Thirty Years of Orphan Drug Legislation and the Development of Drugs to Treat Rare Seizure Conditions: A Cross Sectional Analysis.

Science.gov (United States)

Döring, Jan Henje; Lampert, Anette; Hoffmann, Georg F; Ries, Markus

2016-01-01

Epilepsy is a serious chronic health condition with a high morbidity impairing the life of patients and afflicted families. Many epileptic conditions, especially those affecting children, are rare disorders generating an urgent medical need for more efficacious therapy options. Therefore, we assessed the output of the US and European orphan drug legislations. Quantitative analysis of the FDA and EMA databases for orphan drug designations according to STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) criteria. Within the US Orphan Drug Act 40 designations were granted delivering nine approvals, i.e. clobazam, diazepam viscous solution for rectal administration, felbamate, fosphenytoin, lamotrigine, repository corticotropin, rufinamide, topiramate, and vigabatrin. Since 2000 the EMA granted six orphan drug designations whereof two compounds were approved, i.e. rufinamide and stiripentol. In the US, two orphan drug designations were withdrawn. Orphan drugs were approved for conditions including Lennox-Gastaut syndrome, infantile spasms, Dravet syndrome, and status epilepticus. Comparing time to approval for rufinamide, which was approved in the US and the EU to treat rare seizure conditions, the process seems faster in the EU (2.2 years) than in the US (4.3 years). Orphan drug development in the US and in the EU delivered only few molecular entities to treat rare seizure disorders. The development programs focused on already approved antiepileptic drugs or alternative pharmaceutical formulations. Most orphan drugs approved in the US are not approved in the EU to treat rare seizures although some were introduced after 2000 when the EU adopted the Orphan Drug Regulation.

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

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.

Splenic Trapping of Heat-Treated Erythrocytes in Leukaemia and Allied Conditions

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Badrawi, H. S.; Razzak, M. A.; Guirgis, B. [Department of Medicine and Division of Nuclear Medicine, Faculty of Medicine, Cairo University, Cairo, United Arab Republic (Egypt)

1971-02-15

In a trial to find whether or not the enlarged spleen plays a role in the production of the form of anaemia commonly encountered in leukaemias and allied conditions, 44 patients suffering from these disease states were studied using {sup 51}Cr-labelled erythrocytes heated at 50 Degree-Sign C for 60 min. Cells altered in this manner have been shown by various workers to be selectively sequestered by the spleen. As a control, the test was performed on 24 normal subjects. In these normals, the disappearance half-time of radioactivity from the circulation (T{sub Vulgar-Fraction-One-Half} amounted to 172 {+-} 69 min (mean {+-} 1 S.D.), the lowest limit being 74 min. Accordingly, patients with less than 74 min were considered to have an abnormally rapid disappearance of heat-treated erythrocytes from the circulation and consequently exaggerated splenic sequestration of these altered cells. Splenic trapping of heat-treated erythrocytes was most marked in acute leukaemia (four out of six patients). However, three had associated normoblastic hypoplasia of the sternal marrow. Corticosteroids induced a remission with reversion of both processes responsible for the anaemia in two out of the four patients. In chronic myeloid leukaemia, exaggerated splenic sequestration of altered cells was seen in four of the 15 cases examined. This condition was of extra-erythrocytic origin, since repetition of the test using normal donor heat-treated erythrocytes did not significantly alter the disappearance half-time. However, there was no correlation between the size of the spleen and its avidity for trapping the altered cells. Follow-up studies showed that therapy caused prolongation of the half-time of heat-treated erythrocytes, the effect being more apparent after corticosteroids than with X-rays or Endoxan, In Hodgkin's disease, increased red cell trapping was observed in two out of the seven patients studied. In contrast, five cases of chronic lymphatic leukaemia, six lymphosarcoma and

Health status in patients treated with cardiac resynchronization therapy

DEFF Research Database (Denmark)

Schiffer, Angélique A; Denollet, Johan; Pedersen, Susanne S.

2008-01-01

Cardiac resynchronization therapy (CRT) is a promising treatment in chronic heart failure (CHF). However, a subgroup of patients still report impaired health status, cardiac symptoms, and feelings of disability following CRT. The aims of this study were to examine (1) whether CHF patients treated...

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...

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.

Macroeconomic conditions and health: Inspecting the transmission mechanism.

Science.gov (United States)

Colombo, Emilio; Rotondi, Valentina; Stanca, Luca

2018-02-01

We study the relationship between macroeconomic conditions and self-reported health in a large sample of Italian individuals, focusing on the mediating role played by health behaviors (smoking, alcohol consumption, physical activity, eating habits) and economic stress. Our findings indicate that, overall, higher local unemployment is negatively related to individuals' health conditions. A one percentage point increase in the province-level unemployment rate is associated with a significant increase in the probability of experiencing diabetes (0.03 percentage points), infarction (0.01), ulcer (0.06), cirrhosis (0.01) and nervous disorders (0.07), with a time lag that differs across individual health conditions. Employment status and educational level play a significant role as moderators of these relationships. Eating habits, in addition to economic stress, play a key role as mediators, by enhancing the negative relationship between macroeconomic conditions and health outcomes, while physical exercise is found to play a dampening role. Copyright © 2017 Elsevier B.V. All rights reserved.

Shared decision making among parents of children with mental health conditions compared to children with chronic physical conditions.

Science.gov (United States)

Butler, Ashley M; Elkins, Sara; Kowalkowski, Marc; Raphael, Jean L

2015-02-01

High quality care in pediatrics involves shared decision making (SDM) between families and providers. The extent to which children with common mental health disorders experience SDM is not well known. The objectives of this study were to examine how parent-reported SDM varies by child health (physical illness, mental health condition, and comorbid mental and physical conditions) and to examine whether medical home care attenuates any differences. We analyzed data on children (2-17 years) collected through the 2009/2010 National Survey of Children with Special Health Care Needs. The sample consisted of parents of children in one of three child health categories: (1) children with a chronic physical illness but no mental health condition; (2) children with a common mental health condition but no chronic physical condition; and (3) children with comorbid mental and chronic physical conditions. The primary dependent variable was parent-report of provider SDM. The primary independent variable was health condition category. Multivariate linear regression analyses were conducted. Multivariate analyses controlling for sociodemographic variables and parent-reported health condition impact indicated lower SDM among children with a common mental health condition-only (B = -0.40; p mental health condition-only were no longer significant in the model adjusting for medical home care. However, differences in SDM for children with comorbid conditions persisted after adjusting for medical home care. Increasing medical home care may help mitigate differences in SDM for children with mental health conditions-only. Other interventions may be needed to improve SDM among children with comorbid mental and physical conditions.

Financial well-being of older Australians with multiple health conditions.

Science.gov (United States)

Temple, Jeromey B; Williams, Ruth

2018-02-10

Given recent rises in out-of-pocket health expenses, we examined the financial well-being of older Australians with multiple health conditions and disabilities. The 2014 General Social Survey was used to measure the: (i) current financial position; (ii) propensity to experience financial difficulties; and (iii) types of behaviours older people with multiple health conditions engage in to improve financial resilience. Compared to older Australians with no health conditions, respondents with multiple health conditions had lower incomes and assets and a higher propensity to hold consumer debt (once controls were included). They were at a higher risk of cash flow difficulties, dissaving to meet day-to-day living expenses and exclusion from financial providers. However, the majority of people with multiple health conditions engaged in financially resilient behaviours. Many older Australians with multiple health conditions were in a financially precarious situation with implications for the ability to afford ongoing increases in out-of-pocket health-care costs. © 2018 AJA Inc.

Oral Health Condition of Children Living with HIV

Directory of Open Access Journals (Sweden)

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.

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 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.

Treating the elite athlete: anti-doping information for the health professional.

Science.gov (United States)

Tandon, Shikha; Bowers, Larry D; Fedoruk, Matthew N

2015-01-01

Physicians and health professionals are a vital component in preserving the integrity of competition and the core principles of true sport. When treating an athlete, health professionals need to be cognizant of the anti-doping rules of the relevant sport organization. This review aims to provide an overview of the World Anti-Doping Agency Prohibited List, Therapeutic Use Exemptions, roles and responsibilities of the health professional, as well as provide resources that will guide their work with athletes.

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

[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.

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.

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

Science.gov (United States)

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

following an ED visit. The block of enabling factors was the strongest predictor of hospitalization following an ED visit compared to predisposing and need factors. Our findings also provide evidence of disparities in hospitalization of the uninsured and racial and ethnic minority patients with ED visits for behavioral health conditions. Thus, improved access to community-based behavioral health services and an increased capacity for inpatient psychiatric hospitals for treating indigent patients may be needed to improve the efficiency of ED services in our region for patients with behavioral health conditions. Among need factors, a discharge diagnosis of schizophrenia/psychotic spectrum disorder, an affective disorder, a personality disorder, an impulse control disorder, or dementia as well as secondary diagnoses of suicidal ideation and/or suicidal behavior increased the likelihood of hospitalization following an ED visit, also suggesting an opportunity for improving the efficiency of ED care through the provision of psychiatric services to stabilize and treat patients with serious mental illness. © 2016 by the Society for Academic Emergency Medicine.

