotions was short-lived, while the effect on negative emotions lasted until evening. Findings show that participation in arts-based groups benefits the emotions of both healthy adults and those experiencing mental health conditions through individual and interpersonal processes. Individuals with chronic mental health conditions often experience difficulties in emotion processing Participation in arts-based groups was associated with significant increases in positive emotions although these were short-lived Negative emotion was significantly decreased during arts-based group activities, and sustained to the evening assessment Adults with chronic mental health conditions were equally able to derive emotional benefits as healthy adults. © 2017 The

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…

Impact of socioeconomic status and medical conditions on health and healthcare utilization among aging Ghanaians.

Science.gov (United States)

Saeed, Bashiru Ii; Xicang, Zhao; Yawson, Alfred Edwin; Nguah, Samuel Blay; Nsowah-Nuamah, Nicholas N N

2015-03-20

This study attempts to examine the impact of socioeconomic and medical conditions in health and healthcare utilization among older adults in Ghana. Five separate models with varying input variables were estimated for each response variable. Data (Wave 1 data) were drawn from the World Health Organization Global Ageing and Adult Health (SAGE) conducted during 2007-2008 and included a total of 4770 respondents aged 50+ and 803 aged 18-49 in Ghana. Ordered logits was estimated for self-rated health, and binary logits for functional limitation and healthcare utilization. Our results show that the study provides enough grounds for further research on the interplay between socioeconomic and medical conditions on one hand and the health of the aged on the other. Controlling for socioeconomic status substantially contributes significantly to utilization. Also, aged women experience worse health than men, as shown by functioning assessment, self-rated health, chronic conditions and functional limitations. Women have higher rates of healthcare utilization, as shown by significantly higher rates of hospitalization and outpatient encounters. Expansion of the national health insurance scheme to cover the entire older population--for those in both formal and informal employments--is likely to garner increased access and improved health states for the older population.

Health conditions in people with spinal cord injury: Contemporary evidence from a population-based community survey in Switzerland.

Science.gov (United States)

Brinkhof, Martin W G; Al-Khodairy, Abdul; Eriks-Hoogland, Inge; Fekete, Christine; Hinrichs, Timo; Hund-Georgiadis, Margret; Meier, Sonja; Scheel-Sailer, Anke; Schubert, Martin; Reinhardt, Jan D

2016-02-01

Health conditions in people with spinal cord injury are major determinants for disability, reduced well-being, and mortality. However, population-based evidence on the prevalence and treatment of health conditions in people with spinal cord injury is scarce. To investigate health conditions in Swiss residents with spinal cord injury, specifically to analyse their prevalence, severity, co-occurrence, and treatment. Cross-sectional data (n = 1,549) from the community survey of the Swiss Spinal Cord Injury (SwiSCI) cohort study, including Swiss residents with spinal cord injury aged over 16 years, were analysed. Nineteen health conditions and their self-reported treatment were assessed with the spinal cord injury Secondary Conditions Scale and the Self-Administered Comorbidity Questionnaire. Prevalence and severity were compared across demographics and spinal cord injury characteristics. Co-occurrence of health conditions was examined using a binary non-metric dissimilarity measure and multi-dimensional scaling. Treatment rates were also examined. Number of concurrent health conditions was high (median 7; interquartile range 4-9; most frequent: spasticity, chronic pain, sexual dysfunction). Prevalence of health conditions increased with age and was higher in non-traumatic compared with traumatic spinal cord injury. Spinal cord injury specific conditions co-occurred. Relative frequencies of treatment were low (median 44%, interquartile range 25-64%), even for significant or chronic problems. A high prevalence of multimorbidity was found in community-dwelling persons with spinal cord injury. Treatment for some highly prevalent health conditions was infrequent.

[Relationships between air conditioning, airborne microorganisms and health].

Science.gov (United States)

Parat, S; Perdrix, A; Baconnier, P

1999-01-01

Concurrently with the increase of air-conditioning, potentially severe or frequent new diseases have emerged, giving rise to social and economical consequences. The first part of this work is a state of the art review of the relationships between air-conditioning, airborne microorganisms and health, through a technical, metrological and medical approach. The second part presents four studies performed in this field. Two of them deal with the relationship between airborne microorganisms and technical features of air-conditioning. Measurements performed on actual sites demonstrated the benefit of using high efficiency filters and low risk components in air-conditioning systems. The third study was aimed to look for a relationship between airborne microorganisms and sick building syndrome symptoms. Statistical analyses of individual data revealed significant associations between airborne bacteria or fungi and symptoms. These results may be the first step in determining a dose-response relationship, in order to define threshold limit values in this field. In the fourth study, the contribution of particle counting in assessing exposure to airborne microorganisms was explored by monitoring simultaneous variations of microbial and particle concentrations. The results showed that associating particle counting may allow to detect microbial variations instantaneously, and therefore improve the assessment of exposure to airborne microorganisms.

Factors Associated With the Likelihood of Hospitalization Following Emergency Department Visits for Behavioral Health Conditions.

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Hamilton, Jane E; Desai, Pratikkumar V; Hoot, Nathan R; Gearing, Robin E; Jeong, Shin; Meyer, Thomas D; Soares, Jair C; Begley, Charles E

2016-11-01

Behavioral health-related emergency department (ED) visits have been linked with ED overcrowding, an increased demand on limited resources, and a longer length of stay (LOS) due in part to patients being admitted to the hospital but waiting for an inpatient bed. This study examines factors associated with the likelihood of hospital admission for ED patients with behavioral health conditions at 16 hospital-based EDs in a large urban area in the southern United States. Using Andersen's Behavioral Model of Health Service Use for guidance, the study examined the relationship between predisposing (characteristics of the individual, i.e., age, sex, race/ethnicity), enabling (system or structural factors affecting healthcare access), and need (clinical) factors and the likelihood of hospitalization following ED visits for behavioral health conditions (n = 28,716 ED visits). In the adjusted analysis, a logistic fixed-effects model with blockwise entry was used to estimate the relative importance of predisposing, enabling, and need variables added separately as blocks while controlling for variation in unobserved hospital-specific practices across hospitals and time in years. Significant predisposing factors associated with an increased likelihood of hospitalization following an ED visit included increasing age, while African American race was associated with a lower likelihood of hospitalization. Among enabling factors, arrival by emergency transport and a longer ED LOS were associated with a greater likelihood of hospitalization while being uninsured and the availability of community-based behavioral health services within 5 miles of the ED were associated with lower odds. Among need factors, having a discharge diagnosis of schizophrenia/psychotic spectrum disorder, an affective disorder, a personality disorder, dementia, or an impulse control disorder as well as secondary diagnoses of suicidal ideation and/or suicidal behavior increased the likelihood of hospitalization

Condition Monitoring for Roller Bearings of Wind Turbines Based on Health Evaluation under Variable Operating States

Directory of Open Access Journals (Sweden)

Lei Fu

2017-10-01

Full Text Available Condition monitoring (CM is used to assess the health status of wind turbines (WT by detecting turbine failure and predicting maintenance needs. However, fluctuating operating conditions cause variations in monitored features, therefore increasing the difficulty of CM, for example, the frequency-domain analysis may lead to an inaccurate or even incorrect prediction when evaluating the health of the WT components. In light of this challenge, this paper proposed a method for the health evaluation of WT components based on vibration signals. The proposed approach aimed to reduce the evaluation error caused by the impact of the variable operating condition. First, the vibration signal was decomposed into a set of sub-signals using variational mode decomposition (VMD. Next, the sub-signal energy and the probability distribution were obtained and normalized. Finally, the concept of entropy was introduced to evaluate the health condition of a monitored object to provide an effective guide for maintenance. In particular, the health evaluation for CM was based on a performance review over a range of operating conditions, rather than at a certain single operating condition. Experimental investigations were performed which verified the efficiency of the evaluation method, as well as a comparison with the previous method.

Expanding the universe of universal coverage: the population health argument for increasing coverage for immigrants.

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Nandi, Arijit; Loue, Sana; Galea, Sandro

2009-12-01

As the US recession deepens, furthering the debate about healthcare reform is now even more important than ever. Few plans aimed at facilitating universal coverage make any mention of increasing access for uninsured non-citizens living in the US, many of whom are legally restricted from certain types of coverage. We conducted a critical review of the public health literature concerning the health status and access to health services among immigrant populations in the US. Using examples from infectious and chronic disease epidemiology, we argue that access to health services is at the intersection of the health of uninsured immigrants and the general population and that extending access to healthcare to all residents of the US, including undocumented immigrants, is beneficial from a population health perspective. Furthermore, from a health economics perspective, increasing access to care for immigrant populations may actually reduce net costs by increasing primary prevention and reducing the emphasis on emergency care for preventable conditions. It is unlikely that proposals for universal coverage will accomplish their objectives of improving population health and reducing social disparities in health if they do not address the substantial proportion of uninsured non-citizens living in the US.

Multitarget survey on the Finance Police personnel: assessment of the health condition.

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Barraco, Giancarlo; Pagano, Stefano; Lupoli, Grazia; Dolci, Alessandro; Colagrosso, Beniamino

2014-01-01

Over the past 10-15 years, Italy has undergone a social transformation, and the class of employees and workers has become more economically stable with a higher buying power. Along with the increased expectations of patients on the quality of life, it has now become a priority to make health and social services ready to face users bearing new requirements and different needs. To provide a description of the state of health of the operating personnel of the Finance Police (Guardia di Finanza), including elements for planning the most appropriate interventions for health promotion and prevention. The study analyzed the health condition of a group of soldiers (178 subjects, divided into different age classes) by evaluating the effectiveness of a training and information program and subsequently the level of benefit. The study population showed a good state of health correlated to the quality of life. Although the population voluntarily submitted to health assessment, the rigour of the calls and briefings carried out in the military health unit and the attention of the group to follow instructions on prevention underlined a positive trend, even in behaviours considered as health-risky. Socio-cultural components and the work environment influence the quality of life. In the case of military health care, the specific military organization was useful to monitor the health condition of the population, maximizing the effectiveness of services, enhancing the information and carrying out prevention strategies and demand of care, which should be an example for the public health services.

Associations between headache and stress, alcohol drinking, exercise, sleep, and comorbid health conditions in a Japanese population.

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Yokoyama, Masako; Yokoyama, Tetsuji; Funazu, Kazuo; Yamashita, Takeshi; Kondo, Shuji; Hosoai, Hiroshi; Yokoyama, Akira; Nakamura, Haruo

2009-06-01

We conducted a cross-sectional survey of 12,988 subjects aged 20-79 years (5,908 men and 7,090 women) receiving health checkups at a Tokyo clinic. They filled out a self-administered structured questionnaire, and 5.4% of the men and 15.4% of the women reported having headaches. Younger subjects were more prone to having headaches. The likelihood of having headaches increased with stress level and decreased ability to relieve stress in both genders. There was an inverse dose-response relationship between having headaches and alcohol consumption, and less walking/exercise and sleep problems increased the likelihood of headaches in both genders. Headache sufferers of both genders were more likely to report multiple additional poor health conditions. A multivariate stepwise logistic analysis showed that age, self-estimated degree of stress, reported number of additional poor health conditions, and less alcohol consumption were independently correlated with having headaches. In conclusion, although women were more susceptible to headache, Japanese men and women in Tokyo shared factors associated with headache, including age, stress, having other poor health conditions, alcohol consumption, sleep, and exercise.

Web-Based Mindfulness Interventions for People With Physical Health Conditions: Systematic Review.

Science.gov (United States)

Toivonen, Kirsti I; Zernicke, Kristin; Carlson, Linda E

2017-08-31

Mindfulness-based interventions (MBIs) are becoming increasingly popular for helping people with physical health conditions. Expanding from traditional face-to-face program delivery, there is growing interest in Web-based application of MBIs, though Web-based MBIs for people with physical health conditions specifically have not been thoroughly reviewed to date. The objective of this paper was to review Web-based MBIs for people with physical health conditions and to examine all outcomes reported (eg, efficacy or effectiveness for physical changes or psychological changes; feasibility). Databases PubMed, PsycINFO, Science Direct, CINAHL Plus, and Web of Science were searched. Full-text English papers that described any Web-based MBI, examining any outcome, for people with chronic physical health conditions were included. Randomized, nonrandomized, controlled, and uncontrolled trials were all included. Extracted data included intervention characteristics, population characteristics, outcomes, and quality indicators. Intervention characteristics (eg, synchronicity and guidance) were examined as potential factors related to study outcomes. Of 435 publications screened, 19 published papers describing 16 studies were included. They examined Web-based MBIs for people with cancer, chronic pain or fibromyalgia, irritable bowel syndrome (IBS), epilepsy, heart disease, tinnitus, and acquired brain injury. Overall, most studies reported positive effects of Web-based MBIs compared with usual care on a variety of outcomes including pain acceptance, coping measures, and depressive symptoms. There were mixed results regarding the effectiveness of Web-based MBIs compared with active control treatment conditions such as cognitive behavioral therapy. Condition-specific symptoms (eg, cancer-related fatigue and IBS symptoms) targeted by treatment had the largest effect size improvements following MBIs. Results are inconclusive regarding physical variables. Preliminary evidence suggests

Quantitative microbial risk assessment (QMRA) shows increased public health risk associated with exposure to river water under conditions of riverbed sediment resuspension.

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Abia, Akebe Luther King; Ubomba-Jaswa, Eunice; Genthe, Bettina; Momba, Maggy Ndombo Benteke

2016-10-01

Although higher microbial concentrations have been reported in sediments than in the overlying water column, most quantitative microbial risk assessment (QMRA) studies have not clearly indicated the contribution of sediment-borne pathogens to estimated risks. Thus, the present study aimed at determining the public health risk associated with exposure to pathogenic bacteria in polluted river water under undisturbed conditions and conditions of sediment resuspension in the Apies River, Gauteng, South Africa. Microbial pathogens were isolated and identified using culture and molecular methods. The beta-Poisson dose-response model was used to estimate the probability of infection (Pi) with the various pathogens, following accidental/intentional ingestion of 1mL or 100mL (or 50mL) of untreated river water. Mean wet season Escherichia coli counts ranged between 5.8E+01 and 8.8E+04MPN/100mL (water column) and between 2.40E+03 and 1.28E+05MPN/100mL (sediments). Mean dry season E. coli counts ranged between 5.11E+00 and 3.40E+03MPN/100mL (water column) and between 5.09E+00 and 6.30E+03MPN/100mL (sediments). Overall (water and sediments) Vibrio cholerae was the most detected pathogen (58.8%) followed by Salmonella spp. (23.9%) and Shigella (10.1%). Ingestion of 1mL of river water could lead to 0%-4% and 1%-74% Pi with E. coli during the dry and wet season, respectively. During the dry season, the Pi with V. cholerae, Salmonella spp. and Shigella spp. were 0%-1.39%, 0%-4.11% and 0%-0.16% respectively, depending on volume of water ingested. The risks of infections with all microorganisms increased during the wet season. A 2-log increase in water E. coli count following sediments disturbance led to approximately 10 times higher Pi with E. coli than when sediments were undisturbed. Therefore, the use of the untreated water from the Apies River for drinking, household purposes or recreational activities poses a potential health risk to the users of the river. Copyright © 2016

How to change environmental conditions for health.

Science.gov (United States)

Commers, Matthew J; Gottlieb, Nell; Kok, Gerjo

2007-03-01

Since the Lalonde report, contemporary public-health theory has given steadily more attention to the role of environments in influencing health status. Environments, both social and physical, influence health directly or through complex interactions with behavior, genetics and health-care systems. They are also important for public-health because environments are the complex systems through which people are both empowered and exercise their empowerment. If public-health professionals are to play a significant role in influencing environments for health, they need analytical instruments that enable them to link specific environmental conditions with the actions necessary to improve them. These instruments must also enable public-health professionals to identify points of leverage for stimulating key actors to take the actions necessary to make environments more promoting of health. This article first presents one such analytical instrument. Then, building on examples relating to socio-economic health inequities, the analytical instrument is applied to reveal how it can add value to health professionals' effectiveness in planning interventions for more health-promoting environments.

Mental Health of Elementary Schoolteachers in Southern Brazil: Working Conditions and Health Consequences.

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Cezar-Vaz, Marta Regina; Bonow, Clarice Alves; de Almeida, Marlise Capa Verde; Rocha, Laurelize Pereira; Borges, Anelise Miritz

2015-01-01

The mental health of educators is a growing problem in many countries. This study sought to identify self-reported stressful working conditions of elementary schoolteachers and the biopsychosocial consequences of those working conditions and then identify working conditions that promote well-being for teachers in the workplace. Exploratory study was done with 37 teachers. Data collection was performed using a structured interview with a questionnaire. Results show that stressful working conditions are related to inadequate salary, an excessive number of activities, and having to take work home. Biopsychosocial consequences include anxiety, stress, and sleep disorders. There was a statistically significant association between inadequate salary and anxiety (p = 0.01) and between an excessive number of activities and stress (p = 0.01). Teachers reported that a good relationship among colleagues is a working condition that promotes well-being in the workplace. The identification of stressful working conditions for teachers, the biopsychosocial consequences, and working conditions that promote well-being in the workplace are relevant to determining actions that improve the work environment and, consequently, the health of teachers.

Mental Health of Elementary Schoolteachers in Southern Brazil: Working Conditions and Health Consequences

Directory of Open Access Journals (Sweden)

Marta Regina Cezar-Vaz

2015-01-01

Full Text Available The mental health of educators is a growing problem in many countries. This study sought to identify self-reported stressful working conditions of elementary schoolteachers and the biopsychosocial consequences of those working conditions and then identify working conditions that promote well-being for teachers in the workplace. Exploratory study was done with 37 teachers. Data collection was performed using a structured interview with a questionnaire. Results show that stressful working conditions are related to inadequate salary, an excessive number of activities, and having to take work home. Biopsychosocial consequences include anxiety, stress, and sleep disorders. There was a statistically significant association between inadequate salary and anxiety (p = 0.01 and between an excessive number of activities and stress (p = 0.01. Teachers reported that a good relationship among colleagues is a working condition that promotes well-being in the workplace. The identification of stressful working conditions for teachers, the biopsychosocial consequences, and working conditions that promote well-being in the workplace are relevant to determining actions that improve the work environment and, consequently, the health of teachers.

Health coaching interventions for persons with chronic conditions: a systematic review and meta-analysis protocol.

Science.gov (United States)

Boehmer, Kasey R; Barakat, Suzette; Ahn, Sangwoo; Prokop, Larry J; Erwin, Patricia J; Murad, M Hassan

2016-09-01

Chronic conditions are increasingly more common and negatively impact quality of life, disability, morbidity, and mortality. Health coaching has emerged as a possible intervention to help individuals with chronic conditions adopt health supportive behaviors that improve both quality of life and health outcomes. We planned a systematic review and meta-analysis of the contemporary health coaching literature published in the last decade to evaluate the effect of health coaching on clinically important, disease-specific, functional, and behavioral outcomes. We will include randomized controlled trials or quasi-experimental studies that compared health coaching to alternative interventions or usual care. To enable adoption of effective interventions, we aim to explore how the effect of intervention is modified by the intervention components, delivering personnel (i.e., health professionals vs trained lay or peer persons), dose, frequency, and setting. Analysis of intervention outcomes will be reported and classified using an existing theoretical framework, the Theory of Patient Capacity, to identify the areas of patients' capacity to access and use healthcare and enact self-care where coaching may be an effective intervention. This systematic review and meta-analysis will identify and synthesize evidence to inform the practice of health coaching by providing evidence on components and characteristics of the intervention essential for success in individuals with chronic health conditions. PROSPERO CRD42016039730.

Unemployment and health selection in diverging economic conditions: Compositional changes? Evidence from 28 European countries.

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Heggebø, Kristian; Dahl, Espen

2015-11-04

Unemployment and health selection in diverging economic conditions: Compositional changes? Evidence from 28 european countries. People with ill health tend to be overrepresented among the unemployment population. The relationship between health and unemployment might, however, be sensitive to the overall economic condition. Specifically, the health composition of the unemployment population could change dramatically when the economy takes a turn for the worse. Using EU-SILC cross sectional data from 2007 (pre-crisis) and 2011 (during crisis) and linear regression models, this paper investigates the relationship between health and unemployment probabilities under differing economic conditions in 28 European countries. The countries are classified according to (i) the level of and (ii) increase in unemployment rate (i.e. >10 percent and doubling of unemployment rate = crisis country). Firstly, the unemployment likelihood for people with ill health is remarkably stable over time in Europe: the coefficients are very similar in pre-crisis and crisis years. Secondly, people with ill health have experienced unemployment to a lesser extent than those with good health status in the crisis year (when we pool the data and compare 2007 and 2011), but only in the countries with a high and rising unemployment rate. The health composition of the unemployment population changes significantly for the better, but only in those European countries that have been severely hit by the current economic crisis.

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

Increasing Equitable Care for Youth through Coordinated School Health

Science.gov (United States)

Sanetti, Lisa M. Hagermoser

2017-01-01

Nearly a quarter of the students in the U.S. education system have a chronic health condition, disability, or special healthcare need. Students living in poverty and those at risk for or with disabilities have higher rates of health issues and encounter more barriers to accessing appropriate health care than their peers. The reciprocal influences…

[Socio-demographics characteristics and health conditions of older homeless persons of Lima, Peru].

Science.gov (United States)

Moquillaza-Risco, Marlene; León, Elsa; Dongo, Mario; Munayco, César V

2015-10-01

Determine the socio-demographics characteristics and health conditions of older homeless persons at the time of enrollment into the National Program "Vida Digna" and the probability of functional dependency by age, and stratified by gender and cognitive impairment. MATERIALS ANDE METHODS: We performed a cross sectional study, reviewing all registration forms of the program in order to identify socio-demographic variables and health conditions of older homeless persons at the time of enrollment in the program. We did a descriptive analysis of the socio-demographic variables and we also determined the frequency of health conditions. Furthermore, we determined the probability of functional dependency by age, and stratified by gender and cognitive impairment through a logistic regression model. The older homeless persons at the time of enrollment in the program were mostly single men, with a primary education or no education. The study subjects had a high frequency of chronic and mental diseases. 50% of them had certain level of functional impairment and roughly 70% had a certain level of cognitive impairment. The probability of functional dependency increased by age, and it was higher in women than in men. This probability increased according to the level of cognitive impairment. This study shows that older homeless persons are a vulnerable population not only because they live outdoors but also because they a have also for the high prevalence of chronic and mental diseases. These diseases prevent the homeless persons from living by themselves special care to overcome their situations.

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...

Gendered work conditions, health, and work outcomes.

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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.

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.

[Increased financial risks for health insurers: a challenge for providers of mental health care in the Netherlands].

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Daansen, P J; van Schilt, J

2014-01-01

As from 2014 Dutch health insurance companies will bear the full financial risk for their clients in mental health care. Over the next years the existing risk settlement shared between insurance companies will gradually be brought to a close. Municipalities and the Ministry of Justice are already responsible for or will soon become responsible for financing health care for adolescents, patients with severe psychiatric disorders and forensic psychiatric patients. As a result, the health insurance companies are beginning to impose ever stricter conditions regarding the care 'product' they are 'buying'. To study the possible consequences, for mental health care institutions, of the increased risk to be borne by health care insurers. Use was made of relevant marketing literature and literature relating to mental health care. Studies of Dutch mental health care literature indicate that in the future the purchasing procedure will no longer consider the immediate treatment outcome as the sole performance indicator but will also take into account additional factors such as long-term improvements in patients' health, customer satisfaction and degree of patient participation, patient empowerment and autonomy. In formulating the details of their health products and business strategies, health care providers will now have to take into account not only the efficacy of the treatment they provide but also the purchasing policy and strategy of the health insurance companies.

Increased health care utilisation in international adoptees

DEFF Research Database (Denmark)

Graff, Heidi Jeannet; Siersma, Volkert Dirk; Kragstrup, Jakob

2015-01-01

comprised internationallyadopted children (n = 6,820), adopted between 1994 and2005, and all non-adopted children (n = 492,374) who couldbe matched with the adopted children on sex, age, municipalityand family constellation at the time of adoption. Results: International adoption increased the use......Introduction: Several studies have documented thatinternational adoptees have an increased occurrence ofhealth problems and contacts to the health-care systemafter arriving to their new country of residence. This maybe explained by pre-adoption adversities, especially for theperiod immediately...... after adoption. Our study aimed to theassess health-care utilisation of international adoptees inprimary and secondary care for somatic and psychiatricdiagnoses in a late post-adoption period. Is there an increaseduse of the health-care system in this period, evenwhen increased morbidity in the group...

Integrative review of research on general health status and prevalence of common physical health conditions of women after childbirth.

Science.gov (United States)

Cheng, Ching-Yu; Li, Qing

2008-01-01

Postpartum mothers experience certain physical health conditions that may affect their quality of life, future health, and health of their children. Yet, the physical health of postpartum mothers is relatively neglected in both research and practice. The purpose of this review is to describe the general health status and prevalence of common physical health conditions of postpartum mothers. The review followed standard procedures for integrative literature reviews. Twenty-two articles were reviewed from searches in scientific databases, reference lists, and an up-to-date survey. Three tables were designed to answer review questions. In general, postpartum mothers self-rate their health as good. They experience certain physical conditions such as fatigue/physical exhaustion, sleep-related problems, pain, sex-related concerns, hemorrhoids/constipation, and breast problems. Despite a limited number of studies, the findings provide a glimpse of the presence of a number of physical health conditions experienced by women in the 2 years postpartum. In the articles reviewed, physical health conditions and postpartum period were poorly defined, no standard scales existed, and the administration of surveys varied widely in time. Those disparities prevented systematic comparisons of results and made it difficult to gain a coherent understanding of the physical health conditions of postpartum mothers. More longitudinal research is needed that focuses on the etiology, predictors, and management of the health conditions most prevalent among postpartum mothers. Instruments are needed that target a broader range of physical conditions in respect to type and severity.

The relationship between local area labor market conditions and the use of Veterans Affairs health services.

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Wong, Edwin S; Liu, Chuan-Fen

2013-03-13

In the U.S., economic conditions are intertwined with labor market decisions, access to health care, health care utilization and health outcomes. The Veterans Affairs (VA) health care system has served as a safety net provider by supplying free or reduced cost care to qualifying veterans. This study examines whether local area labor market conditions, measured using county-level unemployment rates, influence whether veterans obtain health care from the VA. We used survey data from the Behavioral Risk Factor Surveillance System in years 2000, 2003 and 2004 to construct a random sample of 73,964 respondents self-identified as veterans. VA health service utilization was defined as whether veterans received all, some or no care from the VA. Hierarchical ordered logistic regression was used to address unobserved state and county random effects while adjusting for individual characteristics. Local area labor market conditions were defined as the average 12-month unemployment rate in veterans' county of residence. The mean unemployment rate for veterans receiving all, some and no care was 5.56%, 5.37% and 5.24%, respectively. After covariate adjustment, a one percentage point increase in the unemployment rate in a veteran's county of residence was associated with an increase in the probability of receiving all care (0.34%, p-value = 0.056) or some care (0.29%, p-value = 0.023) from the VA. Our findings suggest that the important role of the VA in providing health care services to veterans is magnified in locations with high unemployment.

Musculoskeletal Health Conditions Represent a Global Threat to Healthy Aging: A Report for the 2015 World Health Organization World Report on Ageing and Health.

Science.gov (United States)

Briggs, Andrew M; Cross, Marita J; Hoy, Damian G; Sànchez-Riera, Lídia; Blyth, Fiona M; Woolf, Anthony D; March, Lyn

2016-04-01

Persistent pain, impaired mobility and function, and reduced quality of life and mental well-being are the most common experiences associated with musculoskeletal conditions, of which there are more than 150 types. The prevalence and impact of musculoskeletal conditions increase with aging. A profound burden of musculoskeletal disease exists in developed and developing nations. Notably, this burden far exceeds service capacity. Population growth, aging, and sedentary lifestyles, particularly in developing countries, will create a crisis for population health that requires a multisystem response with musculoskeletal health services as a critical component. Globally, there is an emphasis on maintaining an active lifestyle to reduce the impacts of obesity, cardiovascular conditions, cancer, osteoporosis, and diabetes in older people. Painful musculoskeletal conditions, however, profoundly limit the ability of people to make these lifestyle changes. A strong relationship exists between painful musculoskeletal conditions and a reduced capacity to engage in physical activity resulting in functional decline, frailty, reduced well-being, and loss of independence. Multilevel strategies and approaches to care that adopt a whole person approach are needed to address the impact of impaired musculoskeletal health and its sequelae. Effective strategies are available to address the impact of musculoskeletal conditions; some are of low cost (e.g., primary care-based interventions) but others are expensive and, as such, are usually only feasible for developed nations. In developing nations, it is crucial that any reform or development initiatives, including research, must adhere to the principles of development effectiveness to avoid doing harm to the health systems in these settings. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Working conditions, health and productivity among dentists in Swedish public dental care - a prospective study during a 5-year period of rationalisation

DEFF Research Database (Denmark)

Rolander, B.; Jonker, D.; Winkel, Jørgen

2013-01-01

' working conditions, health and productivity during a 5-year period. In 2003 and 2008, 65 dentists responded to questionnaires measuring work conditions and health. Treatment times for patients and productivity were tracked in electronic registers. Paired t-tests showed that the number of treated adult...... patients per dentist increased, and perceived physical working conditions improved while perceived work control and leadership deteriorated. Structural equation modelling showed that physical factors were important for health and productivity. When assessing risks in the work environment, there is a need...... to understand the interaction of effects on working conditions and health due to rationalisations so as to increase the sustainability of production systems. Practioner Summary: Dentistry in Sweden has undergone considerable change. Questionnaire surveys with dentists, undertaken in 2003 and 2008, found...

Chronic health conditions and school performance in first graders: A prospective cohort study.

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Hoffmann, Isabell; Diefenbach, Christiane; Gräf, Christine; König, Jochem; Schmidt, Martina F; Schnick-Vollmer, Kathleen; Blettner, Maria; Urschitz, Michael S

2018-01-01

Children with chronic health conditions may perform poorer at school. Associations may be confounded by numerous social factors. We aimed to estimate the effects of a chronic health condition on overall school performance in first graders with an emphasis on rigorous adjustment for potential confounders. A population-based cohort study was performed in the area of Mainz-Bingen (Germany). In 2015 all preschoolers were approached and the presence of a chronic health condition was assessed by parental questionnaires and preschool health examination data. The identification of a chronic health condition was based on special health care needs and presence of a doctor's diagnosis out of 24 school-relevant diseases. At the end of the first school year, overall school performance was assessed by teachers and rated on a 5-item scale ranging from -10 to +10. Of 3683 children approached, 2003 were enrolled. Overall school performance was available for 1462 children (51% boys). Of these, 52% suffered from a chronic health condition. Compared to children without a chronic health condition, children with special health care needs (15%) performed worse at school (adjusted mean difference: -0.95, 95% CI: [-1.55; -0.35], P = 0.002). Children with a doctor's diagnosis but without special health care needs (37%) did not perform worse at school. The effect was further analysed considering the extent of special health care needed. Chronic health conditions affect overall school performance early in primary school. To identify academically at-risk children, a chronic health condition identification based on special health care needs may be used.

Environmental, health and economic conditions perceived by 50 rural communities in Bangladesh.

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Ohtsuka, Ryutaro; Inaoka, Tsukasa; Moji, Kazuhiko; Karim, Enamul; Yoshinaga, Mari

2002-12-01

For randomly selected 50 villages in Bangladesh, an interview survey with a structured questionnaire was conducted to reveal their perception on the environmental, health and economic conditions at present and for the past 10-year change. The eight following items were analyzed in this paper: air pollution and water pollution, which represent environmental conditions with close relation to health conditions, soil degradation and deforestation, which represent environmental conditions with close relation to economic conditions, epidemic diseases and malnutrition, which represent health conditions, and poverty and jobless, which represent economic conditions. Among the 50 villages, deforestation was most frequently perceived serious at present and worsened in the past 10 years. Of the remaining seven items, those related to economic conditions were more seriously perceived than those related to health and environmental conditions. As revealed by the cluster analysis for the inter-item relations, epidemic diseases, which formed the same cluster with the environmental items, were recognized less serious whereas malnutrition, which formed the same cluster with the economic items, was recognized more serious. These findings are useful not only for rural development programs but also for mitigation programs toward health and environmental hazards in Bangladesh.

Can conditional health policies be justified? A policy analysis of the new NHS dental contract reforms.

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Laverty, Louise; Harris, Rebecca

2018-06-01

Conditional policies, which emphasise personal responsibility, are becoming increasingly common in healthcare. Although used widely internationally, they are relatively new within the UK health system where there have been concerns about whether they can be justified. New NHS dental contracts include the introduction of a conditional component that restricts certain patients from accessing a full range of treatment until they have complied with preventative action. A policy analysis of published documents on the NHS dental contract reforms from 2009 to 2016 was conducted to consider how conditionality is justified and whether its execution is likely to cause distributional effects. Contractualist, paternalistic and mutualist arguments that reflect notions of responsibility and obligation are used as justification within policy. Underlying these arguments is an emphasis on preserving the finite resources of a strained NHS. We argue that the proposed conditional component may differentially affect disadvantaged patients, who do not necessarily have access to the resources needed to meet the behavioural requirements. As such, the conditional component of the NHS dental contract reform has the potential to exacerbate oral health inequalities. Conditional health policies may challenge core NHS principles and, as is the case with any conditional policy, should be carefully considered to ensure they do not exacerbate health inequities. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Relationships of working conditions, health problems and vehicle accidents in bus rapid transit (BRT) drivers.

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Gómez-Ortiz, Viviola; Cendales, Boris; Useche, Sergio; Bocarejo, Juan P

2018-04-01

The aim of this study was to estimate accident risk rates and mental health of bus rapid transit (BRT) drivers based on psychosocial risk factors at work leading to increased stress and health problems. A cross-sectional research design utilized a self-report questionnaire completed by 524 BRT drivers. Some working conditions of BRT drivers (lack of social support from supervisors and perceived potential for risk) may partially explain Bogota's BRT drivers' involvement in road accidents. Drivers' mental health problems were associated with higher job strain, less support from co-workers, fewer rewards and greater signal conflict while driving. To prevent bus accidents, supervisory support may need to be increased. To prevent mental health problems, other interventions may be needed such as reducing demands, increasing job control, reducing amount of incoming information, simplifying current signals, making signals less contradictory, and revising rewards. © 2018 Wiley Periodicals, Inc.

Availability of health services vs. health condition of residents of rural areas in Poland – Analysis performed on the basis of EHIS 2009

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Iwona Laskowska

2015-12-01

Full Text Available [b]Introduction. [/b]One of the aspects considered in a debate preceding the establishment of the new retirement age in Poland, was the health condition of the Polish population. A steady increase in the average life expectancy, observed for several years, is much higher in the cities than in the country. One of the reasons for this might be a limited availability of health services in rural areas. [b]Objective[/b]. The aim of the study is to assess the scale of income-related inequalities in the access to health services in rural areas, and subsequently to assess the impact of having to give up some medical services on the subjective perception of health condition by rural inhabitants. [b]Materials and methods.[/b] Individual data derived from the European Health Interview Survey (EHIS conducted in 2009 constituted the basis for the presented analysis. The concentration index was used to measure the income-related inequalities in the use of medical services. The ordered logit model was used to verify the hypothesis that the availability of health services has an impact on the health condition. [b]Results.[/b] Significant differences in the distribution of medical services utilization with regard to income, were found only in the case of hospital services. People with low income stay in hospital more often. The obtained inequality indices show a lack of income-related inequality in the use of outpatient services. The performed analyses confirm a negative impact of giving up this type of services on the health condition of residents of rural areas. [b]Conclusions.[/b] The availability of medical services is an important determinant of the health condition. Too few medical institutions and scarce medical personnel limits the use of these services, and not only for people with low income.

Using Health Conditions for Laughs and Health Policy Support: The Case of Food Allergies.

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Abo, Melissa M; Slater, Michael D; Jain, Parul

2017-07-01

Health conditions are sometimes included in entertainment media comedies as a context for and as a source of humor. Food allergies are a typical case in point: They are potentially life-threatening yet may be used in humorous contexts. We conducted a content analysis of food allergies in entertainment media and tested the effects of humorous portrayals from an exemplar entertainment program. The content analysis confirmed that when food allergies were portrayed in television and the movies, it was most frequently in a humorous context and often contained inaccurate information. A follow-up experiment showed viewing a humorous portrayal of food allergies had an indirect negative effect on related health policy support via decreased perceived seriousness of food allergies. Inclusion of an educational video eliminated this effect on reduced policy support, with cognitive dissonance as a mediator. Findings support the hypothesis that portraying a health condition in a humorous context may reduce perceptions of seriousness and willingness to support public health policies to address risks associated with the condition, supporting and extending prior research findings.

Comparison of Health Information Technology Use Between American Adults With and Without Chronic Health Conditions: Findings From The National Health Interview Survey 2012.

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Zhang, Yan; Lauche, Romy; Sibbritt, David; Olaniran, Bolanle; Cook, Ronald; Adams, Jon

2017-10-05

Health information technology (HIT) is utilized by people with different chronic conditions such as diabetes and hypertension. However, there has been no comparison of HIT use between persons without a chronic condition, with one chronic condition, and multiple (≥2) chronic conditions (MCCs). The aim of the study was to assess the difference in HIT use between persons without a chronic condition, with one chronic condition, and with MCCs, to describe the characteristics of HIT use among those with chronic conditions and to identify the predictors of HIT use of the persons with one chronic condition and MCCs. A secondary data analysis was conducted in spring 2017 using the National Health Interview Survey (NHIS) 2012 Family Core and Sample Adult Core datasets that yielded 34,525 respondents aged 18 years and older. Measures included overall HIT use (ie, any use of the following five HIT on the Internet: seeking health information, ordering prescription, making appointment, emailing health provider, and using health chat groups), as well as sociodemographic and health-related characteristics. Sociodemographic and health characteristics were compared between HIT users and nonusers among those who reported having at least one chronic condition using chi-square tests. Independent predictors of HIT use were identified using multiple logistic regression analyses for those with one chronic condition, with MCCs, and without a chronic condition. Analyses were weighted and performed at significance level of .005. In 2012, adults with one health chronic condition (raw count 4147/8551, weighted percentage 48.54%) was significantly higher than among those with MCCs (3816/9637, 39.55%) and those with none of chronic condition (7254/16,337, 44.40%, PHIT use. Chi-square tests revealed that among adults with chronic conditions, those who used HIT were significantly different from their counterpart peers who did not use HIT in terms of sociodemographic and health characteristics

Climate and Health Vulnerability to Vector-Borne Diseases: Increasing Resilience under Climate Change Conditions in Africa

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Ceccato, P.

2015-12-01

The International Research Institute for Climate and Society (IRI), the City University of New York (CUNY) and NASA Jet Propulsion Laboratory (JPL) in collaboration with NASA SERVIR are developing tools to monitor climate variables (precipitation, temperature, vegetation, water bodies, inundation) that help projects in Africa to increase resilience to climate change for vector-borne diseases ( malaria, trypanosomiasis, leishmaniasis, and schistosomiasis). Through the development of new products to monitor precipitation, water bodies and inundation, IRI, CUNY and JPL provide tools and capacity building to research communities; ministries of health; the WMO Global Framework for Climate and Services; and World Health Organization in Africa to: 1) Develop research teams' ability to appropriately use climate data as part of their research 2) Enable research teams and ministries to integrate climate information into social and economic drivers of vulnerability and opportunities for adaptation to climate change 3) Inform better policies and programs for climate change adaptation. This oral presentation will demonstrate how IRI, CUNY, and JPL developed new products, tools and capacity building to achieve the three objectives mentioned above with examples in South Africa, Zimbabwe, Tanzania and Malawi.

Comparison of health conditions treated with traditional and biomedical health care in a Quechua community in rural Bolivia.

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Vandebroek, Ina; Thomas, Evert; Sanca, Sabino; Van Damme, Patrick; Puyvelde, Luc Van; De Kimpe, Norbert

2008-01-14

The objective of the present study was to reveal patterns in the treatment of health conditions in a Quechua-speaking community in the Bolivian Andes based on plant use data from traditional healers and patient data from a primary health care (PHC) service, and to demonstrate similarities and differences between the type of illnesses treated with traditional and biomedical health care, respectively. A secondary analysis of plant use data from semi-structured interviews with eight healers was conducted and diagnostic data was collected from 324 patients in the community PHC service. Health conditions were ranked according to: (A) the percentage of patients in the PHC service diagnosed with these conditions; and (B) the citation frequency of plant use reports to treat these conditions by healers. Healers were also queried about the payment modalities they offer to their patients. Plant use reports from healers yielded 1166 responses about 181 medicinal plant species, which are used to treat 67 different health conditions, ranging from general symptoms (e.g. fever and body pain), to more specific ailments, such as arthritis, biliary colic and pneumonia. The results show that treatment offered by traditional medicine overlaps with biomedical health care in the case of respiratory infections, wounds and bruises, fever and biliary colic/cholecystitis. Furthermore, traditional health care appears to be complementary to biomedical health care for chronic illnesses, especially arthritis, and for folk illnesses that are particularly relevant within the local cultural context. Payment from patients to healers included flexible, outcome contingent and non-monetary options. Traditional medicine in the study area is adaptive because it corresponds well with local patterns of morbidity, health care needs in relation to chronic illnesses, cultural perceptions of health conditions and socio-economic aspects of health care. The quantitative analysis of plant use reports and patient

Increasing women in leadership in global health.

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Downs, Jennifer A; Reif, Lindsey K; Hokororo, Adolfine; Fitzgerald, Daniel W

2014-08-01

Globally, women experience a disproportionate burden of disease and death due to inequities in access to basic health care, nutrition, and education. In the face of this disparity, it is striking that leadership in the field of global health is highly skewed towards men and that global health organizations neglect the issue of gender equality in their own leadership. Randomized trials demonstrate that women in leadership positions in governmental organizations implement different policies than men and that these policies are more supportive of women and children. Other studies show that proactive interventions to increase the proportion of women in leadership positions within businesses or government can be successful. Therefore, the authors assert that increasing female leadership in global health is both feasible and a fundamental step towards addressing the problem of women's health. In this Perspective, the authors contrast the high proportion of young female trainees who are interested in academic global health early in their careers with the low numbers of women successfully rising to global health leadership roles. The authors subsequently explore reasons for female attrition from the field of global health and offer practical strategies for closing the gender gap in global health leadership. The authors propose solutions aimed to promote female leaders from both resource-wealthy and resource-poor countries, including leadership training grants, mentorship from female leaders in global professions, strengthening health education in resource-poor countries, research-enabling grants, and altering institutional policies to support women choosing a global health career path.

Lifestyle and health conditions of adults with spinal cord injury.

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Xavier de França, Inacia Sátiro; Cruz Enders, Bertha; Silva Coura, Alexsandro; Pereira Cruz, Giovanna Karinny; da Silva Aragão, Jamilly; Carvalho de Oliveira, Déborah Raquel

2014-01-01

. To describe the lifestyle of adults with spinal cord injury and explore its relation with some health conditions. Cross sectional study, in which a questionnaire containing sociodemographic, habits and health conditions variables was used. Forty-seven people with spinal cord injury participated and answered the self-report questionnaire. The group under study was predominantly male (92%), under 40 years of age (47%), and had low educational level (76%). The most frequent risk factors related to the lifestyle were: smoking (28%), alcohol consumption (36%), coffee consumption (92%) and being physically inactive (64%). Association was found between having four or more risk factors related to lifestyle and the loss of appetite, as well as constipation. . The actual inadequate lifestyle is associated with the health conditions of patients, and the nursing team should pay special attention to the education and promotion of health related to people with spinal cord injury.

Associations between lifetime potentially traumatic events and chronic physical conditions in the South African Stress and Health Survey: a cross-sectional study.

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Atwoli, Lukoye; Platt, Jonathan M; Basu, Archana; Williams, David R; Stein, Dan J; Koenen, Karestan C

2016-07-07

This study examined the association between the type, and cumulative number of lifetime potentially traumatic events (PTEs), and chronic physical conditions, in a South African sample. PTE exposures have been associated with an increased risk for a wide range of chronic physical conditions, but it is unclear whether psychiatric disorders mediate this association. Given the established differences in trauma occurrence, and the epidemiology of posttraumatic stress disorder (PTSD) in South Africa relative to other countries, examining associations between PTEs and chronic physical conditions, particularly while accounting for psychiatric comorbidity is important. Data were drawn from the South African Stress and Health Study, a cross-sectional population-representative study of psychological and physical health of South African adults. Twenty-seven PTEs, based on the World Health Organization Composite International Diagnostic Interview Version 3.0, DSM-IV PTSD module were grouped into seven PTE types (war events, physical violence, sexual violence, accidents, unexpected death of a loved one, network events, and witnessing PTEs). Five clusters of physical conditions (cardiovascular, arthritis, respiratory, chronic pain, and other health conditions) were examined. Logistic regressions assessed the odds of reporting a physical condition in relation to type and cumulative number of PTEs. Cochran-Armitage test for trend was used to examine dose-response effect of cumulative PTEs on physical conditions. After adjusting for sociodemographic variables and psychiatric disorders, respondents with any PTE had increased odds of all assessed physical conditions, ranging between 1.48 (95 % CI: 1.06-2.07) for arthritis and 2.07 (95 % CI: 1.57-2.73) for respiratory conditions, compared to those without PTE exposure. Sexual violence, physical violence, unexpected death of a loved one, and network PTEs significantly increased the odds of all or nearly all the physical conditions

The Population Impact of Childhood Health Conditions on Dropout from Upper-Secondary Education.

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Mikkonen, Janne; Moustgaard, Heta; Remes, Hanna; Martikainen, Pekka

2018-05-01

To quantify how large a part of educational dropout is due to adverse childhood health conditions and to estimate the risk of dropout across various physical and mental health conditions. A registry-based cohort study was conducted on a 20% random sample of Finns born in 1988-1995 (n = 101 284) followed for school dropout at ages 17 and 21. Four broad groups of health conditions (any, somatic, mental, and injury) and 25 specific health conditions were assessed from inpatient and outpatient care records at ages 10-16 years. We estimated the immediate and more persistent risks of dropout due to health conditions and calculated population-attributable fractions to quantify the population impact of childhood health on educational dropout, while accounting for a wide array of sociodemographic confounders and comorbidity. Children with any health condition requiring inpatient or outpatient care at ages 10-16 years were more likely to be dropouts at ages 17 years (risk ratio 1.71, 95% CI 1.61-1.81) and 21 years (1.46, 1.37-1.54) following adjustment for individual and family sociodemographic factors. A total of 30% of school dropout was attributable to health conditions at age 17 years and 21% at age 21 years. Mental disorders alone had an attributable fraction of 11% at age 21 years, compared with 5% for both somatic conditions and injuries. Adjusting for the presence of mental disorders reduced the effects of somatic conditions. More than one fifth of educational dropout is attributable to childhood health conditions. Early-onset mental disorders emerge as key targets in reducing dropout. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Does Increased Access Increase Equality? Gender and Child Health Investments in India

OpenAIRE

Emily Oster

2006-01-01

Policymakers often argue that increasing access to health care is one crucial avenue for decreasing gender inequality in the developing world. Although this is generally true in the cross section, time series evidence does not always point to the same conclusion. This paper analyzes the relationship between access to child health investments and gender inequality in those health investments in India. A simple theory of gender-biased parental investment suggests that gender inequality may actu...

Increase in social inequality in health expectancy in Denmark

DEFF Research Database (Denmark)

Brønnum-Hansen, Henrik; Baadsgaard, Mikkel

2008-01-01

AIMS: Health expectancy represents the average lifetime in various states of health and differs among social groups. The purpose of the study was to determine trends in social inequality in health expectancy since 1994 between groups with high, medium and low educational levels in Denmark. METHODS...... educational level, the increase was 2.7 years for men and 2.2 years for women. The difference between people with low and high educational level in expected lifetime in self-rated good health increased by 2.0 and 1.3 years for 30-year-old men and women, respectively. The social gap also increased for other...... indicators. CONCLUSIONS: During the past 12 years, social inequality in life expectancy and health expectancy has increased in Denmark, but the proportion of the population with a low educational level has decreased....

Psychosocial work conditions and quality of life among primary health care employees: a cross sectional study

Science.gov (United States)

2014-01-01

Background Workers in Primary Health Care are often exposed to stressful conditions at work. This study investigated the association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers. Methods This cross-sectional study included all 797 Primary Health Care workers of a medium-sized city, Brazil: doctors, nurses, nursing technicians and nursing assistants, dentists, oral health technicians, and auxiliary oral hygienists, and community health workers. Data were collected by interviews. Quality of life was assessed using the WHOQOL-BREF; general quality of life, as well as the physical, psychological, social and environmental domains were considered, with scores from 0 to 100. Higher scores indicate a better quality of life. Poor quality of life was defined by the lowest quartiles of the WHOQOL score distributions for each of the domains. Adverse psychosocial work conditions were investigated by the Effort-Reward Imbalance model. Associations were verified using multiple logistic regression. Results Poor quality of life was observed in 117 (15.4%) workers. Workers with imbalanced effort-reward (high effort/low reward) had an increased probability of general poor quality of life (OR = 1.91; 1.07–3.42), and in the physical (OR = 1.62; 1.02–2.66), and environmental (OR = 2.39; 1.37–4.16) domains; those with low effort/low reward demonstrated a greater probability of poor quality of life in the social domain (OR = 1.82; 1.00–3.30). Workers with overcommitment at work had an increased likelihood of poor quality of life in the physical (OR = 1.55, 1.06–2.26) and environmental (OR = 1.69; 1.08–2.65) domains. These associations were independent of individual characteristics, job characteristics, lifestyle, perception of general health, or psychological and biological functions. Conclusions There is an association between adverse psychosocial work conditions and poor quality of life among

Psychosocial work conditions and quality of life among primary health care employees: a cross sectional study.

Science.gov (United States)

Teles, Mariza Alves Barbosa; Barbosa, Mirna Rossi; Vargas, Andréa Maria Duarte; Gomes, Viviane Elizângela; Ferreira, Efigênia Ferreira e; Martins, Andréa Maria Eleutério de Barros Lima; Ferreira, Raquel Conceição

2014-05-15

Workers in Primary Health Care are often exposed to stressful conditions at work. This study investigated the association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers. This cross-sectional study included all 797 Primary Health Care workers of a medium-sized city, Brazil: doctors, nurses, nursing technicians and nursing assistants, dentists, oral health technicians, and auxiliary oral hygienists, and community health workers. Data were collected by interviews. Quality of life was assessed using the WHOQOL-BREF; general quality of life, as well as the physical, psychological, social and environmental domains were considered, with scores from 0 to 100. Higher scores indicate a better quality of life. Poor quality of life was defined by the lowest quartiles of the WHOQOL score distributions for each of the domains. Adverse psychosocial work conditions were investigated by the Effort-Reward Imbalance model. Associations were verified using multiple logistic regression. Poor quality of life was observed in 117 (15.4%) workers. Workers with imbalanced effort-reward (high effort/low reward) had an increased probability of general poor quality of life (OR = 1.91; 1.07–3.42), and in the physical (OR = 1.62; 1.02–2.66), and environmental (OR = 2.39; 1.37–4.16) domains; those with low effort/low reward demonstrated a greater probability of poor quality of life in the social domain (OR = 1.82; 1.00–3.30). Workers with overcommitment at work had an increased likelihood of poor quality of life in the physical (OR = 1.55, 1.06–2.26) and environmental (OR = 1.69; 1.08–2.65) domains. These associations were independent of individual characteristics, job characteristics, lifestyle, perception of general health, or psychological and biological functions. There is an association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers.

Lifestyle and health conditions of adults with spinal cord injury

Directory of Open Access Journals (Sweden)

Inacia Sátiro Xavier de França

2014-07-01

Full Text Available Objective. To describe the lifestyle of adults with spinal cord injury and explore its relation with some health conditions. Methodology. Cross sectional study, in which a questionnaire containing sociodemographic, habits and health conditions variables was used. Forty-seven people with spinal cord injury participated and answered the self-report questionnaire. Results. The group under study was predominantly male (92%, under 40 years of age (47%, and had low educational level (76%. The most frequent risk factors related to the lifestyle were: smoking (28%, alcohol consumption (36%, coffee consumption (92% and being physically inactive (64%. Association was found between having four or more risk factors related to lifestyle and the loss of appetite, as well as constipation. Conclusion. The actual inadequate lifestyle is associated with the health conditions of patients, and the nursing team should pay special attention to the education and promotion of health related to people with spinal cord injury.

The impact of conditional cash transfers on health outcomes and use of health services in low and middle income countries.

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Lagarde, Mylene; Haines, Andy; Palmer, Natasha

2009-10-07

Conditional cash transfers (CCT) provide monetary transfers to households on the condition that they comply with some pre-defined requirements. CCT programmes have been justified on the grounds that demand-side subsidies are necessary to address inequities in access to health and social services for poor people. In the past decade they have become increasingly popular, particularly in middle income countries in Latin America. To assess the effectiveness of CCT in improving access to care and health outcomes, in particular for poorer populations in low and middle income countries. We searched a wide range of international databases, including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE, in addition to development studies and economic databases. We also searched the websites and online resources of numerous international agencies, organisations and universities to find relevant grey literature. The original searches were conducted between November 2005 and April 2006. An updated search in MEDLINE was carried out in May 2009. CCT were defined as monetary transfers made to households on the condition that they comply with some pre-determined requirements in relation to health care. Studies had to include an objective measure of at least one of the following outcomes: health care utilisation, health expenditure, health outcomes or equity outcomes. Eligible study designs were: randomised controlled trial, interrupted time series analysis, or controlled before-after study of the impact of health financing policies following criteria used by the Cochrane Effective Practice and Organisation of Care Group. We performed qualitative analysis of the evidence. We included ten papers reporting results from six intervention studies. Overall, design quality and analysis limited the risks of bias. Several CCT programmes provided strong evidence of a positive impact on the use of health services, nutritional status and health outcomes

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

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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. © The Author(s) 2015.

Macroeconomic conditions and population health in Iceland

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Kristín Helga Birgisdóttir

2017-09-01

Full Text Available Background: Results from recent research on the impact of economic cycles and population health have been mixed, with results appearing to be context-sensitive. Objective: We examine the long-term relationship between economic conditions and population health in Iceland, which has experienced some economically turbulent times in the last years and decades. Methods: We use aggregate annual data for 1981‒2014. We use three aggregate indicators of economic activity to proxy the economic cycle: unemployment rate, real GDP per capita, and real GDP. Life expectancy at birth, infant mortality, and total mortality as well as four cause-specific mortality rates were used as outcome measures. Results: Our results do not suggest a statistically significant relationship between economic conditions and total mortality, infant mortality, or life expectancy. Different responses between causes of death are found, and in some instances between genders, although statistical significance is low. We do, however, find a consistent and statistically significant relationship for females aged 45‒64, where economic downturns are associated with lower all-cause mortality. Conclusions: For the time period studied we do not find a significant relationship between economic cycles and population health, where health is proxied by mortality rates, life expectancy at birth, and infant mortality. Further studies using less extreme health outcomes, such as morbidity rates, are warranted. Contribution: This type of study has not been performed using Icelandic data before and provides a comparison to research from other countries where the relationship has been explored more. Additionally, one of the contributions of this paper is to use a variety of economic indicators as proxies for economic cycles in a study examining their relationship with population health.

Evaluation of the Environmental Health Conditions of Qom Hotels & Inns

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B. Farzinnia

2009-02-01

Full Text Available Background and ObjectivesTourism is one of the three major global industries with 4 percent annual economic growth. Qom with roughly 17 million tourists in 2005 was the second religious tourism center in Iran. This study was designed to determine the environmental health criteria of Qom hotels and inns in 2007.MethodsThis descriptive - cross sectional study was carried out based on a standard check list of substance of edible, drinkable, cosmetic and hygienic products law from ministry of health and medical sciences. The checklist included 73 questions which were completed by face to face interviews and sanitary inspections. After analyzing the results of each residential center, the questionnaires were classified into three categories: hygienic (over 80 score, sanitary (40-79 and unacceptable centers (less than 40. The data were presented and analyzed by descriptive and analytical statistical methods such as X 2 and Fisher exact test.ResultsThe percentages of hygienic, sanitary and unacceptable conditions of hotels and inns were 35.5, 54.8 and 9.7, respectively. There was a direct relationship between academic degree of residential managers and the validity of employees health card (P=0.042 ConclusionBased on this the research, the environmental status of Qom hotels and inns was in relatively desirable conditions. Residential places with unacceptable condition were almost located in the old region of the city (e.g. around the Holly Shrine. Due to the structural failures, architectural problems and tremendous cost for repairs, it’s better that their activities be stopped and banned by government. With regard to the high percentage of hotels with sanitary conditions, at least improvements in health conditions accompanied by training and supervision are recommended. Keywords: Environmental Health; Environment and Public Health; Hotel; Inn; Qom, Iran.

Oral Health Conditions of Older People: Focus on the Balkan Countries

OpenAIRE

Chatzopoulos Georgios S.

2015-01-01

Oral health plays a pivotal role in general health, especially in older people. Oral diseases may affect the development of systemic conditions, such as diabetes mellitus, cardiovascular disease, stroke and hypertension. The most important oral health conditions that have been recorded in dental literature for older population include tooth loss, dental caries, periodontal diseases, xerostomia (dry mouth) and oral cancer. Edentulism influences social life, either causing aesthetic problems or...

Child Maltreatment, Trauma, and Physical Health Outcomes: The Role of Abuse Type and Placement Moves on Health Conditions and Service Use for Youth in Foster Care.

Science.gov (United States)

Jackson, Yo; Cushing, Christopher C; Gabrielli, Joy; Fleming, Kandace; O'Connor, Bridget M; Huffhines, Lindsay

2016-01-01

The purpose of the study was to investigate the relations between abuse types, non-maltreatment-related trauma, and health service utilization in a sample of youth in foster care with and without chronic medical conditions. A total of 213 youth, aged 8-21 years, provided self-report of general trauma and abuse exposure. Medicaid claims for each child were collected from official state databases. Exposure to sexual abuse, neglect, or general trauma but not exposure to physical abuse or psychological abuse increased the rates of medical visits, while only general trauma increased medical hospitalizations.  Trauma types are not equally predictive of health care utilization for youth with chronic health conditions. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Customers' perspectives on the impact of the Pathways to Work condition management programme on their health, well-being and vocational activity.

Science.gov (United States)

Secker, Jenny; Pittam, Gail; Ford, Fiona

2012-11-01

Pathways to Work is a UK initiative aimed at supporting customers on incapacity benefits to return to work. This qualitative study complements previous evaluations of Pathways to Work by exploring customers' perceptions of the impact of the Condition Management Programme (CMP) offered to claimants with long-term health conditions. 39 customers took part in focus groups held at the seven sites where Pathways was originally piloted. The main focus of the discussions was on perceptions of the ways in which participation had impacted on health, well-being and return to work. The discussions were audio-recorded and fully transcribed for analysis using a text analysis framework to enable the development and refinement of categories and overarching patterns in the data. Perceived impacts on health and well-being included a more positive outlook, social contact, changed perceptions of conditions and improvements in health. Some customers also reported an increase in their vocational activity and others felt ready to embark on new activities. Factors associated with positive outcomes included the extent and quality of contact with CMP staff and practical advice about condition management. Factors impeding positive employment outcomes related mainly to obstacles to returning to work. The results indicated that CMP can assist customers to learn about and manage their health conditions and increase their vocational activity, and that CMP therefore provides a promising means of enabling people with long-term health conditions to regain a fulfilling, productive life.

The role of comorbid psychiatric conditions in health status in epilepsy.

Science.gov (United States)

Zeber, John E; Copeland, Laurel A; Amuan, Megan; Cramer, Joyce A; Pugh, Mary Jo V

2007-06-01

Comorbid psychiatric conditions are highly prevalent in patients with epilepsy, yet the long-term implications across multiple mental health conditions are poorly understood. We examined the association between psychiatric diagnoses and self-reported health status in veterans with epilepsy. ANCOVA models were used to derive adjusted SF-36V scores for individuals with epilepsy alone (N=7379) or with additional psychiatric conditions (N=6320): depression, schizophrenia, bipolar disorder, anxiety disorder, substance abuse, and posttraumatic stress disorder (PTSD). Compared with patients with epilepsy alone, scores of veterans with comorbid psychiatric diagnoses averaged 21% lower across all domains. Role Limitation scales exhibited the greatest decrement across domains. A PTSD diagnosis consistently corresponded to lower scores, followed by depression. Schizophrenia contributed the least detriment to perceived health status. Comorbid psychiatric conditions impart significant emotional and physical burdens, requiring timely recognition and treatment of these disorders. Patients with epilepsy are uniquely at risk for high physical-psychiatric comorbidity profiles, with concomitant losses in perceived health status.

29 CFR 825.113 - Serious health condition.

Science.gov (United States)

2010-07-01

... illness, injury, impairment or physical or mental condition that involves inpatient care as defined in... medications such as aspirin, antihistamines, or salves; or bed-rest, drinking fluids, exercise, and other... “serious health conditions” unless inpatient hospital care is required or unless complications develop...

A time series analysis of presentations to Queensland health facilities for alcohol-related conditions, following the increase in 'alcopops' tax.

Science.gov (United States)

Kisely, Steve; Crowe, Elizabeth; Lawrence, David; White, Angela; Connor, Jason

2013-08-01

In response to concerns about the health consequences of high-risk drinking by young people, the Australian Government increased the tax on pre-mixed alcoholic beverages ('alcopops') favoured by this demographic. We measured changes in admissions for alcohol-related harm to health throughout Queensland, before and after the tax increase in April 2008. We used data from the Queensland Trauma Register, Hospitals Admitted Patients Data Collection, and the Emergency Department Information System to calculate alcohol-related admission rates per 100,000 people, for 15 - 29 year-olds. We analysed data over 3 years (April 2006 - April 2009), using interrupted time-series analyses. This covered 2 years before, and 1 year after, the tax increase. We investigated both mental and behavioural consequences (via F10 codes), and intentional/unintentional injuries (S and T codes). We fitted an auto-regressive integrated moving average (ARIMA) model, to test for any changes following the increased tax. There was no decrease in alcohol-related admissions in 15 - 29 year-olds. We found similar results for males and females, as well as definitions of alcohol-related harms that were narrow (F10 codes only) and broad (F10, S and T codes). The increased tax on 'alcopops' was not associated with any reduction in hospital admissions for alcohol-related harms in Queensland 15 - 29 year-olds.

Climate and Population Health Vulnerabilities to Vector-Borne Diseases: Increasing Resilience Under Climate Change Conditions in Africa

Science.gov (United States)

Ceccato, P.; McDonald, K. C.; Podest, E.; De La Torre Juarez, M.; Kruczkiewicz, A.; Lessel, J.; Jensen, K.; Thomson, M. C.

2014-12-01

The International Research Institute for Climate and Society (IRI), the City University of New York (CUNY) and NASA Jet Propulsion Laboratory (JPL) in collaboration with NASA SERVIR are developing tools to monitor climate variables (precipitation, temperature, vegetation, water bodies, inundation) that help projects in Africa to increase resilience to climate change for vector-borne diseases (i.e. malaria, trypanosomiasis, leishmaniasis, and schistosomiasis). Through the development of new products to monitor precipitation, water bodies and inundation, IRI, CUNY and JPL provide tools and capacity building to research communities, ministries of health and World Health Organization in Africa to: 1) Develop research teams' ability to appropriately use climate data as part of their research 2) Enable research teams and ministries to integrate climate information into social and economic drivers of vulnerability and opportunities for adaptation to climate change 3) Inform better policies and programs for climate change adaptation. This oral presentation will demonstrate how IRI, CUNY, and JPL developed new products, tools and capacity building to achieve the three objectives mentioned above.

Understanding stigma in chronic health conditions: implications for nursing.

Science.gov (United States)

Engebretson, Joan

2013-10-01

This article explores the social processes in stigmatization and the theoretical background on the impact in chronic illness. Review of literature from social sciences and applications to health issues. Understanding the social utility of stigmatization in preserving social cohesion and protecting the social order is an important function. However, this process can be harmful when applied to persons with chronic illness, such as HIV-AIDS, and psychiatric illness. These individuals often become shamed, ostracized, isolated, discredited, and socially and economically marginalized. Recent theoretical work on stigma has identified several issues and patient responses that may have implications in many other chronic conditions. Stigma is based on visible or nonvisible health conditions and can be both externally imposed or perceived in a process of self-stigma. Understanding stigma can aid clinicians in providing supportive help for patients with chronic illness. Stigma has been well researched in a few chronic illnesses; however, future studies in other conditions are much needed. Recognizing the underlying social factors has potential use in health-promoting behaviors. Sensitivity to stigma allows health professionals to critically reflect on ways the healthcare environment may add to stigma for their patients. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

Housing conditions and mental health of orphans in South Africa

OpenAIRE

Marais, Lochner; Sharp, Carla; Pappin, Michele; Lenka, Molefi; Cloete, Jan; Skinner, Donald; Serekoane, Joe

2013-01-01

Literature from the developed world suggests that poor housing conditions and housing environments contribute to poor mental health outcomes, although research results are mixed. This study investigates the relationship between housing conditions and the socio-emotional health of orphans and vulnerable children (OVC) in South Africa. The results of the study are mainly inconclusive, although it is suggested that methodological considerations play a vital role in explaining the mixed results. ...

The relationship between social determinants of health, and rehabilitation of neurological conditions: a systematic literature review.

Science.gov (United States)

Frier, Amanda; Barnett, Fiona; Devine, Sue

2017-05-01

This systematic literature review aims to explore the relationship between social determinants of health (SDH), and the rehabilitation of neurological conditions. In particular, the review will consider relationships between social determinants and peoples' attendance and sustained adherence to rehabilitation programs, and motivation regarding neurological rehabilitation. A systematic search of peer-reviewed literature from electronic databases; MEDLINE, Scopus, CINAHL and Informit health, was conducted. Papers published between 2004 and 2014 were considered. Eleven quantitative studies met the inclusion criteria. There was a lack of research addressing SDH and neurological rehabilitation simultaneously. Cardiac and cancer rehabilitation studies reported employment and income, social support, transport, housing and food security as the most frequent SDH factors influencing attendance, sustained adherence and motivation. Given this association, a similar relationship between neurological rehabilitation and SDH is plausible. Rehabilitation of neurological conditions can be a long and difficult process. To pursue optimal outcomes, an individual's social circumstances should be considered. Understanding how SDH interact with neurological rehabilitation may enhance service delivery, thus maximizing the possible rehabilitation outcomes for individuals. Future research that considers SDH and rehabilitation of neurological conditions jointly may benefit service providers and those requiring neurological rehabilitation. Implications for Rehabilitation Social determinants of health are important to consider in the rehabilitation of neurological conditions. Understanding the interplay between the social determinants of health and neurological rehabilitation may enhance the possible outcomes for those requiring rehabilitation. Increased awareness and capacity of health care professionals involved in neurological rehabilitation may hasten momentum towards decreased health

Which Pediatricians Comanage Mental Health Conditions?

Science.gov (United States)

Green, Cori; Storfer-Isser, Amy; Stein, Ruth E K; Garner, Andrew S; Kerker, Bonnie D; Szilagyi, Moira; O'Connor, Karen G; Hoagwood, Kimberly E; Horwitz, Sarah M

2017-07-01

Given the prevalence of mental health (MH) conditions (MHC) in children, pediatricians should initiate treatment alone or in collaboration with a specialist for children with MHC. However, the majority of pediatricians do not manage or comanage common MHC even with an on-site MH provider. We examined which physician, practice, and training characteristics are associated with pediatricians' comanaging at least half of their patients with MHC. We analyzed responses of general pediatricians (n = 305) from the American Academy of Pediatrics 2013 Periodic Survey. Practice characteristics include presence of an on-site MH provider and perceived access to services. Independent variables included sociodemographics, training experiences, and interest in further training. The outcome was comanagement of ≥50% of patients with MHC. Weighted univariate, bivariate, and multivariable analyses were performed. Of the pediatricians who reported comanaging ≥50% of their patients with MHC, logistic regression analysis showed that pediatricians who completed ≥4 weeks of developmental behavioral pediatrics training had 1.8 increased odds (95% confidence interval 1.06, 3.08, P = .03) of comanagement, those very interested in further education in managing/treating MHC had 2.75 increased odds (95% confidence interval 1.63, 3.08, P < .001), and those with more training in MH treatment with medications had 1.4 increased odds (95% confidence interval 1.12, 1.75, P = .004) of comanaging children with MHC. Specific educational experiences and interest in further education in managing or treating MHC were significantly associated with comanaging ≥50% of patients, suggesting that enhanced MH training among pediatricians could increase the comanagement of children with MHC. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Health condition of juvenile Chelonia mydas related to fibropapillomatosis in southeast Brazil

Science.gov (United States)

Renan de Deus Santos, Marcello; Silva Martins, Agnaldo; Baptistotte, Cecília; Work, Thierry M.

2015-01-01

Packed cell volume (PCV), plasma biochemistry, visual body condition (BC), and calculated body condition index (BCI) were evaluated in 170 wild juvenile green sea turtles Chelonia mydas from an aggregation in the effluent canal of a steel mill in Brazil. Occurrence of cutaneous fibropapillomatosis (FP) was observed in 44.1% of the animals examined. BCI alone did not differ significantly between healthy animals and those afflicted with FP. However, all turtles with low BCI were severely afflicted and were uremic, hypoglycemic, and anemic in relation to healthy animals. Severe FP was not always reflected by a poor health condition of the individual. Clinical evaluation and plasma biochemistry indicated that most animals afflicted with FP were in good health condition. Differences in FP manifestations and associated health conditions in different geographic regions must be assessed by long-term health monitoring programs to help define priorities for conservation efforts.

Flexible working conditions and their effects on employee health and wellbeing.

Science.gov (United States)

Joyce, Kerry; Pabayo, Roman; Critchley, Julia A; Bambra, Clare

2010-02-17

Flexible working conditions are increasingly popular in developed countries but the effects on employee health and wellbeing are largely unknown. To evaluate the effects (benefits and harms) of flexible working interventions on the physical, mental and general health and wellbeing of employees and their families. Our searches (July 2009) covered 12 databases including the Cochrane Public Health Group Specialised Register, CENTRAL; MEDLINE; EMBASE; CINAHL; PsycINFO; Social Science Citation Index; ASSIA; IBSS; Sociological Abstracts; and ABI/Inform. We also searched relevant websites, handsearched key journals, searched bibliographies and contacted study authors and key experts. Randomised controlled trials (RCT), interrupted time series and controlled before and after studies (CBA), which examined the effects of flexible working interventions on employee health and wellbeing. We excluded studies assessing outcomes for less than six months and extracted outcomes relating to physical, mental and general health/ill health measured using a validated instrument. We also extracted secondary outcomes (including sickness absence, health service usage, behavioural changes, accidents, work-life balance, quality of life, health and wellbeing of children, family members and co-workers) if reported alongside at least one primary outcome. Two experienced review authors conducted data extraction and quality appraisal. We undertook a narrative synthesis as there was substantial heterogeneity between studies. Ten studies fulfilled the inclusion criteria. Six CBA studies reported on interventions relating to temporal flexibility: self-scheduling of shift work (n = 4), flexitime (n = 1) and overtime (n = 1). The remaining four CBA studies evaluated a form of contractual flexibility: partial/gradual retirement (n = 2), involuntary part-time work (n = 1) and fixed-term contract (n = 1). The studies retrieved had a number of methodological limitations including short follow-up periods

Characterisation of mental health conditions in social media using Informed Deep Learning

Science.gov (United States)

Gkotsis, George; Oellrich, Anika; Velupillai, Sumithra; Liakata, Maria; Hubbard, Tim J. P.; Dobson, Richard J. B.; Dutta, Rina

2017-03-01

The number of people affected by mental illness is on the increase and with it the burden on health and social care use, as well as the loss of both productivity and quality-adjusted life-years. Natural language processing of electronic health records is increasingly used to study mental health conditions and risk behaviours on a large scale. However, narrative notes written by clinicians do not capture first-hand the patients’ own experiences, and only record cross-sectional, professional impressions at the point of care. Social media platforms have become a source of ‘in the moment’ daily exchange, with topics including well-being and mental health. In this study, we analysed posts from the social media platform Reddit and developed classifiers to recognise and classify posts related to mental illness according to 11 disorder themes. Using a neural network and deep learning approach, we could automatically recognise mental illness-related posts in our balenced dataset with an accuracy of 91.08% and select the correct theme with a weighted average accuracy of 71.37%. We believe that these results are a first step in developing methods to characterise large amounts of user-generated content that could support content curation and targeted interventions.

[WORKING CONDITIONS AND STATE OF HEALTH OF TBILISI SUBWAY EMPLOYEES].

Science.gov (United States)

Khunashvili, N; Tsimakuridze, Mar; Bakradze, L; Khachapuridze, N; Tsimakuridze, Maya

2017-03-01

For the purpose of preventive events complex hygienic, clinical-functional, laboratory and biostatic researches are implemented on the basis of Tbilisi Subway. Conditions of work are characterized by complex of unfavorable factors of the working environment and the labor process. Working environment is characterized by combination of unfavorable state of physical factors and air pollution with dust and toxic substances. The levels of noise and vibration refer to the 3.4 class of harmfulness. The content of dust and toxic substances corresponds to 3.1-3.2 classes of working conditions harmfulness. In the indexes of health status, the leading diseases are pathology of cardiovascular, nervous and digestive systems. Cause-effect relationships between working conditions and individual health indicators have been already established, which served as the basis for the development of comprehensive preventive health measures.

Lesbian, gay, & bisexual older adults: linking internal minority stressors, chronic health conditions, and depression.

Science.gov (United States)

Hoy-Ellis, Charles P; Fredriksen-Goldsen, Karen I

2016-11-01

This study aims to: (1) test whether the minority stressors disclosure of sexual orientation; and (2) internalized heterosexism are predictive of chronic physical health conditions; and (3) depression; (4) to test direct and indirect relationships between these variables; and (5) whether chronic physical health conditions are further predictive of depression, net of disclosure of sexual orientation and internalized heterosexism. Secondary analysis of national, community-based surveys of 2349 lesbian, gay, and bisexual adults aged 50 and older residing in the US utilizing structural equation modeling. Congruent with minority stress theory, disclosure of sexual orientation is indirectly associated with chronic physical health conditions and depression, mediated by internalized heterosexism with a suppressor effect. Internalized heterosexism is directly associated with chronic physical health conditions and depression, and further indirectly associated with depression mediated by chronic physical health conditions. Finally, chronic physical health conditions have an additional direct relationship with depression, net of other predictor variables. Minority stressors and chronic physical health conditions independently and collectively predict depression, possibly a synergistic effect. Implications for depression among older sexual minority adults are discussed.

Mobile health applications for the most prevalent conditions by the World Health Organization: review and analysis.

Science.gov (United States)

Martínez-Pérez, Borja; de la Torre-Díez, Isabel; López-Coronado, Miguel

2013-06-14

New possibilities for mHealth have arisen by means of the latest advances in mobile communications and technologies. With more than 1 billion smartphones and 100 million tablets around the world, these devices can be a valuable tool in health care management. Every aid for health care is welcome and necessary as shown by the more than 50 million estimated deaths caused by illnesses or health conditions in 2008. Some of these conditions have additional importance depending on their prevalence. To study the existing applications for mobile devices exclusively dedicated to the eight most prevalent health conditions by the latest update (2004) of the Global Burden of Disease (GBD) of the World Health Organization (WHO): iron-deficiency anemia, hearing loss, migraine, low vision, asthma, diabetes mellitus, osteoarthritis (OA), and unipolar depressive disorders. Two reviews have been carried out. The first one is a review of mobile applications in published articles retrieved from the following systems: IEEE Xplore, Scopus, ScienceDirect, Web of Knowledge, and PubMed. The second review is carried out by searching the most important commercial app stores: Google play, iTunes, BlackBerry World, Windows Phone Apps+Games, and Nokia's Ovi store. Finally, two applications for each condition, one for each review, were selected for an in-depth analysis. Search queries up to April 2013 located 247 papers and more than 3673 apps related to the most prevalent conditions. The conditions in descending order by the number of applications found in literature are diabetes, asthma, depression, hearing loss, low vision, OA, anemia, and migraine. However when ordered by the number of commercial apps found, the list is diabetes, depression, migraine, asthma, low vision, hearing loss, OA, and anemia. Excluding OA from the former list, the four most prevalent conditions have fewer apps and research than the final four. Several results are extracted from the in-depth analysis: most of the apps

Representation of health conditions on Facebook: content analysis and evaluation of user engagement.

Science.gov (United States)

Hale, Timothy M; Pathipati, Akhilesh S; Zan, Shiyi; Jethwani, Kamal

2014-08-04

A sizable majority of adult Internet users report looking for health information online. Social networking sites (SNS) like Facebook represent a common place to seek information, but very little is known about the representation and use of health content on SNS. Our goal in this study was to understand the role of SNS in health information seeking. More specifically, we aimed to describe how health conditions are represented on Facebook Pages and how users interact with these different conditions. We used Google Insights to identify the 20 most searched for health conditions on Google and then searched each of the resulting terms on Facebook. We compiled a list of the first 50 Facebook "Pages" results for each health condition. After filtering results to identify pages relevant to our research, we categorized pages into one of seven categories based on the page's primary purpose. We then measured user engagement by evaluating the number of "Likes" for different conditions and types of pages. The search returned 50 pages for 18 of the health conditions, but only 48 pages were found for "anemia" and 5 pages were found for "flu symptoms", yielding a total of 953 pages. A large number of pages (29.4%, 280/953) were irrelevant to the health condition searched. Of the 673 relevant pages, 151 were not in English or originated outside the United States, leaving 522 pages to be coded for content. The most common type of page was marketing/promotion (32.2%, 168/522) followed by information/awareness (20.7%, 108/522), Wikipedia-type pages (15.5%, 81/522), patient support (9.4%, 49/522), and general support (3.6%, 19/522). Health conditions varied greatly by the primary page type. All health conditions had some marketing/promotion pages and this made up 76% (29/38) of pages on acquired immunodeficiency syndrome (AIDS). The largest percentage of general support pages were cancer (19%, 6/32) and stomach (16%, 4/25). For patient support, stroke (67%, 4/6), lupus (33%, 10

Happiness and life satisfaction prospectively predict self-rated health, physical health, and the presence of limiting, long-term health conditions.

Science.gov (United States)

Siahpush, Mohammad; Spittal, Matt; Singh, Gopal K

2008-01-01

To examine the effect of happiness and life satisfaction on health. Longitudinal data from waves 1 and 3, conducted in 2001 and 2004, respectively, of the Household Income and Labour Dynamics in Australia survey. Australia. A total of 9981 respondents aged 18 years and older. Outcomes were self-reported health; the absence of long-term, limiting health conditions; and physical health. Happiness was assessed with the following question: "During the past 4 weeks, have you been a happy person"? Life satisfaction was determined with the following question: "All things considered, how satisfied are you with your life"? We used multiple regression analysis to estimate odds ratios (ORs), beta coefficients (beta), and 95% confidence intervals (CIs) for the associations between baseline happiness or life satisfaction and health at wave 3. Baseline happiness and life satisfaction both were positively associated at wave 3 with excellent, very good, or good health (OR = 1.50, CI = 1.33-1.70, p < .0001; and OR = 1.62, CI = 1.27-2.08, p < .0001, respectively); with the absence of long-term, limiting health conditions (OR = 1.53, CI = 1.35-1.75, p < .0001; and OR = 1.51, CI = 1.25-1.82, p < .0001, respectively); and with higher physical health levels (beta = .99, CI = .60-1.39, p < .0001; and beta = .99, CI = .20-1.78, p < .0145, respectively). This study showed that happier people and those who were more satisfied with their lives at baseline reported better health (self-rated health; absence of limiting, long-term conditions; and physical health) at the 2-year follow-up when adjusted for baseline health and other relevant covariates.

[Differences in living conditions and health between cities: construction of a composite indicator].

Science.gov (United States)

Luiz, Olinda do Carmo; Heimann, Luiza Sterman; Boaretto, Roberta Cristina; Pacheco, Adriana Galvão; Pessoto, Umberto Catarino; Ibanhes, Lauro Cesar; Castro, Iracema Ester do Nascimento; Kayano, Jorge; Junqueira, Virginia; Rocha, Jucilene Leite da; Cortizo, Carlos Tato; Telesi Junior, Emílio

2009-02-01

To describe an index to identify inequities in living conditions and health and its relationship with health planning. Variables and indicators that would reflect demographic, economic, environment and education processes as well as supply and production of health services were applied for nondimensional scaling and clustering of 5,507 Brazilian municipalities. Data sources were the 2000 Census and the Brazilian Ministry of Health information systems. Z-score test statistic and cluster analysis were performed allowing to defining 4 groups of municipalities by living conditions. There was seen a polarization between the group with the best living conditions and health (Group 1) and the group with the worst living conditions (Group 4). Group 1 consisted of municipalities with larger populations while Group 4 comprised mainly the smallest municipalities. As for Brazilian macroregions, municipalities in Group 1 are clustered in the south and southeast and those in Group 4 are in the Northeast. The living conditions and health index comprises reality dimensions such as housing, environment and health which allows to identifying the most vulnerable municipalities and can provide input for setting priorities, and developing criteria for more equitable financing and resource allocation.

Social integration, socioeconomic conditions and type of ill health preceding disability pension in young women: a Swedish population-based study.