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

Community health center provider ability to identify, treat and account for the social determinants of health: a card study.

Science.gov (United States)

Lewis, Joy H; Whelihan, Kate; Navarro, Isaac; Boyle, Kimberly R

2016-08-27

The social determinants of health (SDH) are conditions that shape the overall health of an individual on a continuous basis. As momentum for addressing social factors in primary care settings grows, provider ability to identify, treat and assess these factors remains unknown. Community health centers care for over 20-million of America's highest risk populations. This study at three centers evaluates provider ability to identify, treat and code for the SDH. Investigators utilized a pre-study survey and a card study design to obtain evidence from the point of care. The survey assessed providers' perceptions of the SDH and their ability to address them. Then providers filled out one anonymous card per patient on four assigned days over a 4-week period, documenting social factors observed during encounters. The cards allowed providers to indicate if they were able to: provide counseling or other interventions, enter a diagnosis code and enter a billing code for identified factors. The results of the survey indicate providers were familiar with the SDH and were comfortable identifying social factors at the point of care. A total of 747 cards were completed. 1584 factors were identified and 31 % were reported as having a service provided. However, only 1.2 % of factors were associated with a billing code and 6.8 % received a diagnosis code. An obvious discrepancy exists between the number of identifiable social factors, provider ability to address them and documentation with billing and diagnosis codes. This disparity could be related to provider inability to code for social factors and bill for related time and services. Health care organizations should seek to implement procedures to document and monitor social factors and actions taken to address them. Results of this study suggest simple methods of identification may be sufficient. The addition of searchable codes and reimbursements may improve the way social factors are addressed for individuals and populations.

Effects of conditioned medium from LL-37 treated adipose stem cells on human fibroblast migration.

Science.gov (United States)

Yang, Eun-Jung; Bang, Sa-Ik

2017-07-01

Adipose stem cell-conditioned medium may promote human dermal fibroblast (HDF) proliferation and migration by activating paracrine peptides during the re-epithelization phase of wound healing. Human antimicrobial peptide LL-37 is upregulated in the skin epithelium as part of the normal response to injury. The effects of conditioned medium (CM) from LL-37 treated adipose stem cells (ASCs) on cutaneous wound healing, including the mediation of fibroblast migration, remain to be elucidated, therefore the aim of the present study was to determine how ASCs would react to an LL-37-rich microenvironment and if CM from LL-37 treated ASCs may influence the migration of HDFs. The present study conducted migration assays with HDFs treated with CM from LL-37 treated ASCs. Expression of CXC chemokine receptor 4 (CXCR4), which controls the recruitment of HDFs, was analyzed at the mRNA and protein levels. To further characterize the stimulatory effects of LL-37 on ASCs, the expression of stromal cell-derived factor-1α (SDF-1α), a CXC chemokine, was investigated. CM from LL-37-treated ASCs induced migration of HDFs in a time- and dose-dependent manner, with a maximum difference in migration observed 24 h following stimulation with LL-37 at a concentration of 10 µg/ml. The HDF migration and the expression of CXCR4 in fibroblasts was markedly increased upon treatment with CM from LL-37-treated ASCs compared with CM from untreated ASCs. SDF-1α expression was markedly increased in CM from LL-37 treated ASCs. It was additionally observed that SDF-1α blockade significantly reduced HDF migration. These findings suggest the feasibility of CM from LL-37-treated ASCs as a potential therapeutic for human dermal fibroblast migration.

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.

Portraying mental illness and drug addiction as treatable health conditions: effects of a randomized experiment on stigma and discrimination.

Science.gov (United States)

McGinty, Emma E; Goldman, Howard H; Pescosolido, Bernice; Barry, Colleen L

2015-02-01

Despite significant advances in treatment, stigma and discrimination toward persons with mental illness and drug addiction have remained constant in past decades. Prior work suggests that portraying other stigmatized health conditions (i.e., HIV/AIDS) as treatable can improve public attitudes toward those affected. Our study compared the effects of vignettes portraying persons with untreated and symptomatic versus successfully treated and asymptomatic mental illness and drug addiction on several dimensions of public attitudes about these conditions. We conducted a survey-embedded randomized experiment using a national sample (N = 3940) from an online panel. Respondents were randomly assigned to read one of ten vignettes. Vignette one was a control vignette, vignettes 2-5 portrayed individuals with untreated schizophrenia, depression, prescription pain medication addiction and heroin addiction, and vignettes 6-10 portrayed successfully treated individuals with the same conditions. After reading the randomly assigned vignette, respondents answered questions about their attitudes related to mental illness or drug addiction. Portrayals of untreated and symptomatic schizophrenia, depression, and heroin addiction heightened negative public attitudes toward persons with mental illness and drug addiction. In contrast, portrayals of successfully treated schizophrenia, prescription painkiller addiction, and heroin addiction led to less desire for social distance, greater belief in the effectiveness of treatment, and less willingness to discriminate against persons with these conditions. Portrayal of persons with successfully treated mental illness and drug addiction is a promising strategy for reducing stigma and discrimination toward persons with these conditions and improving public perceptions of treatment effectiveness. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effects of macroeconomic conditions on health in Brazil.

Science.gov (United States)

Jacinto, Paulo de Andrade; Tejada, César Augusto Oviedo; Sousa, Tanara Rosângela Vieira de

2010-04-01

To analyze the relationship between macroeconomic conditions and health in Brazil. The analysis of the impact of employment and income on mortality in Brazil was based on panel data from Brazilian states between 1981 and 2002. Mortality rates obtained from the national mortality database was used as a proxy for health status, whereas the variables employment, income, and illiteracy rates were used as proxies for macroeconomic and socioeconomic conditions. Static and dynamic models were applied for the analysis of two hypotheses: a) there is a positive relationship between mortality rates and income and employment, as suggested by Ruhm; b) there is a negative relationship between mortality rates and income and employment, as suggested by Brenner. There was found a negative relationship between mortality rates (proxy for health) and macroeconomic conditions (measured by employment rate). The estimates indicated that the overall mortality rate was higher during economic recession, suggesting that as macroeconomic conditions improved, increasing employment rates, there was a decrease in the mortality rate. The estimate for the relationship between illiteracy (proxy for education level) and mortality rate showed that higher levels of education can improve health. The results from the static and dynamic models support Brenner's hypothesis that there is a negative relationship between mortality rates and macroeconomic conditions.

[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.

Assessing the Relationship Between Chronic Health Conditions and Productivity Loss Trajectories

Science.gov (United States)

Pranksy, Glenn

2014-01-01

Objective: To examine the relationship between health conditions and the risk for membership in longitudinal trajectories of productivity loss. Methods: Trajectories of productivity loss from the ages of 25 to 44 years, previously identified in the National Longitudinal Survey of Youth (NLSY79), were combined with information on health conditions from the age 40 years health module in the NLSY79. Multinomial logistic regression was used to examine the relative risk of being in the low-risk, early-onset increasing risk, late-onset increasing risk, or high-risk trajectories compared with the no-risk trajectory for having various health conditions. Results: The trajectories with the greatest probability of productivity loss longitudinally had a greater prevalence of the individual health conditions and a greater total number of health conditions experienced. Conclusions: Health conditions are associated with specific longitudinal patterns of experiencing productivity loss. PMID:25479294

Health Conditions and Passive Suicidal Ideation in the Survey of Health, Ageing, and Retirement in Europe

Science.gov (United States)

Morton, Kimberly; Turiano, Nicholas A.; Fiske, Amy

2016-01-01

Objectives: To examine the associations between health conditions and passive suicidal ideation in middle-aged and older adults. Method: Multivariate logistic regression analyses were conducted on data from 35,664 middle-aged and older adults from the Survey of Health, Ageing, and Retirement in Europe. Mediation analyses were also conducted to test the roles of disability and depression in risk of ideation. Results: After including demographic variables, disability, depression, and other health conditions as covariates, heart attack, diabetes/high blood sugar, chronic lung disease, arthritis, ulcer, and hip/femoral fractures were associated with increased odds of passive suicidal ideation. When grouped by organ systems, conditions affecting the endocrine, respiratory, and musculoskeletal systems were associated with increased odds of passive suicidal ideation, as was the total number of conditions. Individuals with greater numbers of health conditions exhibited greater levels of disability and depression, which partially explained the increased risk of passive suicidal ideation among those with more health conditions. Discussion: Certain specific health conditions, as well as total number of conditions, are associated with passive suicidal ideation in middle age and older adulthood. Health is a critical risk factor for suicidal ideation in late life and should be further studied in this particularly at-risk population. PMID:27013533

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

Accidents involving Brazilian indigenous treated at urgent and emergency services of the Unified Health System.