Science.gov (United States)

Gustafsson, Klas; Aronsson, Gunnar; Marklund, Staffan; Wikman, Anders; Hagman, Maud; Floderus, Birgitta

2014-02-01

Disability pension has increased in recent decades and is seen as a public health and socioeconomic problem in Western Europe. In the Nordic countries, the increase has been particularly steep among young women. The aim was to analyze the influence of low social integration, socioeconomic risk conditions and different measures of self-reported ill health on the risk of receiving disability pension in young women. The study comprised all Swedish women born in 1960 to 1979, who had been interviewed in any of the annual Swedish Surveys of Living Conditions (1990-2002). The assumed predictors were related to disability pension by Cox proportional hazard regression. The mean number of years of follow-up for the 10,936 women was 7 years (SD 3.8), and the study base was restricted to the ages 16 to 43 years of age. An increased risk of receiving a disability pension was found among lone women, those who had sparse contacts with others, job-seeking women, homemakers, as well as women with low education, and poor private financial situations. A tenfold increase in the risk of receiving a disability pension was found among women reporting a long-standing illness and poor self-rated health, compared to women without a long-standing illness and good self-rated health. Psychiatric diagnoses and symptoms/unspecified illness were the strongest predictors of disability pension, particularly before 30 years of age. The study suggests that weak social relations and weak connections to working life contribute to increase the risk of disability pension in young women, also after control for socioeconomic conditions and self-reported ill health. Self-rated health was the strongest predictor, followed by long-standing illness and not having a job (job seekers and homemakers).

Representation of Health Conditions on Facebook: Content Analysis and Evaluation of User Engagement

Science.gov (United States)

Pathipati, Akhilesh S; Zan, Shiyi; Jethwani, Kamal

2014-01-01

Background A sizable majority of adult Internet users report looking for health information online. Social networking sites (SNS) like Facebook represent a common place to seek information, but very little is known about the representation and use of health content on SNS. Objective Our goal in this study was to understand the role of SNS in health information seeking. More specifically, we aimed to describe how health conditions are represented on Facebook Pages and how users interact with these different conditions. Methods We used Google Insights to identify the 20 most searched for health conditions on Google and then searched each of the resulting terms on Facebook. We compiled a list of the first 50 Facebook “Pages” results for each health condition. After filtering results to identify pages relevant to our research, we categorized pages into one of seven categories based on the page’s primary purpose. We then measured user engagement by evaluating the number of “Likes” for different conditions and types of pages. Results The search returned 50 pages for 18 of the health conditions, but only 48 pages were found for “anemia” and 5 pages were found for “flu symptoms”, yielding a total of 953 pages. A large number of pages (29.4%, 280/953) were irrelevant to the health condition searched. Of the 673 relevant pages, 151 were not in English or originated outside the United States, leaving 522 pages to be coded for content. The most common type of page was marketing/promotion (32.2%, 168/522) followed by information/awareness (20.7%, 108/522), Wikipedia-type pages (15.5%, 81/522), patient support (9.4%, 49/522), and general support (3.6%, 19/522). Health conditions varied greatly by the primary page type. All health conditions had some marketing/promotion pages and this made up 76% (29/38) of pages on acquired immunodeficiency syndrome (AIDS). The largest percentage of general support pages were cancer (19%, 6/32) and stomach (16%, 4/25). For

Addressing individual behaviours and living conditions: Four Nordic public health policies

DEFF Research Database (Denmark)

Vallgårda, Signild

2011-01-01

: Analyses of recent public health programmes in Denmark, Finland, Norway, and Sweden. Results: Focus is on either, or both, individual behaviour and living conditions as causes of ill health; the remedies are classical liberal as well as social democratic policies. None of the programmes is consistent...... approach to public health exists. All programmes contain contradictory policies and ideological statements with differences regarding the emphasis on individual behaviour versus choice and living conditions and political responsibility. The policies are not entirely predictable from the political stance...

Global health-related publications in otolaryngology are increasing.

Science.gov (United States)

Chambers, Kyle J; Creighton, Francis; Abdul-Aziz, Dunia; Cheney, Mack; Randolph, Gregory W

2015-04-01

Determine trends in global health-related publication in otolaryngology. A review of research databases. A search of publications available on PubMed and nine additional databases was undertaken reviewing two time periods 10 years apart for the timeframes 1998 to 2002 (early time period) and 2008 to 2012 (recent time period) using specific search terms to identify global health-related publications in otolaryngology. Publications were examined for region of origin, subspecialty, type of publication, and evidence of international collaboration. χ and t test analyses were used to identify trends. In the 1998 to 2002 time period, a total of 26 publications met inclusion criteria for the study, with a mean of 5.2 ± 2.8 publications per year. In the 2008 to 2012 time period, a total of 61 publications met inclusion criteria, with a mean of 12.3 ± 5.6 publications per year. The 235% increase in global health-related publications identified between the two study periods was statistically significant (P = .02). The absolute number of publications in which collaboration occurred between countries increased from three in the early time period to nine the recent time period. There has been a significant increase in the volume of global health-related publications in English language otolaryngology journals over the past decade, providing strong evidence of the increasing trend of global health as an academic pursuit within the field of otolaryngology. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

Living conditions and access to health services by Bolivian immigrants in the city of São Paulo, Brazil.

Science.gov (United States)

Silveira, Cássio; Carneiro Junior, Nivaldo; Ribeiro, Manoel Carlos Sampaio de Almeida; Barata, Rita de Cássia Barradas

2013-10-01

Bolivian immigrants in Brazil experience serious social problems: precarious work conditions, lack of documents and insufficient access to health services. The study aimed to investigate inequalities in living conditions and access to health services among Bolivian immigrants living in the central area of São Paulo, Brazil, using a cross-sectional design and semi-structured interviews with 183 adults. According to the data, the immigrants tend to remain in Brazil, thus resulting in an aging process in the group. Per capita income increases the longer the immigrants stay in the country. The majority have secondary schooling. Work status does not vary according to time since arrival in Brazil. The immigrants work and live in garment sweatshops and speak their original languages. Social networks are based on ties with family and friends. Access to health services shows increasing inclusion in primary care. The authors conclude that the immigrants' social exclusion is decreasing due to greater access to documentation, work (although precarious), and the supply of health services from the public primary care system.

Living conditions and access to health services by Bolivian immigrants in the city of São Paulo, Brazil

Directory of Open Access Journals (Sweden)

Cássio Silveira

2013-10-01

Full Text Available Bolivian immigrants in Brazil experience serious social problems: precarious work conditions, lack of documents and insufficient access to health services. The study aimed to investigate inequalities in living conditions and access to health services among Bolivian immigrants living in the central area of São Paulo, Brazil, using a cross-sectional design and semi-structured interviews with 183 adults. According to the data, the immigrants tend to remain in Brazil, thus resulting in an aging process in the group. Per capita income increases the longer the immigrants stay in the country. The majority have secondary schooling. Work status does not vary according to time since arrival in Brazil. The immigrants work and live in garment sweatshops and speak their original languages. Social networks are based on ties with family and friends. Access to health services shows increasing inclusion in primary care. The authors conclude that the immigrants' social exclusion is decreasing due to greater access to documentation, work (although precarious, and the supply of health services from the public primary care system.

Modularising ontology and designing inference patterns to personalise health condition assessment: the case of obesity.

Science.gov (United States)

Sojic, Aleksandra; Terkaj, Walter; Contini, Giorgia; Sacco, Marco

2016-05-04

The public health initiatives for obesity prevention are increasingly exploiting the advantages of smart technologies that can register various kinds of data related to physical, physiological, and behavioural conditions. Since individual features and habits vary among people, the design of appropriate intervention strategies for motivating changes in behavioural patterns towards a healthy lifestyle requires the interpretation and integration of collected information, while considering individual profiles in a personalised manner. The ontology-based modelling is recognised as a promising approach in facing the interoperability and integration of heterogeneous information related to characterisation of personal profiles. The presented ontology captures individual profiles across several obesity-related knowledge-domains structured into dedicated modules in order to support inference about health condition, physical features, behavioural habits associated with a person, and relevant changes over time. The modularisation strategy is designed to facilitate ontology development, maintenance, and reuse. The domain-specific modules formalised in the Web Ontology Language (OWL) integrate the domain-specific sets of rules formalised in the Semantic Web Rule Language (SWRL). The inference rules follow a modelling pattern designed to support personalised assessment of health condition as age- and gender-specific. The test cases exemplify a personalised assessment of the obesity-related health conditions for the population of teenagers. The paper addresses several issues concerning the modelling of normative concepts related to obesity and depicts how the public health concern impacts classification of teenagers according to their phenotypes. The modelling choices regarding the ontology-structure are explained in the context of the modelling goal to integrate multiple knowledge-domains and support reasoning about the individual changes over time. The presented modularisation

Migration and health in an increasingly diverse Europe.

Science.gov (United States)

Rechel, Bernd; Mladovsky, Philipa; Ingleby, David; Mackenbach, Johan P; McKee, Martin

2013-04-06

The share of migrants in European populations is substantial and growing, despite a slowdown in immigration after the global economic crisis. This paper describes key aspects of migration and health in Europe, including the scale of international migration, available data for migrant health, barriers to accessing health services, ways of improving health service provision to migrants, and migrant health policies that have been adopted across Europe. Improvement of migrant health and provision of access for migrants to appropriate health services is not without challenges, but knowledge about what steps need to be taken to achieve these aims is increasing. Copyright © 2013 Elsevier Ltd. All rights reserved.

Housing conditions and mental health of orphans in South Africa.

Science.gov (United States)

Marais, Lochner; Sharp, Carla; Pappin, Michele; Lenka, Molefi; Cloete, Jan; Skinner, Donald; Serekoane, Joe

2013-11-01

Literature from the developed world suggests that poor housing conditions and housing environments contribute to poor mental health outcomes, although research results are mixed. This study investigates the relationship between housing conditions and the socio-emotional health of orphans and vulnerable children (OVC) in South Africa. The results of the study are mainly inconclusive, although it is suggested that methodological considerations play a vital role in explaining the mixed results. However, a positive relationship was found between living in informal settlements and better socio-emotional health of the OVC. We speculate that the historical context of informal settlement formation in South Africa helps to explain this unexpected result. © 2013 Elsevier Ltd. All rights reserved.

[Chronic health conditions related to quality of life for federal civil servants].

Science.gov (United States)

Saraiva, Luciana Eduardo Fernandes; Medeiros, Lays Pinheiro de; Melo, Marjorie Dantas Medeiros; Tiburcio, Manuela Pinto; Costa, Isabelle Katherinne Fernandes; Torres, Gilson de Vasconcelos

2015-06-01

The aim of this study is to correlate the QOL domains of the civil servants to the type and number of chronic health conditions. A transversal, quantitative study, conducted at the Department of Civil Servant Assistance of the Federal University of Rio Grande do Norte with 215 civil servants, during the period from March to May 2011. Among the chronic health conditions studied, there was significant relationship between non-communicable chronic disease and QOL scores, correlating weakly (r civil servants is negatively influenced by chronic health conditions, compromising, in general, their daily work and life activities.

Evaluation of the nervous-psychic working ability of the operators of the Kozloduj NPP concerning their health conditions

International Nuclear Information System (INIS)

Jonkova, A.

1988-01-01

By means of psychological methods the neuroticism and work tiredness in 170 operators from the Kozloduj NPP have been investigated. The distribution of the individuals with work overtiredness according to health conditions and the operative service duration was considered. In 73 operators, who had sufficiently informative complaints of overtiredness, a high incidence of cardiocascular and gastrointestinal diseases, of neuroses and increased neuroticism was established. The relative part of the individuals with overtiredness augmented substantially after 5-year duration service. Since overtiredness is an inadmissible functional condition for operators, its observation in 42,9% of the examined contingent is estimated as a real danger for decrease of the reliability and for worsening of the health conditions

Setting priorities in primary health care - on whose conditions? A questionnaire study

Directory of Open Access Journals (Sweden)

Arvidsson Eva

2012-11-01

Full Text Available Abstract Background In Sweden three key criteria are used for priority setting: severity of the health condition; patient benefit; and cost-effectiveness. They are derived from the ethical principles established by the Swedish parliament 1997 but have been used only to a limited extent in primary care. The aim of this study was to describe and analyse: 1 GPs', nurses', and patients' prioritising in routine primary care 2 The association between the three key priority setting criteria and the overall priority assigned by the GPs and nurses to individual patients. Methods Paired questionnaires were distributed to all patients and the GPs or nurses they had contact with during a 2-week period at four health centres in Sweden. The staff registered the health conditions or health problem, and the planned intervention. Then they estimated the severity of the health condition, the expected patient benefit, and the cost-effectiveness of the planned intervention. Both the staff and the patients reported their overall prioritisation of the patient. In total, 1851 paired questionnaires were collected. Results Compared to the medical staff, the patients assigned relatively higher priority to acute/minor conditions than to preventive check-ups for chronic conditions. Severity of the health condition was the priority setting criterion that had the strongest association with the overall priority for the staff as a whole, but for the GPs it was cost-effectiveness. Conclusions The challenge for primary care providers is to balance the patients' demands with medical needs and cost-effectiveness. Transparent priority setting in primary care might contribute to a greater consensus between GPs and nurses on how to use the key priority setting criteria.

Setting priorities in primary health care--on whose conditions? A questionnaire study.

Science.gov (United States)

Arvidsson, Eva; André, Malin; Borgquist, Lars; Andersson, David; Carlsson, Per

2012-11-26

In Sweden three key criteria are used for priority setting: severity of the health condition; patient benefit; and cost-effectiveness. They are derived from the ethical principles established by the Swedish parliament 1997 but have been used only to a limited extent in primary care. The aim of this study was to describe and analyse: 1) GPs', nurses', and patients' prioritising in routine primary care 2) The association between the three key priority setting criteria and the overall priority assigned by the GPs and nurses to individual patients. Paired questionnaires were distributed to all patients and the GPs or nurses they had contact with during a 2-week period at four health centres in Sweden. The staff registered the health conditions or health problem, and the planned intervention. Then they estimated the severity of the health condition, the expected patient benefit, and the cost-effectiveness of the planned intervention. Both the staff and the patients reported their overall prioritisation of the patient. In total, 1851 paired questionnaires were collected. Compared to the medical staff, the patients assigned relatively higher priority to acute/minor conditions than to preventive check-ups for chronic conditions. Severity of the health condition was the priority setting criterion that had the strongest association with the overall priority for the staff as a whole, but for the GPs it was cost-effectiveness. The challenge for primary care providers is to balance the patients' demands with medical needs and cost-effectiveness. Transparent priority setting in primary care might contribute to a greater consensus between GPs and nurses on how to use the key priority setting criteria.

Working conditions in mid-life and mental health in older ages.

Science.gov (United States)

Wahrendorf, Morten; Blane, David; Bartley, Mel; Dragano, Nico; Siegrist, Johannes

2013-03-01

This article illustrates the importance of previous working conditions during mid-life (between 40 and 55) for mental health among older retired men and women (60 or older) across 13 European countries. We link information on health from the second wave (2006-2007) of the Survey of Health, Ageing and Retirement in Europe (SHARE) with information on respondents' working life collected retrospectively in the SHARELIFE interview (2008-2009). To measure working conditions, we rely on core assumptions of existing theoretical models of work stress (the demand-control-support and the effort-reward imbalance model) and distinguish four types of unhealthy working conditions: (1) a stressful psychosocial work environment (as assessed by the two work stress models) (2) a disadvantaged occupational position throughout the whole period of mid-life, (3) experience of involuntary job loss, and (4) exposure to job instability. Health after labour market exit is measured using depressive symptoms, as measured by the EURO-D depression scale. Main results show that men and women who experienced psychosocial stress at work or had low occupational positions during mid-life had significantly higher probabilities of high depressive symptoms during retirement. Additionally, men with unstable working careers and an involuntary job loss were at higher risks to report high depressive symptoms in later life. These associations remain significant after controlling for workers' health and social position prior mid-life. These findings support the assumption that mental health of retirees who experienced poor working conditions during mid-life is impaired. Copyright © 2012 Elsevier Ltd. All rights reserved.

Dental health state of children living in different anthropogenic condition

Directory of Open Access Journals (Sweden)

M. A. Luchynskyі

2015-11-01

I. Y. Horbachevskyy Ternopil State Medical University of Ministry of Health of Ukraine, Ukraine, Ternopil (Ternopil, Maydan Voli, 1, 46001   Abstract   The purpose of the work is to study dental health of children living in conditions of combined negative impact of natural and technological factors. Materials and methods. It was performed an epidemiological dental examination of 2,551 children aged 6 to 15 years, who settled in different regions of the Precarpathians, in conditions of iodine and fluoride deficiency (plain - 1087 children, foothills - 730 and mountain - 734 children. Results. Comprehensive epidemiological studies found low levels of dental health of children living in different geochemical and anthropogenic conditions of Ivano-Frankivsk region (48,83 ± 0,36% in the general observation, that is not statistically different by regions examination, moreover girls level is lower, than that of boys in examined regions (48,14 ± 0,50 and (49,51 ± 0,52%, respectively. It was founded, that the main diseases, which contribute to the reduction of dental health in children, is dental caries and its complications and abnormalities of dentoalveolar system. It was found, that the frequency and severity of dentoalveolar abnormalities depend on anthropogenic environmental conditions: in children of plain and foothill regions, that suffer from greater anthropogenic pressure, dentoalveolar abnormalities where found in (67,99 ± 1,42 and (65,21 ± 1,76%, against (45,91 ± 1,84% in children of conditionally pure mountain region. These same children also often recorded more severe pathology – combined anomalies (24,09 ± 1,57 and (22,06 ± 1,90%, against (12,17 ± 1,78%, respectively. It was found the connection between the dentoalveolar abnormalities and the presence of caries (r = + 0,95; p <0,01 and periodontal tissue diseases (r = + 0,79; p <0,05.   Keywords: children, dental health, dentoalveolar abnormalities, dental caries, periodontal disease, hypoplasia.

Consumer health organisations for chronic conditions: why do some people access them and others don’t?

Science.gov (United States)

Sav, Adem; McMillan, Sara S; Kelly, Fiona; Whitty, Jennifer A; Kendall, Elizabeth; King, Michelle A; Wheeler, Amanda J

2014-10-01

Consumer health organisations (CHOs), which operate outside the mainstream healthcare system with a specific focus on supporting people to self-manage their health conditions, have become widespread. Yet, there has been little systematic research into CHOs, including their perceived benefits and barriers, which encourage or deter their access by people with a variety of chronic health conditions. This study explored the benefits of CHOs in self-management and also the barriers that inhibit their access, from the perspective of people with chronic conditions and their unpaid carers. In-depth, semi-structured interviews were completed with 97 participants across four regions of Australia. The sample included a high representation of people from culturally and linguistically diverse backgrounds and Aboriginal and Torres Strait Islander people as well as non-indigenous Australians. Three inter-related themes were identified that represented the benefits of involvement and participation in CHOs: knowledge and information, connection and support and experiential learning. However, limited access pathways emerged as a barrier that inhibited a person’s entry into CHOs. Furthermore, the person’s beliefs and experiences about their own health condition(s) also inhibited their continued participation in CHO programmes. Although our findings confirm that CHOs are a valuable resource in alleviating the ‘work of being a patient’ for some people, there seems to be some barriers that prevent their full access and utilisation.Structured integration systems to increase the reliable delivery and accessibility of CHOs are needed to ensure that people who would benefit from accessing them can do so.

Increased prevalence of chronic physical health disorders in Australians with diagnosed mental illness.

Science.gov (United States)

Scott, David; Burke, Karena; Williams, Susan; Happell, Brenda; Canoy, Doreen; Ronan, Kevin

2012-10-01

To compare chronic physical health disorder prevalence amongst Australian adults with and without mental illness. Total n=1,716 participants (58% female) with a mean age of 52 ± 13 years (range: 18 to 89 years) completed an online survey of Australian adults in 2010. Outcome measures including prevalence of chronic physical conditions and self-reported body mass index (BMI) in n=387 (23%) with a self-reported mental illness diagnosis were compared to respondents without mental illness. A significantly higher proportion of participants with mental illness were obese (BMI ≥ 30; 31 vs 24%, p=0.005). Adjusted odds ratios (OR) for coronary heart disease, diabetes, chronic bronchitis or emphysema, asthma, irritable bowel syndrome, and food allergies or intolerances (OR range: 1.54-3.19) demonstrated that chronic physical disorders were significantly more common in participants with a mental illness. Australian adults with a diagnosis for mental illness have a significantly increased likelihood of demonstrating chronic physical health disorders compared to persons without mental illness. Health professionals must be alert to the increased likelihood of comorbid chronic physical disorders in persons with a mental illness and should consider the adoption of holistic approaches when treating those with either a mental or physical illness. © 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia.

Working conditions and public health risks in slaughterhouses in western Kenya.

Science.gov (United States)

Cook, Elizabeth Anne Jessie; de Glanville, William Anson; Thomas, Lian Francesca; Kariuki, Samuel; Bronsvoort, Barend Mark de Clare; Fèvre, Eric Maurice

2017-01-05

Inadequate facilities and hygiene at slaughterhouses can result in contamination of meat and occupational hazards to workers. The objectives of this study were to assess current conditions in slaughterhouses in western Kenya and the knowledge, and practices of the slaughterhouse workers toward hygiene and sanitation. Between February and October 2012 all consenting slaughterhouses in the study area were recruited. A standardised questionnaire relating to facilities and practices in the slaughterhouse was administered to the foreperson at each site. A second questionnaire was used to capture individual slaughterhouse workers' knowledge, practices and recent health events. A total of 738 slaughterhouse workers from 142 slaughterhouses completed questionnaires. Many slaughterhouses had poor infrastructure, 65% (95% CI 63-67%) had a roof, cement floor and walls, 60% (95% CI 57-62%) had a toilet and 20% (95% CI 18-22%) had hand-washing facilities. The meat inspector visited 90% (95% CI 92-95%) of slaughterhouses but antemortem inspection was practiced at only 7% (95% CI 6-8%). Nine percent (95% CI 7-10%) of slaughterhouses slaughtered sick animals. Only half of workers wore personal protective clothing - 53% (95% CI 51-55%) wore protective coats and 49% (95% CI 46-51%) wore rubber boots. Knowledge of zoonotic disease was low with only 31% (95% CI 29-33%) of workers aware that disease could be transmitted from animals. The current working conditions in slaughterhouses in western Kenya are not in line with the recommendations of the Meat Control Act of Kenya. Current facilities and practices may increase occupational exposure to disease or injury and contaminated meat may enter the consumer market. The findings of this study could enable the development of appropriate interventions to minimise public health risks. Initially, improvements need to be made to facilities and practices to improve worker safety and reduce the risk of food contamination. Simultaneously, training

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

was significantly associated with poor self-rated health, cardiovascular disease, diabetes, and migraine. In addition, high perceived stress, physical inactivity, problems with alcohol, and poor sleep demonstrated an indirect effect on the association between loneliness and adverse health conditions. The findings......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...... affect the development of adverse health conditions. The present study was designed to test the explanation proposed by the Loneliness Model. The sample consisted of 8.593 elderly ranging from 65 to 103 years participating in the 2013 Public Health Survey; “How are you?”. Results showed that loneliness...

Out-of-Pocket Expenditures on Complementary Health Approaches Associated with Painful Health Conditions in a Nationally Representative Adult Sample

Science.gov (United States)

Nahin, Richard L.; Stussman, Barbara J.; Herman, Patricia M.

2015-01-01

National surveys suggest that millions of adults in the United States use complementary health approaches such as acupuncture, chiropractic manipulation, and herbal medicines to manage painful conditions such as arthritis, back pain and fibromyalgia. Yet, national and per person out-of-pocket (OOP) costs attributable to this condition-specific use are unknown. In the 2007 National Health Interview Survey, use of complementary health approaches, reasons for this use, and associated OOP costs were captured in a nationally representative sample of 5,467 adults. Ordinary least square regression models that controlled for co-morbid conditions were used to estimate aggregate and per person OOP costs associated with 14 painful health conditions. Individuals using complementary approaches spent a total of $14.9 billion (S.E. $0.9 billion) OOP on these approaches to manage these painful conditions. Total OOP expenditures seen in those using complementary approaches for their back pain ($8.7 billion, S.E. $0.8 billion) far outstripped that of any other condition, with the majority of these costs ($4.7 billion, S.E. $0.4 billion) resulting from visits to complementary providers. Annual condition-specific per-person OOP costs varied from a low of $568 (SE $144) for regular headaches, to a high of $895 (SE $163) for fibromyalgia. PMID:26320946

Stressful working conditions and poor self-rated health among financial services employees

Directory of Open Access Journals (Sweden)

Luiz Sérgio Silva

2012-06-01

Full Text Available OBJECTIVE: To assess the association between exposure to adverse psychosocial working conditions and poor self-rated health among bank employees. METHODS: A cross-sectional study including a sample of 2,054 employees of a government bank was conducted in 2008. Self-rated health was assessed by a single question: "In general, would you say your health is (...." Exposure to adverse psychosocial working conditions was evaluated by the effort-reward imbalance model and the demand-control model. Information on other independent variables was obtained through a self-administered semi-structured questionnaire. A multiple logistic regression analysis was performed and odds ratio calculated to assess independent associations between adverse psychosocial working conditions and poor self-rated health. RESULTS: The overall prevalence of poor self-rated health was 9%, with no significant gender difference. Exposure to high demand and low control environment at work was associated with poor self-rated health. Employees with high effort-reward imbalance and overcommitment also reported poor self-rated health, with a dose-response relationship. Social support at work was inversely related to poor self-rated health, with a dose-response relationship. CONCLUSIONS: Exposure to adverse psychosocial work factors assessed based on the effort-reward imbalance model and the demand-control model is independently associated with poor self-rated health among the workers studied.

Employee responses to health insurance premium increases.

Science.gov (United States)

Goldman, Dana P; Leibowitz, Arleen A; Robalino, David A

2004-01-01

To determine the sensitivity of employees' health insurance decisions--including the decision to not choose health maintenance organization or fee-for-service coverage--during periods of rapidly escalating healthcare costs. A retrospective cohort study of employee plan choices at a single large firm with a "cafeteria-style" benefits plan wherein employees paid all the additional cost of purchasing more generous insurance. We modeled the probability that an employee would drop coverage or switch plans in response to employee premium increases using data from a single large US company with employees across 47 states during the 3-year period of 1989 through 1991, a time of large premium increases within and across plans. Premium increases induced substantial plan switching. Single employees were more likely to respond to premium increases by dropping coverage, whereas families tended to switch to another plan. Premium increases of 10% induced 7% of single employees to drop or severely cut back on coverage; 13% to switch to another plan; and 80% to remain in their existing plan. Similar figures for those with family coverage were 11%, 12%, and 77%, respectively. Simulation results that control for known covariates show similar increases. When faced with a dramatic increase in premiums--on the order of 20%--nearly one fifth of the single employees dropped coverage compared with 10% of those with family coverage. Employee coverage decisions are sensitive to rapidly increasing premiums, and single employees may be likely to drop coverage. This finding suggests that sustained premium increases could induce substantial increases in the number of uninsured individuals.

Predictive modelling: parents’ decision making to use online child health information to increase their understanding and/or diagnose or treat their child’s health

Directory of Open Access Journals (Sweden)

Walsh Anne M

2012-12-01

Full Text Available Abstract Background The quantum increases in home Internet access and available online health information with limited control over information quality highlight the necessity of exploring decision making processes in accessing and using online information, specifically in relation to children who do not make their health decisions. The aim of this study was to understand the processes explaining parents’ decisions to use online health information for child health care. Methods Parents (N = 391 completed an initial questionnaire assessing the theory of planned behaviour constructs of attitude, subjective norm, and perceived behavioural control, as well as perceived risk, group norm, and additional demographic factors. Two months later, 187 parents completed a follow-up questionnaire assessing their decisions to use online information for their child’s health care, specifically to 1 diagnose and/or treat their child’s suspected medical condition/illness and 2 increase understanding about a diagnosis or treatment recommended by a health professional. Results Hierarchical multiple regression showed that, for both behaviours, attitude, subjective norm, perceived behavioural control, (less perceived risk, group norm, and (non medical background were the significant predictors of intention. For parents’ use of online child health information, for both behaviours, intention was the sole significant predictor of behaviour. The findings explain 77% of the variance in parents’ intention to treat/diagnose a child health problem and 74% of the variance in their intentions to increase their understanding about child health concerns. Conclusions Understanding parents’ socio-cognitive processes that guide their use of online information for child health care is important given the increase in Internet usage and the sometimes-questionable quality of health information provided online. Findings highlight parents’ thirst for information; there is an

Health conditions of inmates in Italy.

Science.gov (United States)

Voller, Fabio; Silvestri, Caterina; Martino, Gianrocco; Fanti, Eleonora; Bazzerla, Giorgio; Ferrari, Fabio; Grignani, Marco; Libianchi, Sandro; Pagano, Antonio Maria; Scarpa, Franco; Stasi, Cristina; Di Fiandra, Teresa

2016-11-16

Several studies have shown that prison is characterized by a higher prevalence of chronic diseases than unconfined settings. The aim of this study was to describe the characteristics and health of inmates, focusing on internal diseases. We designed a specific clinical record using the Python programming language. We considered all of the diagnoses according to the ICD-9-CM. Of a total of 17,086 inmates, 15,751 were enrolled in our study (M = 14,835; F = 869), corresponding to 92.2% of the entire inmate population (mean age of 39.6 years). The project involved a total of 57 detention facilities in six Italian regions (for a total of 28% of all detainees in Italy), as counted in a census taken on February 3, 2014. From the entire study sample, 32.5% of prisoners did not present any disorders, while 67.5% suffered from at least one disease. The most frequent pathologies were psychiatric (41.3%), digestive (14.5%), infectious (11.5%), cardiovascular (11.4%), endocrine, metabolic, and immune (8.6%), and respiratory (5.4%). The findings showed that a large number of detainees were affected by several chronic conditions such as hypertension, dyslipidemia and type 2 diabetes mellitus, with an unusually high prevalence for such a young population. Therefore, a series of preventive measures is recommended to strengthen the entire care process and improve the health and living conditions of prisoners.

Health conditions of inmates in Italy

Directory of Open Access Journals (Sweden)

Fabio Voller

2016-11-01

Full Text Available Abstract Background Several studies have shown that prison is characterized by a higher prevalence of chronic diseases than unconfined settings. The aim of this study was to describe the characteristics and health of inmates, focusing on internal diseases. Methods We designed a specific clinical record using the Python programming language. We considered all of the diagnoses according to the ICD-9-CM. Results Of a total of 17,086 inmates, 15,751 were enrolled in our study (M = 14,835; F = 869, corresponding to 92.2% of the entire inmate population (mean age of 39.6 years. The project involved a total of 57 detention facilities in six Italian regions (for a total of 28% of all detainees in Italy, as counted in a census taken on February 3, 2014. From the entire study sample, 32.5% of prisoners did not present any disorders, while 67.5% suffered from at least one disease. The most frequent pathologies were psychiatric (41.3%, digestive (14.5%, infectious (11.5%, cardiovascular (11.4%, endocrine, metabolic, and immune (8.6%, and respiratory (5.4%. Conclusion The findings showed that a large number of detainees were affected by several chronic conditions such as hypertension, dyslipidemia and type 2 diabetes mellitus, with an unusually high prevalence for such a young population. Therefore, a series of preventive measures is recommended to strengthen the entire care process and improve the health and living conditions of prisoners.

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…

The effect of acceptance training on psychological and physical health outcomes in elders with chronic conditions.

Science.gov (United States)

McDonald, Patricia E; Zauszniewski, Jaclene A; Bekhet, Abir K; DeHelian, Laura; Morris, Diana L

2011-12-01

This pilot trial investigated the short and long-term effects of Acceptance Training (ACT) intervention on acceptance, perceived health, functional status, anxiety, and depression in elders with chronic conditions living in retirement communities (RCs). The ACT intervention combined Rational Emotive Behavior Therapy with music, relaxation, and guided imagery during six weekly 2-hour sessions. Face-to-face interviews were conducted with 16 African-American and 46 White elders across four data collection points in six randomly selected RCs using well-established measures of perceived health, functional status, anxiety, and depression, and a measure of acceptance of chronic conditions adapted from a previous measure of acceptance of diabetes. While changes were found in perceived health, functional status, anxiety, and depression, the most significant changes occurred in the elders' acceptance of chronic conditions immediately after the intervention (t = -2.62, p < .02), and these changes persisted for 6 and 12 weeks (t's = -2.74, -3.32, p's < .01), respectively. Although a 40% attrition rate reduced the sample size from 62 (N = 62) to 37 (N = 37), the significant increases in acceptance over time provide initial evidence for the fidelity of the ACT intervention.

Use of Electronic Health Records and Administrative Data for Public Health Surveillance of Eye Health and Vision-Related Conditions

Science.gov (United States)

Elliott, Amanda; Davidson, Arthur; Lum, Flora; Chiang, Michael; Saaddine, Jinan B; Zhang, Xinzhi; Crews, John E.; Chou, Chiu-Fang

2014-01-01

Purpose To discuss the current trend toward greater use of electronic health records and how these records could enhance public health surveillance of eye health and vision-related conditions. Methods We describe three currently available sources of electronic health data (Kaiser Permanente, the Veterans Health Administration, and the Centers for Medicare & Medicaid Services) and how these sources can contribute to a comprehensive vision and eye health surveillance system. Results Each of the three sources of electronic health data can contribute meaningfully to a comprehensive vision and eye health surveillance system, but none currently provide all the information required. The use of electronic health records for vision and eye health surveillance has both advantages and disadvantages. Conclusions Electronic health records may provide additional information needed to create a comprehensive vision and eye health surveillance system. Recommendations for incorporating electronic health records into such a system are presented. PMID:23158225

Self-management support and training for patients with chronic and complex conditions improves health-related behaviour and health outcomes.

Science.gov (United States)

Harvey, Peter W; Petkov, John N; Misan, Gary; Fuller, Jeffrey; Battersby, Malcolm W; Cayetano, Teofilo N; Warren, Kate; Holmes, Paul

2008-05-01

The Sharing Health Care SA chronic disease self-management (CDSM) project in rural South Australia was designed to assist patients with chronic and complex conditions (diabetes, cardiovascular disease and arthritis) to learn how to participate more effectively in the management of their condition and to improve their self-management skills. Participants with chronic and complex conditions were recruited into the Sharing Health Care SA program and offered a range of education and support options (including a 6-week peer-led chronic disease self-management program) as part of the Enhanced Primary Care care planning process. Patient self-reported data were collected at baseline and subsequent 6-month intervals using the Partners in Health (PIH) scale to assess self-management skill and ability for 175 patients across four data collection points. Health providers also scored patient knowledge and self-management skills using the same scale over the same intervals. Patients also completed a modified Stanford 2000 Health Survey for the same time intervals to assess service utilisation and health-related lifestyle factors. Results show that both mean patient self-reported PIH scores and mean health provider PIH scores for patients improved significantly over time, indicating that patients demonstrated improved understanding of their condition and improved their ability to manage and deal with their symptoms. These results suggest that involvement in peer-led self-management education programs has a positive effect on patient self-management skill, confidence and health-related behaviour.

[The development of the public health system between an increasing market orientation (commercialisation) and social responsibility].

Science.gov (United States)

Trabert, G

2008-02-01

The development of the public health system between an increasing market orientation (commercialisation) and social responsibility is critically reflected by examining the medical care of those who are deprived. Poverty in Germany is dramatically increasing. There are confirmed findings on the correlation of being poor and being ill. Poverty leads to an increased number of cases of illness and a higher mortality rate. And vice versa, chronic illnesses very often cause impoverishment. This correlation has largely been ignored not only by the public but also by experts, especially when public health-care issues are on the political agenda. With reference to the current discussion about public health-care and the widespread disregard of the living conditions of the poor, the categories of "reasonable behaviour" (Kant) and "communicative behaviour" (Habermas) are reflected on in a philosophical excursion. Further interest groups affecting the political sphere, such as the pharmaceutical industry, the medical profession, patients and scientists are also examined with regard to public health-care. What are the premises of a health-care discussion that is controlled by economic considerations, particularly when keeping in mind the humanistic and Christian ethics of our society? And what does this mean for our responsibility for those who are handicapped and are in need of our help? Do decision makers and participants of the health-care discussion satisfy these ethical challenges? And what are the effects of the so-called "social peace" on social cooperation and economic power of a country? The increasing market orientation (commercialisation) of the public health sector can only be accepted on the basis of practiced humanity and social responsibility. In the light of a human public health-care, deprived people are in need of our solidarity.

Macroeconomic policies and increasing social-health inequality in Iran.

Science.gov (United States)

Zaboli, Rouhollah; Seyedin, Seyed Hesam; Malmoon, Zainab

2014-08-01

Health is a complex phenomenon that can be studied from different approaches. Despite a growing research in the areas of Social Determinants of Health (SDH) and health equity, effects of macroeconomic policies on the social aspect of health are unknown in developing countries. This study aimed to determine the effect of macroeconomic policies on increasing of the social-health inequality in Iran. This study was a mixed method research. The study population consisted of experts dealing with social determinants of health. A purposive, stratified and non-random sampling method was used. Semi-structured interviews were conducted to collect the data along with a multiple attribute decision-making method for the quantitative phase of the research in which the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) was employed for prioritization. The NVivo and MATLAB softwares were used for data analysis. Seven main themes for the effect of macroeconomic policies on increasing the social-health inequality were identified. The result of TOPSIS approved that the inflation and economic instability exert the greatest impact on social-health inequality, with an index of 0.710 and the government policy in paying the subsidies with a 0.291 index has the lowest impact on social-health inequality in the country. It is required to invest on the social determinants of health as a priority to reduce health inequality. Also, evaluating the extent to which the future macroeconomic policies impact the health of population is necessary.

Relating Health Locus of Control to Health Care Use, Adherence, and Transition Readiness Among Youths With Chronic Conditions, North Carolina, 2015.

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Nazareth, Meaghan; Richards, Jordan; Javalkar, Karina; Haberman, Cara; Zhong, Yi; Rak, Eniko; Jain, Nina; Ferris, Maria; van Tilburg, Miranda A L

2016-07-21

Health locus of control refers to the belief that health is in one's control (internal control) or is not in one's control (external control). Among adults, external locus of control is associated with negative health outcomes, whereas internal locus of control is associated with favorable outcomes. Few studies examined these associations among youths. The objective of our study was to determine how locus of control relates to health care use, medication adherence, missed school, and readiness for transition to adult medical care for youths with chronic conditions. Participants at a camp for youths aged 6 to 17 years with chronic health conditions completed a survey measuring locus of control, readiness for transition to adult care, and medication adherence. Their parents completed a separate part of the survey about health care use and missed school days in the past year. A total of 163 youths completed the survey (78.5% white; 52.1% female; mean age, 12.3 y). Internal locus of control (β = 0.196; P = .013) and external Doctor locus of control with doctors controlling disease (β = 0.181; P = .025) were positively associated with transition readiness. External control by chance or with others controlling disease was negatively associated with transition readiness (β = -0.248; P = .002) and positively associated with emergency department visits (β = 0.225; P = .004) and with number of hospital inpatient nights at hospital (β = 0.166; P = .04). Adolescents with external control of their health by chance or by other people are at increased risk for negative health outcomes and may fail to develop the self-management skills needed for successful transitioning to adult care. Future studies should examine effects of changes in locus of control on health outcomes among youths.

Revisiting the impact of macroeconomic conditions on health behaviours.

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Di Pietro, Giorgio

2018-02-01

This paper estimates the average population effect of macroeconomic conditions on health behaviours accounting for the heterogeneous impact of the business cycle on individuals. While previous studies use models relying on area-specific unemployment rates to estimate this average effect, this paper employs a model based on area-specific unemployment rates by gender and age group. The rationale for breaking down unemployment rates is that the severity of cyclical upturns and downturns does not only significantly vary across geographical areas, but also across gender and age. The empirical analysis uses microdata from the Italian Multipurpose Household Survey on Everyday Life Issues. The estimates suggest that models employing aggregated and disaggregated unemployment rate measures as a proxy for the business cycle produce similar findings for some health behaviours (such as smoking), whereas different results are obtained for others. While using unemployment rates by gender and age group, fruits and/or vegetables consumption turns out to be procyclical (a 1pp increase in this unemployment rate decreases the probability of consuming at least five daily fruit and/or vegetable servings by 0.0016pp), the opposite effect, though statistically insignificant, is observed once general unemployment rates are used. While both models conclude that physical activity declines during economic downturns, the size of the procyclical effect is much smaller when employing disaggregated rather than aggregated unemployment rates (a 1pp increase in the unemployment rate by gender and age group decreases the probability of doing any physical activity by 0.0017pp). Copyright © 2017 Elsevier B.V. All rights reserved.

Gender differences of the influential factors on the mental health condition of teachers in the A university.

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Kataoka, Mika; Ozawa, Kazuhiro; Tanioka, Tetsuya; Okuda, Kikuko; Chiba, Shinichi; Tomotake, Masahito; King, Beth

2015-01-01

The purpose of this research was to investigate the gender differences of the influential factors on the mental health condition among university teachers in the A university in Japan. A questionnaire survey was mailed to 924 university teachers in Japan, with a survey return rate of 43.8% (N=405). The General Health Questionnaire 28 (GHQ-28), Multidimensional Scale of Perceived Social Support (MSPSS), the Japanese version of the Brief Coping Orientation to Problems Experienced (COPE) and the Work Situation Questionnaire (WSQ) developed by the authors were administered to subjects. The GHQ-28 total score and all of sub-score of the woman was significantly higher than men. In the correlated factor of mental health, level of job satisfaction and job control, social support of significant others was observed in the both sexes. However, gender differences was observed in the coping style. Some copings including self-distraction and self-blame were related to the men, but the woman was related to the substance use. University teachers had some gender differences in the factors affecting their mental health condition. In order to improve university teacher's mental health condition, it is necessary to increase their level of job satisfaction and feeling of job control in the workplace. Especially, it was considered women's coping using substance use was important.

Study of the Working Conditions of Health Extension Workers in ...

African Journals Online (AJOL)

Coverage: 2005-2009” of which “The Health Extension Program (HEP)” is a major component”. Objective: The study focuses on the first batch of Health Extension Workers (HEWs) with the overall objective of assessing the working conditions of HEWs and their job satisfaction. Methods: An in-depth field study was carried ...

System impact research - increasing public health and health care system performance.

Science.gov (United States)

Malmivaara, Antti

2016-01-01

Interventions directed to system features of public health and health care should increase health and welfare of patients and population. To build a new framework for studies aiming to assess the impact of public health or health care system, and to consider the role of Randomized Controlled Trials (RCTs) and of Benchmarking Controlled Trials (BCTs). The new concept is partly based on the author's previous paper on the Benchmarking Controlled Trial. The validity and generalizability considerations were based on previous methodological studies on RCTs and BCTs. The new concept System Impact Research (SIR) covers all the studies which aim to assess the impact of the public health system or of the health care system on patients or on population. There are two kinds of studies in System Impact Research: Benchmarking Controlled Trials (observational) and Randomized Controlled Trials (experimental). The term impact covers in particular accessibility, quality, effectiveness, safety, efficiency, and equality. System Impact Research - creating the scientific basis for policy decision making - should be given a high priority in medical, public health and health economic research, and should also be used for improving performance. Leaders at all levels of health and social care can use the evidence from System Impact Research for the benefit of patients and population. Key messages The new concept of SIR is defined as a research field aiming at assessing the impacts on patients and on populations of features of public health and health and social care systems or of interventions trying to change these features. SIR covers all features of public health and health and social care system, and actions upon these features. The term impact refers to all effects caused by the public health and health and social care system or parts of it, with particular emphasis on accessibility, quality, effectiveness, adverse effects, efficiency, and equality of services. SIR creates the

Air conditioning systems as non-infectious health hazards inducing acute respiratory symptoms.

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Gerber, Alexander; Fischer, Axel; Willig, Karl-Heinz; Groneberg, David A

2006-04-01

Chronic and acute exposure to toxic aerosols belongs to frequent causes of airway diseases. However, asthma attacks due to long-distance inhalative exposure to organic solvents, transmitted via an air condition system, have not been reported so far. The present case illustrates the possibility of air conditioning systems as non-infectious health hazards in occupational medicine. So far, only infectious diseases such as legionella pneumophila pneumonia have commonly been associated to air-conditioning exposures but physicians should be alert to the potential of transmission of toxic volatile substances via air conditioning systems. In view of the events of the 11th of September 2001 with a growing danger of large building terrorism which may even use air conditioning systems to transmit toxins, facility management security staff should be alerted to possible non-infectious toxic health hazards arising from air-conditioning systems.

Health trends in the wake of the financial crisis-increasing inequalities?

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Nelson, Kenneth; Tøge, Anne Grete

2017-08-01

The financial crisis that hit Europe in 2007-2008 and the corresponding austerity policies have generated concern about increasing health inequalities, although impacts have been less salient than initially expected. One explanation could be that health inequalities emerged first a few years into the crisis. This study investigates health trends in the wake of the financial crisis and analyses health inequalities across a number of relevant population subgroups, including those defined by employment status, age, family type, gender, and educational attainment. This study uses individual-level panel data (EU-SILC, 2010-2013) to investigate trends in self-rated health. By applying individual fixed effects regression models, the study estimates the average yearly change in self-rated health for persons aged 15-64 years in 28 European countries. Health inequalities are investigated using stratified analyses. Unemployed respondents, particularly those who were unemployed in all years of observation, had a steeper decline in self-rated health than the employed. Respondents of prime working age (25-54 years) had a steeper decline than their younger (15-24) and older (55-64) counterparts, while single parents had a more favorable trend in self-rated health than dual parents. We did not observe any increasing health inequalities based on gender or educational attainment. Health inequalities increased in the wake of the financial crisis, especially those associated with employment status, age, and family type. We did not observe increasing health inequalities in terms of levels of educational attainment and gender.

Oral Health Conditions of Older People: Focus on the Balkan Countries

Directory of Open Access Journals (Sweden)

Chatzopoulos Georgios S.

2015-07-01

Full Text Available Oral health plays a pivotal role in general health, especially in older people. Oral diseases may affect the development of systemic conditions, such as diabetes mellitus, cardiovascular disease, stroke and hypertension. The most important oral health conditions that have been recorded in dental literature for older population include tooth loss, dental caries, periodontal diseases, xerostomia (dry mouth and oral cancer. Edentulism influences social life, either causing aesthetic problems or affecting functional abilities, such as speaking, chewing and eating. Dental caries in older people is similar to that in people in their thirties. Socio-economic status and living area play a key role in the development of dental caries. In addition, the accumulation of several risk factors, such as plaque or systemic diseases, acts synergistically in the onset of periodontal disease in seniors. Furthermore, older people, mainly due to their medications, exhibit a reduced amount of saliva. Xerostomia causes difficulties in chewing, speaking and swallowing, and it has a substantial impact on older people’s lives. The prevalence of oral cancer is 1-10 per 100,000 patients, and several factors (smoking, alcohol, education, economic status play crucial role. Limited data exists today that evaluates oral health conditions of seniors in the Balkan countries. Aging and socio-economic status of seniors in the Balkans are significantly associated with oral health problems.

Risk and resilience: health inequalities, working conditions and sickness benefit arrangements: an analysis of the 2010 European Working Conditions survey.

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van der Wel, Kjetil A; Bambra, Clare; Dragano, Nico; Eikemo, Terje A; Lunau, Thorsten

2015-11-01

In this article we ask whether the level of sickness benefit provision protects the health of employees, particularly those who are most exposed to hazardous working conditions or who have a little education. The study uses the European Working Condition Survey that includes information on 20,626 individuals from 28 countries. Health was measured by self-reported mental wellbeing and self-rated general health. Country-level sickness benefit provision was constructed using spending data from Eurostat. Group-specific associations were fitted using cross-level interaction terms between sickness benefit provision and physical and psychosocial working conditions respectively, as well as those with little education. The mental wellbeing of employees exposed to psychosocial job strain and physical hazards, or who had little education, was better in countries that offer more generous sickness benefit. These results were found in both men and women and were robust to the inclusion of GDP and country fixed effects. In the analyses of self-reported general health, few group-specific associations were found. This article concludes that generous sickness benefit provision may strengthen employee's resilience against mental health risks at work and risks associated with little education. Consequently, in countries with a generous provision of sickness benefit, social inequalities in mental health are smaller. © 2015 Foundation for the Sociology of Health & Illness.

IS WORK-FAMILY CONFLICT A MULTILEVEL STRESSOR LINKING JOB CONDITIONS TO MENTAL HEALTH? EVIDENCE FROM THE WORK, FAMILY AND HEALTH NETWORK.

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Moen, Phyllis; Kaduk, Anne; Kossek, Ellen Ernst; Hammer, Leslie; Buxton, Orfeu M; O'Donnell, Emily; Almeida, David; Fox, Kimberly; Tranby, Eric; Oakes, J Michael; Casper, Lynne

Most research on the work conditions and family responsibilities associated with work-family conflict and other measures of mental health uses the individual employee as the unit of analysis. We argue that work conditions are both individual psychosocial assessments and objective characteristics of the proximal work environment, necessitating multilevel analyses of both individual- and team-level work conditions on mental health. This study uses multilevel data on 748 high-tech professionals in 120 teams to investigate relationships between team- and individual-level job conditions, work-family conflict, and four mental health outcomes (job satisfaction, emotional exhaustion, perceived stress, and psychological distress). We find that work-to-family conflict is socially patterned across teams, as are job satisfaction and emotional exhaustion. Team-level job conditions predict team-level outcomes, while individuals' perceptions of their job conditions are better predictors of individuals' work-to-family conflict and mental health. Work-to-family conflict operates as a partial mediator between job demands and mental health outcomes. Our findings suggest that organizational leaders concerned about presenteeism, sickness absences, and productivity would do well to focus on changing job conditions in ways that reduce job demands and work-to-family conflict in order to promote employees' mental health. We show that both work-to-family conflict and job conditions can be fruitfully framed as team characteristics, shared appraisals held in common by team members. This challenges the framing of work-to-family conflict as a "private trouble" and provides support for work-to-family conflict as a structural mismatch grounded in the social and temporal organization of work.

Modelling Conditions and Health Care Processes in Electronic Health Records: An Application to Severe Mental Illness with the Clinical Practice Research Datalink.

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Olier, Ivan; Springate, David A; Ashcroft, Darren M; Doran, Tim; Reeves, David; Planner, Claire; Reilly, Siobhan; Kontopantelis, Evangelos

2016-01-01

The use of Electronic Health Records databases for medical research has become mainstream. In the UK, increasing use of Primary Care Databases is largely driven by almost complete computerisation and uniform standards within the National Health Service. Electronic Health Records research often begins with the development of a list of clinical codes with which to identify cases with a specific condition. We present a methodology and accompanying Stata and R commands (pcdsearch/Rpcdsearch) to help researchers in this task. We present severe mental illness as an example. We used the Clinical Practice Research Datalink, a UK Primary Care Database in which clinical information is largely organised using Read codes, a hierarchical clinical coding system. Pcdsearch is used to identify potentially relevant clinical codes and/or product codes from word-stubs and code-stubs suggested by clinicians. The returned code-lists are reviewed and codes relevant to the condition of interest are selected. The final code-list is then used to identify patients. We identified 270 Read codes linked to SMI and used them to identify cases in the database. We observed that our approach identified cases that would have been missed with a simpler approach using SMI registers defined within the UK Quality and Outcomes Framework. We described a framework for researchers of Electronic Health Records databases, for identifying patients with a particular condition or matching certain clinical criteria. The method is invariant to coding system or database and can be used with SNOMED CT, ICD or other medical classification code-lists.

Integrating structural health and condition monitoring

DEFF Research Database (Denmark)

May, Allan; Thöns, Sebastian; McMillan, David

2015-01-01

window’ allowing for the possible detection of faults up to 6 months in advance. The SHM system model uses a reduction in the probability of failure factor to account for lower modelling uncertainties. A case study is produced that shows a reduction in operating costs and also a reduction in risk......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...

Dr Google and the consumer: a qualitative study exploring the navigational needs and online health information-seeking behaviors of consumers with chronic health conditions.

Science.gov (United States)

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

2014-12-02

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 literature exploring the navigational needs of consumers with regards to accessing online health information. Further, existing interventions appear to be didactic in nature, and it is unclear whether such interventions appeal to consumers' needs. Our goal was to explore the navigational needs of consumers with chronic health conditions in finding online health information within the broader context of consumers' online health information-seeking behaviors. Potential barriers to online navigation were also identified. Semistructured interviews were conducted with adult consumers who reported using the Internet for health information and had at least one chronic health condition. Participants were recruited from nine metropolitan community pharmacies within Western Australia, as well as through various media channels. Interviews were audio-recorded, transcribed verbatim, and then imported into QSR NVivo 10. Two established approaches to thematic analysis were adopted. First, a data-driven approach was used to minimize potential bias in analysis and improve construct and criterion validity. A theory-driven approach was subsequently used to confirm themes identified by the former approach and to ensure identified themes were relevant to the objectives. Two levels of analysis were conducted for both data-driven and theory-driven approaches: manifest-level analysis, whereby face-value themes were identified, and latent-level analysis, whereby underlying concepts were identified. We conducted 17

Health-related quality of life and working conditions among nursing providers.

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Silva, Amanda Aparecida; Souza, José Maria Pacheco de; Borges, Flávio Notarnicola da Silva; Fischer, Frida Marina

2010-08-01

To evaluate working conditions associated with health-related quality of life (HRQL) among nursing providers. Cross-sectional study conducted in a university hospital in the city of São Paulo, Southeastern Brazil, during 2004-2005. The study sample comprised 696 registered nurses, nurse technicians and nurse assistants, predominantly females (87.8%), who worked day and/or night shifts. Data on sociodemographic information, working and living conditions, lifestyles, and health symptoms were collected using self-administered questionnaires. The following questionnaires were also used: Job Stress Scale, Effort-Reward Imbalance (ERI) and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Ordinal logistic regression analysis using proportional odds model was performed to evaluate each dimension of the SF-36. Around 22% of the sample was found to be have high strain and 8% showed an effort-reward imbalance at work. The dimensions with the lowest mean scores in the SF-36 were vitality, bodily pain and mental health. High-strain job, effort-reward imbalance (ERI>1.01), and being a registered nurse were independently associated with low scores on the role emotional dimension. Those dimensions associated to mental health were the ones most affected by psychosocial factors at work. Effort-reward imbalance was more associated with health than high-strain (high demand and low control). The study results suggest that the joint analysis of psychosocial factors at work such as effort-reward imbalance and demand-control can provide more insight to the discussion of professional roles, working conditions and HRQL of nursing providers.

Demand-specific work ability, poor health and working conditions in middle-aged full-time employees

DEFF Research Database (Denmark)

Nabe-Nielsen, Kirsten; Thielen, Karsten; Nygaard, Else

2014-01-01

-sectional questionnaire data from 3381 full-time employees responding to questions about vocational education, job demands and social support (working conditions), musculoskeletal pain (MSP) and major depression (MD) (poor health) and seven questions about difficulty managing different job demands (reduced demand......We investigated the prevalence of reduced demand-specific work ability, its association with age, gender, education, poor health, and working conditions, and the interaction between poor health and working conditions regarding reduced demand-specific work ability. We used cross...... was associated with six measures of reduced demand-specific work ability. We found no interaction between working conditions and poor health regarding reduced demand-specific work ability....

"Broken windows": Relationship between neighborhood conditions and behavioral health among low-income African American adolescents.

Science.gov (United States)

Voisin, Dexter R; Kim, Dong Ha

2018-03-01

This study explored the association between neighborhood conditions and behavioral health among African American youth. Cross-sectional data were collected from 683 African American youth from low-income communities. Measures for demographics, neighborhood conditions (i.e. broken windows index), mental health, delinquency, substance use, and sexual risk behaviors were assessed. Major findings indicated that participants who reported poorer neighborhood conditions compared to those who lived in better living conditions were more likely to report higher rates of mental health problems, delinquency, substance use, and unsafe sexual behaviors. Environmental factors need to be considered when addressing the behavioral health of low-income African American youth.

HEALTH CONDITION OF THE FIRST YEAR INFANTS IN MIGRANT FAMILIES

Directory of Open Access Journals (Sweden)

V.Yu. Albitsky

2006-01-01

Full Text Available A complex clinical social study of health status, life style and conditions of infants aged 3 months to 1 year in migrant families living in Pushkino district of Moscow region for more than 2 years was carried out. The study has revealed that children in migrant families fall behind in physical development, most of them show a delay of psychomotor development, the level of revealed pathology is significantly higher vs. children of famia lies permanently residing in the area. The data acquired indicate the need of intent attention to the children in migrant families from both medical and social authorities.Key words: children, health status, physical development, children's condition.

Public-private partnership role in increasing the quality of the health insurance services

Directory of Open Access Journals (Sweden)

Dan CONSTANTINESCU

2012-10-01

Full Text Available In a context in which the social politics tend to become an optimization instrument for adapting the social security system to the market’s forces, and the talk of some analysts about reinventing the European social model, the partnership between the public sector and the private one in the social domain presumes, besides a tight collaboration, a combination of advantages specific to the private sector, more competitive and efficient, with the ones from the public sector, more responsible toward the society regarding the public money spending. The existence of the private health insurances cannot be tied, causally, to a social politics failure, reason for which they don’t intend, usually, to replace the public insurances, but rather, to offer a complementary alternative for them. In such a context, the public-private partnership’s goal regards both increasing the insurant’s satisfaction and increasing his/her access degree to services, and increasing the investments profitability made by the insurant and insurer. We are facing thus a mixed competitive system that combines the peculiarities of the public and private sectors. Interesting is the fact that, although the different meanings for the quality term may generate some problems regarding implementing quality management in the two health insurance sectors, the experts in the area reckon that establishing a good relationship between public buyers and private providers of healthcare can reduce the costs of public health programs. An essential condition for operating efficiently the partnership model is defining correctly the basic medical services packet financed by the public budget. Which doesn’t exclude the possibility of administrating by the private insurers, the sums of money gathered from the employees and employers contributions to the health fund, as a recently initiated project of law intends to do in Romania.

Disparities in chronic conditions and health status by type of disability.

Science.gov (United States)

Horner-Johnson, Willi; Dobbertin, Konrad; Lee, Jae Chul; Andresen, Elena M

2013-10-01

Prior research has established health disparities between people with and without disabilities. However, disparities within the disability population, such as those related to type of disability, have been much less studied. To examine differences in chronic conditions and health status between subgroups of people with different types of disability. We analyzed Medical Expenditure Panel Survey annual data files from 2002 to 2008. Logistic regression analyses considered disparity from three perspectives: 1) basic differences, unadjusted for other factors; 2) controlling for key demographic and health covariates; and 3) controlling for a larger set of demographic variables and socioeconomic status as well as health and access to healthcare. Individuals with vision, physical, cognitive, or multiple disability types fared worse than people with hearing impairment on most health outcomes. This was most consistently true for people with multiple disabilities. Even when all covariates were accounted for, people with multiple types of disability were significantly more likely (p disability types were reduced when controlling for other factors, some differences remained significant. This argues for a more individualized approach to understanding and preventing chronic conditions and poor health in specific disability groups. Copyright © 2013 Elsevier Inc. All rights reserved.

IS WORK-FAMILY CONFLICT A MULTILEVEL STRESSOR LINKING JOB CONDITIONS TO MENTAL HEALTH? EVIDENCE FROM THE WORK, FAMILY AND HEALTH NETWORK

Science.gov (United States)

Moen, Phyllis; Kaduk, Anne; Kossek, Ellen Ernst; Hammer, Leslie; Buxton, Orfeu M.; O’Donnell, Emily; Almeida, David; Fox, Kimberly; Tranby, Eric; Oakes, J. Michael; Casper, Lynne

2015-01-01

Purpose Most research on the work conditions and family responsibilities associated with work-family conflict and other measures of mental health uses the individual employee as the unit of analysis. We argue that work conditions are both individual psychosocial assessments and objective characteristics of the proximal work environment, necessitating multilevel analyses of both individual- and team-level work conditions on mental health. Methodology/approach This study uses multilevel data on 748 high-tech professionals in 120 teams to investigate relationships between team- and individual-level job conditions, work-family conflict, and four mental health outcomes (job satisfaction, emotional exhaustion, perceived stress, and psychological distress). Findings We find that work-to-family conflict is socially patterned across teams, as are job satisfaction and emotional exhaustion. Team-level job conditions predict team-level outcomes, while individuals’ perceptions of their job conditions are better predictors of individuals’ work-to-family conflict and mental health. Work-to-family conflict operates as a partial mediator between job demands and mental health outcomes. Practical implications Our findings suggest that organizational leaders concerned about presenteeism, sickness absences, and productivity would do well to focus on changing job conditions in ways that reduce job demands and work-to-family conflict in order to promote employees’ mental health. Originality/value of the chapter We show that both work-to-family conflict and job conditions can be fruitfully framed as team characteristics, shared appraisals held in common by team members. This challenges the framing of work-to-family conflict as a “private trouble” and provides support for work-to-family conflict as a structural mismatch grounded in the social and temporal organization of work. PMID:25866431

The effects on health behavior and health outcomes of Internet-based asynchronous communication between health providers and patients with a chronic condition: a systematic review.

Science.gov (United States)

de Jong, Catharina Carolina; Ros, Wynand Jg; Schrijvers, Guus

2014-01-16

In support of professional practice, asynchronous communication between the patient and the provider is implemented separately or in combination with Internet-based self-management interventions. This interaction occurs primarily through electronic messaging or discussion boards. There is little evidence as to whether it is a useful tool for chronically ill patients to support their self-management and increase the effectiveness of interventions. The aim of our study was to review the use and usability of patient-provider asynchronous communication for chronically ill patients and the effects of such communication on health behavior, health outcomes, and patient satisfaction. A literature search was performed using PubMed and Embase. The quality of the articles was appraised according to the National Institute for Health and Clinical Excellence (NICE) criteria. The use and usability of the asynchronous communication was analyzed by examining the frequency of use and the number of users of the interventions with asynchronous communication, as well as of separate electronic messaging. The effectiveness of asynchronous communication was analyzed by examining effects on health behavior, health outcomes, and patient satisfaction. Patients' knowledge concerning their chronic condition increased and they seemed to appreciate being able to communicate asynchronously with their providers. They not only had specific questions but also wanted to communicate about feeling ill. A decrease in visits to the physician was shown in two studies (P=.07, P=.07). Increases in self-management/self-efficacy for patients with back pain, dyspnea, and heart failure were found. Positive health outcomes were shown in 12 studies, where the clinical outcomes for diabetic patients (HbA1c level) and for asthmatic patients (forced expiratory volume [FEV]) improved. Physical symptoms improved in five studies. Five studies generated a variety of positive psychosocial outcomes. The effect of

The social gradient in work and health: a cross-sectional study exploring the relationship between working conditions and health inequalities

Science.gov (United States)

2013-01-01

Background Social inequalities in health are widely examined. But the reasons behind this phenomenon still remain unclear in parts. It is undisputed that the work environment plays a crucial role in this regard. However, the contribution of psychosocial factors at work is unclear and inconsistent, and most studies are limited with regard to work factors and health outcomes. This study, therefore, aimed to explore the role and contribution of various physical and psychosocial working conditions to explaining social inequalities in different self-reported health outcomes. Methods Data from a postal survey among the workforces of four medium-sized and large companies from diverse industries of the secondary sector in Switzerland were used and analysed. The study sample covered 1,846 employees aged 20 and 64 and included significant proportions of unskilled manual workers and highly qualified non-manual workers. Cross tabulations and logistic regression analyses were performed to study multiple associations between social status, work factors and health outcomes. Combinations of educational level and occupational position wee used as a measure of social status or class. Results Clear social gradients were observed for almost all adverse working conditions and poor health outcomes studied, but in different directions. While physical workloads and other typical blue-collar job characteristics not suprisingly, were found to be much more common among the lower classes, most psychosocial work demands and job resources were more prevalent in the higher classes. Furthermore, workers in lower classes, i.e. with lower educational and occupational status, were more likely to report poor self-rated health, limited physical functioning and long sickness absence, but at the same time were less likely to experience increased stress feelings and burnout symptoms showing a reversed health gradient. Finally, blue-collar job characteristics contributed substantially to the social

Robust Machine Learning Variable Importance Analyses of Medical Conditions for Health Care Spending.

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Rose, Sherri

2018-03-11

To propose nonparametric double robust machine learning in variable importance analyses of medical conditions for health spending. 2011-2012 Truven MarketScan database. I evaluate how much more, on average, commercially insured enrollees with each of 26 of the most prevalent medical conditions cost per year after controlling for demographics and other medical conditions. This is accomplished within the nonparametric targeted learning framework, which incorporates ensemble machine learning. Previous literature studying the impact of medical conditions on health care spending has almost exclusively focused on parametric risk adjustment; thus, I compare my approach to parametric regression. My results demonstrate that multiple sclerosis, congestive heart failure, severe cancers, major depression and bipolar disorders, and chronic hepatitis are the most costly medical conditions on average per individual. These findings differed from those obtained using parametric regression. The literature may be underestimating the spending contributions of several medical conditions, which is a potentially critical oversight. If current methods are not capturing the true incremental effect of medical conditions, undesirable incentives related to care may remain. Further work is needed to directly study these issues in the context of federal formulas. © Health Research and Educational Trust.

The ethics of attaching research conditions to access to new health technologies.

Science.gov (United States)

Holland, Stephen; Hope, Tony

2012-06-01

Decisions on which new health technologies to provide are controversial because of the scarcity of healthcare resources, the competing demands of payers, providers and patients and the uncertainty of the evidence base. Given this, additional information about new health technologies is often considered valuable. One response is to make access to a new health technology conditional on further research. Access can be restricted to patients who participate in a research study, such as a randomised controlled trial; alternatively, a new treatment can be made generally available, but only on condition that further evidence is collected (eg, on long-term outcomes and adverse events, in patient registries). The National Institute for Health and Clinical Excellence (NICE), which provides guidance on which new health technologies to make available under the UK's NHS, for example, has made some research conditional recommendations, and the current interest in such options suggests that they are likely to become more prevalent in the future. This paper identifies and discusses the main ethical issues created by this distinctive range of recommendations. We argue that decisions to put research conditions on access to new technologies are compatible with widely accepted values, principles and practices relevant to resource allocation. However, there are important features of these distinctive judgements that must be taken into account by resource allocation decision-making bodies and research ethics committees, and that require new sorts of empirical data.

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

[Parents' unemployment, selected life conditions, adolescents' wellbeing and perceived health].

Science.gov (United States)

Supranowicz, Piotr

2005-01-01

Unemployment in Poland is one of the most negative outcomes of the economical transformations taking place in the last decade of the XX and first years of the XXI century. Therefore, the study on an influence of parents' unemployment upon adolescents' life conditions and health was undertaken in Health Promotion and Postgraduate Training Department of the National Institute of Hygiene. The data were collected from randomly selected sample of 783 students aged 14-15 years attending to ten private and public secondary schools (gymnasiums) in Warsaw. A part of the questionnaire elaborated in Health Promotion and Postgraduate Department covered information about negative life events, which had occurred in the previous year, also about a loss of the job by father or mother. The self-assessment of health, and physical and psychical wellbeing measured the perceived health. The study showed that significantly higher percentage of the students, whose father or mother had lost a job in the previous year, noticed also occurrence of father and mother health disorders, lack of support from father and mother, frequent quarrels between parents, too much of home duties, worsening a housing conditions, lack of possibilities to travel away on vacation and lack of own money. The differences were higher, if both the parents were unemployed. Moreover, the children of unemployed parents significantly lower assessed their health, and physical and psychical wellbeing. It is necessary to help immediately the students, whose parents are unemployed, with financial and psychological support in frame of the programmes of unemployment overcoming.

Chiropractic manipulation in pediatric health conditions – an updated systematic review

Directory of Open Access Journals (Sweden)

Gotlib Allan

2008-09-01

Full Text Available Abstract Objective Our purpose was to review the biomedical literature from January 2004 to June 2007 inclusive to determine the extent of new evidence related to the therapeutic application of manipulation for pediatric health conditions. This updates a previous systematic review published in 2005. No critical appraisal of the evidence is undertaken. Data Sources We searched both the indexed and non-indexed biomedical manual therapy literature. This included PubMed, MANTIS, CINAHL, ICL, as well as reference tracking. Other resources included the Cochrane Library, CCOHTA, PEDro, WHO ICTRP, AMED, EMBASE and AHRQ databases, as well as research conferences and symposium proceedings. Results The search identified 1275 citations of which 57 discrete citations met the eligibility criteria determined by three reviewers who then determined by consensus, each citation's appropriate level on the strength of evidence scale. The new evidence from the relevant time period was 1 systematic review, 1 RCT, 2 observational studies, 36 descriptive case studies and 17 conference abstracts. When this additional evidence is combined with the previous systematic review undertaken up to 2003, there are now in total, 2 systematic reviews, 10 RCT's, 3 observational studies, 177 descriptive studies, and 31 conference abstracts defining this body of knowledge. Summary There has been no substantive shift in this body of knowledge during the past 3 1/2 years. The health claims made by chiropractors with respect to the application of manipulation as a health care intervention for pediatric health conditions continue to be supported by only low levels of scientific evidence. Chiropractors continue to treat a wide variety of pediatric health conditions. The evidence rests primarily with clinical experience, descriptive case studies and very few observational and experimental studies. The health interests of pediatric patients would be advanced if more rigorous scientific

Poor Employment Conditions Adversely Affect Mental Health Outcomes Among Surgical Trainees.

Science.gov (United States)

Kevric, Jasmina; Papa, Nathan; Perera, Marlon; Rashid, Prem; Toshniwal, Sumeet

Poor mental health in junior clinicians is prevalent and may lead to poor productivity and significant medical errors. We aimed to provide contemporary data on the mental health of surgical trainees and identify risk factors relating to poorer mental health outcomes. A detailed questionnaire was developed comprising questions based on the 36-item short-form health survey (SF-36) and Physical Activity Questionnaire. Each of the questionnaires has proven validity and reliability in the clinical context. Ethics approval was obtained from the Royal Australasian College of Surgeons. The questionnaire was aimed at surgical registrars. We used Physical Activity Questionnaire, SF-36 scores and linear regression to evaluate the effect of putative predictors on mental health. A total of 83 responses were collected during the study period, of which 49 (59%) were from men and 34 (41%) were from women. The mean Mental Component Summary (MCS) score for both sexes was significantly lower than the population mean at ages 25-34 (p work culture and a feeling of a lack of support at work were extremely strong predictors of a lower MCS score (p Hours of overtime worked, particularly unpaid overtime, were also strong predictors of a poorer score. Australian surgical trainees reported lower MCS scores from the SF-36 questionnaire compared to the general population. Increasing working hours, unpaid overtime, poor job security, and job satisfaction were associated with poorer scores among trainees. Interventions providing improved working conditions need to be considered by professional training bodies and employers. Copyright © 2018 Association of Program Directors in Surgery. All rights reserved.

A new entropy condition for increasing accuracy and convergence rate of TVD scheme

International Nuclear Information System (INIS)

Rashidi, M.M.; Esfahanian, V.

2005-01-01

In this paper, a TVD method is applied to the numerical solution of the flow over axisymmetric steady hypersonic viscous flow using TLNS equations over blunt cone. In the TVD schemes, the artificial viscosity (AV) is implemented using entropy condition. For hypersonic flow, Yee entropy condition shows relatively a better stability and convergence rate than others. This paper presents a new entropy condition for increasing the accuracy and convergence rate of the TVD scheme which does not have the difficulty associated with Yee entropy condition for viscous flow in the hypersonic regime. The entropy condition increases the AV in the shocks and decreases AV in the smooth region. The numerical solution has been compared with the Beam and Warming shock fitting approach indicating a better numerical accuracy. (author)

Community-centered family health history: a customized approach to increased health communication and awareness.

Science.gov (United States)

O'Leary, James; Edelson, Vaughn; Gardner, Nicora; Gepp, Alejandra; Kyler, Panelpha; Moore, Penelope; Petruccio, Claudia; Williams, Marc; Terry, Sharon; Bowen, Deborah

2011-01-01

There has been little study of whether family health history (FHH) tools used by individuals, families, and communities inspire measurable changes in communication and behavior. The Community-Centered Family Health History (CCFHH) project was a collaborative endeavor among national and community-based organizations with an interest in genetics education and health. Using community- based participatory research principles as a foundation, CCFHH examined whether the Does It Run In the Family? toolkit, a set of two customizable booklets on health and genetics, encourages discussion and collection of FHH information across diverse communities. Five communities across the country measured the utility of customized versions of the Does It Run In the Family? toolkit. Each community partner recruited families, consisting of two or more blood relatives, to use the toolkit for 3 months, discuss it among their family members, and consider the implications of the health information. Pre- and postintervention surveys measured family communication about family history and disease risk and the use of FHH information in health care provider interactions. After aggregate, cross-community analysis of individual responses, from pre- to post-toolkit use family members showed increases in communication about family history of disease risk (p < .05) and in awareness about FHH (p < .05). These findings indicate that diverse communities are receptive to FHH intervention, and tailored health educational materials can lead to increased conversations and awareness about health issues across communities.

Children with disabling chronic conditions in the Western health ...

African Journals Online (AJOL)

Background. Children with disabling chronic conditions often have extensive, complex and unmet healthcare and educational needs. ... such children that access specialist health and special educational services, particularly in an urban setting, and what services exist for them. ..... Kromberg J, Zwane E, Manga P, et al.

FORUM Models for increasing the health workforce

African Journals Online (AJOL)

stewardship of the anticipated growth of private education and services ... The Global Health Workforce Alliance3 recognises the importance of increasing ... Action 2010 - 2014 to advance economic growth and development, to be realised by ... of the private higher education sector must be better understood and supported.

Odors, Deployment Stress, and Health: A Conditioning Analysis of Gulf War Syndrome

National Research Council Canada - National Science Library

Dalton, Pamela

2004-01-01

.... The goal of this research is to investigate the extent to which people can acquire stress reactions as conditioned responses to odors and exhibit health symptoms as a result of such conditioning episodes...

Odors, Deployment Stress, and Health: A Conditioning Analysis of Gulf War Syndrome

National Research Council Canada - National Science Library

Dalton, Pamela

2005-01-01

.... The goal of this research is to investigate the extent to which people can acquire stress reactions as conditioned responses to odors and exhibit health symptoms as a result of such conditioning episodes...

Odors, Deployment Stress and Health: A Conditioning Analysis of Gulf War Syndrome

National Research Council Canada - National Science Library

Dalton, Pamela

2006-01-01

.... The goal of this research is to investigate the extent to which people can acquire stress reactions as conditioned responses to odors and exhibit health symptoms as a result of such conditioning episodes...

Interventions to increase use of services; Mental Health Awareness in Nigeria.

Science.gov (United States)

Eaton, Julian; Nwefoh, Emeka; Okafor, Godwin; Onyeonoro, Ugochukwu; Nwaubani, Kenneth; Henderson, Claire

2017-01-01

Mental health services in Nigeria consist mainly of large government psychiatric hospitals and there are very few mental health professionals to serve the large population of the country. However, more recently, community mental health services, which have been shown to improve access to care and clinical outcomes are beginning to develop in some locations. Despite efforts to promote more accessible services, low levels of knowledge about effective treatment of mental disorders means that even where these services are available, a very small proportion of people utilise these services. Therefore interventions to increase service use are an essential component of health system. This intervention was designed to increase use of a mental health services through the work of community-based Village Health Workers. Fifteen Village Health Workers in each Local Government Area (district) were selected and trained to create mental health awareness in communities. Their function also include identification and referral of persons with mental illness to trained mental health nurses in the clinics. Attendance data prior to and after intervention were collected and compared. The incident rate for initial period of intervention is five times higher than the baseline rate (95% CI; 3.42-7.56; p awareness raising using volunteers in communities as part of health programme implementation can increase services use by a population. Mechanisms such as informing populations of the existence of a service which they were previously lacking; explanation of causation of mental illness and achieving community leaders' support for a new service can make investment in services more efficient by increasing attendance.

Health condition identification of multi-stage planetary gearboxes using a mRVM-based method

Science.gov (United States)

Lei, Yaguo; Liu, Zongyao; Wu, Xionghui; Li, Naipeng; Chen, Wu; Lin, Jing

2015-08-01

Multi-stage planetary gearboxes are widely applied in aerospace, automotive and heavy industries. Their key components, such as gears and bearings, can easily suffer from damage due to tough working environment. Health condition identification of planetary gearboxes aims to prevent accidents and save costs. This paper proposes a method based on multiclass relevance vector machine (mRVM) to identify health condition of multi-stage planetary gearboxes. In this method, a mRVM algorithm is adopted as a classifier, and two features, i.e. accumulative amplitudes of carrier orders (AACO) and energy ratio based on difference spectra (ERDS), are used as the input of the classifier to classify different health conditions of multi-stage planetary gearboxes. To test the proposed method, seven health conditions of a two-stage planetary gearbox are considered and vibration data is acquired from the planetary gearbox under different motor speeds and loading conditions. The results of three tests based on different data show that the proposed method obtains an improved identification performance and robustness compared with the existing method.

The Great Recession And Increased Cost Sharing In European Health Systems.

Science.gov (United States)

Palladino, Raffaele; Lee, John Tayu; Hone, Thomas; Filippidis, Filippos T; Millett, Christopher

2016-07-01

European health systems are increasingly adopting cost-sharing models, potentially increasing out-of-pocket expenditures for patients who use health care services or buy medications. Government policies that increase patient cost sharing are responding to incremental growth in cost pressures from aging populations and the need to invest in new health technologies, as well as to general constraints on public expenditures resulting from the Great Recession (2007-09). We used data from the Survey of Health, Ageing and Retirement in Europe to examine changes from 2006-07 to 2013 in out-of-pocket expenditures among people ages fifty and older in eleven European countries. Our results identify increases both in the proportion of older European citizens who incurred out-of-pocket expenditures and in mean out-of-pocket expenditures over this period. We also identified a significant increase over time in the percentage of people who incurred catastrophic health expenditures (greater than 30 percent of the household income) in the Czech Republic, Italy, and Spain. Poorer populations were less likely than those in the highest income quintile to incur an out-of-pocket expenditure and reported lower mean out-of-pocket expenditures, which suggests that measures are in place to provide poorer groups with some financial protection. These findings indicate the substantial weakening of financial protection for people ages fifty and older in European health systems after the Great Recession. Project HOPE—The People-to-People Health Foundation, Inc.

Evidence for the effectiveness of Alexander Technique lessons in medical and health-related conditions: a systematic review.

Science.gov (United States)

Woodman, J P; Moore, N R

2012-01-01

Complementary medicine and alternative approaches to chronic and intractable health conditions are increasingly being used, and require critical evaluation. The aim of this review was to systematically evaluate available evidence for the effectiveness and safety of instruction in the Alexander Technique in health-related conditions. PUBMED, EMBASE, PSYCHINFO, ISI Web-of-Knowledge, AMED, CINHAL-plus, Cochrane library and Evidence-based Medicine Reviews were searched to July 2011. Inclusion criteria were prospective studies evaluating Alexander Technique instruction (individual lessons or group delivery) as an intervention for any medical indication/health-related condition. Studies were categorised and data extracted on study population, randomisation method, nature of intervention and control, practitioner characteristics, validity and reliability of outcome measures, completeness of follow-up and statistical analyses.   Of 271 publications identified, 18 were selected: three randomised, controlled trials (RCTs), two controlled non-randomised studies, eight non-controlled studies, four qualitative analyses and one health economic analysis. One well-designed, well-conducted RCT demonstrated that, compared with usual GP care, Alexander Technique lessons led to significant long-term reductions in back pain and incapacity caused by chronic back pain. The results were broadly supported by a smaller, earlier RCT in chronic back pain. The third RCT, a small, well-designed, well-conducted study in individuals with Parkinson's disease, showed a sustained increased ability to carry out everyday activities following Alexander lessons, compared with usual care. The 15 non-RCT studies are also reviewed. Strong evidence exists for the effectiveness of Alexander Technique lessons for chronic back pain and moderate evidence in Parkinson's-associated disability. Preliminary evidence suggests that Alexander Technique lessons may lead to improvements in balance skills in the

Evaluation of Forest Health Conditions using Unmanned Aircraft Systems (UAS)

Science.gov (United States)

Hatfield, M. C.; Heutte, T. M.

2016-12-01

US Forest Service Alaska Region Forest Health Protection (FHP) and University of Alaska Fairbanks, Alaska Center for Unmanned Aircraft Systems Integration (ACUASI) are evaluating capability of Unmanned Aerial Systems (UAS) to monitor forest health conditions in Alaska's Interior Region. In July 2016, the team deployed UAS at locations in the Tanana Valley near Fairbanks in order to familiarize FHP staff with capabilities of UAS for evaluating insect and disease damage. While many potential uses of UAS to evaluate and monitor forest health can be envisioned, this project focused on use of a small UAS for rapid assessment of insect and disease damage. Traditional ground-based methods are limited by distance from ground to canopy and inaccessibility of forest stands due to terrain conditions. Observation from fixed-wing aircraft provide a broad overview of conditions but are limited by minimum safe flying altitude (500' AGL) and aircraft speed ( 100 mph). UAS may provide a crucial bridge to fill in gaps between ground and airborne methods, and offer significant cost savings and greater flexibility over helicopter-based observations. Previous uses of UAS for forest health monitoring are limited - this project focuses on optimizing choice of vehicle, sensors, resolution and area scanned from different altitudes, and use of visual spectrum vs NIR image collection. The vehicle selected was the ACUASI Ptarmigan, a small hexacopter (based on DJI S800 airframe and 3DR autopilot) capable of carrying a 1.5 kg payload for 15 min for close-range environmental monitoring missions. Sites were chosen for conditions favorable to UAS operation and presence of forest insect and disease agents including spruce broom rust, aspen leaf miner, birch leaf roller, and willow leafblotch miner. A total of 29 flights were conducted with 9000+ images collected. Mission variables included camera height, UAS speed, and medium- (Sony NEX-7) vs low-resolution (GoPro Hero) cameras. Invaluable

Psychosocial work conditions, unemployment and self-reported psychological health: a population-based study.