Science.gov (United States)

Souza, Edinilsa Ramos de; Njaine, Kathie; Mascarenhas, Márcio Dênis Medeiros; Oliveira, Maria Conceição de

2016-12-01

Abstract We analyzed the accidents with Brazilian indigenous treated at urgent and emergency services of the Unified Health System (SUS). Data were obtained from the 2014 Viva Survey, which included 86 services from 24 capitals and the Federal District. The demographic profile of the indigenous, the event and the attendance were characterized. Most of the attended people were male in the 20-39 years age group. Falls and traffic accidents were the main reasons for attendance. Alcohol use was informed by 5.6% of the attended people, a figure that increases to 19.1% in traffic accidents, 26.1% among drivers and 22.8% among motorcyclists. There was a statistical difference between genders in relation to age, disability, place of occurrence of the event, work-related event and victim's condition in the traffic accident. We emphasize the importance of providing visibility to accidents with indigenous and engage them in the prevention of such events. Data reliability depends on the adequate completion in indigenous health information systems.

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....

Management of common eye conditions in a primary health care ...

African Journals Online (AJOL)

treated by properly trained middle cadre eye health worker working with simple diagnostic tools in a primary health care setting or by referring to secondary care in a timely ... Personal and environmental hygiene: (regular hand and face washing, proper disposal of garbage, human and animal waste and maintenance of a.

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.

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.

Oral health impacts of medications used to treat mental illness.

Science.gov (United States)

Cockburn, N; Pradhan, A; Taing, M W; Kisely, S; Ford, P J

2017-12-01

Many psychotropic medications affect oral health. This review identified oral side effects for antidepressant, antipsychotic, anticonvulsant, antianxiety and sedative drugs that are recommended in Australia for the management of common mental illnesses and provides recommendations to manage these side-effects. The Australian Therapeutic Guidelines and the Australian Medicines Handbook were searched for medications used to treat common mental health conditions. For each medication, the generic name, class, and drug company reported side-effects were extracted from the online Monthly Index of Medical Specialties (eMIMs) and UpToDate databases. Meyler's Side Effect of Drugs Encyclopaedia was used to identify additional oral adverse reactions to these medications. Fifty-seven drugs were identified: 23 antidepressants, 22 antipsychotics or mood stabilisers, and 12 anxiolytic or sedative medications. Xerostomia (91%) the most commonly reported side effect among all classes of medications of the 28 identified symptoms. Other commonly reported adverse effects included dysguesia (65%) for antidepressants, and tardive dyskinesia (94%) or increased salivation (78%) for antipsychotic medications. While xerostomia has often been reported as a common adverse effect of psychotropic drugs, this review has identified additional side effects including dysguesia from antidepressants and tardive dyskinesia and increased salivation from antipsychotics. Clinicians should consider oral consequences of psychotropic medication in addition to other side-effects when prescribing. For antidepressants, this would mean choosing duloxetine, agomelatine and any of the serotonin re-uptake inhibitors except sertraline. In the case of antipsychotics and mood stabilisers, atypical agents have less oral side effects than older alternatives. Copyright © 2017 Elsevier B.V. All rights reserved.

Environmental conditions in health care facilities in low- and middle-income countries: Coverage and inequalities.

Science.gov (United States)

Cronk, Ryan; Bartram, Jamie

2018-04-01

Safe environmental conditions and the availability of standard precaution items are important to prevent and treat infection in health care facilities (HCFs) and to achieve Sustainable Development Goal (SDG) targets for health and water, sanitation, and hygiene. Baseline coverage estimates for HCFs have yet to be formed for the SDGs; and there is little evidence describing inequalities in coverage. To address this, we produced the first coverage estimates of environmental conditions and standard precaution items in HCFs in low- and middle-income countries (LMICs); and explored factors associated with low coverage. Data from monitoring reports and peer-reviewed literature were systematically compiled; and information on conditions, service levels, and inequalities tabulated. We used logistic regression to identify factors associated with low coverage. Data for 21 indicators of environmental conditions and standard precaution items were compiled from 78 LMICs which were representative of 129,557 HCFs. 50% of HCFs lack piped water, 33% lack improved sanitation, 39% lack handwashing soap, 39% lack adequate infectious waste disposal, 73% lack sterilization equipment, and 59% lack reliable energy services. Using nationally representative data from six countries, 2% of HCFs provide all four of water, sanitation, hygiene, and waste management services. Statistically significant inequalities in coverage exist between HCFs by: urban-rural setting, managing authority, facility type, and sub-national administrative unit. We identified important, previously undocumented inequalities and environmental health challenges faced by HCFs in LMICs. The information and analyses provide evidence for those engaged in improving HCF conditions to develop evidence-based policies and efficient programs, enhance service delivery systems, and make better use of available resources. Copyright © 2018 The Authors. Published by Elsevier GmbH.. All rights reserved.

Obligation for transparency regarding treating physician credentials at academic health centres.

Science.gov (United States)

Martin, Paul J; Skill, N James; Koniaris, Leonidas G

2018-02-26

Academic health centres have historically treated patients with the most complex of diseases, served as training grounds to teach the next generations of physicians and fostered an innovative environment for research and discovery. The physicians who hold faculty positions at these institutions have long understood how these key academic goals are critical to serve their patient community effectively. Recent healthcare reforms, however, have led many academic health centres to recruit physicians without these same academic expectations and to partner with non-faculty physicians at other health systems. There has been limited transparency in regard to the expertise among the physicians and the academic faculty within these larger entities. Such lack of transparency may lead to confusion among patients regarding the qualifications of who is actually treating them. This could threaten the ethical principles of patient autonomy, benevolence and non-maleficence as patients risk making uninformed decisions that might lead to poorer outcomes. Furthermore, this lack of transparency unjustly devalues the achievements of physician faculty members as well as potentially the university they represent. In this paper, it is suggested that academic health centres have an obligation to foster total transparency regarding what if any role a physician has at a university or medical school when university or other academic monikers are used at a hospital. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Chronic health conditions and school performance among children and youth.

Science.gov (United States)

Crump, Casey; Rivera, Diana; London, Rebecca; Landau, Melinda; Erlendson, Bill; Rodriguez, Eunice

2013-04-01

Chronic health conditions are common and increasing among U.S. children and youth. We examined whether chronic health conditions are associated with low school performance. This retrospective cohort study of 22,730 children and youth (grades 2-11) in San Jose, California, was conducted from 2007 through 2010. Health conditions were defined as chronic if reported in each of the first 2 years, and school performance was measured using standardized English language arts (ELA) and math assessments. Chronic health conditions were independently associated with low ELA and math performance, irrespective of ethnicity, socioeconomic status, or grade level. Adjusted odds ratios for the association between any chronic health condition and low ("basic or below") performance were 1.25 (95% confidence interval [CI], 1.16-1.36; P absenteeism had little effect on these results. The strongest associations were found for ADHD, autism, and seizure disorders, whereas a weak association was found for asthma before but not after adjusting for absenteeism, and no associations were found for cardiovascular disorders or diabetes. Chronic neurodevelopmental and seizure disorders, but not cardiovascular disorders or diabetes, were independently associated with low school performance among children and youth. Copyright © 2013 Elsevier Inc. All rights reserved.

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.

Science.gov (United States)

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.

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

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.

Science.gov (United States)

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

2004-01-01

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

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.

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.

Physical health, self-reliance, and emotional control as moderators of the relationship between locus of control and mental health among men treated for prostate cancer.

Science.gov (United States)

Burns, Shaun Michael; Mahalik, James R

2006-12-01

This investigation examined the moderating effects of physical health and scripts for masculinity (i.e., self-reliance and emotional control) on the relationship between powerful other people locus of control and mental health for 230 men treated for prostate cancer. Regression analyses indicated that physical health and masculine gender scripts moderated the association between powerful other people locus of control and mental health. Specifically, men with poor physical health evinced negative mental health when they endorsed masculine gender scripts and believed powerful other people (i.e., family, friends, or peers) were influential in controlling their cancer. By comparison, men reporting poor physical health, strong beliefs that powerful other people controlled their cancer, and less adherence to masculine scripts experienced positive mental health. The authors discuss future research directions and potential mental health implications for men treated for prostate cancer.

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

Science.gov (United States)

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.

Science.gov (United States)

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.

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

Comorbid mental and physical health and health access in Cambodian refugees in the US.

Science.gov (United States)

Berthold, S Megan; Kong, Sengly; Mollica, Richard F; Kuoch, Theanvy; Scully, Mary; Franke, Todd

2014-12-01

Little research has been conducted on the prevalence of physical health problems in Cambodian refugees and the relationship between their mental and physical health. We identified the relationship between mental and physical health problems and barriers to healthcare access in Cambodian refugee adults. We used a cross-sectional survey design with a snowball sample of 136 Cambodian refugee adult residents of Connecticut and Western Massachusetts. 61% reported being diagnosed with three or more physical conditions and 73% with depression, posttraumatic stress disorder (PTSD) or both. Language and transportation problems were the primary barriers to accessing care. Participants with probable comorbid PTSD and depression had 1.850 times more physical health problems than those without either condition (p > .001; CI 1.334-2.566). Age moderated this relationship. Participants who had been diagnosed with both depression and PTSD reported a consistent number of health conditions across the age span while those who had no mental health conditions or only one of the two reported fewer health conditions when they were younger and more when they were older. These two groups were significantly different from the group reporting both. There is a significant relationship between chronic comorbid mental and physical health diseases affecting Cambodian refugees resettled in the US Having comorbid depression and PTSD puts Cambodian refugees at risk for physical health problems no matter their age. It is vital that those treating Cambodian genocide survivors identify and treat their prevalent comorbid health conditions. Language and transportation barriers must be addressed to improve access to mental and physical health care in this population.