Science.gov (United States)

Lindström, Martin

2005-10-01

To investigate the association between psychosocial conditions at work, unemployment and self-reported psychological health. A cross-sectional postal questionnaire for the 2000 public health survey in Scania was administered to both working and unemployed people aged 18-64 years. Logistic regression models were used to investigate the association between psychosocial factors at work/unemployment and self-reported psychological health (General Health Questionnaire 12). Psychosocial conditions at work were classified according to the Karasek-Theorell demand-control/decision latitudes into relaxed, active, passive and job strain. The multivariate analyses included age, country of origin, education, economic stress and social participation. A total of 5180 people returned their questionnaire, giving a participation rate of 59%. Fifteen per cent of men and 20% of women reported poor psychological health. Those with high demands and high control (active category), those with high demands and low control (job strain category) and the unemployed had significantly higher odds ratios of poor psychological health compared to those with low demands and high control (relaxed category). Those with low demands and low control (passive category) did not differ significantly from the relaxed category. The associations remained in the multivariate analyses. The study found that certain psychosocial work factors are associated with higher levels of self-reported psychological ill-health and illustrates the great importance of psychosocial conditions in determining psychological health at the population level. As found elsewhere, being unemployed was an even stronger predictor of psychological ill-health.

Adverse health effects of high-effort/low-reward conditions.

Science.gov (United States)

Siegrist, J

1996-01-01

In addition to the person-environment fit model (J. R. French, R. D. Caplan, & R. V. Harrison, 1982) and the demand-control model (R. A. Karasek & T. Theorell, 1990), a third theoretical concept is proposed to assess adverse health effects of stressful experience at work: the effort-reward imbalance model. The focus of this model is on reciprocity of exchange in occupational life where high-cost/low-gain conditions are considered particularly stressful. Variables measuring low reward in terms of low status control (e.g., lack of promotion prospects, job insecurity) in association with high extrinsic (e.g., work pressure) or intrinsic (personal coping pattern, e.g., high need for control) effort independently predict new cardiovascular events in a prospective study on blue-collar men. Furthermore, these variables partly explain prevalence of cardiovascular risk factors (hypertension, atherogenic lipids) in 2 independent studies. Studying adverse health effects of high-effort/low-reward conditions seems well justified, especially in view of recent developments of the labor market.

Income-related inequalities in diseases and health conditions over the business cycle

OpenAIRE

Asgeirsdottir, Tinna Laufey; Hildur Margrét, Jóhannsdóttir

2017-01-01

How business cycles affect income-related distribution of diseases and health disorders is largely unknown. We examine how the prevalence of thirty diseases and health conditions is distributed across the income spectrum using survey data collected in Iceland in 2007, 2009 and 2012. Thus, we are able to take advantage of the unusually sharp changes in economic conditions in Iceland during the Great Recession initiated in 2008 and the partial recovery that had already taken place by 2012 to an...

Home Health Agency Characteristics and Quality Outcomes for Medicare Beneficiaries With Rehabilitation-Sensitive Conditions.

Science.gov (United States)

Mroz, Tracy M; Meadow, Ann; Colantuoni, Elizabeth; Leff, Bruce; Wolff, Jennifer L

2018-06-01

To examine associations between organizational characteristics of home health agencies (eg, profit status, rehabilitation therapy staffing model, size, and rurality) and quality outcomes in Medicare beneficiaries with rehabilitation-sensitive conditions, conditions for which occupational, physical, and/or speech therapy have the potential to improve functioning, prevent or slow substantial decline in functioning, or increase ability to remain at home safely. Retrospective analysis. Home health agencies. Fee-for-service beneficiaries (N=1,006,562) admitted to 9250 Medicare-certified home health agencies in 2009. Not applicable. Institutional admission during home health care, community discharge, and institutional admission within 30 days of discharge. Nonprofit (vs for-profit) home health agencies were more likely to discharge beneficiaries to the community (odds ratio [OR], 1.23; 95% confidence interval [CI], 1.13-1.33) and less likely to have beneficiaries incur institutional admissions within 30 days of discharge (OR, .93; 95% CI, .88-.97). Agencies in rural (vs urban) counties were less likely to discharge patients to the community (OR, .83; 95% CI, .77-.90) and more likely to have beneficiaries incur institutional admissions during home health (OR, 1.24; 95% CI, 1.18-1.30) and within 30 days of discharge (OR, 1.15; 95% CI, 1.10-1.22). Agencies with contract (vs in-house) therapy staff were less likely to discharge beneficiaries to the community (OR, .79, 95% CI, .70-.91) and more likely to have beneficiaries incur institutional admissions during home health (OR, 1.09; 95% CI, 1.03-1.15) and within 30 days of discharge (OR, 1.17; 95% CI, 1.07-1.28). As payers continue to test and implement reimbursement mechanisms that seek to reward value over volume of services, greater attention should be paid to organizational factors that facilitate better coordinated, higher quality home health care for beneficiaries who may benefit from rehabilitation. Copyright © 2017

Occupational class inequalities in health across employment sectors: the contribution of working conditions.

Science.gov (United States)

Lahelma, Eero; Laaksonen, Mikko; Aittomäki, Akseli

2009-01-01

While health inequalities among employees are well documented, their variation and determinants among employee subpopulations are poorly understood. We examined variations in occupational class inequalities in health within four employment sectors and the contribution of working conditions to these inequalities. Cross-sectional data from the Helsinki Health Study in 2000-2002 were used. Each year, employees of the City of Helsinki, aged 40-60 years, received a mailed questionnaire (n = 8,960, 80% women, overall response rate for 3 years 67%). The outcome was physical health functioning measured by the overall physical component summary of SF-36. The socioeconomic indicator was occupational social class. Employment sectors studied were health care, education, social welfare and administration (n = 6,557). Physical and mental workload, and job demands and job control were explanatory factors. Inequality indices from logistic regression analysis were calculated. Occupational class inequalities in physical health functioning were slightly larger in education (1.47) than in the other sectors (1.43-1.40). Physical workload explained 95% of inequalities in social welfare and 32-36% in the other sectors. Job control also partly explained health inequalities. However, adjusting for mental workload and job demands resulted in larger health inequalities. Inequalities in physical health functioning were found within each employment sector, with minor variation in their magnitude. Physical workload was the main explanation for these inequalities, but its contribution varied between the sectors. In contrast, considering psychosocial working conditions led to wider inequalities. Improving physical working conditions among the lower occupational classes would help reduce health inequalities within different employment sectors.

Smartphone ownership and interest in mobile applications to monitor symptoms of mental health conditions.

Science.gov (United States)

Torous, John; Friedman, Rohn; Keshavan, Matcheri

2014-01-21

Patient retrospective recollection is a mainstay of assessing symptoms in mental health and psychiatry. However, evidence suggests that these retrospective recollections may not be as accurate as data collection though the experience sampling method (ESM), which captures patient data in "real time" and "real life." However, the difficulties in practical implementation of ESM data collection have limited its impact in psychiatry and mental health. Smartphones with the capability to run mobile applications may offer a novel method of collecting ESM data that may represent a practical and feasible tool for mental health and psychiatry. This paper aims to provide data on psychiatric patients' prevalence of smartphone ownership, patterns of use, and interest in utilizing mobile applications to monitor their mental health conditions. One hundred psychiatric outpatients at a large urban teaching hospital completed a paper-and-pencil survey regarding smartphone ownership, use, and interest in utilizing mobile applications to monitor their mental health condition. Ninety-seven percent of patients reported owning a phone and 72% reported that their phone was a smartphone. Patients in all age groups indicated greater than 50% interest in using a mobile application on a daily basis to monitor their mental health condition. Smartphone and mobile applications represent a practical opportunity to explore new modalities of monitoring, treatment, and research of psychiatric and mental health conditions.

Adults with an epilepsy history fare significantly worse on positive mental and physical health than adults with other common chronic conditions-Estimates from the 2010 National Health Interview Survey and Patient Reported Outcome Measurement System (PROMIS) Global Health Scale.

Science.gov (United States)

Kobau, Rosemarie; Cui, Wanjun; Zack, Matthew M

2017-07-01

Healthy People 2020, a national health promotion initiative, calls for increasing the proportion of U.S. adults who self-report good or better health. The Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health Scale (GHS) was identified as a reliable and valid set of items of self-reported physical and mental health to monitor these two domains across the decade. The purpose of this study was to examine the percentage of adults with an epilepsy history who met the Healthy People 2020 target for self-reported good or better health and to compare these percentages to adults with history of other common chronic conditions. Using the 2010 National Health Interview Survey, we compared and estimated the age-standardized prevalence of reporting good or better physical and mental health among adults with five selected chronic conditions including epilepsy, diabetes, heart disease, cancer, and hypertension. We examined response patterns for physical and mental health scale among adults with these five conditions. The percentages of adults with epilepsy who reported good or better physical health (52%) or mental health (54%) were significantly below the Healthy People 2020 target estimate of 80% for both outcomes. Significantly smaller percentages of adults with an epilepsy history reported good or better physical health than adults with heart disease, cancer, or hypertension. Significantly smaller percentages of adults with an epilepsy history reported good or better mental health than adults with all other four conditions. Health and social service providers can implement and enhance existing evidence-based clinical interventions and public health programs and strategies shown to improve outcomes in epilepsy. These estimates can be used to assess improvements in the Healthy People 2020 Health-Related Quality of Life and Well-Being Objective throughout the decade. Published by Elsevier Inc.

Private prayer associations with depression, anxiety and other health conditions: an analytical review of clinical studies.

Science.gov (United States)

Anderson, James W; Nunnelley, Paige A

2016-09-01

To critically analyze appropriate clinical studies to assess the relationship between health conditions and the frequency of private prayer. Private prayer is defined as individuals praying for themselves. Using PubMed and other search engines, we identified over 300 articles reporting relationships between prayer and health conditions. We identified 41 observational clinical studies that evaluated the relationship between private prayer and health conditions. Prayer scores of 5 to 1 were assigned to studies, with 5 being private prayer for health and 1 being prayer in combination with meditation or Bible study. Frequency scores ranged from 3 to 1 with 3 being twice daily or more and 0 when frequency was not assessed. Studies were ranked from 8 to 1 based on the sum of Prayer and Frequency Scores. Twenty-one studies had Prayer-Frequency scores of 5 to 8, indicating that they evaluated private prayer (praying for one's own health) of suitable frequency in association with health conditions. Nine of 11 studies indicated that private prayer was associated with a significantly lower prevalence of depression (P value, prayer in four studies (P value, P prayer (P prayer did not have a significant effect on physical health or blood pressure. The reported observational studies suggest that frequent private prayer is associated with a significant benefit for depression, optimism, coping, and other mental health conditions such as anxiety. Controlled clinical trials are required to critically assess the associations of private prayer and health conditions.

Family vulnerability index to disability and dependence (FVI-DD), by social and health conditions.

Science.gov (United States)

Amendola, Fernanda; Alvarenga, Márcia Regina Martins; Latorre, Maria do Rosário Dias de Oliveira; Oliveira, Maria Amélia de Campos

2017-06-01

The Family Vulnerability Index to Disability and Dependence (FVI-DD) aims to summarize the dimensions of vulnerability to disability and dependence using family data monitored by Family Health Strategy (ESF) teams. This study aims to analyze the FVI-DD according to the social and health vulnerability, to validate and extract a cutoff point for each dimension. The FVI-DD was built with a sample of 248 families living in a region of São Paulo. The dimension related to health conditions was validated with good internal consistency, with respect to the Katz Index and the Lawton Scale, whereas the dimension related to social conditions was only validated in relation to Lawton Scale. Thus, a vulnerable family was defined as one with 15 or more points in the Total FVI-DD, and a vulnerable family in health conditions that with a score of 6 or more points in that dimension. Therefore, it is possible to classify families as not vulnerable, vulnerable in the social aspects, vulnerable in the health aspects and the more vulnerable family (social and health) using social indicators of empowerment and wear and health indicators related not only to the biological sphere, but also in the access to health services, health self-assessment and existing vulnerable groups.

Alcohol Use and Mental Health Conditions Among Black College Males: Do Those Attending Postsecondary Minority Institutions Fare Better Than Those at Primarily White Institutions?

Science.gov (United States)

Barry, Adam E; Jackson, Zachary; Watkins, Daphne C; Goodwill, Janelle R; Hunte, Haslyn E R

2017-07-01

While there is a sizeable body of research examining the association between alcohol use and mental health conditions among college students, there are sparse investigations specifically focusing on these associations among Black college students. This is concerning given Black college students face different stressors compared with their non-Black peers. Black males appear especially at risk, exhibiting increased susceptibility to mental health issues and drinking in greater quantities and more frequently than Black females. This investigation examined the association between alcohol consumption and mental health conditions among Black men attending institutions of higher education in the United States and sought to determine differences between Black men attending predominantly White institutions (PWIs) compared with those attending postsecondary minority institutions. Final sample included 416 Black men, 323 of which attended a PWI. Data were from the National College Health Assessment. Black men attending a PWI reported significantly greater levels of alcohol consumption and significantly more mental health conditions. Attendance at a minority-serving institution was associated with fewer mental health conditions among Black men. Future studies should seek to replicate these findings and conduct culturally sensitive and gender-specific research examining why Black men at PWIs report greater alcohol consumption and more mental health conditions than their peers attending postsecondary minority institutions.

Mental health conditions in Korean atomic bomb survivors. A survey in Seoul

International Nuclear Information System (INIS)

Koshimoto, Rika; Nakane, Hideyuki; Kim, Hyen

2011-01-01

More than 60 years have elapsed since the atomic bombings to Hiroshima and Nagasaki, and since all of the atomic bomb survivors have become old, the importance of caring their mental health has become increasing in Japan. Although approximately 70% of overseas atomic bomb are living in Korea, there have been quite few studies on their mental health. The objectives of the present study were to elucidate whether the mental health conditions of atomic bomb survivor in Korea are similar to those in Japan. The subjects were 181 Korean atomic bomb survivors living in Korea (cases) and 209 outpatients of a hospital in Seoul who were not exposed to atomic bombs (controls). Interviewers administered them at the hospital a questionnaire with Impact of Event Scale-Revised, General Health Questionnaire 12 (GHQ-12), Korean version of short form Geriatric Depression Scale and the K scale of the Minnesota Multiphasic Personality Inventory. Excluding subjects with incomplete responses we analyzed 162 cases and 189 controls. The proportion of subjects with high score of GHQ-12 (≥4) was significantly higher in cases (78/162 or 48.1%) than in controls (42/189 or 22.2%) (p<0.0001, Fisher's exact test). The present results, though preliminary, indicate that atomic bomb survivors in Korea have also mental health problems similar to those observed in Japanese atomic bomb survivors, indicating the necessity of a larger study. (author)

The analysis of the medical university students’ health condition and lifestyle

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OLGA KHURS

2017-01-01

Full Text Available Introduction: Significant psychophysiological burdens and unhealthy lifestyle constitute the risk factors leading to students’ health deterioration. Purpose: The purpose of the research was the analysis of students’ health condition and lifestyle in medical university. Material and methods: The objects of the research were 100 third year students of the Faculties of General Medicine and Pediatrics of Grodno State Medical University. For the study of students’ orientation on healthy lifestyle, a special scale-type questionnaire was developed and used. Results: According to the respondents’ opinions it has been detected that the basic factors influencing the state of health are the lifestyle and the living conditions. The students activity is evaluated as very low as well as their rational nutrition. The majority of them smoke and drink alcohol. Conclusions: The peculiarities of studying at a medical university accompanied by imbalanced nutrition might lead to the deterioration of health in the students which are doctors to be. The results ought to lead to the optimization of prophylaxis programs and entire alteration of the students’ lifestyles.

Effects of managed care on service use and access for publicly insured children with chronic health conditions.

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Davidoff, Amy; Hill, Ian; Courtot, Brigette; Adams, Emerald

2007-05-01

Our goal was to estimate the effects of managed care program type on service use and access for publicly insured children with chronic health conditions. Data on Medicaid and State Children's Health Insurance Program managed care programs were linked by county and year to pooled data from the 1997-2002 National Health Interview Survey. We used multivariate techniques to examine the effects of managed care program type, relative to fee-for-service, on a broad array of service use and access outcomes. Relative to fee-for-service, managed care program assignment was associated with selected reductions in service use but not with deterioration in reported access. Capitated managed care plans with mental health or specialty carve-outs were associated with a 7.4-percentage-point reduction in the probability of a specialist visit, a 6.3-percentage-point reduction in the probability of a mental health specialty visit, and a 5.9-percentage-point decrease in the probability of regular prescription drug use. Reductions in use associated with primary care case management and integrated capitated programs (without carve-outs) were more limited, and integrated capitated plans were associated with a reduction in unmet medical care need. We failed to find significant effects of special managed care programs for children with chronic health conditions. Managed care is associated with reduced service use, particularly when capitated programs carve out services. This finding is of key policy importance, as the proportion of children enrolled in plans with carve-out arrangements has been increasing over time. It is not possible to determine whether reductions in services represent better care management or skimping. However, despite the reductions in use, we did not observe a corresponding increase in perceived unmet need; thus, the net change may represent improved care management.

Gender and Ageing at Work in Chile: Employment, Working Conditions, Work-Life Balance and Health of Men and Women in an Ageing Workforce.

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Vives, Alejandra; Gray, Nora; González, Francisca; Molina, Agustín

2018-04-18

In Chile, working after retirement age has grown substantially over the last years. This, in addition to the country's current discussion about extending retirement age, motivates the need of generating evidence on the occupational health and safety of the working old, with a special focus on women, who are critically disadvantaged in Chile's labour market. The objective of this paper is to describe and compare the ageing workforce of women and men in Chile in terms of labour market participation, employment and working conditions, work-life balance, and health. The social determinants of health and employment sustainability frameworks guide this study. Cross-sectional data from three publicly available sources: the Chilean Labour Force Survey, NENE (2010); the first Chilean Employment and working conditions survey, ENETS (2009-2010) and the second National Health Survey, ENS (2009). Participation rates and employment conditions (NENE and ENETS), working conditions, occupational health and work-life balance (ENETS) and chronic health conditions (ENS) were described by 5-year age groups separately for women and men. Descriptions cover all age groups in order to identify trends and patterns characteristic of older workers. Rates of occupation decrease sharply after age 54 in women and 59 in men. Ageing women and men who continue to work are more likely to be in own-account (self-employed) work than younger workers; in the case of women, in households as domestic workers, and men, in agriculture. Social protection and workplace rights are markedly reduced in older workers. Part-time work increases from the age of 50 onwards, especially among women, but average working hours do not decrease under 30 h a week for either women or men. Interestingly, between ages 60 and 64, there is a peak increase of day and night shift-work among women, which co-occurs with a peak in domestic work, possibly corresponding to women working as caretakers of elderly people. Several

Psychological distress is associated with a range of high-priority health conditions affecting working Australians.

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Holden, Libby; Scuffham, Paul; Hilton, Michael; Vecchio, Nerina; Whiteford, Harvey

2010-06-01

Psychological distress is growing in prevalence in Australia. Comorbid psychological distress and/or depressive symptoms are often associated with poorer health, higher healthcare utilisation and decreased adherence to medical treatments. The Australian Work Outcomes Research Cost-benefit (WORC) study cross-sectional screening dataset was used to explore the association between psychological distress and a range of health conditions in a sample of approximately 78,000 working Australians. The study uses the World Health Organization Health and Productivity Questionnaire (HPQ), to identify self-reported health status. Within the HPQ is the Kessler 6 (K6), a six-item scale of psychological distress which strongly discriminates between those with and without a mental disorder. Potential confounders of age, sex, marital status, number of children, education level and annual income were included in multivariate logistic regression models. Psychological distress was significantly associated with all investigated health conditions in both crude and adjusted estimates. The conditions with the strongest adjusted association were, in order from highest: drug and alcohol problems, fatigue, migraine, CVD, COPD, injury and obesity. Psychological distress is strongly associated with all 14 health conditions or risk factors investigated in this study. Comorbid psychological distress is a growing public health issue affecting Australian workers.

Oral health conditions and frailty in Mexican community-dwelling elderly: a cross sectional analysis

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Castrejón-Pérez Roberto

2012-09-01

Full Text Available Abstract Background Oral health is an important component of general well-being for the elderly. Oral health-related problems include loss of teeth, nonfunctional removable dental prostheses, lesions of the oral mucosa, periodontitis, and root caries. They affect food selection, speaking ability, mastication, social relations, and quality of life. Frailty is a geriatric syndrome that confers vulnerability to negative health-related outcomes. The association between oral health and frailty has not been explored thoroughly. This study sought to identify associations between the presence of some oral health conditions, and frailty status among Mexican community-dwelling elderly. Methods Analysis of baseline data of the Mexican Study of Nutritional and Psychosocial Markers of Frailty, a cohort study carried out in a representative sample of people aged 70 and older residing in one district of Mexico City. Frailty was defined as the presence of three or more of the following five components: weight loss, exhaustion, slowness, weakness, and low physical activity. Oral health variables included self-perception of oral health compared with others of the same age; utilization of dental services during the last year, number of teeth, dental condition (edentate, partially edentate, or completely dentate, utilization and functionality of removable partial or complete dentures, severe periodontitis, self-reported chewing problems and xerostomia. Covariates included were gender, age, years of education, cognitive performance, smoking status, recent falls, hospitalization, number of drugs, and comorbidity. The association between frailty and dental variables was determined performing a multivariate logistic regression analysis. Final models were adjusted by socio-demographic and health factors Results Of the 838 participants examined, 699 had the information needed to establish the criteria for diagnosis of frailty. Those who had a higher probability of being

Variation in the health and biochemical condition of the coral Acropora tenuis along two water quality gradients on the Great Barrier Reef, Australia.

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Rocker, Melissa M; Francis, David S; Fabricius, Katharina E; Willis, Bette L; Bay, Line K

2017-06-30

This study explores how plasticity in biochemical attributes, used as indicators of health and condition, enables the coral Acropora tenuis to respond to differing water quality regimes in inshore regions of the Great Barrier Reef. Health attributes were monitored along a strong and weak water quality gradient, each with three reefs at increasing distances from a major river source. Attributes differed significantly only along the strong gradient; corals grew fastest, had the least dense skeletons, highest symbiont densities and highest lipid concentrations closest to the river mouth, where water quality was poorest. High nutrient and particulate loads were only detrimental to skeletal density, which decreased as linear extension increased, highlighting a trade-off. Our study underscores the importance of assessing multiple health attributes in coral reef monitoring. For example, autotrophic indices are poor indicators of coral health and condition, but improve when combined with attributes like lipid content and biomass. Copyright © 2017 Elsevier Ltd. All rights reserved.

No longer diseases of the wealthy: prevalence and health-seeking for self-reported chronic conditions among urban poor in Southern India.

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Bhojani, Upendra; Beerenahalli, Thriveni S; Devadasan, Roopa; Munegowda, C M; Devadasan, Narayanan; Criel, Bart; Kolsteren, Patrick

2013-08-13

The burden of chronic conditions is high in low- and middle-income countries and poses a significant challenge to already weak healthcare delivery systems in these countries. Studies investigating chronic conditions among the urban poor remain few and focused on specific chronic conditions rather than providing overall profile of chronic conditions in a given community, which is critical for planning and managing services within local health systems. We aimed to assess the prevalence and health- seeking behaviour for self-reported chronic conditions in a poor neighbourhood of a metropolitan city in India. We conducted a house-to-house survey covering 9299 households (44514 individuals) using a structured questionnaire. We relied on self-report by respondents to assess presence of any chronic conditions, including diabetes and hypertension. Multivariable logistic regression was used to analyse the prevalence and health-seeking behaviour for self-reported chronic conditions in general as well as for diabetes and hypertension in particular. The predictor variables included age, sex, income, religion, household poverty status, presence of comorbid chronic conditions, and tiers in the local health care system. Overall, the prevalence of self-reported chronic conditions was 13.8% (95% CI = 13.4, 14.2) among adults, with hypertension (10%) and diabetes (6.4%) being the most commonly reported conditions. Older people and women were more likely to report chronic conditions. We found reversal of socioeconomic gradient with people living below the poverty line at significantly greater odds of reporting chronic conditions than people living above the poverty line (OR = 3, 95% CI = 1.5, 5.8). Private healthcare providers managed over 80% of patients. A majority of patients were managed at the clinic/health centre level (42.9%), followed by the referral hospital (38.9%) and the super-specialty hospital (18.2%) level. An increase in income was positively associated with the use

Achieving compliance with environmental health-related land use planning conditions in Hong Kong: perspectives from traditional motivation theories.

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Man, Rita Li Yi

2009-11-01

Environmental health-related land use planning conditions can enhance the environment in Hong Kong. Previous research by others has shown, however, that a lack of compliance with planning conditions often occurs. And as no direct enforcement of planning conditions exists in Hong Kong, it is of interest to understand possible ways in which to increase the motivation of land developers and property owners to comply with planning conditions. The author looked at motivation from the perspective of three traditional motivation theories: Theory X, Theory Y, and incentive theory. While the majority of this article focuses on the enforcement and the legal tests in land use planning conditions, it also presents the results of the first study of the motivations behind Hong Kong land developers to comply with land use planning conditions.

Emerging technologies to measure neighborhood conditions in public health: implications for interventions and next steps.

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Schootman, M; Nelson, E J; Werner, K; Shacham, E; Elliott, M; Ratnapradipa, K; Lian, M; McVay, A

2016-06-23

Adverse neighborhood conditions play an important role beyond individual characteristics. There is increasing interest in identifying specific characteristics of the social and built environments adversely affecting health outcomes. Most research has assessed aspects of such exposures via self-reported instruments or census data. Potential threats in the local environment may be subject to short-term changes that can only be measured with more nimble technology. The advent of new technologies may offer new opportunities to obtain geospatial data about neighborhoods that may circumvent the limitations of traditional data sources. This overview describes the utility, validity and reliability of selected emerging technologies to measure neighborhood conditions for public health applications. It also describes next steps for future research and opportunities for interventions. The paper presents an overview of the literature on measurement of the built and social environment in public health (Google Street View, webcams, crowdsourcing, remote sensing, social media, unmanned aerial vehicles, and lifespace) and location-based interventions. Emerging technologies such as Google Street View, social media, drones, webcams, and crowdsourcing may serve as effective and inexpensive tools to measure the ever-changing environment. Georeferenced social media responses may help identify where to target intervention activities, but also to passively evaluate their effectiveness. Future studies should measure exposure across key time points during the life-course as part of the exposome paradigm and integrate various types of data sources to measure environmental contexts. By harnessing these technologies, public health research can not only monitor populations and the environment, but intervene using novel strategies to improve the public health.

Impact of a 7-Day Field Training on Oral Health Condition in Japan Ground Self-Defense Force Personnel.

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Yamashita, Koji; Nishiyama, Takeshi; Nagata, Emi; Ramadhani, Atik; Kawada-Matsuo, Miki; Komatsuzawa, Hitoshi; Oho, Takahiko

2017-07-01

In the Japan Ground Self-Defense Force (JGSDF), personnel periodically perform intensive training that mimics the conditions seen in battle and during natural disasters. Military training involves intensive, stressful conditions, and changes in immune responses have been found in personnel following training. Good oral condition is important for military personnel to fulfill their duties; however, they have difficulty performing daily oral care under training conditions. In this study, we investigated the impact of a 7-day field training on the oral health status of JGSDF personnel by comparing their oral condition before and just after training. The participants were 59 male and 3 female JGSDF personnel undergoing a 7-day field training. All personnel provided informed written consent to participate, and this study was approved by the ethics committee of the Kagoshima University Graduate School of Medical and Dental Sciences. Oral health behaviors before and during the training period were surveyed using a self-administered questionnaire. Dental caries was assessed before training in terms of decayed, missing and filled teeth (DMFT), and periodontal condition was examined before and immediately after training using the community periodontal index (CPI). The presence of eight species of bacteria in dental plaque, including commensal streptococci that are early colonizers on the tooth surface, cariogenic bacteria, and periodontopathic bacteria, was determined using real-time polymerase chain reaction. We also assessed antibacterial factors and a stress marker in saliva samples. Sample collection was performed before and just after training. In addition to difference analysis between groups, logistic regression analysis was performed to examine the association between each health behavior and periodontal deterioration. The frequency of toothbrushing decreased, and snacking increased during the training period. Thirty-five personnel (56.5%) showed an increase in

[Working conditions and common mental disorders among primary health care workers from Botucatu, São Paulo State].

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Braga, Ludmila Candida de; Carvalho, Lidia Raquel de; Binder, Maria Cecília Pereira

2010-06-01

Common mental disorders (CMD) present high prevalence among general populations and workers with important individual and social consequences. This cross-sectional and descriptive study explores the relationship between psychological job demands, job control degree and job support and prevalence of CMD among primary health care workers of Botucatu - SP. The data collection was carried out using an unidentified self-administered questionnaire, with emphasis on items relating to demand-control-support situation and occurrence of CMD (Self Reporting Questionnaire, SRQ-20). The data were stored using the software Excel / Office XP 2003, and the statistical analyses were performed in SAS system. It was evidenced that 42.6% of primary health care workers presented CMD. The observed association - high prevalence of CMD with high-strain job (Karasek model) and low prevalence of CMD with low-strain job - indicates that, in the studied city, primary health care work conditions are contributive factors to workers' illness. The survey reveals the need of interventions aiming at caring the workers and also gets better work conditions and increase social support at work.

Health conditions of young and old elderly

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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.

Psychosocial work conditions and quality of life among primary health care employees: a cross sectional study

OpenAIRE

Teles, Mariza Alves Barbosa; Barbosa, Mirna Rossi; Vargas, Andréa Maria Duarte; Gomes, Viviane Elizângela; e Ferreira, Efigênia Ferreira; Martins, Andréa Maria Eleutério de Barros Lima; Ferreira, Raquel Conceição

2014-01-01

Background Workers in Primary Health Care are often exposed to stressful conditions at work. This study investigated the association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers. Methods This cross-sectional study included all 797 Primary Health Care workers of a medium-sized city, Brazil: doctors, nurses, nursing technicians and nursing assistants, dentists, oral health technicians, and auxiliary oral hygienists, and community health...

Increasing User Involvement in Health Care and Health Research Simultaneously

DEFF Research Database (Denmark)

Kaltoft, Mette Kjer; Nielsen, Jesper Bo; Salkeld, Glenn

2014-01-01

of the effects of different actions and interventions on their health, including those implying contact with health care services. We see their research as primarily carried out in order to make better decisions for themselves, but they can offer to contribute the results to the wider population. We see...... at the point of decision need, when motivation is highest. Some basic distinctions, such as those between science and non-science, research and practice, community and individual, and lay and professional become somewhat blurred and may need to be rethought in light of this approach....... to increased user involvement, though somewhat more aligned with the former. METHODS: Our online decision support tools, delivered directly to the person in the community and openly accessible, are to be seen as research resources. They will take the form of interactive decision aids for a variety of specific...

How Veterans With Post-Traumatic Stress Disorder and Comorbid Health Conditions Utilize eHealth to Manage Their Health Care Needs: A Mixed-Methods Analysis.

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Whealin, Julia M; Jenchura, Emily C; Wong, Ava C; Zulman, Donna M

2016-10-26

Mental health conditions are prevalent among US veterans and pose a number of self-management and health care navigation challenges. Post-Traumatic Stress Disorder (PTSD) with comorbid chronic medical conditions (CMCs) is especially common, in both returning Iraq or Afghanistan and earlier war-era veterans. Patient-facing electronic health (eHealth) technology may offer innovative strategies to support these individuals' needs. This study was designed to identify the types of eHealth tools that veterans with PTSD and comorbid CMCs use, understand how they currently use eHealth technology to self-manage their unique health care needs, and identify new eHealth resources that veterans feel would empower them to better manage their health care. A total of 119 veterans with PTSD and at least one CMC who have used the electronic personal health record system of the US Department of Veterans Affairs (VA) responded to a mailed survey about their chronic conditions and preferences related to the use of technology. After the survey, 2 focus groups, stratified by sex, were conducted with a subgroup of patients to explore how veterans with PTSD and comorbid CMCs use eHealth technology to support their complex health care needs. Focus groups were transcribed verbatim and analyzed using standard content analysis methods for coding textual data, guided by the "Fit between Individual, Task, and Technology" framework. Survey respondents had a mean age of 64.0 (SD 12.0) years, 85.1% (97/114) were male, 72.4% (84/116) were white, and 63.1% (70/111) had an annual household income of eHealth literacy was 27.7 (SD 9.8). Of the respondents, 44.6% (50/112) used health-related technology 1 to 3 times per month and 21.4% (24/112) used technology less than once per month. Veterans reported using technology most often to search for health information (78.9%, 90/114), communicate with providers (71.1%, 81/114), and track medications (64.9%, 74/114). Five major themes emerged that describe how

Technology as friend or foe? Do electronic health records increase burnout?

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Ehrenfeld, Jesse M; Wanderer, Jonathan P

2018-06-01

To summarize recent relevant studies regarding the use of electronic health records and physician burnout. Recently acquired knowledge regarding the relationship between electronic health record use, professional satisfaction, burnout, and desire to leave clinical practice are discussed. Adoption of electronic health records has increased across the United States and worldwide. Although electronic health records have many benefits, there is growing concern about the adverse consequences of their use on physician satisfaction and burnout. Poor usability, incongruent workflows, and the addition of clerical tasks to physician documentation requirements have been previously highlighted as ongoing concerns with electronic health record adoption. In multiple recent studies, electronic health records have been shown to decrease professional satisfaction, increase burnout, and the likelihood that a physician will reduce or leave clinical practice. One interventional study demonstrated a positive effect of a dedicated electronic health record entry clerk on physicians working in an outpatient practice.

Increasing compliance with the World Health Organization Surgical Safety Checklist-A regional health system's experience.

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Gitelis, Matthew E; Kaczynski, Adelaide; Shear, Torin; Deshur, Mark; Beig, Mohammad; Sefa, Meredith; Silverstein, Jonathan; Ujiki, Michael

2017-07-01

In 2009, NorthShore University HealthSystem adapted the World Health Organization Surgical Safety Checklist (SSC) at each of its 4 hospitals. Despite evidence that SSC reduces intraoperative mistakes and increase patient safety, compliance was found to be low with the paper form. In November 2013, NorthShore integrated the SSC into the electronic health record (EHR). The aim was to increase communication between operating room (OR) personnel and to encourage best practices during the natural workflow of surgeons, anesthesiologists, and nurses. The purpose of this study was to examine the impact of an electronic SSC on compliance and patient safety. An anonymous OR observer selected cases at random and evaluated the compliance rate before the rollout of the electronic SSC. In June 2014, an electronic audit was performed to assess the compliance rate. Random OR observations were also performed throughout the summer in 2014. Perioperative risk events, such as consent issues, incorrect counts, wrong site, and wrong procedure were compared before and after the electronic SSC rollout. A perception survey was also administered to NorthShore OR personnel. Compliance increased from 48% (n = 167) to 92% (n = 1,037; P World Health Organization SSC is a validated tool to increase patient safety and reduce intraoperative complications. The electronic SSC has demonstrated an increased compliance rate, a reduced number of risk events, and most OR personnel believe it will have a positive impact on patient safety. Copyright © 2016 Elsevier Inc. All rights reserved.

Monitoring health spending increases: incremental budget analyses reveal challenging tradeoffs.

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Hartman, Micah; Smith, Cynthia; Heffler, Stephen; Freeland, Mark

2006-01-01

With each passing decade, health care has consumed a larger share of gross domestic product (GDP) and Federal budgets. By the 2000-2004 period, society was willing to devote over 20 percent of the cumulative increase in GDP and the cumulative increase in Federal outlays towards health care. The financing challenges are expected to become more acute for private payers as well as Federal, State, and local budgets. With the implementation of Part D in 2006, the U.S. Office of Management and Budget projects that Federal budget pressures will heighten, bringing increased attention to Medicare's long-term fiscal outlook.

System impact research – increasing public health and health care system performance

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Malmivaara, Antti

2016-01-01

Abstract Background Interventions directed to system features of public health and health care should increase health and welfare of patients and population. Aims To build a new framework for studies aiming to assess the impact of public health or health care system, and to consider the role of Randomized Controlled Trials (RCTs) and of Benchmarking Controlled Trials (BCTs). Methods The new concept is partly based on the author's previous paper on the Benchmarking Controlled Trial. The validity and generalizability considerations were based on previous methodological studies on RCTs and BCTs. Results The new concept System Impact Research (SIR) covers all the studies which aim to assess the impact of the public health system or of the health care system on patients or on population. There are two kinds of studies in System Impact Research: Benchmarking Controlled Trials (observational) and Randomized Controlled Trials (experimental). The term impact covers in particular accessibility, quality, effectiveness, safety, efficiency, and equality. Conclusions System Impact Research – creating the scientific basis for policy decision making - should be given a high priority in medical, public health and health economic research, and should also be used for improving performance. Leaders at all levels of health and social care can use the evidence from System Impact Research for the benefit of patients and population.Key messagesThe new concept of SIR is defined as a research field aiming at assessing the impacts on patients and on populations of features of public health and health and social care systems or of interventions trying to change these features.SIR covers all features of public health and health and social care system, and actions upon these features. The term impact refers to all effects caused by the public health and health and social care system or parts of it, with particular emphasis on accessibility, quality, effectiveness, adverse effects, efficiency

Can broader diffusion of value-based insurance design increase benefits from US health care without increasing costs? Evidence from a computer simulation model.

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Braithwaite, R Scott; Omokaro, Cynthia; Justice, Amy C; Nucifora, Kimberly; Roberts, Mark S

2010-02-16

Evidence suggests that cost sharing (i.e.,copayments and deductibles) decreases health expenditures but also reduces essential care. Value-based insurance design (VBID) has been proposed to encourage essential care while controlling health expenditures. Our objective was to estimate the impact of broader diffusion of VBID on US health care benefits and costs. We used a published computer simulation of costs and life expectancy gains from US health care to estimate the impact of broader diffusion of VBID. Two scenarios were analyzed: (1) applying VBID solely to pharmacy benefits and (2) applying VBID to both pharmacy benefits and other health care services (e.g., devices). We assumed that cost sharing would be eliminated for high-value services (value services ($100,000-$300,000 per life-year or unknown), and would be increased for low-value services (>$300,000 per life-year). All costs are provided in 2003 US dollars. Our simulation estimated that approximately 60% of health expenditures in the US are spent on low-value services, 20% are spent on intermediate-value services, and 20% are spent on high-value services. Correspondingly, the vast majority (80%) of health expenditures would have cost sharing that is impacted by VBID. With prevailing patterns of cost sharing, health care conferred 4.70 life-years at a per-capita annual expenditure of US$5,688. Broader diffusion of VBID to pharmaceuticals increased the benefit conferred by health care by 0.03 to 0.05 additional life-years, without increasing costs and without increasing out-of-pocket payments. Broader diffusion of VBID to other health care services could increase the benefit conferred by health care by 0.24 to 0.44 additional life-years, also without increasing costs and without increasing overall out-of-pocket payments. Among those without health insurance, using cost saving from VBID to subsidize insurance coverage would increase the benefit conferred by health care by 1.21 life-years, a 31% increase

Increased biomass yield of Lactococcus lactis during energetically limited growth and respiratory conditions

DEFF Research Database (Denmark)

Købmann, Brian Jensen; Blank, Lars Mathias; Solem, Christian

2008-01-01

(glucose/mannose-specific phosphotransferase system). Amino acid catabolism could be excluded as the source of the additional ATP. Since mutants without a functional H+-ATPase produced less ATP under sugar starvation and respiratory conditions, the additional ATP yield appears to come partly from energy......Lactococcus lactis is known to be capable of respiration under aerobic conditions in the presence of haemin. In the present study the effect of respiration on ATP production during growth on different sugars was examined. With glucose as the sole carbon source, respiratory conditions in L. lactis...... MG1363 resulted in only a minor increase, 21%, in biomass yield. Since ATP production through substrate-level phosphorylation was essentially identical with and without respiration, the increased biomass yield was a result of energy-saving under respiratory conditions estimated to be 0.4 mol of ATP...

Working conditions and public health risks in slaughterhouses in western Kenya

Directory of Open Access Journals (Sweden)

Elizabeth Anne Jessie Cook

2017-01-01

Full Text Available Abstract Background Inadequate facilities and hygiene at slaughterhouses can result in contamination of meat and occupational hazards to workers. The objectives of this study were to assess current conditions in slaughterhouses in western Kenya and the knowledge, and practices of the slaughterhouse workers toward hygiene and sanitation. Methods Between February and October 2012 all consenting slaughterhouses in the study area were recruited. A standardised questionnaire relating to facilities and practices in the slaughterhouse was administered to the foreperson at each site. A second questionnaire was used to capture individual slaughterhouse workers’ knowledge, practices and recent health events. Results A total of 738 slaughterhouse workers from 142 slaughterhouses completed questionnaires. Many slaughterhouses had poor infrastructure, 65% (95% CI 63–67% had a roof, cement floor and walls, 60% (95% CI 57–62% had a toilet and 20% (95% CI 18–22% had hand-washing facilities. The meat inspector visited 90% (95% CI 92–95% of slaughterhouses but antemortem inspection was practiced at only 7% (95% CI 6–8%. Nine percent (95% CI 7–10% of slaughterhouses slaughtered sick animals. Only half of workers wore personal protective clothing - 53% (95% CI 51–55% wore protective coats and 49% (95% CI 46–51% wore rubber boots. Knowledge of zoonotic disease was low with only 31% (95% CI 29–33% of workers aware that disease could be transmitted from animals. Conclusions The current working conditions in slaughterhouses in western Kenya are not in line with the recommendations of the Meat Control Act of Kenya. Current facilities and practices may increase occupational exposure to disease or injury and contaminated meat may enter the consumer market. The findings of this study could enable the development of appropriate interventions to minimise public health risks. Initially, improvements need to be made to facilities and practices to improve

Modern environmental health hazards: a public health issue of increasing significance in Africa.

Science.gov (United States)

Nweke, Onyemaechi C; Sanders, William H

2009-06-01

Traditional hazards such as poor sanitation currently account for most of Africa's environmentally related disease burden. However, with rapid development absent appropriate safeguards for environment and health, modern environmental health hazards (MEHHs) may emerge as critical contributors to the continent's disease burden. We review recent evidence of human exposure to and health effects from MEHHs, and their occurrence in environmental media and consumer products. Our purpose is to highlight the growing significance of these hazards as African countries experience urbanization, industrial growth, and development. We reviewed published epidemiologic, exposure, and environmental studies of chemical agents such as heavy metals and pesticides. The body of evidence demonstrates ongoing environmental releases of MEHHs and human exposures sometimes at toxicologically relevant levels. Several sources of MEHHs in environmental media have been identified, including natural resource mining and processing and automobile exhaust. Biomonitoring studies provided direct evidence of human exposure to metals such as mercury and lead and pesticides such as p,p'-dichlorodiphenyltrichloroethane (DDT) and organophosphates. Land and water resource pollution and industrial air toxics are areas of significant data gaps, notwithstanding the presence of several emitting sources. Unmitigated MEHH releases and human exposure have implications for Africa's disease burden. For Africans encumbered by conditions such as malnutrition that impair resilience to toxicologic challenges, the burden may be higher. A shift in public health policy toward accommodating the emerging diversity in Africa's environmental health issues is necessary to successfully alleviate the burden of avoidable ill health and premature death for all its communities now and in the future.

Medicaid Expansion And Grant Funding Increases Helped Improve Community Health Center Capacity.

Science.gov (United States)

Han, Xinxin; Luo, Qian; Ku, Leighton

2017-01-01

Through the expansion of Medicaid eligibility and increases in core federal grant funding, the Affordable Care Act (ACA) sought to increase the capacity of community health centers to provide primary care to low-income populations. We examined the effects of the ACA Medicaid expansion and changes in federal grant levels on the centers' numbers of patients, percentages of patients by type of insurance, and numbers of visits from 2012 to 2015. In the period after expansion (2014-15), health centers in expansion states had a 5 percent higher total patient volume, larger shares of Medicaid patients, smaller shares of uninsured patients, and increases in overall visits and mental health visits, compared to centers in nonexpansion states. Increases in federal grant funding levels were associated with increases in numbers of patients and of overall, medical, and preventive service visits. If federal grant levels are not sustained after 2017, there could be marked reductions in health center capacity in both expansion and nonexpansion states. Project HOPE—The People-to-People Health Foundation, Inc.

The Atlas of Health and Working Conditions by Occupation. 1. Occupational ranking lists and occupational profiles from periodical occupational health survey data

NARCIS (Netherlands)

Broersen, J. P.; van Dijk, F. J.; Weel, A. N.; Verbeek, J. H.

1995-01-01

In this article, we describe methods which have been applied in the compilation of the Atlas of Health and Working conditions by Occupation. First, we discuss the need for information systems to identify problems concerning working conditions and health. Such information systems have an exploratory

Working conditions and workplace health and safety promotion in home care: A mixed-method study from Swedish managers' perspectives.

Science.gov (United States)

Gard, Gunvor; Larsson, Agneta

2017-11-02

Today, we can see a trend toward increased psychosocial strain at work among home-care managers and staff. The aim of this study is to describe home care managers' views on their own psychosocial working conditions and on how to promote workplace health and safety in a municipality in northern Sweden. A mixed-methods design was used, including questionnaire and qualitative focus group data. The qualitative data were analyzed by manifest content analysis. The results indicate that most managers perceived increased variety in work and opportunities for development at work, but at the same time increased demands. The managers suggested that workplace health and safety could be improved by risk assessment and improved communication, a clear communication chain by a real as well as a virtual platform for communication. In summary, workplace health and safety could be improved by risk assessments and by a physical as well as a virtual platform for communication.

Are health inequalities rooted in the past? Income inequalities in metabolic syndrome decomposed by childhood conditions

Science.gov (United States)

San Sebastian, Miguel; Ivarsson, Anneli; Weinehall, Lars; Gustafsson, Per E.

2017-01-01

Abstract Background: Early life is thought of as a foundation for health inequalities in adulthood. However, research directly examining the contribution of childhood circumstances to the integrated phenomenon of adult social inequalities in health is absent. The present study aimed to examine whether, and to what degree, social conditions during childhood explain income inequalities in metabolic syndrome in mid-adulthood. Methods: The sample (N = 12 481) comprised all 40- and 50-year-old participants in the Västerbotten Intervention Program in Northern Sweden 2008, 2009 and 2010. Measures from health examinations were used to operationalize metabolic syndrome, which was linked to register data including socioeconomic conditions at age 40–50 years, as well as childhood conditions at participant age 10–12 years. Income inequality in metabolic syndrome in middle age was estimated by the concentration index and decomposed by childhood and current socioeconomic conditions using decomposition analysis. Results: Childhood conditions jointed explained 7% (men) to 10% (women) of health inequalities in middle age. Adding mid-adulthood sociodemographic factors showed a dominant contribution of chiefly current income and educational level in both gender. In women, the addition of current factors slightly attenuated the contribution of childhood conditions, but with paternal income and education still contributing. In contrast, the corresponding addition in men removed all explanation attributable to childhood conditions. Conclusions: Despite that the influence of early life conditions to adult health inequalities was considerably smaller than that of concurrent conditions, the study suggests that early interventions against social inequalities potentially could reduce health inequalities in the adult population for decades to come. PMID:27744345

Portuguese expatriates' health in Angola and Mozambique-a cross-sectional study: increasing awareness and need for more surveillance.

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Fonseca, Ana Glória; Dias, Sara S; Baptista, João Luis; Torgal, Jorge

2017-07-01

Increasing numbers of expatriates are working in sub-Saharan Africa. There is little published data on the complex population and this survey aimed at understanding expatriate morbidity by accessing self-reported health problems and malaria preventive practices. A cross-sectional web-based survey was conducted targeting Portuguese expatriates in Angola and Mozambique. Logistic regression analysis explored factors associated with self-reported health problems and psychological symptoms in the previous 3 months. A total sample of 352 adult Portuguese urban civil occupational expatriates was obtained. Median length of expatriation was 3 years. Considering a 3-month timeframe, one in five expatriates reported new health problems and need of medical assistance, 5% were hospitalized and 64% reported general psychological symptoms. Less than 2% of subjects were on malaria chemoprophylaxis. Having chronic health conditions doubled the reporting of new health problems. Increasing length of expatriation was associated with decreasing reporting of general psychological symptoms. Directors and executive managers and expatriates living alone tended to report more general psychological symptoms. Expatriate communities deserve enhanced surveillance for the health issues that affect them. This will improve evidence-based preparation and intervention by public and travel health practitioners. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Socio-demographics characteristics and health conditions of older homeless persons of Lima, Peru

OpenAIRE

Moquillaza-Risco, Marlene; Programa Nacional Vida Digna (PNVD), Ministerio de la Mujer y Poblaciones Vulnerables. Lima, Perú.; León, Elsa; Programa Nacional Vida Digna (PNVD), Ministerio de la Mujer y Poblaciones Vulnerables. Lima, Perú.; Dongo, Mario; Programa Nacional Vida Digna (PNVD), Ministerio de la Mujer y Poblaciones Vulnerables. Lima, Perú.; Munayco, César V.; Programa Nacional Vida Digna (PNVD), Ministerio de la Mujer y Poblaciones Vulnerables. Lima, Perú.

2015-01-01

Objectives. Determine the socio-demographics characteristics and health conditions of older homeless persons at the time of enrollment into the National Program “Vida Digna” and the probability of functional dependency by age, and stratified by gender and cognitive impairment. Materials ande methods. We performed a cross sectional study, reviewing all registration forms of the program in order to identify socio-demographic variables and health conditions of older homeless persons at the time ...

Can broader diffusion of value-based insurance design increase benefits from US health care without increasing costs? Evidence from a computer simulation model.

Directory of Open Access Journals (Sweden)

R Scott Braithwaite

2010-02-01

Full Text Available BACKGROUND: Evidence suggests that cost sharing (i.e.,copayments and deductibles decreases health expenditures but also reduces essential care. Value-based insurance design (VBID has been proposed to encourage essential care while controlling health expenditures. Our objective was to estimate the impact of broader diffusion of VBID on US health care benefits and costs. METHODS AND FINDINGS: We used a published computer simulation of costs and life expectancy gains from US health care to estimate the impact of broader diffusion of VBID. Two scenarios were analyzed: (1 applying VBID solely to pharmacy benefits and (2 applying VBID to both pharmacy benefits and other health care services (e.g., devices. We assumed that cost sharing would be eliminated for high-value services ($300,000 per life-year. All costs are provided in 2003 US dollars. Our simulation estimated that approximately 60% of health expenditures in the US are spent on low-value services, 20% are spent on intermediate-value services, and 20% are spent on high-value services. Correspondingly, the vast majority (80% of health expenditures would have cost sharing that is impacted by VBID. With prevailing patterns of cost sharing, health care conferred 4.70 life-years at a per-capita annual expenditure of US$5,688. Broader diffusion of VBID to pharmaceuticals increased the benefit conferred by health care by 0.03 to 0.05 additional life-years, without increasing costs and without increasing out-of-pocket payments. Broader diffusion of VBID to other health care services could increase the benefit conferred by health care by 0.24 to 0.44 additional life-years, also without increasing costs and without increasing overall out-of-pocket payments. Among those without health insurance, using cost saving from VBID to subsidize insurance coverage would increase the benefit conferred by health care by 1.21 life-years, a 31% increase. CONCLUSION: Broader diffusion of VBID may amplify benefits from

Marine algal toxins: origins, health effects, and their increased occurrence

International Nuclear Information System (INIS)

Van Dolah, Frances M.

2000-01-01

Certain marine algae produce potent toxins that impact human health through the consumption of contaminated shellfish and finfish and through water or aerosol exposure. Over the past three decades, the frequency and global distribution of toxic algal incidents appear to have increased, and human intoxications from novel algal sources have occurred. This increase is of particular concern, since it parallels recent evidence of large-scale ecologic disturbances that coincide with trends in global warming. The extent to which human activities have contributed to their increase therefore comes into question. This review summarizes the origins and health effects of marine algal toxins, as well as changes in their current global distribution, and examines possible causes for the recent increase in their occurrence. (Author)

77 FR 24628 - World Trade Center Health Program Requirements for the Addition of New WTC-Related Health Conditions

Science.gov (United States)

2012-04-25

...; and a physician experienced with treating WTC-related health conditions requested that a mental... likely to be a significant factor in aggravating, contributing to, or causing the illness or condition... specified in the statute. We agree with commenters who pointed out that we neglected to specify a time frame...

Potential of human health in the modern conditions

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O. V. Dobryden

2016-03-01

Full Text Available This article proves that man’s relationship to their health  in each case have varying traits under the influence of sociocultural, psychological and physiological factors  which the world outlook is created from childhood, which implies the appropriate type of behavior that is fixed through the media and social authorities. It is established that scientific knowledge should not be against a man, and should enhance the power of man over nature, but can be transformed into a powerful weapon against humanity. It is noted that science is neutral in terms of values. Will it carry a positive or negative charge to human health depends on the social and cultural markers specific historical era and behavior of the individual. It was found that in addition to the economic crisis, which requires long-term joint economic and political transformations, the most important factor and more accessible to maintaining high adaptive potential health functions at all levels is valeological literacy social subjects and, therefore, imperative the systematic distribution of hygiene recommendations is a significant component of preventive medicine. With the growth of social and technological factors with their aggressive effect on psychophysiological state of man is seen timely more  talk even not about health in general, but should talk about  potential health, which underlines  the  difficulties adaptive and protective processes and susceptibility factors and resistance to pathological changes in the human body. All the more so when we following the formal standards of medicine is unlikely, unfortunately, we be found absolutely healthy people. Under the proposed potential health understood as a set of quantitative and qualitative structural and functional characteristics of the organism, which determine the level of adaptation and protection of human capabilities in adverse conditions, internal and external environment. It is proposed to examine potential

The influence of social capital and socio-economic conditions on self-rated health among residents of an economically and health-deprived South African township

Directory of Open Access Journals (Sweden)

Cramm Jane M

2011-11-01

Full Text Available Abstract Background Surprisingly few studies have investigated the interplay of multiple factors affecting self-rated health outcomes and the role of social capital on health in developing countries, a prerequisite to strengthening our understanding of the influence of social and economic conditions on health and the most effective aid. Our study aimed to identify social and economic conditions for health among residents of an economically and health-deprived community. Methods Data were gathered through a survey administered to respondents from 1,020 households in Grahamstown a suburb in the Eastern Cape, South Africa (response rate 97.9%. We investigated the influence of social and economic conditions (education, employment, income, social capital, housing quality and neighborhood quality on self-rated health. We used ordinal logistic regression analyses to identify the relationship of these conditions and self-rated health. Results Our study found that education and social capital positively correlated with health; unemployment, poor educational level and advanced age negatively correlated. We found no significant correlations between self-rated health and housing quality, neighbourhood quality, income, gender, or marital status. Conclusion We highlight the possible impacts of social capital, employment, and education on health, and suggest that health outcomes may be improved through interventions beyond the health system: creating job opportunities, strengthening social capital, bettering educational systems, and promoting educational access. Policymakers should consider the benefits of such programmes when addressing health outcomes in financially distressed districts.

[Women in informal economy health and work conditions Bogotá. 2007].

Science.gov (United States)

Sotelo-Suárez, Nidia R; Quiroz-Arcentáles, Jorge L; Mahecha-Montilla, Charo P; López-Sánchez, Paola A

2012-06-01

To determine work and health conditions of women working in informal economy in Bogotá, as well as to recommend priority action plans for preventing illnesses and accidents related to work and their consequences. Descriptive observational study. This study analyzed information collected by local groups in work-related contexts during 2007 as part of a set of forms of intervention established according to the Plan de Atención Básica (Primary Care Plan). This plan included 3 715 units of informal work from every point of the city. 3 936 women registers in all were analyzed. This study reveals evident precariousness conditions of women in this economic sector. Specifically, there are certain evident conditions that had shown in this study such as low education levels, incomes below the minimum legal standards, high exposure to damaging health work conditions, long work hours, and few hours for leisure and free time. Furthermore, 75 % of women included in this study are female head of household. This condition makes them more vulnerable to a heavier family and social burden. Closer attention to informal economy phenomenon is suggested in order to avoid vulnerable conditions of working women. Besides, it is necessary to improve the articulation between Academy and forms of intervention through public policies for knowing deeply repeated phenomena regarding the population of study. This articulation can be thought for implementing programs designed for improving women's quality of life.

Processing Conditions, Rice Properties, Health and Environment

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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.

Addressing Health Care Disparities and Increasing Workforce Diversity: The Next Step for the Dental, Medical, and Public Health Professions

Science.gov (United States)

Mitchell, Dennis A.; Lassiter, Shana L.

2006-01-01

The racial/ethnic composition of our nation is projected to change drastically in the coming decades. It is therefore important that the health professions improve their efforts to provide culturally competent care to all patients. We reviewed literature concerning health care disparities and workforce diversity issues—particularly within the oral health field—and provide a synthesis of recommendations to address these issues. This review is highly relevant to both the medical and public health professions, because they are facing similar disparity and workforce issues. In addition, the recent establishment of relationships between oral health and certain systemic health conditions will elevate oral health promotion and disease prevention as important points of intervention in the quest to improve our nation’s public health. PMID:17077406

Health Care Use, Health Behaviors, and Medical Conditions Among Individuals in Same-Sex and Opposite-Sex Partnerships: A Cross-Sectional Observational Analysis of the Medical Expenditures Panel Survey (MEPS), 2003-2011.

Science.gov (United States)

Blosnich, John R; Hanmer, Janel; Yu, Lan; Matthews, Derrick D; Kavalieratos, Dio

2016-06-01

Prior research documents disparities between sexual minority and nonsexual minority individuals regarding health behaviors and health services utilization. However, little is known regarding differences in the prevalence of medical conditions. To examine associations between sexual minority status and medical conditions. We conducted multiple logistic regression analyses of the Medical Expenditure Panel Survey (2003-2011). We identified individuals who reported being partnered with an individual of the same sex, and constructed a matched cohort of individuals in opposite-sex partnerships. A total of 494 individuals in same-sex partnerships and 494 individuals in opposite-sex partnerships. Measures of health risk (eg, smoking status), health services utilization (eg, physician office visits), and presence of 15 medical conditions (eg, cancer, diabetes, arthritis, HIV, alcohol disorders). Same-sex partnered men had nearly 4 times the odds of reporting a mood disorder than did opposite-sex partnered men [adjusted odds ratio (aOR)=3.96; 95% confidence interval (CI), 1.85-8.48]. Compared with opposite-sex partnered women, same-sex partnered women had greater odds of heart disease (aOR=2.59; 95% CI, 1.19-5.62), diabetes (aOR=2.75; 95% CI, 1.10-6.90), obesity (aOR=1.92; 95% CI, 1.26-2.94), high cholesterol (aOR=1.89; 95% CI, 1.03-3.50), and asthma (aOR=1.90; 95% CI, 1.02-1.19). Even after adjusting for sociodemographics, health risk behaviors, and health conditions, individuals in same-sex partnerships had 67% increased odds of past-year emergency department utilization and 51% greater odds of ≥3 physician visits in the last year compared with opposite-sex partnered individuals. A combination of individual-level, provider-level, and system-level approaches are needed to reduce disparities in medical conditions and health care utilization among sexual minority individuals.

Numerical investigation of the effect of friction conditions to increase die life

Science.gov (United States)

Mutlu, M. O.; Guleryuz, C. G.; Parlar, Z.

2017-02-01

The standard die materials in aluminium extrusion offer good mechanical properties like high tempering resistance, high strength and ductility. On the other hand, they struggle with the problem of sliding wear. As a result, there is a growing interest in using surface treatment techniques to increase the wear resistance of extrusion dies. In this study, it is aimed to observe the effects of the different friction conditions on material flow and contact pressure in extrusion process. These friction conditions can be obtained with the application of a variety of surface treatment. In this way, it is expected to decrease the friction force on the die bearing area and to increase the homogeneity of the material flow which will result in the increase of the quality of the extrudate as well as the improvement of the process economically by extending die life. For this purpose, an extrusion process is simulated with a finite element software. A die made of 1.2344 hot work tool steel-commonly used die material for aluminium extrusion process- has been modelled and Al 1100 alloy used as billet material. Various friction factor values defined on the die surface under the same process parameters and effects of changing frictional conditions on the die and the extrusion process have been discussed.

The impact of psychosocial and organizational working conditions on the mental health of female cleaning personnel in Norway.

Science.gov (United States)

Gamperiene, Migle; Nygård, Jan F; Sandanger, Inger; Waersted, Morten; Bruusgaard, Dag

2006-11-01

This study examined the association between psychosocial and organizational work conditions and mental health among women employed in the cleaning profession in Norway. Self-report questionnaires were mailed to 661 cleaning staff personnel from seven cleaning organizations in seven different cities across Norway. The response rate was 64%, of which 374 (88%) respondents were women. The questionnaires assessed socio-demographic information and employment history, work organization, and psychosocial working conditions. The Hopkins Symptoms Checklist (HSCL-25) was included to assess mental health. On average, respondents were 43 years old and reported 10.8 years of experience working in the cleaning industry. The proportion of women scoring a HSCL-25 equal to or above 1.75 was 17.5%, which was higher than the average prevalence of mental health problems among working Norwegian women (8.4%). A factor analysis of the questions specific to the psychosocial work environment identified the following four underlying dimensions: leadership, co-workers, time pressure/control, and information/knowledge. Two of these, poor satisfaction with leadership (OR = 3.6) and poor satisfaction with co-workers (OR = 2.3), were significantly related to mental health. In addition, having contact with colleagues less than once a day (OR = 2.4) and not being ethnically Norwegian (OR = 3.0) increased the risk for mental health problems. Mental health problems are frequent among female cleaning professionals in Norway. Our results indicate that quality of leadership, collaboration with co-workers, and ethnicity were significantly associated with mental health.

Maternal pre- and postnatal mental health and infant development in war conditions: The Gaza Infant Study.

Science.gov (United States)

Punamäki, Raija-Leena; Diab, Safwat Y; Isosävi, Sanna; Kuittinen, Saija; Qouta, Samir R

2018-03-01

Women and their infants need special protection in war context, as traumatic events can risk maternal mental and obstetric health and compromise infant development. This prospective study examined, first, how exposure to war trauma is associated with maternal mental health in pregnancy and postpartum, obstetric and newborn health, and infant development. Second, it tested the role of maternal mental health and obstetric risks in mediating between war trauma and infant development. Palestinian women (N = 511) from the Gaza strip participated during pregnancy (T1) and at 4 (T2) and 12 (T3) months postpartum. They reported PTSD, depressive, anxiety, and dissociative symptoms, as well as pregnancy complications, newborn health risks such as prematurity, and infant sensorimotor and language development. First, exposure to war trauma was associated with high levels of maternal mental health and complications at pregnancy, and with increased postpartum mental health symptoms, but exposure was not directly associated with newborn health risks or problems in infant development. Second, maternal mental health both in pregnancy and postpartum, but not pregnancy complications or newborn health, mediated the negative impact of war trauma on infant sensorimotor and language development at 12 months. Interventions to protect early child development in war conditions should be tailored to support maternal mental health. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The Role of Condition-Specific Preference-Based Measures in Health Technology Assessment.

Science.gov (United States)

Rowen, Donna; Brazier, John; Ara, Roberta; Azzabi Zouraq, Ismail

2017-12-01

A condition-specific preference-based measure (CSPBM) is a measure of health-related quality of life (HRQOL) that is specific to a certain condition or disease and that can be used to obtain the quality adjustment weight of the quality-adjusted life-year (QALY) for use in economic models. This article provides an overview of the role and the development of CSPBMs, and presents a description of existing CSPBMs in the literature. The article also provides an overview of the psychometric properties of CSPBMs in comparison with generic preference-based measures (generic PBMs), and considers the advantages and disadvantages of CSPBMs in comparison with generic PBMs. CSPBMs typically include dimensions that are important for that condition but may not be important across all patient groups. There are a large number of CSPBMs across a wide range of conditions, and these vary from covering a wide range of dimensions to more symptomatic or uni-dimensional measures. Psychometric evidence is limited but suggests that CSPBMs offer an advantage in more accurate measurement of milder health states. The mean change and standard deviation can differ for CSPBMs and generic PBMs, and this may impact on incremental cost-effectiveness ratios. CSPBMs have a useful role in HTA where a generic PBM is not appropriate, sensitive or responsive. However, due to issues of comparability across different patient groups and interventions, their usage in health technology assessment is often limited to conditions where it is inappropriate to use a generic PBM or sensitivity analyses.

Essential conditions for the implementation of comprehensive school health to achieve changes in school culture and improvements in health behaviours of students

Directory of Open Access Journals (Sweden)

Kate E. Storey

2016-11-01

Full Text Available Abstract Background Comprehensive School Health (CSH is an internationally recognized framework that holistically addresses school health by transforming the school culture. It has been shown to be effective in enhancing health behaviours among students while also improving educational outcomes. Despite this effectiveness, there is a need to focus on how CSH is implemented. Previous studies have attempted to uncover the conditions necessary for successful operationalization, but none have described them in relation to a proven best practice model of implementation that has demonstrated positive changes to school culture and improvements in health behaviours. Methods The purpose of this research was to identify the essential conditions of CSH implementation utilizing secondary analysis of qualitative interview data, incorporating a multitude of stakeholder perspectives. This included inductive content analysis of teacher (n = 45, principal (n = 46, and school health facilitator (n = 34 viewpoints, all of whom were employed within successful CSH project schools in Alberta, Canada between 2008 and 2013. Results Many themes were identified, here called conditions, that were divided into two categories: ‘core conditions’ (students as change agents, school-specific autonomy, demonstrated administrative leadership, dedicated champion to engage school staff, community support, evidence, professional development and ‘contextual conditions’ (time, funding and project supports, readiness and prior community connectivity. Core conditions were defined as those conditions necessary for CSH to be successfully implemented, whereas contextual conditions had a great degree of influence on the ability for the core conditions to be obtained. Together, and in consideration of already established ‘process conditions’ developed by APPLE Schools (assess, vision, prioritize; develop and implement an action plan; monitor, evaluate, celebrate

Utilization of emergency medical transports and hospital admissions among persons with behavioral health conditions.

Science.gov (United States)

Cuddeback, Gary; Patterson, P Daniel; Moore, Charity Galena; Brice, Jane H

2010-04-01

Emergency medical services transport and emergency department misuse among persons with behavioral health conditions is a concern. Administrative data were used to examine medical transports and hospital admissions among persons with behavioral health conditions. Data on 70,126 medical transports to emergency departments in three southeastern counties were analyzed. Compared with general medical transports, fewer behavioral health transports resulted in a hospital admission. Among behavioral health transports, persons with schizophrenia were 2.62 times more likely than those with substance use disorders to be admitted, and persons with mood disorders were 4.36 times more likely than those with substance use disorders to be admitted. Also, among behavioral health transports, rural transports were less likely than more urban transports to result in a hospital admission. More training of emergency medical services personnel and more behavioral health crisis resources, especially targeting rural areas and substance use disorders, are needed.

Patients' increasing search for health information on internet.

NARCIS (Netherlands)

Schee, E. van der; Delnoij, D.

2004-01-01

Background: The number of web sites on the internet, providing health information, discussion groups, internet doctors or selling drugs is increasing fast. In 2001, the number was rated over 100.000 (Risk and Dzenowagis, 2001). The growing number of websites on these topics might be expected to

Maternal health care utilization in Viet Nam: increasing ethnic inequity.

Science.gov (United States)

Målqvist, Mats; Lincetto, Ornella; Du, Nguyen Huy; Burgess, Craig; Hoa, Dinh Thi Phuong

2013-04-01

To investigate changes that took place between 2006 and 2010 in the inequity gap for antenatal care attendance and delivery at health facilities among women in Viet Nam. Demographic, socioeconomic and obstetric data for women aged 15-49 years were extracted from Viet Nam's Multiple Indicator Cluster Survey for 2006 (MICS3) and 2010-2011 (MICS4). Multivariate logistic regression was performed to determine if antenatal care attendance and place of delivery were significantly associated with maternal education, maternal ethnicity (Kinh/Hoa versus other), household wealth and place of residence (urban versus rural). These independent variables correspond to the analytical framework of the Commission on Social Determinants of Health. Large discrepancies between urban and rural populations were found in both MICS3 and MICS4. Although antenatal care attendance and health facility delivery rates improved substantially between surveys (from 86.3 to 92.1% and from 76.2 to 89.7%, respectively), inequities increased, especially along ethnic lines. The risk of not giving birth in a health facility increased significantly among ethnic minority women living in rural areas. In 2006 this risk was nearly five times higher than among women of Kinh/Hoa (majority) ethnicity (odds ratio, OR: 4.67; 95% confidence interval, CI: 2.94-7.43); in 2010-2011 it had become nearly 20 times higher (OR: 18.8; 95% CI: 8.96-39.2). Inequity in maternal health care utilization has increased progressively in Viet Nam, primarily along ethnic lines, and vulnerable groups in the country are at risk of being left behind. Health-care decision-makers should target these groups through affirmative action and culturally sensitive interventions.

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.

Effect of a 21-day balneotherapy program on blood cell counts, ponogen levels, and blood biochemical indexes in servicemen in sub-health condition.

Science.gov (United States)

Xu, Li; Wu, Lin; Liu, Tingting; Xing, Wenrong; Cao, Xinsheng; Zhang, Shu; Su, Zongyi

2017-09-01

[Purpose] The aim of our study was to explore the changes in the blood of servicemen in sub-health conditions during a 21-day balneotherapy program. [Subjects and Methods] For this study, 129 servicemen in sub-health condition were recruited. The subjects were randomly divided into either the balneotherapy group (70) or the control group (59). Subjects in the balneotherapy group received whole-body immersion bath therapy in thermomineral water (30 min daily) for 21 days. Their blood samples were examined 1 day before and after balneotherapy. The parameters studied included mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), white blood cell (WBC), lactic acid (LAC), alanine aminotransferase (ALT), glucose (GLU), and triglycerides (TG) levels. [Results] After 21 days of balneotherapy, MCH levels and MCHC increased significantly and WBC counts increased significantly. LAC levels decreased significantly. ALT, GLU, and TG levels decreased significantly. In the control group, there were no statistical differences before and after tap water baths following the same procedure. [Conclusion] A 21-day balneotherapy program significantly improved blood cell counts and blood biochemical indexes and reduced ponogen levels in servicemen in sub-health condition.

Dietary behaviors and body image recognition of college students according to the self-rated health condition.

Science.gov (United States)

Kim, Mi Joung; Lim, Ye Rom; Kwak, Ho Kyung

2008-01-01

This study was done to investigate the relationship between the perception of body image, body weight satisfaction or dietary behavior and self-rated health status in Korean college students. Subjects, 285 college students, were divided into three groups (healthy, normal, and unhealthy) according to the answer for the self-rated health question. Information about demographic status, self-rated health condition, height and weight, perception of body image, satisfaction of body weight, concern for body weight control, dietary behavior, nutritional knowledge, and health-related characteristics collected by a self-reported questionnaire. The proportion of men and women in each group was not significantly different. The academic year, major, experience of nutritional education, and type of residence were not significantly related with self-rated health but the pocket money range was significantly associated (ppocket money range and was increased in less than 210 thousand won or over 300 thousand won pocket money ranges. There were no significant differences for age, height, weight and BMI between the groups. The body image perception and body weight satisfaction levels of healthy group was significantly higher than those of unhealthy group (p<0.01 and p<0.001, respectively), but the level of concern for body weight control in healthy subjects was significantly lower than that in unhealthy subjects (p<0.05). The proportion of subjects reported as healthy was significantly increased with increased frequencies of following food behaviors; weekly use of protein foods (p<0.01), vegetables (p<0.05) and dairy products (p<0.01), and food habits such as "regularity of meal time" (p<0.01), "eating in moderation" (p<0.05), and "eating breakfast" (p<0.001). Overall results suggested that the college students have tended to have a better perception of health when they have better body image perception, body weight satisfaction and dietary behaviors.

Experience of primary care among homeless individuals with mental health conditions.

Directory of Open Access Journals (Sweden)

Joya G Chrystal

Full Text Available The delivery of primary care to homeless individuals with mental health conditions presents unique challenges. To inform healthcare improvement, we studied predictors of favorable primary care experience among homeless persons with mental health conditions treated at sites that varied in degree of homeless-specific service tailoring. This was a multi-site, survey-based comparison of primary care experiences at three mainstream primary care clinics of the Veterans Administration (VA, one homeless-tailored VA clinic, and one tailored non-VA healthcare program. Persons who accessed primary care service two or more times from July 2008 through June 2010 (N = 366 were randomly sampled. Predictor variables included patient and organization characteristics suggested by the patient perception model developed by Sofaer and Firminger (2005, with an emphasis on mental health. The primary care experience was assessed with the Primary Care Quality-Homeless (PCQ-H questionnaire, a validated survey instrument. Multiple regression identified predictors of positive experiences (i.e. higher PCQ-H total score. Significant predictors of a positive experience included a site offering tailored service design, perceived choice among providers, and currently domiciled status. There was an interaction effect between site and severe psychiatric symptoms. For persons with severe psychiatric symptoms, a homeless-tailored service design was significantly associated with a more favorable primary care experience. For persons without severe psychiatric symptoms, this difference was not significant. This study supports the importance of tailored healthcare delivery designed for homeless persons' needs, with such services potentially holding special relevance for persons with mental health conditions. To improve patient experience among the homeless, organizations may want to deliver services that are tailored to homelessness and offer a choice of providers.

Experience of Primary Care among Homeless Individuals with Mental Health Conditions

Science.gov (United States)

Chrystal, Joya G.; Glover, Dawn L.; Young, Alexander S.; Whelan, Fiona; Austin, Erika L.; Johnson, Nancy K.; Pollio, David E.; Holt, Cheryl L.; Stringfellow, Erin; Gordon, Adam J.; Kim, Theresa A.; Daigle, Shanette G.; Steward, Jocelyn L.; Kertesz, Stefan G

2015-01-01

The delivery of primary care to homeless individuals with mental health conditions presents unique challenges. To inform healthcare improvement, we studied predictors of favorable primary care experience among homeless persons with mental health conditions treated at sites that varied in degree of homeless-specific service tailoring. This was a multi-site, survey-based comparison of primary care experiences at three mainstream primary care clinics of the Veterans Administration (VA), one homeless-tailored VA clinic, and one tailored non-VA healthcare program. Persons who accessed primary care service two or more times from July 2008 through June 2010 (N = 366) were randomly sampled. Predictor variables included patient and organization characteristics suggested by the patient perception model developed by Sofaer and Firminger (2005), with an emphasis on mental health. The primary care experience was assessed with the Primary Care Quality-Homeless (PCQ-H) questionnaire, a validated survey instrument. Multiple regression identified predictors of positive experiences (i.e. higher PCQ-H total score). Significant predictors of a positive experience included a site offering tailored service design, perceived choice among providers, and currently domiciled status. There was an interaction effect between site and severe psychiatric symptoms. For persons with severe psychiatric symptoms, a homeless-tailored service design was significantly associated with a more favorable primary care experience. For persons without severe psychiatric symptoms, this difference was not significant. This study supports the importance of tailored healthcare delivery designed for homeless persons’ needs, with such services potentially holding special relevance for persons with mental health conditions. To improve patient experience among the homeless, organizations may want to deliver services that are tailored to homelessness and offer a choice of providers. PMID:25659142

Using Technology to Increase Physical Activity in Health Profession Students

Directory of Open Access Journals (Sweden)

Mary Ann Stark

2016-01-01

Full Text Available Health profession students may need help establishing and maintaining positive health behaviors when they are in college. This study explored the effectiveness of text messaging as an innovative method for promoting an increase in daily physical activity. A convenience sample (N = 134 was recruited from students at a college of Health and Human Services in Michigan. The participants were randomized into an intervention or control group (n = 67 each. The intervention group received daily affective text messages encouraging more physical activity by taking more steps. The control group received only messages reminding them to report their number of steps. All of the participants received a pedometer, completed a demographics and daily habits questionnaire, and completed the Perceived Stress Scale (PSS. There was no significant difference between the intervention and control groups in their number of daily steps. However, the most inactive participants had a significant increase in steps during the study period. Health profession students’ lifestyle behaviors have consequences, as they become caregivers in our dynamic, demanding health-care system. For those with the greatest need for physical activity, encouraging such activity via text messaging may improve their ability to care for themselves and their clients.

Using eHealth to Increase Autonomy Supportive Care

DEFF Research Database (Denmark)

Johnsen, Helle; Blom, Karina Fischer; Lee, Anne

2018-01-01

eHealth solutions are increasingly implemented in antenatal care to enhance women's involvement. The main aim of this study was to evaluate women's assessment of autonomy supportive care during the antenatal care visits among low-risk pregnant women. An intervention study was conducted including...... a control group attending standard antenatal care and an intervention group having access to an eHealth knowledge base, in addition to standard care. A total of 87 women were included in the control group and a total of 121 women in the intervention group. Data were collected using an online questionnaire 2...... weeks after participants had given birth. Data were analyzed using χ tests and Wilcoxon rank sums. Use of an eHealth knowledge base was associated with statistically significant higher scores for women's overall assessment of antenatal care visits, the organization of antenatal care visits, confidence...

EFFICACY AND SAFETY OF THE INFLUENZA VACCINE AMONG CHILDREN WITH DIFFERENT HEALTH CONDITIONS

OpenAIRE

M.G. Galitskaya

2007-01-01

Efficacy and safety of vaccine «Grippol» among children with different health status was analyzed. The most efficacy of the influenza vaccine revealed in the group of children with compromised health status, as well as in the group of allergic children. The safety of influenza vaccination was confirmed in children with different health conditions.Key words: children, vaccination, influenza, efficacy, safety.

Predictors of mental health in adults with congenital craniofacial conditions attending the Australian craniofacial unit.

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Roberts, R M; Mathias, J L

2013-07-01

Objective : Adults with craniofacial conditions experience more psychosocial problems than adults in the general population, but little is known about the factors that render a person more or less susceptible to these problems. Guided by research on adults with other conditions that affect appearance, this study examined predictors of psychosocial outcome in adults with craniofacial conditions. Design : Single-sample cross-sectional design. Setting : The Australian Craniofacial Unit, Women's and Children's Hospital, Adelaide, one of the main craniofacial treatment centers in Australia. Participants : Adults (N  =  93; 36.9% of the potential sample) with congenital craniofacial conditions (excluding cleft lip and/or cleft palate) who were treated in the Australian Craniofacial Unit. Main Outcome Measures : All participants completed measures assessing anxiety, depression, and quality of life (Hospital Anxiety and Depression Scale, Short-Form Health Survey) and variables predicted to affect these outcomes (SF-36 Health Survey - Multidimensional Scale of Perceived Social Support, Rosenberg Self-Esteem Scale, Cleft Satisfaction Profile, Brief Fear of Negative Evaluation Scale, Derriford Appearance Scale). Results : Multiple regression analyses revealed that anxiety was predicted by social support, self-esteem, and fear of negative evaluation, while depression was predicted by self-esteem and social support. Physical quality of life was not predicted by any of the measures. Satisfaction with appearance, gender, age, and education were not related to outcome. Conclusions : Interventions designed to increase perceived social support and self-esteem and reduce fear of negative evaluation appear to be indicated and may assist in establishing a causal relationship between these variables.

Consent for use of personal information for health research: Do people with potentially stigmatizing health conditions and the general public differ in their opinions?

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Schwartz Lisa

2009-07-01

Full Text Available Abstract Background Stigma refers to a distinguishing personal trait that is perceived as or actually is physically, socially, or psychologically disadvantageous. Little is known about the opinion of those who have more or less stigmatizing health conditions regarding the need for consent for use of their personal information for health research. Methods We surveyed the opinions of people 18 years and older with seven health conditions. Participants were drawn from: physicians' offices and clinics in southern Ontario; and from a cross-Canada marketing panel of individuals with the target health conditions. For each of five research scenarios presented, respondents chose one of five consent choices: (1 no need for me to know; (2 notice with opt-out; (3 broad opt-in; (4 project-specific permission; and (5 this information should not be used. Consent choices were regressed onto: demographics; health condition; and attitude measures of privacy, disclosure concern, and the benefits of health research. We conducted focus groups to discuss possible reasons for observed consent choices. Results We observed substantial variation in the control that people wish to have over use of their personal information for research. However, consent choice profiles were similar across health conditions, possibly due to sampling bias. Research involving profit or requiring linkage of health information with income, education, or occupation were associated with more restrictive consent choices. People were more willing to link their health information with biological samples than with information about their income, occupation, or education. Conclusions The heterogeneity in consent choices suggests individuals should be offered some choice in use of their information for different types of health research, even if limited to selectively opting-out. Some of the implementation challenges could be designed into the interoperable electronic health record. However, many

Web Use for Symptom Appraisal of Physical Health Conditions: A Systematic Review.