Guided self-help interventions for mental health disorders in children with neurological conditions: study protocol for a pilot randomised controlled trial.

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Bennett, Sophie; Heyman, Isobel; Coughtrey, Anna; Simmonds, Jess; Varadkar, Sophia; Stephenson, Terence; DeJong, Margaret; Shafran, Roz

2016-11-04

Rates of mental health disorders are significantly greater in children with physical illnesses than in physically well children. Children with neurological conditions, such as epilepsy, are known to have particularly high rates of mental health disorders. Despite this, mental health problems in children with neurological conditions have remained under-recognised and under-treated in clinical settings. Evidence-based guided self-help interventions are efficacious in reducing symptoms of mental health disorders in children, but their efficacy in reducing symptoms of common mental health disorders in children with neurological conditions has not been investigated. We aim to pilot a guided self-help intervention for the treatment of mental health disorders in children with neurological conditions. A pilot randomised controlled trial with 18 patients with neurological conditions and mental health disorders will be conducted. Participants attending specialist neurology clinics at a National UK Children's Hospital will be randomised to receive guided self-help for common mental health disorders or to a 12-week waiting list control. Participants in the treatment group will receive 10 sessions of guided self-help delivered over the telephone. The waiting list control group will receive the intervention after a waiting period of 12 weeks. The primary outcome measure is reduction in symptoms of mental health disorders. Exclusion criteria are limited to those at significant risk of harm to self or others, the presence of primary mental health disorder other than anxiety, depression or disruptive behaviour (e.g. psychosis, eating disorder, obsessive-compulsive disorder) or intellectual disability at a level meaning potential participants would be unable to access the intervention. The study has ethical approval from the Camden and Islington NHS Research Ethics Committee, registration number 14.LO.1353. Results will be disseminated to patients, the wider public, clinicians and

Analysis of health condition of workers RHMK Trepca - Zvecan

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Galjak Milivoje

2016-01-01

Full Text Available Working conditions in RMHK Trepca directly conditioned by exposure to a wide variety of harmful causes of the diseases, both physical, and chemical hazards and occupational exposure to heavy metals. The aim is to analyze the health status of workers metarluškog-Mining-Chemical Combine Trepca - Zvečan (RMHK Trepca. The research was conducted at the Health Zvecan in Zvecan using the results of the periodic inspection of employees RMHK Trepca. The study included 738 employees in 2014 and 628 employees in 2015. Department of Occupational Health of the Health Zvečan organized and done these examinations in accordance with the rules on conducting preliminary and periodic medical examinations of employees at the workplace with increased risk to health, and as an additional source of data used is referred to a periodic review of employee (form no. 2 containing information on sex, age, occupation, place of work, qualification, education level, the drive, the total working age, the expository seniority, the requirements in the workplace, working conditions and workers' exposure to harmful agents or elements of job description city of the Act on risk assessment specific workplace. Diseases of the heart and blood vessels after the hearing damage to the second place in both 2014 (28.86% and in 2015 (18.47%. Followed by diseases of the urinary tract, respiratory organs. Able to work at the workplace with increased risk to the health worker was 92.67% in 2014 and 83.44% of workers in 2015. Preventive measures should be directed towards reducing occupational hazards and adverse working conditions and to insist on the strict implementation of safety measures. Periodic medical examinations to the full extent and quality prescribed in the rules are of great importance for the prevention of occupational morbidity, trauma and disability.

Lifestyle and health conditions of adults with spinal cord injury.

Science.gov (United States)

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.

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

Science.gov (United States)

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.

Mortality and health-related quality of life in patients surgically treated for spondylodiscitis

DEFF Research Database (Denmark)

Dragsted, Casper; Aagaard, Theis; Ohrt-Nissen, Søren

2017-01-01

center. Indications for surgery, pre- and postoperative neurological impairment, comorbidities, and mortality were recorded. A survey was conducted on all eligible patients with the EuroQol 5-dimension (EQ-5D) questionnaire and Oswestry Disability Index (ODI). RESULTS: Sixty-five patients were diagnosed...... neurological impairment. CONCLUSIONS: Several years after surgery, patients surgically treated for spondylodiscitis have significantly lower HRQL and more disability than the background population. Neurological impairment prior to index surgery predicts adverse outcome in terms of disability and lower HRQL.......PURPOSE: To assess mortality, disability, and health-related quality of life (HRQL) in patients surgically treated for spondylodiscitis. METHODS: A retrospective longitudinal study was conducted on all patients surgically treated for spondylodiscitis over a 6-year period at a single tertiary spine...

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.

Study of secondary recrystallization in grain-oriented steel treated under dynamical heat treatment conditions

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V. Stoyka

2009-04-01

Full Text Available The present study was made to investigate secondary recrystallization in grain-oriented steels annealed at short time temperature exposures with application of dynamical heating. The investigated GO steels for experiments were taken from one industrial line after final cold rolling reduction and subsequent box annealing. It was shown that application of short time heat treatment conditions could lead to complete abnormal grain growth in the investigated GO steel. The texture and microstructure obtained in the laboratory treated material is similar to that observed in the same GO steel taken after industrial final box-annealing. However, some “parasitic” grains were observed in the secondary recrystallized matrix of the laboratory treated GO steel. These “parasitic” grains possess the unwanted from magnetic properties point of view {111} orientation components.

Treating Intraradicular Pockets of molars

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H. Lotfizade

1987-10-01

Full Text Available It appears that until bone graft has not achieved 100% success, intraradicular diseases remain controversial and therefore, different treatment plans are suggested for them. Treating intraradicular diseases depend on many factors: maxillary molars are more prone to bone loss and have worse prognosis. To assess prognosis more carefully these factors should be considered: 1 bone loss: its apical depth, local or generalized 2 bone condition: buccal, lingual, mesial and distal aspects 3 tooth mobility: grades 2 and 3 have not good prognosis. Crown root ratio is also important. 4 the angle of divergence of roots: the more the roots are divergent, the better the prognosis would be. 5adjacent teeth health 6tooth position in jaws 7 age and general health of the patients 8 oral hygiene In general, teeth with 2 roots can be treated more effectively than 3 root ones. Maxillary first premolars are exceptions that do not respond to the treatments positively. We should look forward to the future investigations and findings.

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.

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

Science.gov (United States)

Alves, Joana; Maia, Ângela; Teixeira, Filipa

2016-05-01

Detained women have certain health conditions prior to incarceration and these conditions can improve, worsen, or remain the same in prison, depending on the prisoner's background, the characteristics of the prison, and the arrest experience. This study investigated the health of detained women and the influence of incarceration from their perspective. Three focus groups were conducted among 15 inmates, and data were analyzed according to thematic analysis procedures. Detainer's health backgrounds varied with regard to their level of health concerns, contact with health services, and health behaviors. A positive influence of incarceration was described by patients with chronic illness, patients with drug addiction, and victims of interpersonal violence. Among women with mental illnesses or those without previous health problems, reports do not reveal benefits of imprisonment for mental health. These data emphasize the importance of specialized health care and the need to invest in mental health care in corrective institutions. © The Author(s) 2015.

Treated and Untreated Remission from Problem Drinking in Late Life: Post-Remission Functioning and Health-Related Quality of Life

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Schutte, Kathleen K.; Brennan, Penny L.; Moos, Rudolf H.

2009-01-01

Objective To evaluate the post-remission status of older remitted problem drinkers who achieved stable remission without treatment. Method The post-remission drinking behavior, health-related functioning, life context, coping, and help-seeking of older, untreated (n = 330) and treated (n = 120) former problem drinkers who had been remitted for a minimum of six years were compared twice over the course of six-years to each other and to lifetime nonproblem drinkers (n = 232). Analyses considered the impact of severity of drinking problem history. Results Untreated remitters were more likely than treated remitters to continue to drink, exhibited fewer chronic health problems and less depressive symptomatology, and were less likely to smoke. Untreated remitters’ life contexts were somewhat more benign than those of treated ones, and they were less likely to describe a coping motive for drinking and engage in post-remission help-seeking. Although untreated remitters more closely resembled lifetime nonproblem drinkers than did treated remitters, both untreated and treated remitter groups exhibited worse health-related functioning, more financial and interpersonal stressors, and more post-remission help-seeking than did lifetime nonproblem drinkers. Conclusions Regardless of whether late-life remission was gained without or with treatment, prior drinking problems conveyed a legacy of health-related and life context deficits. PMID:18829184

Self-esteem in adolescents treated in an outpatient mental health setting.