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Mueller, Julia; Jay, Caroline; Harper, Simon; Davies, Alan; Vega, Julio; Todd, Chris

2017-06-13

The Web has become an important information source for appraising symptoms. We need to understand the role it currently plays in help seeking and symptom evaluation to leverage its potential to support health care delivery. The aim was to systematically review the literature currently available on Web use for symptom appraisal. We searched PubMed, EMBASE, PsycINFO, ACM Digital Library, SCOPUS, and Web of Science for any empirical studies that addressed the use of the Web by lay people to evaluate symptoms for physical conditions. Articles were excluded if they did not meet minimum quality criteria. Study findings were synthesized using a thematic approach. A total of 32 studies were included. Study designs included cross-sectional surveys, qualitative studies, experimental studies, and studies involving website/search engine usage data. Approximately 35% of adults engage in Web use for symptom appraisal, but this proportion varies between 23% and 75% depending on sociodemographic and disease-related factors. Most searches were symptom-based rather than condition-based. Users viewed only the top search results and interacted more with results that mentioned serious conditions. Web use for symptom appraisal appears to impact on the decision to present to health services, communication with health professionals, and anxiety. Web use for symptom appraisal has the potential to influence the timing of help seeking for symptoms and the communication between patients and health care professionals during consultations. However, studies lack suitable comparison groups as well as follow-up of participants over time to determine whether Web use results in health care utilization and diagnosis. Future research should involve longitudinal follow-up so that we can weigh the benefits of Web use for symptom appraisal (eg, reductions in delays to diagnosis) against the disadvantages (eg, unnecessary anxiety and health care use) and relate these to health care costs. ©Julia Mueller

Demand-specific work ability, poor health and working conditions in middle-aged full-time employees.

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Nabe-Nielsen, Kirsten; Thielen, Karsten; Nygaard, Else; Thorsen, Sannie Vester; Diderichsen, Finn

2014-07-01

We investigated the prevalence of reduced demand-specific work ability, its association with age, gender, education, poor health, and working conditions, and the interaction between poor health and working conditions regarding reduced demand-specific work ability. We used cross-sectional questionnaire data from 3381 full-time employees responding to questions about vocational education, job demands and social support (working conditions), musculoskeletal pain (MSP) and major depression (MD) (poor health) and seven questions about difficulty managing different job demands (reduced demand-specific work ability). Reduced demand-specific work ability varied from 9% to 19% among the 46-year old and from 11% to 21% among the 56-year old. Age was associated with two, gender with four, and education with all measures of reduced demand-specific work ability. MSP was associated with four and MD was associated with six measures of reduced demand-specific work ability. We found no interaction between working conditions and poor health regarding reduced demand-specific work ability. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Increased meal frequency attenuates fat-free mass losses and some markers of health status with a portion-controlled weight loss diet.

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Alencar, Michelle K; Beam, Jason R; McCormick, James J; White, Ailish C; Salgado, Roy M; Kravitz, Len R; Mermier, Christine M; Gibson, Ann L; Conn, Carole A; Kolkmeyer, Deborah; Ferraro, Robert T; Kerksick, Chad M

2015-05-01

Increased meal frequency (MF) may be associated with improvements in blood markers of health and body composition during weight loss; however, this claim has not been validated. The purpose of the study was to determine if either a 2-meal (2 MF) or 6-meal frequency (6 MF) regimen can improve body composition and blood-based markers of health while consuming a portion-controlled equihypocaloric diet. Eleven (N=11) obese women (52 ± 7 years, 101.7 ± 22.6 kg, 39.1 ± 7.6 kg/m(2)) were randomized into treatment condition (2 MF or 6 MF) for 2 weeks, completed a 2-week washout, and alternated treatment conditions. In pre/post fashion, changes in body composition, glucose, insulin, and lipid components were measured in response to a test meal. Body mass was successfully lost (P ≤ .05) under both feeding regimens (2 MF: -2.8 ± 1.5 vs 6 MF: -1.9 ± 1.5 kg). Altering MF did not impact glucose, insulin, total cholesterol, or low-density lipoprotein cholesterol (P>.05). On average, fat-free mass (FFM) decreased by -3.3% ± 2.6% following the 2 MF condition and, on average, increased by 1.2% ± 1.7% following the 6 MF condition (P ≤ .05). Fasting high-density lipoprotein cholesterol (HDL-C) percentage increased during the 2 MF condition; this was significantly greater than that in the 6 MF condition (1.3% ± 12.2% vs 0.12% ± 10.3%) (P ≤ .05). Overall, reductions in MF (2 MF) were associated with improved HDL-C levels; but the clinical significance is not clear. Alternatively, increased MF (6 MF) did appear to favorably preserve FFM during weight loss. In conclusion, caloric restriction was effective in reducing body mass and attenuating FFM changes in body composition; however, glucose, insulin, and lipid metabolism had no significant differences between MF. Copyright © 2015 Elsevier Inc. All rights reserved.

The World Health Organization's mechanisms for increasing the ...

African Journals Online (AJOL)

These scenarios are a mixture of a surcharge on taxable income, an increase in value-added tax and a payroll tax. Five alternative options, suggested by the World Health Organization, are interrogated as ways to decrease the general taxation proposed in the White Paper. The five mechanisms (corporate tax, financial ...

The impact of the work conditions of allied health professionals on satisfaction, commitment and psychological distress.

Science.gov (United States)

Rodwell, John; Noblet, Andrew; Demir, Defne; Steane, Peter

2009-01-01

Allied health professionals are integral to the effective delivery of hospital-based health care, yet little is known about the working conditions associated with the attitudinal and health outcomes of these employees. The purpose of this study was to investigate the extent to which the demand-control-support model, in combination with organizational justice variables, predicts the employee-level outcomes of allied health professionals. Allied health professionals from an Australian health care organization were surveyed, with 113 (52.6%) participating. The survey included measures of job demands, job control, social support, organizational justice, satisfaction, commitment and psychological distress. Multiple regression analyses reveal that the additive demand-control-support model predicts the outcome variables of job satisfaction, organizational commitment and psychological distress, whereas the organizational justice variables predicted organizational commitment and psychological distress. Further, both work and nonwork sources of support, in addition to specific justice dimensions, were closely associated with employee-level outcomes. When coupled with previous research involving social support and organizational justice, the findings from this study suggest that initiatives aimed at strengthening supervisor and nonwork support, while enhancing perceptions of organizational fairness, may offer useful avenues for increasing the levels of satisfaction, commitment and well-being experienced by allied health professionals.

Use of electronic health records and administrative data for public health surveillance of eye health and vision-related conditions in the United States.

Science.gov (United States)

Elliott, Amanda F; Davidson, Arthur; Lum, Flora; Chiang, Michael F; Saaddine, Jinan B; Zhang, Xinzhi; Crews, John E; Chou, Chiu-Fang

2012-12-01

To discuss the current trend toward greater use of electronic health records and how these records could enhance public health surveillance of eye health and vision-related conditions. Perspective, comparing systems. We describe 3 currently available sources of electronic health data (Kaiser Permanente, the Veterans Health Administration, and the Centers for Medicare & Medicaid Services) and how these sources can contribute to a comprehensive vision and eye health surveillance system. Each of the 3 sources of electronic health data can contribute meaningfully to a comprehensive vision and eye health surveillance system, but none currently provide all the information required. The use of electronic health records for vision and eye health surveillance has both advantages and disadvantages. Electronic health records may provide additional information needed to create a comprehensive vision and eye health surveillance system. Recommendations for incorporating electronic health records into such a system are presented. Copyright © 2012 Elsevier Inc. All rights reserved.

Multiple Stressors in a Top Predator Seabird: Potential Ecological Consequences of Environmental Contaminants, Population Health and Breeding Conditions.

Directory of Open Access Journals (Sweden)

Jan O Bustnes

Full Text Available Environmental contaminants may have impacts on reproduction and survival in wildlife populations suffering from multiple stressors. This study examined whether adverse effects of persistent organic pollutants (POPs increased with poor population health and breeding conditions in three colonies (60-74°N of great skua (Stercorarius skua in the north-eastern Atlantic (Shetland, Iceland and Bjørnøya [Bear Island]. POPs (organochlorines [OCs] and polybrominated diphenyl ethers [BDEs] were measured in plasma of incubating birds (n = 222, concentrations differing nearly tenfold among colonies: Bjørnøya (2009 > Bjørnøya (2010 > Iceland (2009 > Shetland (2009. Reproductive success (hatching success and chick survival showed that breeding conditions were favourable in Shetland and at Bjørnøya (2010, but were very poor in Iceland and at Bjørnøya (2009. Biomarkers indicated that health was poor in the Shetland population compared to the other populations. Females whose chicks hatched late had high POP concentrations in all colonies except at Bjørnøya (2010, and females losing their eggs at Bjørnøya (2009 tended to have higher concentrations than those hatching. Moreover, there was a negative relationship between female POP concentrations and chick body condition at hatching in Iceland and at Bjørnøya (2010. Supplementary feeding experiments were conducted, and in Iceland where feeding conditions were poor, significant negative relationships were found between female POP concentrations and daily growth-rate in first-hatched chicks of control nests, but not in food supplemented nests. This suggests that negative impacts of POPs were mitigated by improved feeding conditions. For second-chicks, there was a strong negative relationship between the female POP concentrations and growth-rate, but no effects of supplementary feeding. Lowered adult return-rate between breeding seasons with increasing POP loads were found both at Bjørnøya (2009 and

Health conditions and their impact among adolescents and young adults with Down syndrome.

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Terri J Pikora

Full Text Available OBJECTIVE: To examine the prevalence of medical conditions and use of health services among young adults with Down syndrome and describe the impact of these conditions upon their lives. METHODS: Using questionnaire data collected in 2011 from parents of young adults with Down syndrome we investigated the medical conditions experienced by their children in the previous 12 months. Univariate, linear and logistic regression analyses were performed. RESULTS: We found that in addition to the conditions commonly experienced by children with Down syndrome, including eye and vision problems (affecting 73%, ear and hearing problems (affecting 45%, cardiac (affecting 25% and respiratory problems (affecting 36%, conditions also found to be prevalent within our young adult cohort included musculoskeletal conditions (affecting 61%, body weight (affecting 57%, skin (affecting 56% and mental health (affecting 32% conditions and among young women menstrual conditions (affecting 58%. Few parents reported that these conditions had no impact, with common impacts related to restrictions in opportunities to participate in employment and community leisure activities for the young people, as well as safety concerns. CONCLUSION: There is the need to monitor, screen and provide appropriate strategies such as through the promotion of healthy lifestyles to prevent the development of comorbidities in young people with Down syndrome and, where present, to reduce their impact.

Recession contributes to slowest annual rate of increase in health spending in five decades.

Science.gov (United States)

Martin, Anne; Lassman, David; Whittle, Lekha; Catlin, Aaron

2011-01-01

In 2009, US health care spending grew 4.0 percent--a historically low rate of annual increase--to $2.5 trillion, or $8,086 per person. Despite the slower growth, the share of the gross domestic product devoted to health spending increased to 17.6 percent in 2009 from 16.6 percent in 2008. The growth rate of health spending continued to outpace the growth of the overall economy, which experienced its largest drop since 1938. The recession contributed to slower growth in private health insurance spending and out-of-pocket spending by consumers, as well as a reduction in capital investments by health care providers. The recession also placed increased burdens on households, businesses, and governments, which meant that fewer financial resources were available to pay for health care. Declining federal revenues and strong growth in federal health spending increased the health spending share of total federal revenue from 37.6 percent in 2008 to 54.2 percent in 2009.

Benchmarking working conditions for health and safety in the frontline healthcare industry: Perspectives from Australia and Malaysia.

Science.gov (United States)

McLinton, Sarven S; Loh, May Young; Dollard, Maureen F; Tuckey, Michelle M R; Idris, Mohd Awang; Morton, Sharon

2018-04-06

To present benchmarks for working conditions in healthcare industries as an initial effort into international surveillance. The healthcare industry is fundamental to sustaining the health of Australians, yet it is under immense pressure. Budgets are limited, demands are increasing as are workplace injuries and all of these factors compromise patient care. Urgent attention is needed to reduce strains on workers and costs in health care, however, little work has been done to benchmark psychosocial factors in healthcare working conditions in the Asia-Pacific. Intercultural comparisons are important to provide an evidence base for public policy. A cross-sectional design was used (like other studies of prevalence), including a mixed-methods approach with qualitative interviews to better contextualize the results. Data on psychosocial factors and other work variables were collected from healthcare workers in three hospitals in Australia (N = 1,258) and Malaysia (N = 1,125). 2015 benchmarks were calculated for each variable and comparison was conducted via independent samples t tests. Healthcare samples were also compared with benchmarks for non-healthcare general working populations from their respective countries: Australia (N = 973) and Malaysia (N = 225). Our study benchmarks healthcare working conditions in Australia and Malaysia against the general working population, identifying trends that indicate the industry is in need of intervention strategies and job redesign initiatives that better support psychological health and safety. We move toward a better understanding of the precursors of psychosocial safety climate in a broader context, including similarities and differences between Australia and Malaysia in national culture, government occupational health and safety policies and top-level management practices. © 2018 John Wiley & Sons Ltd.

The Reallocation of Compensation in Response to Health Insurance Premium Increases

OpenAIRE

Dana P. Goldman; Neeraj Sood; Arleen Leibowitz

2003-01-01

This paper examines how compensation packages change when health insurance premiums rise. We use data on employee choices within a single large firm with a flexible benefits plan; an increasingly common arrangement among medium and large firms. In these companies, employees explicitly choose how to allocate compensation between cash and various benefits such as retirement, medical insurance, life insurance, and dental benefits. We find that a $1 increase in the price of health insurance leads...

The impact of psychosocial and organizational working conditions on the mental health of female cleaning personnel in Norway

Directory of Open Access Journals (Sweden)

Sandanger Inger

2006-11-01

Full Text Available Abstract Background This study examined the association between psychosocial and organizational work conditions and mental health among women employed in the cleaning profession in Norway. Methods Self-report questionnaires were mailed to 661 cleaning staff personnel from seven cleaning organizations in seven different cities across Norway. The response rate was 64%, of which 374 (88% respondents were women. The questionnaires assessed socio-demographic information and employment history, work organization, and psychosocial working conditions. The Hopkins Symptoms Checklist (HSCL-25 was included to assess mental health. Results On average, respondents were 43 years old and reported 10.8 years of experience working in the cleaning industry. The proportion of women scoring a HSCL-25 equal to or above 1.75 was 17.5%, which was higher than the average prevalence of mental health problems among working Norwegian women (8.4%. A factor analysis of the questions specific to the psychosocial work environment identified the following four underlying dimensions: leadership, co-workers, time pressure/control, and information/knowledge. Two of these, poor satisfaction with leadership (OR = 3.6 and poor satisfaction with co-workers (OR = 2.3, were significantly related to mental health. In addition, having contact with colleagues less than once a day (OR = 2.4 and not being ethnically Norwegian (OR = 3.0 increased the risk for mental health problems. Conclusion Mental health problems are frequent among female cleaning professionals in Norway. Our results indicate that quality of leadership, collaboration with co-workers, and ethnicity were significantly associated with mental health.

Health effects of 'Juntos', a conditional cash transfer programme in Peru.

Science.gov (United States)

Pérez-Lu, José E; Cárcamo, Cesar; Nandi, Arijit; Kaufman, Jay S

2017-07-01

In some countries, conditional cash transfer (CCT) programmes show an impact on maternal and child health. Juntos, the CCT programme in Peru, has been evaluated several times operationally, but seldom for maternal and child health outcomes. The objective of this study is to evaluate the impact of Juntos on children under 6 years, pregnant women and mothers of children under 17 years. Outcomes evaluated included (1) anaemia in women and children; (2) acute malnutrition in children; (3) post-partum complications in mothers; and (4) underweight and overweight in mothers. We identified Juntos eligible respondents from the Demographic and Health Surveys of Peru for years 2007 to 2013. Propensity score matching was used to identify comparable treatment and control groups, including eligible respondents enrolled in Juntos vs. those not enrolled in Juntos (individual-level analysis), as well as eligible respondents living in Juntos districts vs. those not residing in Juntos districts (district-level analysis). We then used generalized linear models to estimate prevalence ratios. Individual level analysis showed that Juntos reduced underweight in women (PR:0.39, 95%CI:0.18 - 0.85) and anaemia in children (PR:0.93, 95%CI:0.86 - 1.00). In the district level analysis, the programme was associated with a reduction of overweight in women (PR:0.94, 95%CI:0.90 - 0.98) and acute malnutrition in children (PR:0.49, 95%CI:0.32 - 0.73), but an increase in the prevalence of anaemia in children (PR:1.09, 95%CI:1.01 - 1.17). We found that Juntos had an effect on maternal and child health indicators, but further studies are required to overcome some limitations encountered here. © 2016 John Wiley & Sons Ltd.

Use of health care claims data to study patients with ophthalmologic conditions.

Science.gov (United States)

Stein, Joshua D; Lum, Flora; Lee, Paul P; Rich, William L; Coleman, Anne L

2014-05-01

To describe what information is or is not included in health care claims data, provide an overview of the main advantages and limitations of performing analyses using health care claims data, and offer general guidance on how to report and interpret findings of ophthalmology-related claims data analyses. Systematic review. Not applicable. A literature review and synthesis of methods for claims-based data analyses. Not applicable. Some advantages of using claims data for analyses include large, diverse sample sizes, longitudinal follow-up, lack of selection bias, and potential for complex, multivariable modeling. The disadvantages include (a) the inherent limitations of claims data, such as incomplete, inaccurate, or missing data, or the lack of specific billing codes for some conditions; and (b) the inability, in some circumstances, to adequately evaluate the appropriateness of care. In general, reports of claims data analyses should include clear descriptions of the following methodological elements: the data source, the inclusion and exclusion criteria, the specific billing codes used, and the potential confounding factors incorporated in the multivariable models. The use of claims data for research is expected to increase with the enhanced availability of data from Medicare and other sources. The use of claims data to evaluate resource use and efficiency and to determine the basis for supplementary payment methods for physicians is anticipated. Thus, it will be increasingly important for eye care providers to use accurate and descriptive codes for billing. Adherence to general guidance on the reporting of claims data analyses, as outlined in this article, is important to enhance the credibility and applicability of findings. Guidance on optimal ways to conduct and report ophthalmology-related investigations using claims data will likely continue to evolve as health services researchers refine the metrics to analyze large administrative data sets. Copyright �

[Impact of the crisis on the relationship between housing and health. Policies for good practice to reduce inequalities in health related to housing conditions].

Science.gov (United States)

Novoa, Ana M; Bosch, Jordi; Díaz, Fernando; Malmusi, Davide; Darnell, Mercè; Trilla, Carme

2014-06-01

Housing conditions can impact on physical and mental health through 4 interrelated dimensions: 1) the home (the emotional housing conditions), 2) the physical housing conditions, and 3) the physical environment, and 4) the social (community) environment of the neighborhood where the house is located. In Spain, the use of the construction market as an engine for economic growth and the promotion of private property as the main type of housing tenure has led to the use of housing as a speculative good instead of its being considered a first-necessity good. While Spain is the Organisation for Economic Co-operation and Development (OECD) country with the largest housing stock per inhabitant, this stock is highly underutilized, thus excluding the most deprived sector of the population from access to housing. The impact of the current economic crisis on housing has mainly been due to a reduction in household income, which has increased the number of families or persons struggling to cover their housing costs or being evicted. Evidence indicates that this type of problem has a negative impact on health, especially on mental health, but financial problems also make it difficult to meet other basic needs such as eating. There are several instruments to reduce the impact of the economic crisis, such as debt financing or deed of assignment in payment. In the long-term, the creation of a social housing stock should be promoted, as well as rental assistance mechanisms. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

Health plan utilization and costs of specialty drugs within 4 chronic conditions.

Science.gov (United States)

Gleason, Patrick P; Alexander, G Caleb; Starner, Catherine I; Ritter, Stephen T; Van Houten, Holly K; Gunderson, Brent W; Shah, Nilay D

2013-09-01

Drugs are most typically defined as specialty because they are expensive; however, other criteria used to define a drug as specialty include biologic drugs, the need to inject or infuse the drug, the requirement for special handling, or drug availability only via a limited distribution network. Specialty drugs play an increasingly important role in the treatment of chronic conditions such as multiple sclerosis (MS), rheumatoid arthritis (RA), psoriasis, and inflammatory bowel disease (IBD), yet little is known regarding the comprehensive medical and pharmacy benefit utilization and cost trends for these conditions. To describe MS, RA, psoriasis, and IBD trends for condition prevalence, treatment with specialty drugs, specialty costs, nonspecialty costs, and total direct costs of care within the medical and pharmacy benefits. This was a descriptive analysis of a commercially insured population made up of 1 million members, using integrated medical and pharmacy administrative claims data from 2008 to 2010. Analyses were limited to continuously enrolled commercially insured individuals less than 65 years of age. Condition-specific cohorts for MS, RA, psoriasis, and IBD were defined using standardized criteria. Trends in condition prevalence, specialty drug use for the conditions, and direct total cost of care were analyzed. The direct costs were subcategorized into the following: medical benefit specialty drug costs, medical benefit all other costs, pharmacy benefit specialty drug costs, and pharmacy benefit all other costs. Trends and compound annual growth rates were calculated for the total cost of care and subcategory costs from 2008 through 2010. Condition prevalence ranged from a low of 1,720 per million members for MS to a high of 4,489 per million members for RA. Psoriasis and MS condition prevalence rates were unchanged over the 3 years; however, IBD prevalence increased 7.0%, and RA prevalence increased 9.7%. The rate of specialty drug use was lowest for IBD

Increased fitness of a key appendicularian zooplankton species under warmer, acidified seawater conditions.

Directory of Open Access Journals (Sweden)

Jean-Marie Bouquet

Full Text Available Ocean warming and acidification (OA may alter the fitness of species in marine pelagic ecosystems through community effects or direct physiological impacts. We used the zooplanktonic appendicularian, Oikopleura dioica, to assess temperature and pH effects at mesocosm and microcosm scales. In mesocosms, both OA and warming positively impacted O. dioica abundance over successive generations. In microcosms, the positive impact of OA, was observed to result from increased fecundity. In contrast, increased pH, observed for example during phytoplankton blooms, reduced fecundity. Oocyte fertility and juvenile development were equivalent under all pH conditions, indicating that the positive effect of lower pH on O. dioica abundance was principally due to increased egg number. This effect was influenced by food quantity and quality, supporting possible improved digestion and assimilation at lowered pH. Higher temperature resulted in more rapid growth, faster maturation and earlier reproduction. Thus, increased temperature and reduced pH had significant positive impacts on O. dioica fitness through increased fecundity and shortened generation time, suggesting that predicted future ocean conditions may favour this zooplankton species.

Mimic sensor to monitor condition of human health; Mimic sensor wo riyoshita taicho monitoring

Energy Technology Data Exchange (ETDEWEB)

Nagata, Y. [Mechanical Engineering Lab., Tokyo (Japan)

2000-04-01

In the aging society where the birth rate decreases and the number of nuclear families increases, it is very important to inquire after the aged or physically handicapped people, to monitor their physical conditions, and to take steps to keep them healthy. As for the in-home physical measurement for the aged or physically handicapped people and the work of health management for them based on such measurement, it is feared that under the present conditions the invalid themselves or their family members or nurses will inevitably have to bear the burden and that nobody can deny the difficulty of continuing such nursing care. If daily physical condition measurement and related data collection are automatically carried out, however, interested people' burden will lessen and in-home heath management will become actually feasible. In this paper, a mimic sensor for realizing such a situation is described, which will measure physical conditions without interfering with the daily life of interested people. Serving as the mimic sensor is a blood flow sensor embedded in a telephone receiver, and changes in the blood flow during telephone conversation and changes in the gaps between peeks will be monitored. The feasibility is shown of continual collection of information necessary for the measurement of physical conditions of the aged or physically handicapped persons. (NEDO)

Delayed otolaryngology referral for voice disorders increases health care costs.

Science.gov (United States)

Cohen, Seth M; Kim, Jaewhan; Roy, Nelson; Courey, Mark

2015-04-01

Despite the accepted role of laryngoscopy in assessing patients with laryngeal/voice disorders, controversy surrounds its timing. This study sought to determine how increased time from first primary care to first otolaryngology outpatient visit affected the health care costs of patients with laryngeal/voice disorders. Retrospective analysis of a large, national administrative claims database was performed. Patients had an International Classification of Diseases, 9(th) Revision-coded diagnosis of a laryngeal/voice disorder; initially saw a primary care physician and, subsequently, an otolaryngologist as outpatients; and provided 6 months of follow-up data after the first otolaryngology evaluation. The outpatient health care costs accrued from the first primary care outpatient visit through the 6 months after the first otolaryngology outpatient visit were determined. There were 260,095 unique patients who saw a primary care physician as an outpatient for a laryngeal/voice disorder, with 8999 (3.5%) subsequently seeing an otolaryngologist and with 6 months postotolaryngology follow-up data. A generalized linear regression model revealed that, compared with patients who saw an otolaryngologist ≤1 month after the first primary care visit, patients in the >1-month and ≤3-months and >3-months time periods had relative mean cost increases of $271.34 (95% confidence interval $115.95-$426.73) and $711.38 (95% confidence interval $428.43-$993.34), respectively. Increased time from first primary care to first otolaryngology evaluation is associated with increased outpatient health care costs. Earlier otolaryngology examination may reduce health care expenditures in the evaluation and management of patients with laryngeal/voice disorders. Copyright © 2015 Elsevier Inc. All rights reserved.

Examining the incremental impact of long-standing health conditions on subjective well-being alongside the EQ-5D.

Science.gov (United States)

Wu, Mengjun; Brazier, John; Relton, Clare; Cooper, Cindy; Smith, Christine; Blackburn, Joanna

2014-04-29

Generic preference-based measures such as the EQ-5D and SF-6D have been criticised for being narrowly focused on a sub-set of dimensions of health. Our study aims to explore whether long-standing health conditions have an incremental impact on subjective well-being alongside the EQ-5D. Using data from the South Yorkshire Cohort study (N = 13,591) collected between 2010 and 2012 on the EQ-5D, long-standing health conditions (self-reported), and subjective well-being measure--life satisfaction using a response scale from 0 (completely dissatisfied) to 10 (completely satisfied), we employed generalised logit regression models. We assessed the impact of EQ-5D and long-standing health conditions together on life satisfaction by examining the size and significance of their estimated odds ratios. The EQ-5D had a significant association with life satisfaction, in which anxiety/depression and then self-care had the largest weights. Some long-standing health conditions were significant in some models, but most did not have an independent impact on life satisfaction. Overall, none of the health conditions had a consistent impact on life satisfaction alongside the EQ-5D. Out study suggests that the impact of long-standing health conditions on life satisfaction is adequately captured by the EQ-5D, although the findings are limited by reliance on self-reported conditions and a single item life satisfaction measure.

Obstetric Outcomes and Delivery-Related Health Care Utilization and Costs Among Pregnant Women With Multiple Chronic Conditions

Science.gov (United States)

Winkelman, Tyler N. A.; Heisler, Michele; Dalton, Vanessa K.

2018-01-01

Our objective was to measure obstetric outcomes and delivery-related health care utilization and costs among pregnant women with multiple chronic conditions. We used 2013–2014 data from the National Inpatient Sample to measure obstetric outcomes and delivery-related health care utilization and costs among women with no chronic conditions, 1 chronic condition, and multiple chronic conditions. Women with multiple chronic conditions were at significantly higher risk than women with 1 chronic condition or no chronic conditions across all outcomes measured. High-value strategies are needed to improve birth outcomes among vulnerable mothers and their infants. PMID:29420168

Guided self-help for mental health disorders in children and young people with chronic neurological conditions: A qualitative evaluation.

Science.gov (United States)

Bennett, Sophie D; Coughtrey, Anna E; Heyman, Isobel; Greally, Suzanna; Clarkson, Harriet; Bhattacharyya, Tuhina; Lewis, Corah; Varadkar, Sophia; Shafran, Roz

2018-03-09

Children with neurological conditions such as epilepsy are at high risk of developing mental health disorders. Guided self-help can be used to increase access to psychological therapies. When developing and evaluating interventions, it is important to obtain the views of service-users about their acceptability. A telephone-guided self-help intervention was used to treat common mental health difficulties in children and young people with neurological conditions. The intervention was not adapted in content to account for chronic illness. This study therefore reports on qualitative interviews with participants to determine the acceptability of the intervention. Semi-structured interviews were conducted with 27 participants (25 parents and 2 young people) who had undertaken a telephone-delivered guided self-help intervention for common mental health difficulties in the context of a paediatric neurological condition. Transcripts were analysed thematically using the framework approach. Thirteen themes were extracted, organised into three main domains, which covered: the practicalities of telephone guided self-help treatment; the outcomes of the intervention; and the extent to which adaptation was needed for chronic illness. Most families found the intervention helpful in working towards their specific goals and noticed changes for the child and/or parents and family. Participants had a positive experience of the intervention and the majority of parents found the standard intervention with individualised goals sufficient to meet the young person's mental health needs. Copyright © 2018 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Days out of role due to common physical and mental conditions: results from the Northern Ireland study of health and stress.

Science.gov (United States)

Ennis, Edel; O'Neill, S; Murphy, S; Bunting, B

2016-11-01

Days out of role due to health problems are a major source of lost human capital. We examined the relative importance of common physical and mental disorders in accounting for days out of role in Northern Ireland using the Northern Ireland Study of Health and Stress (NISHS) WHO World Mental Health (WMH) Survey. Face-to-face interviews were carried out with 4340 respondents (68.4 % response rate). Multiple regression analysis estimated associations of specific chronic physical disorders and mental disorders conditions and comorbidities with days out of role controlling for basic socio-demographics. Overall, 16.8 % of respondents had at least one day totally out of role in the previous year. The strongest population-level effect was associated with arthritis, which accounted for 23.5 % of all days out of role. The strongest individual-level effects (days out of role per year) were associated with any anxiety disorder (32.3) arthritis (26.1) and pain (22.0). The 11 conditions accounted for 93 % of all days out of role, as measured by population attributable risk proportions (PARPs). Common health conditions, including mental disorders, make up a large proportion of the number of days out of role and should be addressed to substantially increase overall productivity.

Developing a gender-based approach to chronic conditions and women's health: a qualitative investigation of community-dwelling women and service provider perspectives.

Science.gov (United States)

DiGiacomo, Michelle; Green, Anna; Rodrigues, Emma; Mulligan, Kathryn; Davidson, Patricia M

2015-11-21

Chronic conditions contribute to over 70 % of Australia's total disease burden, and this is set to increase to 80 % by 2020. Women's greater longevity means that they are more likely than men to live with disability and have unique health concerns related to their gender based roles in society. Cultural and social issues can impact on women's health and are important to consider in health services planning and research. In this study, we aimed to identify barriers and facilitators to providing a gender-based approach to chronic conditions and women's health in an eastern metropolitan region of Australia. Focus groups were used to engage both community-dwelling women who had chronic conditions and relevant professional stakeholders in the target area. Recorded proceedings underwent thematic analysis. Five focus groups were conducted with professional stakeholders and women community members in February and March 2014. Resultant themes included: women's disempowerment through interactions with health systems; social and economic constraints and caregiving roles act to exclude women from participating in self-care and society; and empowerment can be achieved through integrated models of care that facilitate voice and enable communication and engagement. This study underscores the importance of including perspectives of sex and gender in health care services planning. Tailoring services to socio-demographic and cultural groups is critical in promoting access to health care services. Unique epidemiological trends, particularly the ageing of women and new migrant groups, require particular attention.

Self-reported gingival conditions and self-care in the oral health of Danish women during pregnancy

DEFF Research Database (Denmark)

Christensen, L.B.; Jeppe-Jensen, Dorte; Petersen, P.E.

2003-01-01

AND METHODS: The study group comprised 1935 pregnant women living in two areas of Denmark consecutively recruited from August 1998 to March 1999. The survey data were based on telephone interviews. Questions in the interview concerned general health, lifestyles, socioeconomic conditions, gingival conditions......OBJECTIVES: The purpose of the present study was to describe the self-assessment of gingival health conditions in pregnant women, their oral hygiene behaviour and dental visiting habits, and to analyse self-care practices of pregnant women in relation to perceived gingival problems. MATERIAL......, oral hygiene and utilisation of dental health services. RESULTS: One-third of the study population perceived signs of gingival inflammation; 5% of the pregnant women assessed their gingiva as poor, while 95% reported good or "normal" gingival condition. Ninety six per cent brushed their teeth at least...

Hot yoga establishments in local communities serving pregnant women: a pilot study on the health implications of its practice and environmental conditions.

Science.gov (United States)

Nguyen-Feng, Viann N; Feng, Steven L; Babbar, Shilpa; Rankins, Nicole Calloway; Blando, James D

2014-10-01

Hot yoga establishments have been increasing in popularity in local communities. Studios may support participation among pregnant women though no clinical studies currently exist that examine prenatal hot yoga effects. The pilot study described in this article aimed to assess the spread of prenatal hot yoga and to provide information on the environmental conditions and practices of those who engage in hot yoga within a local community. A thermal environment meter was used to measure ambient air conditions during three 90-minute hot yoga classes. Mothers who practiced prenatal hot yoga were more likely than non-hot yoga practitioners to have someone aside from an obstetrician/gynecologist discuss prenatal exercise safety with them. Prenatal public health education campaigns need to be refined. Public health officials and obstetricians/gynecologists need to be aware that those who engage in a hot yoga practice are more likely to trust someone other than their health care provider or public health professional regarding safety of this practice.

Working conditions of female part-time and full-time teachers in relation to health status.

Science.gov (United States)

Seibt, Reingard; Matz, Annerose; Hegewald, Janice; Spitzer, Silvia

2012-08-01

Teacher's volume of employment and health status are controversially discussed in the current literature. This study focused on female teachers with part-time versus full-time jobs in association with working conditions and health status depending on age. A sample of 263 part-time and 367 full-time female teachers (average age 46.7 ± 7.8 vs. 46.0 ± 6.3) participated in an occupational health screening. Specific work conditions, stressors (job history-questionnaire) and effort-reward-imbalance ratio (ERI-Q) were measured and their relationships to mental and physical health were analysed. Health status was quantified by complaints (BFB questionnaire), general mental health status (GHQ-12) and cardiovascular risk factors. On average, teachers in part-time positions reported 36 and in full-time positions 42 h per week. The effort-reward ratios were significantly associated with the volume of employment. Teachers in part-time jobs had only a slightly lower ERI-ratio. There were no differences between full-time and part-time teachers regarding health status. Eighteen percentage of both groups reported impaired mental health (GHQ ≥ 5), 48% of part-time teachers and 53% of full-time teachers suffered from high blood pressure. Low physical fitness was observed in 12% of part-time and 6% of full-time teachers. In this study, neither the volume of employment nor working conditions were found to be significantly correlated with health status. Part-time and full-time employment status did not appear to influence health in the teaching profession. Although there are differences in quantitative working demands, while the health status does not differ between both teacher groups.

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.

Health inequities: lower socio-economic conditions and higher incidences of intestinal parasites

Directory of Open Access Journals (Sweden)

Limoncu M Emin

2007-11-01

Full Text Available Abstract Background Intestinal parasitic infections affect child health and development and slow down growth, while reducing adults' productivity and work capacity. The aim of the present study was to determine and compare the incidences of intestinal parasitic infections and the socio-economic status of two near primary school children in Manisa, a western city of Turkey. Methods A total of 352 children were involved a questionnaire study from a private school (Ülkem Primary School – ÜPS, 116 children and a community-based school (Şehzadeler Primary School – ŞPS, 236 children. Of these, stool samples could be obtained from a total of 294 students; 97 (83.6% from ÜPS, and 197 (83.5% from ŞPS. The wet mount preparations of the stool samples were examined; samples were also fixed in polyvinyl alcohol and examined with modified formalin ethyl acetate sedimentation and trichrome staining techniques. Data were analyzed using SPSS for Windows version 10.0. The chi-squared test was used for the analytic assessment. Results The percentages of the students found to be infected with intestinal parasites, were 78 (39.6% and 13 (13.4% in ŞPS and ÜPS, respectively. Totally 91 (31.0% of the students from both schools were found to be infected with at least one intestinal parasite. Giardia lamblia was found to be the most common pathogenic intestinal parasite and Blastocystis hominis was prevalent independently from the hygienic conditions. The factors which significantly (p Conclusion Intestinal parasitic infections in school children were found to be a public health problem that increased due to lower socio-economic conditions. We conclude that organization of education seminars including the topics such as prevention of the infectious diseases, improving general hygienic conditions, and application of supportive programs for the parents may be suggested not only to reduce intestinal parasitic infections, but also to elevate the socio

Increased water-use efficiency does not lead to enhanced tree growth under xeric and mesic conditions

NARCIS (Netherlands)

Lévesque, M.; Siegwolf, R.; Saurer, M.; Eilmann, B.; Rigling, A.

2014-01-01

Higher atmospheric CO2 concentrations (ca ) can under certain conditions increase tree growth by enhancing photosynthesis, resulting in an increase of intrinsic water-use efficiency (i WUE) in trees. However, the magnitude of these effects and their interactions with changing climatic conditions are

An assessment of the relationships between overweight, obesity, related chronic health conditions and worker absenteeism.

Science.gov (United States)

Howard, Jeffrey T; Potter, Lloyd B

2014-01-01

Worker absenteeism is an important area of study within the field of occupational health. Prior studies have linked the presence of obesity to higher rates of absenteeism, but have not examined whether or not the relationship is moderated by the presence of other chronic health conditions or whether or not the relationships have been stable over time. Data from the 2000 and 2010 National Health Interview Survey, a nationally representative sample of the US population, were analyzed to determine the extent to which the presence of 5 obesity-related chronic health conditions moderates the relationship between overweight/obesity and worker absenteeism, and whether or not these relationships are stable over time. Logistic regression was used to examine the relationships between overweight/obesity, the obesity-related chronic health conditions and worker absenteeism, while controlling for demographic, socio-economic, occupational, health related and behavioral variables. The findings suggest that obesity (p absenteeism, and that the effect is doubled for those with both class III obesity (BMI ≥ 40) and diabetes. The moderating effect between class III obesity and diabetes was observed only in 2010, indicating that this may be a relatively new phenomenon. © 2014 Asian Oceanian Association for the Study of Obesity . Published by Elsevier Ltd. All rights reserved.

Conditional cash transfer programs and the health and nutrition of Latin American children

Directory of Open Access Journals (Sweden)

Sofia Segura-Pérez

Full Text Available ABSTRACT Objective To 1 describe the benefits, conditions, coverage, funding, goals, governance, and structure of well-established conditional cash transfer programs (CCTs in Latin America and 2 identify their health and nutritional impacts among children under 5 years old. Methods A realist review was conducted. CCTs were included if they met the following inclusion criteria: 1 current national-level program; 2 coverage of at least 50% of the target population; 3 continuous operation at scale for 10+ years; 4 clear description of structure, funding sources, and governance; 5 both health/nutrition- and education-related conditions for participation; and 6 available impact evaluation studies with health, development, and/or nutrition indicators among children under 5 years old. Three CCTs (one each in Brazil, Colombia, and Mexico met the criteria. Results There was consistent evidence that the three CCTs selected for review had positive impacts on child health and nutrition outcomes in their respective countries. In all three countries, the programs were scaled up and positive impacts were documented relatively quickly. All three programs had strong political support and clear and transparent governance structures, including accountability and social participation mechanisms, which might explain their success and sustainability. Conclusions CCTs in Latin America have had a positive impact on child health and nutrition outcomes among the poorest families. A key challenge for the future is to reform these programs to help families move out of not only extreme poverty but all poverty in order to lead healthy and productive lives, as called for in the post-2105 Sustainable Development Goals.

Primary health care quality and hospitalizations for ambulatory care sensitive conditions in the public health system in Porto Alegre, Brazil.

Science.gov (United States)

Gonçalves, Marcelo Rodrigues; Hauser, Lisiane; Prestes, Isaías Valente; Schmidt, Maria Inês; Duncan, Bruce Bartholow; Harzheim, Erno

2016-06-01

To investigate the relation of hospitalization for ambulatory care sensitive conditions (ACSC) with the quality of public primary care health services in Porto Alegre, Brazil. Cohort study constructed by probabilistic record linkage performed from August 2006 to December 2011 in a population ≥18 years of age that attended public primary care health services. The Primary Care Assessment Tool (PCATool-Brazil) was used for evaluation of primary care services. Of 1200 subjects followed, 84 were hospitalized for primary care sensitive conditions. The main causes of ACSC hospital admissions were cardiovascular (40.5%) and respiratory (16.2%) diseases. The PCATool average score was 5.3, a level considerably below that considered to represent quality care. After adjustment through Cox proportional hazard modelling for covariates, >60 years of age [hazard ratio (HR): 1.13; P = 0.001), lesser education (HR: 0.66; P = 0.02), ethnicity other than white (HR: 1.77; P = 0.01) and physical inactivity (HR: 1.65; P = 0.04) predicted hospitalization, but higher quality of primary health care did not. Better quality of health care services, in a setting of overwhelmingly low quality services not adapted to the care of chronic conditions, did not influence the rate of avoidable hospitalizations, while social and demographic characteristics, especially non-white ethnicity and lesser schooling, indicate that social inequities play a predominant role in health outcomes. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Supporting self-management of chronic health conditions: common approaches.