Science.gov (United States)

Modrcin-Talbott, M A; Pullen, L; Ehrenberger, H; Zandstra, K; Muenchen, B

1998-01-01

Although self-esteem is an important concept, nursing has only begun to focus on the significance of self-esteem as a mechanism for achieving wellness among adolescents, and as a variable for targeted intervention. Nursing studies identifying self-esteem as the primary focus of their research in an adolescent population seeking treatment in mental health settings are scarce. The Roy Adaptation Model's Theory of a Person as an Adaptive System was used to guide this descriptive, correlational study. Research examined the self-report of self-esteem on age, gender, smoking, exercise, depression, anger, and parental alcohol use in a sample of adolescents ages 12-19 years who were being treated in an outpatient mental health setting.

Health-related quality of life and long-term mortality in patients treated with percutaneous coronary intervention

DEFF Research Database (Denmark)

Schenkeveld, Lisanne; Pedersen, Susanne S.; van Nierop, Josephine W I

2010-01-01

Health status has become increasingly important as an outcome measure in patients with cardiovascular disease. Poor patient-rated health status has been shown to predict mortality in patients with coronary artery disease and heart failure. In patients treated with percutaneous coronary interventi...

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.

Treating leachate by Fenton oxidation

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Roger Iván Méndez Novelo

2010-01-01

Full Text Available Leachates are formed from liquids, mainly rainwater, percolating through solid wastes during stabilisation. Their composition is variable and highly toxic; leachate treatment is therefore a complex task. Leachates represent a high risk to health due to the Yucatan Peninsula’s highly permeable soil. The results are presented from applying the Fenton process to treating leachate from the sanitary Merida landfill, Yucatan, Mexico. The Fenton process consists of treating the contaminant load with an H2O2 and FeSO4 combination in acidic conditions. Optimal reaction time, pH value, Fenton reagent dose, post treatment coagulation – flocculation doses and increased biodegradability index were all determined. Optimal oxidation conditions and doses were 202+ minute contact time, 4 pH, 600 mg/L H2O2 concentration and 1,000 mg/L Fe. Average organic matter removal rate, measured as CODS and TOC, were 78% and 87% respectively. The biodegradability index increased from 0.07 to 0.11 during the Fenton process and up to 0.13 when the Fenton process was followed by coagulation-flocculation.

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...

Herpes labialis and Nigerian dental health care providers: knowledge, attitudes, behaviors, and refusal to treat.

Science.gov (United States)

Azodo, Clement Chinedu; Umoh, Agnes O

2015-09-15

The few existing studies on herpes labialis among health care workers have been predominantly among non-dental health care workers. The purpose of this study was to determine Nigerian dental health care providers' knowledge of, attitudes toward, preventive behaviors for, and refusal to treat patients with herpes labialis. This cross-sectional study was conducted among final-year dental students at the University of Benin, dental house officers, and residents at the University of Benin Teaching Hospital, Benin City, Nigeria. Data collection was via a self-administered questionnaire. Bivariate statistics and logistic regression were used to relate the dependent and independent variables. Of the 120 questionnaires distributed, 110 were completed and returned, giving a 91.7% retrieval rate. However, 15 of the returned questionnaires were discarded because they were improperly completed, leaving a total of 95 questionnaires for final analysis in this study. The majority of participants were over 28 years old (54.7%), male (67.4%), unmarried (66.3%), and postgraduate dental health care providers (51.6%). Less than half (43.2%) of participants demonstrated adequate overall knowledge of herpes labialis. About one-tenth (10.5%) and more than three-quarters (87.4%) of participants reported a positive attitude and performance of adequate preventive behaviors, respectively. A total of 16.8% of participants reported a high tendency to refuse treatment to patients with herpes labialis. Although not statistically significant, young, unmarried, male undergraduate participants reported a greater likelihood to refuse treatment to herpes labialis patients. We found a statistically significant positive correlation between attitude and refusal to treat patients with herpes labialis. However, marital status and the attitude of participants toward these patients emerged as the determinants for refusal to treat patients with herpes labialis. Data from this study revealed a high level of

Texture evolution in Fe-3% Si steel treated under unconventional annealing conditions

International Nuclear Information System (INIS)

Stoyka, Vladimir; Kovac, Frantisek; Stupakov, Oleksandr; Petryshynets, Ivan

2010-01-01

The present work investigates texture evolution stages in grain-oriented steel heat-treated using unconventional conditions. The Fe-3%Si steel taken after final cold rolling reduction from an industrial line was subjected to a laboratory isothermal annealing at different temperatures. The annealing temperatures were varied in a range of 850-1150 deg. C. During the annealing each specimen was heated at 10 deg. C/s and kept at the stated temperature for 5 min. Development of microstructure and texture in the annealed specimens were followed by the DC measurements of magnetic properties. The grain oriented steel, taken from the same industrial line after final box annealing was also analyzed and compared with the laboratory annealed specimens. It was shown that there is an optimal temperature region that, with combination of a fast heating rate, led to the best conditions of a drastically reduced development time of the {110} crystallographic texture in the cold rolled grain-oriented steel. Materials heat treated below the optimum temperature region account for a primary recrystallization, while applying heat above this region leads to a secondary recrystallization without abnormal grain growth. Moreover, in the optimum temperature range, there was a particular temperature leading to the most optimal microstructure and texture. The magnetic properties, measured after the optimal heat treatment, were close to that measured on specimens taken after the final box annealing. The electron back scattered diffraction measurement technique revealed that sharpness of the {110} crystallographic texture, developed at the optimum temperature is comparable to the steel taken after the industrial final box annealing. This fact is evidence that there is a temperature where the abnormal grain growth proceeds optimally.

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.

Comparison of steam sterilization conditions efficiency in the treatment of Infectious Health Care Waste.

Science.gov (United States)

Maamari, Olivia; Mouaffak, Lara; Kamel, Ramza; Brandam, Cedric; Lteif, Roger; Salameh, Dominique

2016-03-01

Many studies show that the treatment of Infectious Health Care Waste (IHCW) in steam sterilization devices at usual operating standards does not allow for proper treatment of Infectious Health Care Waste (IHCW). Including a grinding component before sterilization allows better waste sterilization, but any hard metal object in the waste can damage the shredder. The first objective of the study is to verify that efficient IHCW treatment can occur at standard operating parameters defined by the contact time-temperature couple in steam treatment systems without a pre-mixing/fragmenting or pre-shredding step. The second objective is to establish scientifically whether the standard operation conditions for a steam treatment system including a step of pre-mixing/fragmenting were sufficient to destroy the bacterial spores in IHCW known to be the most difficult to treat. Results show that for efficient sterilization of dialysis cartridges in a pilot 60L steam treatment system, the process would require more than 20 min at 144°C without a pre-mixing/fragmenting step. In a 720L steam treatment system including pre-mixing/fragmenting paddles, only 10 min at 144°C are required to sterilize IHCW proved to be sterilization challenges such as dialysis cartridges and diapers in normal conditions of rolling. Copyright © 2016 Elsevier Ltd. All rights reserved.

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...

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.

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. ...

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.

Nutrition in children with long-term health conditions

OpenAIRE

Westwood, A

2015-01-01

Long-term health conditions (LTHCs) in children may affect nutrition and growth by means of multiple mechanisms. Both undernutrition and overweight/obesity are risk factors. Direct effects of the condition that may cause undernutrition include increased resting energy expenditure, excess losses through malabsorption, difficulty ingesting food, and decreased appetite. Indirect effects of LTHCs may be mediated by learnt or adaptive behaviours, secondary anorexia, inappropriate diets, or conditi...

[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.

Antiretroviral therapy related adverse effects: Can sub-Saharan Africa cope with the new "test and treat" policy of the World Health Organization?

Science.gov (United States)

Nansseu, Jobert Richie N; Bigna, Jean Joel R

2017-02-15

Recent studies have shown that early antiretroviral therapy (ART) initiation results in significant HIV transmission reduction. This is the rationale behind the "test and treat" policy of the World Health Organization (WHO). Implementation of this policy will lead to an increased incidence of ART-related adverse effects, especially in sub-Saharan Africa (SSA). Is the region yet ready to cope with such a challenging issue? The introduction and widespread use of ART have drastically changed the natural history of HIV/AIDS, but exposure to ART leads to serious medication-related adverse effects mainly explained by mitochondrial toxicities, and the situation will get worse in the near future. Indeed, ART is associated with an increased risk of developing cardiovascular disease, lipodystrophy, prediabetes and overt diabetes, insulin resistance and hyperlactatemia/lactic acidosis. The prevalence of these disorders is already high in SSA, and the situation will be exacerbated by the implementation of the new WHO recommendations. Most SSA countries are characterized by (extreme) poverty, very weak health systems, inadequate and low quality of health services, inaccessibility to existing health facilities, lack of (qualified) health personnel, lack of adequate equipment, inaccessibility and unaffordability of medicines, and heavy workload in a context of a double burden of disease. Additionally, there is dearth of data on the incidence and predictive factors of ART-related adverse effects in SSA, to anticipate on strategies that should be put in place to prevent the occurrence of these conditions or properly estimate the upcoming burden and prepare an adequate response plan. These are required if we are to anticipate and effectively prevent this upcoming burden. While SSA would be the first region to experience the huge benefits of implementing the "test and treat" policy of the WHO, the region is not yet prepared to manage the consequential increased burden of ART

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.

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.

Tricky Treats

Centers for Disease Control (CDC) Podcasts

2008-08-04

The Eagle Books are a series of four books that are brought to life by wise animal characters - Mr. Eagle, Miss Rabbit, and Coyote - who engage Rain That Dances and his young friends in the joy of physical activity, eating healthy foods, and learning from their elders about health and diabetes prevention. Tricky Treats shows children the difference between healthy snacks and sweet treats.  Created: 8/4/2008 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 8/5/2008.

Association of Adverse Childhood Experiences with Co-occurring Health Conditions in Early Childhood.

Science.gov (United States)

Bright, Melissa A; Thompson, Lindsay A

2018-01-01

To understand how adverse childhood experiences (ACEs) are associated with co-occurring physical, mental and developmental problems during early childhood. A subsample of 19,957 children aged 2-5 years were selected from the 2011-2012 National Survey for Child Health. Outcomes included 18 health conditions organized in singular condition domains (physical, mental, and developmental), and combinations of condition domains (e.g., physical plus mental, mental plus developmental, etc.). Predictors included 8 ACEs (divorce of a parent, death of a parent, exposure to domestic violence, living with someone with a drug or alcohol abuse problem, household member with a mental illness, parent incarceration, neighborhood violence, discrimination). Multivariable logistic regression was performed controlling for demographic characteristics, having a personal doctor, health insurance coverage, and seeing a health care professional in the previous year. Experiencing 3 or more ACEs before the age of 5 years was associated with increased likelihood of nearly every co-occurring condition combination across 3 domains of health. Most notably, experiencing 3 or more ACEs was also associated with a 2-fold increase in likelihood of having ≥1 physical condition and ≥1 developmental condition, a 9-fold increase in likelihood of having ≥1 mental and ≥1 developmental condition, and a 7-fold increase in likelihood of having ≥1 physical, ≥1 mental, and ≥1 developmental condition. This study demonstrates that we can identify the health effects of adversity quite early in development and that management should include communication between both health care and early childhood education providers.

[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.

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...

Risk of Adverse Health Outcomes and Decrements in Performance Due to In-flight Medical Conditions

Science.gov (United States)

Antonsen,Erik

2017-01-01

The drive to undertake long-duration space exploration missions at greater distances from Earth gives rise to many challenges concerning human performance under extreme conditions. At NASA, the Human Research Program (HRP) has been established to investigate the specific risks to astronaut health and performance presented by space exploration, in addition to developing necessary countermeasures and technology to reduce risk and facilitate safer, more productive missions in space (NASA Human Research Program 2009). The HRP is divided into five subsections, covering behavioral health, space radiation, habitability, and other areas of interest. Within this structure is the ExMC Element, whose research contributes to the overall development of new technologies to overcome the challenges of expanding human exploration and habitation of space. The risk statement provided by the HRP to the ExMC Element states: "Given that medical conditions/events will occur during human spaceflight missions, there is a possibility of adverse health outcomes and decrements in performance in mission and for long term health" (NASA Human Research Program 2016). Within this risk context, the Exploration Medical Capabilities (ExMC) Element is specifically concerned with establishing evidenced-based methods of monitoring and maintaining astronaut health. Essential to completing this task is the advancement in techniques that identify, prevent, and treat any health threats that may occur during space missions. The ultimate goal of the ExMC Element is to develop and demonstrate a pathway for medical system integration into vehicle and mission design to mitigate the risk of medical issues. Integral to this effort is inclusion of an evidence-based medical and data handling system appropriate for long-duration, exploration-class missions. This requires a clear Concept of Operations, quantitative risk metrics or other tools to address changing risk throughout a mission, and system scoping and system

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.

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

Directory of Open Access Journals (Sweden)

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

[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.

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.

A cross-sectional survey of pharmacists to understand their personal preference of brand and generic over-the-counter medications used to treat common health conditions.

Science.gov (United States)

Patel, Mira; Slack, Marion; Cooley, Janet; Bhattacharjee, Sandipan

2016-01-01

Consumers are hesitant in choosing generic medications as they are under the assumption that they are not as safe nor effective as brand medications. However, pharmacists do have the education and training to know that this is not the case. The aim of this study was to determine pharmacists' preference of generic versus brand over-the-counter (OTC) medication for their personal use as self-treatment for various health symptoms. A prospective, cross sectional study was conducted on 553 licensed pharmacists who were presumed to have expertise in the use of generic and brand name OTC medications. In a single Southwestern state in the United States, from December 2014 to January 2015, a web-based questionnaire was sent to pharmacists to explore their preference of brand and generic medications based on various health symptoms. Thirty-one brand-generic medication pairs were used to identify which medication type pharmacists preferred when asked about nine health symptoms. Frequency counts of pharmacists' preference of a brand medication or a generic OTC medication overall and for each of the nine health symptoms were determined. Chi-squared analyses and one-way ANOVA were conducted to determine if there were any differences between the preferences of brand and generic OTC medications across each symptom. The study overall showed that pharmacists preferred generic OTC medications to brand OTC medications (62 to 5 %, respectively). Based on an 11-point rating scale, pharmacists were likely to take OTC generic medications (as their choice of self-treatment) when presented with health symptoms (mean = 7.32 ± 2.88). In addition, pharmacists chose generic OTC medications over brand medications regardless of health symptoms (p brand name OTC medications for self-treating a variety of health symptoms. These study findings support the theory that expertise affects preference for generic versus brand name OTC medications. This information can be used to provide

Citizens' preferences for brand name drugs for treating acute and chronic conditions: a pilot study.

Science.gov (United States)

Denoth, Arina; Pinget, Christophe; Wasserfallen, Jean-Blaise

2011-03-01

Generic drugs have been advocated to decrease the proportion of healthcare costs devoted to drugs, but are still underused. To assess citizens' preferences for brand name drugs (BNDs) compared with generic drugs for treating acute and chronic conditions. A questionnaire with eight hypothetical scenarios describing four acute and four chronic conditions was developed, with willingness to pay (WTP) determined using a payment card system randomized to ascending (AO) or descending order (DO) of prices. The questionnaire was distributed with an explanation sheet, an informed consent form and a pre-stamped envelope over a period of 3 weeks in 19 community pharmacies in Lausanne, Switzerland. The questionnaire was distributed to every third customer who also had health insurance, understood French and was aged ≥16 years (up to a maximum of ten customers per day and 100 per pharmacy). The main outcome measure was preferences assessed by WTP for BNDs as compared with generics, and impact of participants' characteristics on WTP. Of the 1800 questionnaires, 991 were distributed and 393 returned (pharmacy participation rate = 55%, subject participation rate = 40%, overall response rate = 22%); 51.7% were AO and 48.3% DO. Participants were predominantly women (62.6%) and of median age 62 years (range 16-90). The majority (70%) declared no WTP for BNDs as compared with generics. WTP was higher in people with an acute disease than in those with a chronic disease, did not depend on the type of chronic disease, and was higher in people from countries other than Switzerland. Most citizens visiting pharmacies attribute no added value to BNDs as compared with generics, although some citizen characteristics affected WTP. These results could be of interest to several categories of decision makers within the healthcare system.

Increased 30-Day Emergency Department Revisits Among Homeless Patients with Mental Health Conditions

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Chun Nok Lam

2016-09-01

Full Text Available Introduction: Patients with mental health conditions frequently use emergency medical services. Many suffer from substance use and homelessness. If they use the emergency department (ED as their primary source of care, potentially preventable frequent ED revisits and hospital readmissions can worsen an already crowded healthcare system. However, the magnitude to which homelessness affects health service utilization among patients with mental health conditions remains unclear in the medical community. This study assessed the impact of homelessness on 30-day ED revisits and hospital readmissions among patients presenting with mental health conditions in an urban, safety-net hospital. Methods: We conducted a secondary analysis of administrative data on all adult ED visits in 2012 in an urban safety-net hospital. Patient demographics, mental health status, homelessness, insurance coverage, level of acuity, and ED disposition per ED visit were analyzed using multilevel modeling to control for multiple visits nested within patients. We performed multivariate logistic regressions to evaluate if homelessness moderated the likelihood of mental health patients’ 30-day ED revisits and hospital readmissions. Results: Study included 139,414 adult ED visits from 92,307 unique patients (43.5±15.1 years, 51.3% male, 68.2% Hispanic/Latino. Nearly 8% of patients presented with mental health conditions, while 4.6% were homeless at any time during the study period. Among patients with mental health conditions, being homeless contributed to an additional 28.0% increase in likelihood (4.28 to 5.48 odds of 30-day ED revisits and 38.2% increase in likelihood (2.04 to 2.82 odds of hospital readmission, compared to non-homeless, non-mental health (NHNM patients as the base category. Adjusted predicted probabilities showed that homeless patients presenting with mental health conditions have a 31.1% chance of returning to the ED within 30-day post discharge and a 3

Women's health: selected topics.