Science.gov (United States)

Lawn, Sharon; Schoo, Adrian

2010-08-01

The aims of this paper are to provide a description of the principles of chronic condition self-management, common approaches to support currently used in Australian health services, and benefits and challenges associated with using these approaches. We examined literature in this field in Australia and drew also from our own practice experience of implementing these approaches and providing education and training to primary health care professionals and organizations in the field. Using common examples of programs, advantages and disadvantages of peer-led groups (Stanford Courses), care planning (The Flinders Program), a brief primary care approach (the 5As), motivational interviewing and health coaching are explored. There are a number of common approaches used to enhance self-management. No one approach is superior to other approaches; in fact, they are often complimentary. The nature and context for patients' contact with services, and patients' specific needs and preferences are what must be considered when deciding on the most appropriate support mode to effectively engage patients and promote self-management. Choice of approach will also be determined by organizational factors and service structures. Whatever self-management support approaches used, of importance is how health services work together to provide support. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

La Palabra Es Salud: A Comparative Study of the Effectiveness of Popular Education vs. Traditional Education for Enhancing Health Knowledge and Skills and Increasing Empowerment among Parish-Based Community Health Workers

Science.gov (United States)

Wiggins, Noelle

2010-01-01

Popular education is a mode of teaching and learning which seeks to bring about more equitable social conditions by creating settings in which people can identify and solve their own problems. While the public health literature offers evidence to suggest that popular education is an effective strategy for increasing empowerment and improving…

Occupational Safety and Health Conditions Aboard Small- and Medium-Size Fishing Vessels: Differences among Age Groups.

Science.gov (United States)

Zytoon, Mohamed A; Basahel, Abdulrahman M

2017-02-24

Although marine fishing is one of the most hazardous occupations, research on the occupational safety and health (OSH) conditions aboard marine fishing vessels is scarce. For instance, little is known about the working conditions of vulnerable groups such as young and aging fishermen. The objective of the current paper is to study the OSH conditions of young and aging fishermen compared to middle-aged fishermen in the small- and medium-size (SM) marine fishing sector. A cross-sectional study was designed, and 686 fishermen working aboard SM fishing vessels were interviewed to collect information about their safety and health. The associations of physical and psychosocial work conditions with safety and health outcomes, e.g., injuries, illnesses and job satisfaction, are presented. The results of the current study can be utilized in the design of effective accident prevention and OSH training programs for the three age groups and in the regulation of working conditions aboard fishing vessels.

Increased demand for E-mail health consultation service: analysis of a Web survey.

Science.gov (United States)

Klinar, Ivana; Balazin, Ana; Basić, Martina; Plantas, Igor; Biskupić, Kresimir

2010-06-01

The aim of the study was to explore characteristics of the users of the Interactive Service "Your Questions" that is based on E-mail health consultations. We wanted to find out what motivated users to use it, were they satisfied with it and what were its impacts on their health behavior. Therefore, we developed a Web survey and invited 2,747 users to take part in it. 919 (33.5%) of users responded. Results showed that the majority of respondents were women (79.1%) and that most hold at least a college degree (52.4%). The Service was mostly used for obtaining information about certain medical symptoms or medical conditions (50.1%), for a second opinion on a diagnosis (18.6%) and for more information about medical treatment (14.4%). In terms of Service features, it was used because of its convenience with regard to time (38.7%) and a sense of privacy (25.7%). Before posting a question to the Service, 93.2% of the respondents searched for health articles on the PLIVAzdravlje portal while 90% of them read the Questions and Answers database. Over half of them (61.8%) posted their question after they already visited their physicians on that particular issue. Nevertheless, 48% of them were encouraged to visit their physicians after they received the answer. The results show an important trend of increased demand for e-mail health consultation and the need for reliable medical information, with one thousand questions submitted to the Service in the observed period of 40 days. If the source of medical information is reliable, as in case of our Service as well as other forms of e-mail health consultations, it can have positive impact on valuable physician-patient communication based on knowledge and mutual understanding.

Resolving embarrassing medical conditions with online health information.

Science.gov (United States)

Redston, Sarah; de Botte, Sharon; Smith, Carl

2018-06-01

Reliance on online health information is proliferating and the Internet has the potential to revolutionize the provision of public health information. The anonymity of online health information may be particularly appealing to people seeking advice on 'embarrassing' health problems. The purpose of this study was to investigate (1) whether data generated by the embarrassingproblems.com health information site showed any temporal patterns in problem resolution, and (2) whether successful resolution of a medical problem using online information varied with the type of medical problem. We analyzed the responses of visitors to the embarrassingproblems.com website on the resolution of their problems. The dataset comprised 100,561 responses to information provided on 77 different embarrassing problems grouped into 9 classes of medical problem over an 82-month period. Data were analyzed with a Bernoulli Generalized Linear Model using Bayesian inference. We detected a statistically important interaction between embarrassing problem type and the time period in which data were collected, with an improvement in problem resolution over time for all of the classes of medical problem on the website but with a lower rate of increase in resolution for urinary health problems and medical problems associated with the mouth and face. As far as we are aware, this is the first analysis of data of this nature. Findings support the growing recognition that online health information can contribute to the resolution of embarrassing medical problems, but demonstrate that outcomes may vary with medical problem type. The results indicate that building data collection into online information provision can help to refine and focus health information for online users. Copyright © 2018 Elsevier B.V. All rights reserved.

The Relationship Between Aerobic Activity Health Conditions and Medical Visits Among Men and Women Serving Aboard Navy Ships

National Research Council Canada - National Science Library

Hughes, Linda

2002-01-01

.... Contingency tables were computed for amount of self-reported aerobic activity and prevalence rate of adverse health conditions, number of adverse health conditions, number of medical visits, and gender...

Social conditions and urban health inequities: realities, challenges and opportunities to transform the urban landscape through research and action.

Science.gov (United States)

de Snyder, V Nelly Salgado; Friel, Sharon; Fotso, Jean Christophe; Khadr, Zeinab; Meresman, Sergio; Monge, Patricia; Patil-Deshmukh, Anita

2011-12-01

The process of urbanization entails social improvements with the consequential better quality-of-life for urban residents. However, in many low-income and some middle-income countries, urbanization conveys inequality and exclusion, creating cities and dwellings characterized by poverty, overcrowded conditions, poor housing, severe pollution, and absence of basic services such as water and sanitation. Slums in large cities often have an absence of schools, transportation, health centers, recreational facilities, and other such amenities. Additionally, the persistence of certain conditions, such as poverty, ethnic heterogeneity, and high population turnover, contributes to a lowered ability of individuals and communities to control crime, vandalism, and violence. The social vulnerability in health is not a "natural" or predefined condition but occurs because of the unequal social context that surrounds the daily life of the disadvantaged, and often, socially excluded groups. Social exclusion of individuals and groups is a major threat to development, whether to the community social cohesion and economic prosperity or to the individual self-realization through lack of recognition and acceptance, powerlessness, economic vulnerability, ill health, diminished life experiences, and limited life prospects. In contrast, social inclusion is seen to be vital to the material, psychosocial, and political aspects of empowerment that underpin social well-being and equitable health. Successful experiences of cooperation and networking between slum-based organizations, grassroots groups, local and international NGOs, and city government are important mechanisms that can be replicated in urban settings of different low- and middle-income countries. With increasing urbanization, it is imperative to design health programs for the urban poor that take full advantage of the social resources and resourcefulness of their own communities.

Personality Characteristics, Job Stressors, and Job Satisfaction: Main and Interaction Effects on Psychological and Physical Health Conditions of Italian Schoolteachers.

Science.gov (United States)

Zurlo, Maria Clelia; Pes, Daniela; Capasso, Roberto

2016-08-01

The study proposed an application of the transactional model of stress in teaching elaborated by Travers and Cooper in 1996, and aimed to investigate the influence of personality characteristics (coping strategies, type A behaviors), situational characteristics (sources of pressure), and perceived job satisfaction in the prediction of teachers' psychophysical health conditions. The Italian version of the Teacher Stress Questionnaire was administered to 621 teachers. Logistic regression was used to evaluate significant main and interaction effects of personality characteristics, situational characteristics, and perceived job satisfaction on teachers' self-reported psychophysical health conditions. The findings highlighted specific coping strategies (focused on the problem, on innovation, and on hobbies and pastimes) and dimensions of job satisfaction (related to intrinsic aspects of job and to employee relations) buffering the negative effects of several job stressors. Type A behaviors and coping strategies focused on mobilized social support, suppression of stress, and not confronting the situation had main and interactions with negative effects on psychophysical health. Findings confirmed the necessity to run multi-factor research to analyze the different combinations of individual and situational variables implicated in negative health outcomes and to highlight the most significant buffering or increasing associations. © The Author(s) 2016.

Working Conditions, Occupational Injuries, and Health Among Filipino Fish Processing Workers in Dutch Harbor, Alaska.

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Garcia, Gabriel Macasiray; de Castro, Butch

2017-05-01

This study explored how unique environmental conditions in Alaska influenced occupational health and safety for Filipino fish processing workers, many of whom migrated from warm locations (e.g., the Philippines, California, and Nevada). In-depth interviews were conducted with 26 Filipino workers in one commercial fish processing company in Dutch Harbor. Results indicated that cold weather interferes with workers' job performance, increasing their risk for injury and illness, whereas the community's isolation and rural nature causes loneliness and boredom, resulting in more high-risk behaviors. Other non-environmental factors affecting worker health include roommate and supervisor concerns and culture-specific practices. Findings suggest the importance of job rotation to avoid long exposures to cold temperatures, the value of a designated individual to inform workers about company and community resources that promote healthy lifestyles, and the possible utility of a joint worker-management safety committee.

Exploring the Impacts of Housing Condition on Migrants’ Mental Health in Nanxiang, Shanghai: A Structural Equation Modelling Approach

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Xiao, Yang; Sarkar, Chinmoy; Geng, Huizhi

2018-01-01

Although rapid urbanization and associated rural-to-urban migration has brought in enormous economic benefits in Chinese cities, one of the negative externalities include adverse effects upon the migrant workers’ mental health. The links between housing conditions and mental health are well-established in healthy city and community planning scholarship. Nonetheless, there has thusfar been no Chinese study deciphering the links between housing conditions and mental health accounting for macro-level community environments, and no study has previously examined the nature of the relationships in locals and migrants. To overcome this research gap, we hypothesized that housing conditions may have a direct and indirect effects upon mental which may be mediated by neighbourhood satisfaction. We tested this hypothesis with the help of a household survey of 368 adult participants in Nanxiang Town, Shanghai, employing a structural equation modeling approach. Our results point to the differential pathways via which housing conditions effect mental health in locals and migrants. For locals, housing conditions have direct effects on mental health, while as for migrants, housing conditions have indirect effects on mental health, mediated via neighborhood satisfaction. Our findings have significant policy implications on building an inclusive and harmonious society. Upstream-level community interventions in the form of sustainable planning and designing of migrant neighborhoods can promote sense of community, social capital and support, thereby improving mental health and overall mental capital of Chinese cities. PMID:29382174

Exploring the Impacts of Housing Condition on Migrants’ Mental Health in Nanxiang, Shanghai: A Structural Equation Modelling Approach

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Yang Xiao

2018-01-01

Full Text Available Although rapid urbanization and associated rural-to-urban migration has brought in enormous economic benefits in Chinese cities, one of the negative externalities include adverse effects upon the migrant workers’ mental health. The links between housing conditions and mental health are well-established in healthy city and community planning scholarship. Nonetheless, there has thusfar been no Chinese study deciphering the links between housing conditions and mental health accounting for macro-level community environments, and no study has previously examined the nature of the relationships in locals and migrants. To overcome this research gap, we hypothesized that housing conditions may have a direct and indirect effects upon mental which may be mediated by neighbourhood satisfaction. We tested this hypothesis with the help of a household survey of 368 adult participants in Nanxiang Town, Shanghai, employing a structural equation modeling approach. Our results point to the differential pathways via which housing conditions effect mental health in locals and migrants. For locals, housing conditions have direct effects on mental health, while as for migrants, housing conditions have indirect effects on mental health, mediated via neighborhood satisfaction. Our findings have significant policy implications on building an inclusive and harmonious society. Upstream-level community interventions in the form of sustainable planning and designing of migrant neighborhoods can promote sense of community, social capital and support, thereby improving mental health and overall mental capital of Chinese cities.

Inequality in oral health related to early and later life social conditions: a study of elderly in Norway and Sweden.

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Gülcan, Ferda; Ekbäck, Gunnar; Ordell, Sven; Lie, Stein Atle; Åstrøm, Anne Nordrehaug

2015-02-10

A life course perspective recognizes influences of socially patterned exposures on oral health across the life span. This study assessed the influence of early and later life social conditions on tooth loss and oral impacts on daily performances (OIDP) of people aged 65 and 70 years. Whether social inequalities in oral health changed after the usual age of retirement was also examined. In accordance with "the latent effect life course model", it was hypothesized that adverse early-life social conditions increase the risk of subsequent tooth loss and impaired OIDP, independent of later-life social conditions. Data were obtained from two cohorts studies conducted in Sweden and Norway. The 2007 and 2012 waves of the surveys were used for the present study. Early-life social conditions were measured in terms of gender, education and country of birth, and later-life social conditions were assessed by working status, marital status and size of social network. Logistic regression and Generalized Estimating Equations (GEE) were used to analyse the data. Inverse probability weighting (IPW) was used to adjust estimates for missing responses and loss to follow-up. Early-life social conditions contributed to tooth loss and OIDP in each survey year and both countries independent of later-life social conditions. Lower education correlated positively with tooth loss, but did not influence OIDP. Foreign country of birth correlated positively with oral impacts in Sweden only. Later-life social conditions were the strongest predictors of tooth loss and OIDP across survey years and countries. GEE revealed significant interactions between social network and survey year, and between marital status and survey year on tooth loss. The results confirmed the latent effect life course model in that early and later life social conditions had independent effects on tooth loss and OIDP among the elderly in Norway and Sweden. Between age 65 and 70, inequalities in tooth loss related to marital

Do Physical Proximity and Availability of Adequate Infrastructure at Public Health Facility Increase Institutional Delivery? A Three Level Hierarchical Model Approach.

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Patel, Rachana; Ladusingh, Laishram

2015-01-01

This study aims to examine the inter-district and inter-village variation of utilization of health services for institutional births in EAG states in presence of rural health program and availability of infrastructures. District Level Household Survey-III (2007-08) data on delivery care and facility information was used for the purpose. Bivariate results examined the utilization pattern by states in presence of correlates of women related while a three-level hierarchical multilevel model illustrates the effect of accessibility, availability of health facility and community health program variables on the utilization of health services for institutional births. The study found a satisfactory improvement in state Rajasthan, Madhya Pradesh and Orissa, importantly, in Bihar and Uttaranchal. The study showed that increasing distance from health facility discouraged institutional births and there was a rapid decline of more than 50% for institutional delivery as the distance to public health facility exceeded 10 km. Additionally, skilled female health worker (ANM) and observed improved public health facility led to significantly increase the probability of utilization as compared to non-skilled ANM and not-improved health centers. Adequacy of essential equipment/laboratory services required for maternal care significantly encouraged deliveries at public health facility. District/village variables neighborhood poverty was negatively related to institutional delivery while higher education levels in the village and women's residing in more urbanized districts increased the utilization. "Inter-district" variation was 14 percent whereas "between-villages" variation for the utilization was 11 percent variation once controlled for all the three-level variables in the model. This study suggests that the mere availability of health facilities is necessary but not sufficient condition to promote utilization until the quality of service is inadequate and inaccessible considering

Do Physical Proximity and Availability of Adequate Infrastructure at Public Health Facility Increase Institutional Delivery? A Three Level Hierarchical Model Approach.

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Rachana Patel

Full Text Available This study aims to examine the inter-district and inter-village variation of utilization of health services for institutional births in EAG states in presence of rural health program and availability of infrastructures. District Level Household Survey-III (2007-08 data on delivery care and facility information was used for the purpose. Bivariate results examined the utilization pattern by states in presence of correlates of women related while a three-level hierarchical multilevel model illustrates the effect of accessibility, availability of health facility and community health program variables on the utilization of health services for institutional births. The study found a satisfactory improvement in state Rajasthan, Madhya Pradesh and Orissa, importantly, in Bihar and Uttaranchal. The study showed that increasing distance from health facility discouraged institutional births and there was a rapid decline of more than 50% for institutional delivery as the distance to public health facility exceeded 10 km. Additionally, skilled female health worker (ANM and observed improved public health facility led to significantly increase the probability of utilization as compared to non-skilled ANM and not-improved health centers. Adequacy of essential equipment/laboratory services required for maternal care significantly encouraged deliveries at public health facility. District/village variables neighborhood poverty was negatively related to institutional delivery while higher education levels in the village and women's residing in more urbanized districts increased the utilization. "Inter-district" variation was 14 percent whereas "between-villages" variation for the utilization was 11 percent variation once controlled for all the three-level variables in the model. This study suggests that the mere availability of health facilities is necessary but not sufficient condition to promote utilization until the quality of service is inadequate and

Deployment Related Risk of Incident Mental Health Conditions Among Aeromedical Evacuation Crewmembers

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2015-09-01

everyday life, and decreasing the stigma associated with a diagnosis of a mental health condition. The Holmes-Rehe Stress Scale is commonly used to...being fatigued. A crucial factor to consider with this study is the stigma related to receiving a mental health diagnosis. While the Office of the...Alliance on Mental Illness estimates that up to 33% of qualified individuals are turned down for a job due to a psychiatric label (Williamson & Mulhall

Health, Health Inequality, and Cost Impacts of Annual Increases in Tobacco Tax: Multistate Life Table Modeling in New Zealand.

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Tony Blakely

2015-07-01

Full Text Available Countries are increasingly considering how to reduce or even end tobacco consumption, and raising tobacco taxes is a potential strategy to achieve these goals. We estimated the impacts on health, health inequalities, and health system costs of ongoing tobacco tax increases (10% annually from 2011 to 2031, compared to no tax increases from 2011 ["business as usual," BAU], in a country (New Zealand with large ethnic inequalities in smoking-related and noncommunicable disease (NCD burden.We modeled 16 tobacco-related diseases in parallel, using rich national data by sex, age, and ethnicity, to estimate undiscounted quality-adjusted life-years (QALYs gained and net health system costs over the remaining life of the 2011 population (n = 4.4 million. A total of 260,000 (95% uncertainty interval [UI]: 155,000-419,000 QALYs were gained among the 2011 cohort exposed to annual tobacco tax increases, compared to BAU, and cost savings were US$2,550 million (95% UI: US$1,480 to US$4,000. QALY gains and cost savings took 50 y to peak, owing to such factors as the price sensitivity of youth and young adult smokers. The QALY gains per capita were 3.7 times greater for Māori (indigenous population compared to non-Māori because of higher background smoking prevalence and price sensitivity in Māori. Health inequalities measured by differences in 45+ y-old standardized mortality rates between Māori and non-Māori were projected to be 2.31% (95% UI: 1.49% to 3.41% less in 2041 with ongoing tax rises, compared to BAU. Percentage reductions in inequalities in 2041 were maximal for 45-64-y-old women (3.01%. As with all such modeling, there were limitations pertaining to the model structure and input parameters.Ongoing tobacco tax increases deliver sizeable health gains and health sector cost savings and are likely to reduce health inequalities. However, if policy makers are to achieve more rapid reductions in the NCD burden and health inequalities, they will also

Health, Health Inequality, and Cost Impacts of Annual Increases in Tobacco Tax: Multistate Life Table Modeling in New Zealand

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Blakely, Tony; Cobiac, Linda J.; Cleghorn, Christine L.; Pearson, Amber L.; van der Deen, Frederieke S.; Kvizhinadze, Giorgi; Nghiem, Nhung; McLeod, Melissa; Wilson, Nick

2015-01-01

Background Countries are increasingly considering how to reduce or even end tobacco consumption, and raising tobacco taxes is a potential strategy to achieve these goals. We estimated the impacts on health, health inequalities, and health system costs of ongoing tobacco tax increases (10% annually from 2011 to 2031, compared to no tax increases from 2011 [“business as usual,” BAU]), in a country (New Zealand) with large ethnic inequalities in smoking-related and noncommunicable disease (NCD) burden. Methods and Findings We modeled 16 tobacco-related diseases in parallel, using rich national data by sex, age, and ethnicity, to estimate undiscounted quality-adjusted life-years (QALYs) gained and net health system costs over the remaining life of the 2011 population (n = 4.4 million). A total of 260,000 (95% uncertainty interval [UI]: 155,000–419,000) QALYs were gained among the 2011 cohort exposed to annual tobacco tax increases, compared to BAU, and cost savings were US$2,550 million (95% UI: US$1,480 to US$4,000). QALY gains and cost savings took 50 y to peak, owing to such factors as the price sensitivity of youth and young adult smokers. The QALY gains per capita were 3.7 times greater for Māori (indigenous population) compared to non-Māori because of higher background smoking prevalence and price sensitivity in Māori. Health inequalities measured by differences in 45+ y-old standardized mortality rates between Māori and non-Māori were projected to be 2.31% (95% UI: 1.49% to 3.41%) less in 2041 with ongoing tax rises, compared to BAU. Percentage reductions in inequalities in 2041 were maximal for 45–64-y-old women (3.01%). As with all such modeling, there were limitations pertaining to the model structure and input parameters. Conclusions Ongoing tobacco tax increases deliver sizeable health gains and health sector cost savings and are likely to reduce health inequalities. However, if policy makers are to achieve more rapid reductions in the NCD

[Survey regarding mental health conditions of high school students and attitudes of students and their teachers toward students' mental health issues].

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Hattori, Isao; Fujii, Chiyo; Fukuzawa, Ayako

2013-01-01

We administered a self-reporting questionnaire survey regarding the mental health conditions of high school students and attitudes of students and their teachers toward students' mental health issues. In addition, we discussed the requirements for high school students' mental health support system. The subjects were 3,312 students and 208 teachers in four Shizuoka prefectural public high schools in 2009. University Personality Inventory (UPI) is usually conducted to assess university students' mental state and is a questionnaire that high school students can answer easily. Therefore, we adopted UPI for this survey. UPI was composed of 56 unhealthy and 4 healthy condition items. High school students completed the UPI and determined the sum of unhealthy condition items; a higher score indicated a poorer mental health status. The average UPI score of all students (n = 3,312) was 12.7 points, and that of females (n = 1,217)was 15.2 points, which was significantly higher than the 11.3 points of males (n = 2,095). Those with scores > or = 30 points (7.5%), which was more than half of the maximum score, were designated as the High Score (HS) group and considered to have poor mental health. Those with scores of > or = 40 (1.4%) seemed to have very poor mental health, and there was concern that they may be suffering from psychosis. Our observations indicated that HS students were likely to avoid seeking help regarding mental health issues, which was especially true for male HS students. The majority of students chose their friends and parents as advisers, but HS students were significantly more likely to choose advisers who were engaged in jobs related to medical work. Students in both the HS and non-HS groups who did not wish to consult anyone else about their mental conditions wanted to be approached by those around them. High school teachers hesitated to intervene with mentally disturbed students and attempted to resolve problems within the school. Thus, it appears

Does Health Insurance Premium Exemption Policy for Older People Increase Access to Health Care? Evidence from Ghana.

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Duku, Stephen Kwasi Opuku; van Dullemen, Caroline Elisabeth; Fenenga, Christine

2015-01-01

Aging in Sub-Saharan Africa causes major challenges for policy makers in social protection. Our study focuses on Ghana, one of the few Sub-Saharan African countries that passed a National Policy on Aging in 2010. Ghana is also one of the first Sub-Saharan African countries that launched a National Health Insurance Scheme (NHIS; NHIS Act 650, 2003) with the aim to improve access to quality health care for all citizens, and as such can be considered as a means of poverty reduction. Our study assesses whether premium exemption policy under the NHIS that grants non-payments of annual health insurance premiums for older people increases access to health care. We assessed differences in enrollment coverage among four different age groups (18-49, 50-59, 60-69, and 70+). We found higher enrollment for the 70+ and 60-69 age groups. The likelihood of enrollment was 2.7 and 1.7 times higher for the 70+ and 60-69 age groups, respectively. Our results suggest the NHIS exemption policy increases insurance coverage of the aged and their utilization of health care services.

Self-rated health and chronic conditions are associated with blood concentrations of persistent organic pollutants in the general population of Catalonia, Spain.

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Gasull, Magda; Pallarès, Natàlia; Salcedo, Natalia; Pumarega, José; Alonso, Jordi; Porta, Miquel

2015-11-01

Self-rated health (SRH) is a powerful predictor of mortality, morbidity, and need for health services. SRH generally increases with educational level, and decreases with age, number of chronic conditions, and body mass index (BMI). Because human concentrations of most persistent organic pollutants (POPs) also vary by age, education, and BMI, and because of the physiological and clinical effects of POPs, we hypothesized that body concentrations of POPs are inversely associated with SRH. To analyze the relation between serum concentrations of POPs and SRH in the general population of Catalonia, Spain, taking into account sociodemographic factors and BMI, as well as chronic health conditions and mental disorders, measured by the General Health Questionnaire-12 (GHQ-12). POP serum concentrations were measured by gas chromatography with electron-capture detection in 919 participants of the Catalan Health Interview Survey. Individuals with higher concentrations of POPs had significantly poorer SRH; e.g., the median concentration of HCB in subjects with poor SRH was twice as high as in subjects with excellent SRH (366 ng/g vs. 169 ng/g, respectively; p-valuehigher in subjects with POP concentrations in the top quartile. In models adjusted for age or for chronic conditions virtually all ORs were near unity. No associations were found between POP levels and GHQ-12. Individuals with higher concentrations of POPs had significantly poorer SRH, an association likely due to age and chronic conditions, but not to sex, education, social class, BMI, or mental disorders. Copyright © 2015 Elsevier Inc. All rights reserved.

Psychosocial work conditions, unemployment and health locus of control: a population-based study.

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Sadiq Mohammad Ali; Lindström, Martin

2008-06-01

To investigate the association between psychosocial work conditions, unemployment and lack of belief in the possibility of influencing one's own health. The 2000 public health survey in Scania is a cross-sectional postal questionnaire study with a 59% participation rate. In total, 5180 persons aged 18-64 years who belonged to the workforce and the unemployed were included in this study. Logistic regression models were used to investigate the associations between psychosocial factors at work and unemployment, and lack of belief in the possibility of influencing one's own health (external locus of control). Psychosocial conditions at work were defined according to the Karasek-Theorell demand-control/decision latitudes into relaxed, active, passive, and job strain categories. The multivariate analyses included age, country of birth, education, economic stress, and social participation. In total, 26.6% of all men and 26.9% of all women lack an internal locus of control. The passive, job strain and unemployed categories have significantly higher odds ratios of lack of internal locus of control, as compared to the relaxed reference category. No such significant differences are observed for the active category. These patterns remain in the multivariate models, with the exception of the passive and unemployed categories among men, in which the significant differences disappear. Psychosocial work conditions and unemployment may affect health locus of control. The control dimension in the Karasek-Theorell model seems to be of greatest importance.

Effects of a Self-Directed Nutrition Intervention among Adults with Chronic Health Conditions

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Baruth, Meghan; Wilcox, Sara; Jake-Schoffman, Danielle E.; Schlaff, Rebecca A.; Goldufsky, Tatum M.

2018-01-01

Chronic diseases are common among adults. A healthy diet may be beneficial for managing the consequences of such conditions. The purpose of this study was to evaluate the effects of a self-directed nutrition program on dietary behaviors among adults with chronic health conditions. As part of a larger trial examining the effects of a self-directed…

Poverty and Health in Argentina

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Maria Alejandra Silva

2009-06-01

Full Text Available This article examines health conditions in the rural areas of Central Argentina, the country’s main region for soy-bean production and export. Health conditions are analyzed through the concepts of emerging and re-emerging diseases in a context of increasing poverty. Data on poverty and health was obtained from both primary sources (trade union, government officials, rural doctors and the South Watch/FA/FODEPAL/UNR working group and secondary sources (IPEC/INDEC, IDESA, Consultora Equis, the Argentine Ministry of Employment, ILO, the Ministry of Health, the Ministry of the Environment, toxicology centers and rural doctors. Analysis of rural health conditions gives cause for concern. There is evidence of deterioration in the social determinants of health such as an increase in rural and urban poverty associated with informal employment and child labor. At the same time lack of government epidemiological and toxicological data appears to hide or distort the reality of health conditions.

The Economic Impact of Loss of Performance Due to Absenteeism and Presenteeism Caused by Depressive Symptoms and Comorbid Health Conditions among Japanese Workers

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WADA, Koji; ARAKIDA, Mikako; WATANABE, Rika; NEGISHI, Motomi; SATO, Jun; TSUTSUMI, Akizumi

2013-01-01

We aimed to determine the economic impact of absenteeism and presenteeism from five conditions potentially comorbid with depressive symptoms—back or neck disorders, depression, anxiety, or emotional disorders, chronic headaches, stomach or bowel disorders, and insomnia—among Japanese workers aged 18–59 yr. Participants from 19 workplaces anonymously completed Stanford Presenteeism Scale questionnaires. Participants identified one primary health condition and determined the resultant performance loss (0–100%) over the previous 4-wk period. We estimated the wage loss by gender, using 10-yr age bands. A total of 6,777 participants undertook the study. Of these, we extracted the data for those in the 18–59 yr age band who chose targeted primary health conditions (males, 2,535; females 2,465). The primary health condition identified was back or neck disorders. We found that wage loss due to presenteeism and absenteeism per 100 workers across all 10-yr age bands was high for back or neck disorders. Wage loss per person was relatively high among those identifying depression, anxiety, or emotional disorders. These findings offer insight into developing strategies for workplace interventions on increasing work performance. PMID:23892900

The economic impact of loss of performance due to absenteeism and presenteeism caused by depressive symptoms and comorbid health conditions among Japanese workers.

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Wada, Koji; Arakida, Mikako; Watanabe, Rika; Negishi, Motomi; Sato, Jun; Tsutsumi, Akizumi

2013-01-01

We aimed to determine the economic impact of absenteeism and presenteeism from five conditions potentially comorbid with depressive symptoms-back or neck disorders, depression, anxiety, or emotional disorders, chronic headaches, stomach or bowel disorders, and insomnia-among Japanese workers aged 18-59 yr. Participants from 19 workplaces anonymously completed Stanford Presenteeism Scale questionnaires. Participants identified one primary health condition and determined the resultant performance loss (0-100%) over the previous 4-wk period. We estimated the wage loss by gender, using 10-yr age bands. A total of 6,777 participants undertook the study. Of these, we extracted the data for those in the 18-59 yr age band who chose targeted primary health conditions (males, 2,535; females 2,465). The primary health condition identified was back or neck disorders. We found that wage loss due to presenteeism and absenteeism per 100 workers across all 10-yr age bands was high for back or neck disorders. Wage loss per person was relatively high among those identifying depression, anxiety, or emotional disorders. These findings offer insight into developing strategies for workplace interventions on increasing work performance.

Association of a behaviorally based high school health education curriculum with increased exercise.

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Annesi, James J; Trinity, John; Mareno, Nicole; Walsh, Stephanie M

2015-06-01

Increasing exercise in children and adolescents through academic classes is an understudied area. Potential benefits include associated improvements in health, psychosocial, and quality-of-life factors. A sample of 98 students (M(age) = 14.3) from high school health education classes received six, 40-min lessons incorporating cognitive-behavioral methods to increase exercise over 6 weeks. Significant within-group improvements in exercise, mood, and body satisfaction were found, with slightly larger effect sizes identified for the boys. Increase in exercise was significantly associated with reduced mood distress (β = -.17, p goal setting and self-regulation within high school health education classes may foster increased exercise and associated improvements in mood and body satisfaction. For girls, the positive effects may reinforce one another. © The Author(s) 2014.

Physical health condition and physical organism readiness levels of sports veteran wrestlers

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Oleksiy Goncharov

2017-10-01

Full Text Available Purpose: study and an assessment of the physical state of health and the degree of physical fitness of the organism among active veteran wrestlers. Material & Methods: participants: 16 active veteran athletes, 7 of them judoka and 9 sambo wrestlers aged 36–45. Sports qualification of athletes: MS – 10 people, MSIC – 6 people. The stability of the organism to the conditions of hypoxia and hypercapnia was assessed by the results of the Stange and Genci tests. To determine the statistical balancing, the Bondarevsky trial was used. The degree of physical readiness was evaluated by the results of the distance traveled on the treadmill of Kettler, comparing it with the Cooper table. To assess the level of physical state, the formula was used by E. A. Pirogova. Results: investigation determined that the actions of the wrestlers – sports veterans of the body's resistance to the conditions of hypoxia and hypercapnia, as well as the indicator VC indices correspond young people. Indicators of statistical balancing among the acting veterans of judoists and sambo wrestlers corresponded to those of 20–30-year-old people. Level of physical condition (LPC of health in 71,4% of veteran-judoists at the average level and only 28,6% is of a high level. Sambo veterans observed the following: 44,4% of sportsmen of the LPC are above the average; 33,3% have an average level of physical health; in 11,1% of athletes the average LPC and 11,1% of the judo veterans have indicators corresponding to the level below the average. Conclusion: conducted step-by-step medical and pedagogical control allowed to reveal some violations of the adaptive mechanisms of the cardiovascular system, which once again confirms the possibility of using the data of heart rate, blood pressure, Cooper's test for studying and analyzing the physical state of health and the degree of physical preparedness, as well as forecasting the health status of veterans sports.

Mechanisms of Change in the ARC Organizational Strategy: Increasing Mental Health Clinicians' EBP Adoption Through Improved Organizational Culture and Capacity.

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Williams, Nathaniel J; Glisson, Charles; Hemmelgarn, Anthony; Green, Philip

2017-03-01

The development of efficient and scalable implementation strategies in mental health is restricted by poor understanding of the change mechanisms that increase clinicians' evidence-based practice (EBP) adoption. This study tests the cross-level change mechanisms that link an empirically-supported organizational strategy for supporting implementation (labeled ARC for Availability, Responsiveness, and Continuity) to mental health clinicians' EBP adoption and use. Four hundred seventy-five mental health clinicians in 14 children's mental health agencies were randomly assigned to the ARC intervention or a control condition. Measures of organizational culture, clinicians' intentions to adopt EBPs, and job-related EBP barriers were collected before, during, and upon completion of the three-year ARC intervention. EBP adoption and use were assessed at 12-month follow-up. Multilevel mediation analyses tested changes in organizational culture, clinicians' intentions to adopt EBPs, and job-related EBP barriers as linking mechanisms explaining the effects of ARC on clinicians' EBP adoption and use. ARC increased clinicians' EBP adoption (OR = 3.19, p = .003) and use (81 vs. 56 %, d = .79, p = .003) at 12-month follow-up. These effects were mediated by improvement in organizational proficiency culture leading to increased clinician intentions to adopt EBPs and by reduced job-related EBP barriers. A combined mediation analysis indicated the organizational culture-EBP intentions mechanism was the primary carrier of ARC's effects on clinicians' EBP adoption and use. ARC increases clinicians' EBP adoption and use by creating proficient organizational cultures that increase clinicians' intentions to adopt EBPs.

Mechanisms of change in the ARC organizational strategy: Increasing mental health clinicians’ EBP adoption through improved organizational culture and capacity

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Williams, Nathaniel J.; Glisson, Charles; Hemmelgarn, Anthony; Green, Philip

2016-01-01

Background The development of efficient and scalable implementation strategies in mental health is restricted by poor understanding of the change mechanisms that increase clinicians’ evidence-based practice (EBP) adoption. This study tests the cross-level change mechanisms that link an empirically-supported organizational strategy for supporting implementation (labeled ARC for Availability, Responsiveness, and Continuity) to mental health clinicians’ EBP adoption and use. Method Four hundred seventy five mental health clinicians in 14 children’s mental health agencies were randomly assigned to the ARC intervention or a control condition. Measures of organizational culture, clinicians’ intentions to adopt EBPs, and job-related EBP barriers were collected before, during, and upon completion of the three-year ARC intervention. EBP adoption and use were assessed at 12-month follow-up. Multilevel mediation analyses tested changes in organizational culture, clinicians’ intentions to adopt EBPs, and job-related EBP barriers as linking mechanisms explaining the effects of ARC on clinicians’ EBP adoption and use. Results ARC increased clinicians’ EBP adoption (OR = 3.19, p = .003) and use (81% vs. 56%, d = .79, p = .003) at 12-month follow-up. These effects were mediated by improvement in organizational proficiency culture leading to increased clinician intentions to adopt EBPs and by reduced job-related EBP barriers. A combined mediation analysis indicated the organizational culture-EBP intentions mechanism was the primary carrier of ARC’s effects on clinicians’ EBP adoption and use. Conclusions ARC increases clinicians’ EBP adoption and use by creating proficient organizational cultures that increase clinicians’ intentions to adopt EBPs. PMID:27236457

Self-rated health and chronic conditions are associated with blood concentrations of persistent organic pollutants in the general population of Catalonia, Spain

International Nuclear Information System (INIS)

Gasull, Magda; Pallarès, Natàlia; Salcedo, Natalia; Pumarega, José; Alonso, Jordi; Porta, Miquel

2015-01-01

Background: Self-rated health (SRH) is a powerful predictor of mortality, morbidity, and need for health services. SRH generally increases with educational level, and decreases with age, number of chronic conditions, and body mass index (BMI). Because human concentrations of most persistent organic pollutants (POPs) also vary by age, education, and BMI, and because of the physiological and clinical effects of POPs, we hypothesized that body concentrations of POPs are inversely associated with SRH. Objectives: To analyze the relation between serum concentrations of POPs and SRH in the general population of Catalonia, Spain, taking into account sociodemographic factors and BMI, as well as chronic health conditions and mental disorders, measured by the General Health Questionnaire-12 (GHQ-12). Methods: POP serum concentrations were measured by gas chromatography with electron-capture detection in 919 participants of the Catalan Health Interview Survey. Results: Individuals with higher concentrations of POPs had significantly poorer SRH; e.g., the median concentration of HCB in subjects with poor SRH was twice as high as in subjects with excellent SRH (366 ng/g vs. 169 ng/g, respectively; p-value<0.001). In crude models and in models adjusted for sex and BMI, the POPs-SRH association was often dose-dependent, and the likelihood of poor or regular SRH was 2 to 4-times higher in subjects with POP concentrations in the top quartile. In models adjusted for age or for chronic conditions virtually all ORs were near unity. No associations were found between POP levels and GHQ-12. Conclusions: Individuals with higher concentrations of POPs had significantly poorer SRH, an association likely due to age and chronic conditions, but not to sex, education, social class, BMI, or mental disorders. - Highlights: • The relation between POPs and self-rated and mental health has seldom been studied. • Subjects with higher POP levels had poorer self-rated health (SRH) (dose

Self-rated health and chronic conditions are associated with blood concentrations of persistent organic pollutants in the general population of Catalonia, Spain

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Gasull, Magda; Pallarès, Natàlia [Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia (Spain); CIBER de Epidemiología y Salud Pública (CIBERESP) (Spain); School of Medicine, Universitat Autònoma de Barcelona (Spain); Salcedo, Natalia [Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia (Spain); School of Medicine, Universitat Autònoma de Barcelona (Spain); Pumarega, José [Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia (Spain); CIBER de Epidemiología y Salud Pública (CIBERESP) (Spain); Alonso, Jordi [Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia (Spain); CIBER de Epidemiología y Salud Pública (CIBERESP) (Spain); Universitat Pompeu Fabra, Catalonia (Spain); Porta, Miquel, E-mail: mporta@imim.es [Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia (Spain); CIBER de Epidemiología y Salud Pública (CIBERESP) (Spain); School of Medicine, Universitat Autònoma de Barcelona (Spain)

2015-11-15

Background: Self-rated health (SRH) is a powerful predictor of mortality, morbidity, and need for health services. SRH generally increases with educational level, and decreases with age, number of chronic conditions, and body mass index (BMI). Because human concentrations of most persistent organic pollutants (POPs) also vary by age, education, and BMI, and because of the physiological and clinical effects of POPs, we hypothesized that body concentrations of POPs are inversely associated with SRH. Objectives: To analyze the relation between serum concentrations of POPs and SRH in the general population of Catalonia, Spain, taking into account sociodemographic factors and BMI, as well as chronic health conditions and mental disorders, measured by the General Health Questionnaire-12 (GHQ-12). Methods: POP serum concentrations were measured by gas chromatography with electron-capture detection in 919 participants of the Catalan Health Interview Survey. Results: Individuals with higher concentrations of POPs had significantly poorer SRH; e.g., the median concentration of HCB in subjects with poor SRH was twice as high as in subjects with excellent SRH (366 ng/g vs. 169 ng/g, respectively; p-value<0.001). In crude models and in models adjusted for sex and BMI, the POPs-SRH association was often dose-dependent, and the likelihood of poor or regular SRH was 2 to 4-times higher in subjects with POP concentrations in the top quartile. In models adjusted for age or for chronic conditions virtually all ORs were near unity. No associations were found between POP levels and GHQ-12. Conclusions: Individuals with higher concentrations of POPs had significantly poorer SRH, an association likely due to age and chronic conditions, but not to sex, education, social class, BMI, or mental disorders. - Highlights: • The relation between POPs and self-rated and mental health has seldom been studied. • Subjects with higher POP levels had poorer self-rated health (SRH) (dose

The correlations of work conditions with unhealthy lifestyles and occupational health problems of casino croupiers in Macau.