Science.gov (United States)

Zoorob, Roger J; Sidani, Mohamad; Williams, Jamila; Grief, Samuel N

2010-06-01

Complementary and alternative medicine (CAM) therapies have become increasingly popular for the treatment of a variety of conditions. The World Health Organization has recognized the value of traditional healing techniques, which are classified as CAM, for 30 years. In the United States nearly 50% of women use CAM for common medical conditions, significantly more than men. This pattern is frequently seen in the treatment of women's health conditions such as infertility, premenstrual syndrome, and menopause. This article provides an integrative approach for conditions commonly encountered in the primary care setting among women, discusses alternative therapies used to treat these health conditions, and provides an evidence-based summary of recommendations based on a review of the literature. Copyright 2010 Elsevier Inc. All rights reserved.

Preventive culture and oral health condition of patients with HIV / AIDS treated in a national hospital

OpenAIRE

Pérez Cahuaya, Lisbeth Cynthia

2014-01-01

The aim of the study was to determine the safety culture and oral health status of patients with HIV / AIDS care in a national hospital in 2012. The type of study was descriptive, cross-sectional and retrospective. The sample consisted of 250 patients of both sexes. The sample selection was convenience. The method used for data collection was questionnaire and clinical observation. The results were: a level of oral health preventive culture low in 67.6%, moderate presence of plaque in 55.6%, ...

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

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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

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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.

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...

[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.

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.

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

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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.

Identifying Knowledge Gaps in Clinicians Who Evaluate and Treat Vocal Performing Artists in College Health Settings.

Science.gov (United States)

McKinnon-Howe, Leah; Dowdall, Jayme

2018-05-01

The goal of this study was to identify knowledge gaps in clinicians who evaluate and treat performing artists for illnesses and injuries that affect vocal function in college health settings. This pilot study utilized a web-based cross-sectional survey design incorporating common clinical scenarios to test knowledge of evaluation and management strategies in the vocal performing artist. A web-based survey was administered to a purposive sample of 28 clinicians to identify the approach utilized to evaluate and treat vocal performing artists in college health settings, and factors that might affect knowledge gaps and influence referral patterns to voice specialists. Twenty-eight clinicians were surveyed, with 36% of respondents incorrectly identifying appropriate vocal hygiene measures, 56% of respondents failing to identify symptoms of vocal fold hemorrhage, 84% failing to identify other indications for referral to a voice specialist, 96% of respondents acknowledging unfamiliarity with the Voice Handicap Index and the Singers Voice Handicap Index, and 68% acknowledging unfamiliarity with the Reflux Symptom Index. The data elucidated specific knowledge gaps in college health providers who are responsible for evaluating and treating common illnesses that affect vocal function, and triaging and referring students experiencing symptoms of potential vocal emergencies. Future work is needed to improve the standard of care for this population. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

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

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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…

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.

Acute health care utilization and outcomes for outpatient-treated urinary tract infections in children.

Science.gov (United States)

Copp, Hillary L; Hanley, Janet; Saigal, Christopher S; Saperston, Kara

2016-08-01

The majority of urinary tract infections (UTIs) in children are treated in the ambulatory setting. The goal of this study is to describe the course of outpatient UTI management, including health services utilization, antibiotic switching (change from empirically prescribed antibiotic to another antibiotic), and antibiotic side effects. Using a large claims database, Truven Health MarketScan Research Database, we analyzed all children younger than 18 years old who had an antibiotic prescribed for an outpatient UTI from 2002 to 2010. We evaluated health services utilization and antibiotic switching in the 21-day period after UTI diagnosis. We compared side effects with rates in patients receiving narrow versus broad-spectrum antibiotic treatment. Chi-square analysis was used for descriptive statistics. We identified 242,819 outpatient, antibiotic-treated, UTI episodes. During the 21-day period after presentation, 26% required more than one visit for UTI management and children did not have imaging within 21 days of UTI: renal bladder ultrasound in 6%, VCUG in 2.6%, and DMSA in 0.05%. Broad-spectrum antibiotics were empirically prescribed to 34% of patients. Antibiotic switching occurred in only 8% of UTI episodes, indicating that empiric prescription covered the offending uropathogen the majority of the time. Antibiotic side effects occurred in 8% of UTI episodes. The most common side effects were gastrointestinal (∼3% of UTI episodes). All other side effects occurred in UTI episodes. Although there were statistically significant differences in side effects between broad- and narrow-spectrum antibiotics, these differences were not clinically relevant. Most outpatient UTIs in children do not require more than one healthcare visit, hospital admission, or change in empiric antibiotic therapy. This study supports the fact that pediatric UTIs can be effectively treated in the ambulatory setting. Copyright © 2016. Published by Elsevier Ltd.

Neutrophil-induced transmigration of tumour cells treated with tumour-conditioned medium is facilitated by granulocyte-macrophage colony-stimulating factor.

LENUS (Irish Health Repository)

Wu, Q D

2012-02-03

OBJECTIVE: To investigate the effect of different cytokines that are present in tumour-conditioned medium on human neutrophil (PMN)-induced tumour cell transmigration. DESIGN: Laboratory study. SETTING: University hospital, Ireland. MATERIAL: Isolated human PMN and cultured human breast tumour cell line, MDA-MB-231. Interventions: Human PMN treated with either tumour-conditioned medium or different media neutralised with monoclonal antibodies (MoAb), and MDA-MB-231 cells were plated on macrovascular and microvascular endothelial monolayers in collagen-coated transwells to assess migration of tumour cells. MAIN OUTCOME MEASURES: Cytokines present in tumour-conditioned medium, PMN cytocidal function and receptor expression, and tumour cell transmigration. RESULTS: tumour-conditioned medium contained high concentrations of granulocyte-macrophage colony-stimulating factor (GM-CSF), vascular endothelial growth factor (VEGF), and interleukin 8 (IL-8), but not granulocyte colony-stimulating factor (G-CSF) and interleukin 3 (IL-3). Anti-GM-CSF MoAb significantly reduced PMN-induced transmigration of tumour cells treated with tumour-conditioned medium (p < 0.05), whereas anti-VEGF and anti-IL-8 MoAbs did not affect their migration. In addition, anti-GM-CSF MoAb, but not anti-VEGF or anti-IL-8 MoAb, reduced PMN CD11b and CD18 overexpression induced by tumour-conditioned medium (p < 0.05). CONCLUSION: These results indicate that the GM-CSF that is present in tumour-conditioned medium may be involved, at least in part, in alterations in PMN function mediated by the medium and subsequently PMN-induced transmigration of tumour cells.

Quality of cowpea seeds treated with chemicals and stored in controlled and uncontrolled temperature and humidity conditions

Directory of Open Access Journals (Sweden)

Lucicléia Mendes de Oliveira

2015-06-01

Full Text Available The cowpea is a Fabaceae originated in Africa cultivated in the northern and northeastern of Brazil, where stands out as the main source of protein for the population. For the establishment of culture, seeds are treated to control and prevent pest attacks and diseases, can also attach nutrients to the seeds which will be available for plant development. The objective of the research was to evaluate the performance of cowpea seeds treated with chemical products and stored in controlled and uncontrolled temperature and humidity conditions. The following seeds treatments were applied: control (no treatment; micronutrient Comol 118, insecticide thiamethoxam, fipronil and pyraclostrobin+thiophanate-methyl and imidacloprid+thiodicarb were then stored in a cold environment and natural. The assessment of physiological seed quality was made initially and every 45 days through the germination and vigor. Among all products used, the imidacloprid + thiodicarb and fipronil + pyraclostrobin + thiophanate methyl provides stimulating effect on seed performance; seeds treated with thiamethoxam were less affected by storage than the untreated seeds; seeds treated with micronutrients exhibits similar behavior to untreated seeds and storage in a controlled environment better preserves the seed physiological quality.

Educational and Health Outcomes of Children Treated for Attention-Deficit/Hyperactivity Disorder.

Science.gov (United States)

Fleming, Michael; Fitton, Catherine A; Steiner, Markus F C; McLay, James S; Clark, David; King, Albert; Mackay, Daniel F; Pell, Jill P

2017-07-03

Attention-deficit/hyperactivity disorder (ADHD) affects 39 million people worldwide; in isolation, it doubles annual health care costs and, when associated with comorbid mental health problems, it quadruples the costs. To compare the education and health outcomes of schoolchildren treated for ADHD with their peers. In this population-based cohort study, individual-level record linkage was performed of 8 Scotland-wide administrative databases covering dispensed prescriptions, admissions to acute and psychiatric hospitals, maternity records, annual pupil census, examinations, school absences and exclusions, and unemployment. The study cohort comprised 766 244 children attending Scottish primary, secondary, and special schools at any point between September 21, 2009, and September 18, 2013. Data analysis was performed from June 1, 2015, to December 6, 2016. Medication approved solely for ADHD treatment. Special educational needs, academic attainment, unauthorized absence, exclusion, age at leaving school, unemployment after leaving, and hospitalization. Outcomes were adjusted for potential sociodemographic, maternity, and comorbidity confounders. Of the 766 244 schoolchildren, 7413 (1.0%) were treated for ADHD; 6287 (84.8%) were male. These children had higher rates of unauthorized absence (adjusted incidence rate ratio [IRR], 1.16; 95% CI, 1.14-1.19) and exclusion (adjusted IRR, 5.79; 95% CI, 5.45-6.16), more commonly had a record of special educational need (adjusted odds ratio [OR], 8.62; 95% CI, 8.26-9.00), achieved lower academic attainment (adjusted OR, 3.35; 95% CI, 3.00-3.75), were more likely to leave school before age 16 years (1546 [64.3%] vs 61 235 [28.4%]), and were more likely to be unemployed (adjusted OR, 1.39; 95% CI, 1.25-1.53). Children with ADHD were more likely to require hospitalization overall (adjusted hazard ratio [HR], 1.25; 95% CI, 1.19-1.31) and for injury (adjusted HR, 1.52; 95% CI, 1.40-1.65). Even while receiving medication

Tricky Treats

Centers for Disease Control (CDC) Podcasts

The Eagle Books are a series of four books that are brought to life by wise animal characters - Mr. Eagle, Miss Rabbit, and Coyote - who engage Rain That Dances and his young friends in the joy of physical activity, eating healthy foods, and learning from their elders about health and diabetes prevention. Tricky Treats shows children the difference between healthy snacks and sweet treats.

Effective Nutrition Intervention to Treat Children Under 5 Years Old Suffering MAM in Public Primary Health Care Services in El Salvador

International Nuclear Information System (INIS)

Sanchez, Ana

2014-01-01

Full text: Background: In El Salvador Moderate Acute Malnutrition (MAM) affects less than 1% of children under 5 years old. The importance of MAM has been neglected as a public health issue. Although moderate wasting is not a condition of medical urgency, it can easily deteriorate. If some of these undernourished children with moderate wasting do not receive adequate support, they may progress towards severe acute malnutrition (SAM), defined by the presence of severe wasting and/or bilateral pitting oedema, which is a life-threatening condition. Since 2010, a complementary feeding program for children from 6 to 59 months old was implemented at the primary health clinics for the management of moderate malnutrition. Program was implemented in 100 municipalities identified with the greatest levels of poverty at national level and it consists of a corn-soy fortified flour to be prepared at home as a poudrige given to children during the routine health controls. During the first months of program implementation, an acceptability test was conducted and it was determined that more than 85% of children had good acceptance of the product. The treatment consists of 45 grams per day of complementary food. Mothers were instructed on how to prepare the product and every month they would have to bring their children to the clinic to receive complementary food and control weight gain. If mothers did not attend the control, a health promotion worker would go visit the mother at their home and bring the complementary food to the child. Objective: Assess the results on nutritional status of children under 5 years old with MAM treated with complementary food during health controls at primary health facilities in El Salvador during January to October 2013. Methods: Transversal study. Inclusion criteria was children 6 to 59 months old attending health controls coming from prioritize municipalities, diagnose with MAM by a health professional without other disease or infections that

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 ...

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 ...

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.

Surgical treatment of disabling conditions caused by anogenital lichen sclerosus in women

DEFF Research Database (Denmark)

Rangatchew, Filip; Knudsen, Jens; Thomsen, Michael V

2017-01-01

BACKGROUND: Anogenital lichen sclerosus (LS), a chronic dermatitis that causes scarring and introital stenosis, may prevent sexual intercourse and reduce health-related quality of life (QoL). Surgery can restore the anatomy, allowing patients to resume their sexual lives. This study investigates...... outcomes in women treated with local skin flaps. METHODS: Thirty-eight consecutive LS-verified patients, surgically treated for debilitating conditions between 1990 and 2013, were retrospectively evaluated. A survey measured patient satisfaction, benefits, and health-related QoL, and the patients were also...

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

Science.gov (United States)

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.

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.

Science.gov (United States)

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.

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

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.

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.

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...

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

Science.gov (United States)

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.

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

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

Science.gov (United States)

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.

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.

[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.

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

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

Science.gov (United States)

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...

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.

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...

[Health literacy in patients with heart failure treated in primary care].

Science.gov (United States)

Santesmases-Masana, Rosalia; González-de Paz, Luis; Real, Jordi; Borràs-Santos, Alicia; Sisó-Almirall, Antoni; Navarro-Rubio, Maria Dolors

2017-01-01

The level of health literacy is examined, as well as its conditioning factors in patients with heart failure who are seen routinely in a Primary Health Care Area. A multicentre cross-sectional study. 10 Primary care centres from the metropolitan area of Barcelona. Patients diagnosed with heart failure. to have visited the Primary Health Care centre in the last year, being able to arrive at the primary care setting independently, and voluntarily participation. Health Literacy Survey-European Union - Questionnaire (HLS-EU-Q) and Spanish version of the European Heart Failure Self-care Behaviour Scale. An analysis was made of the relationships between health literacy, self-care practices, sociodemographic, and clinical variables using ANOVA test and a multiple linear regression model. The study included 318 patients (51.2% women) with a mean age of 77.9±8.7 years. The index of health literacy of 79.6% (n=253) of the participants indicated problems in understanding healthcare information. Health literacy level was explained by academic level (P<.001), the extent of heart failure (P=.032), self-care, and age (P<.04).The academic level explained 61.6% of the health of literacy (95% bootstrap: 44.58%; 46.75%). In patients with stable heart failure, it is important to consider all factors that help patients to understand the healthcare information. Health literacy explains patient self-care attitude in heart failure. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Treatment persistence & health care costs of adult MDD patients treated with escitalopram vs. citalopram in a medicaid population.

Science.gov (United States)

Wu, Eric Q; Ben-Hamadi, Rym; Lu, Mei; Beaulieu, Nicolas; Yu, Andrew P; Erder, M Haim

2012-01-01

Compare treatment persistence and health care costs of major depressive disorder (MDD) Medicaid patients treated with escitalopram versus citalopram. Retrospective analysis of Medicaid administrative claims data. Analyzed administrative claims data from the Florida Medicaid program (07/2002-06/2006) for patients ages 18-64 years with 21 inpatient claim or 2 independent medical claims for MDD. Outcomes included discontinuation and switching rates and prescription drug, medical, and total health care costs, all-cause and related to mental disorder. Contingency table analysis and survival analysis were used to compare outcomes between treatment groups, using both unadjusted analysis and multivariate analysis adjusting for baseline characteristics. The study included 2,650 patients initiated on escitalopram and 630 patients initiated on citalopram. Patients treated with escitalopram were less likely to discontinue the index drug (63.7% vs. 68.9%, P=0.015) or to switch to another second-generation antidepressant (14.9% vs. 18.4%, P=0.029) over the six months post-index date. Patients treated with escitalopram had $1,014 lower total health care costs (P=0.032) and $519 lower health care costs related to mental disorder (P=0.023). More than half of the total cost difference was attributable to savings in inpatient hospitalizations related to mental disorder ($571, P=0.003) and to outpatient costs ($53, PEscitalopram therapy was also associated with $736 lower medical costs related to mental disorder (P=0.009). In the Florida Medicaid program, compared to adult MDD patients initiated on citalopram, escitalopram patients have better treatment persistence and lower total health care costs due to any cause and due to mental disorder, mostly driven by lower hospitalization costs related to mental disorder.

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.

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

Work-related thumb disorders in South African physiotherapists treating musculoskeletal conditions using manual therapy techniques

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Heather Jenkins

2015-05-01

Full Text Available Research question: What is the prevalence of and factors associated with work-related thumb problems (WRTP in South African physiotherapists treating musculoskeletal conditions using manual therapy techniques? Design: A cross-sectional, descriptive study design was used and data were collected using two Internet-based questionnaires. Participants: The sample size calculated for the study was 284 using 95% confidence levels and a 5% margin of error. There were 395 participants that were included in the study. Outcome measures: The variables measured included demographic, employment, educational and occupational factors. Results: The lifetime prevalence of WRTP in the physiotherapists was 65.3%. The manual techniques that were significantly associated with WRTP in the respondents who reported thumb problems were all grades of transverse glides applied to the spine as well as grade II–IV unilateral and central posterior-anterior pressures to the spine. The factors that remained significantly associated with WRTP in all 395 respondents after regression analysis were the cervical treatment of up to six patients a day and hyperextension > 30° of the non-dominant interphalangeal (IP joint of the thumb. Conclusion: This study confirms that a high percentage of physiotherapists using manual therapy techniques to treat musculoskeletal conditions are experiencing WRTP. Recommendations: The development of a valid and reliable WRTP screening tool is needed to aid in the identification of physiotherapists at risk and thus in the primary prevention of WRTP. A longitudinal study which follows newly qualified physiotherapists is recommended to investigate a possible cause-effect relationship and preventative strategies for WRTP in physiotherapists.

Shared decision making interventions for people with mental health conditions.

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Duncan, Edward; Best, Catherine; Hagen, Suzanne

2010-01-20

One person in every four will suffer from a diagnosable mental health condition during their life course. Such conditions can have a devastating impact on the lives of the individual, their family and society. Increasingly partnership models of mental health care have been advocated and enshrined in international healthcare policy. Shared decision making is one such partnership approach. Shared decision making is a form of patient-provider communication where both parties are acknowledged to bring expertise to the process and work in partnership to make a decision. This is advocated on the basis that patients have a right to self-determination and also in the expectation that it will increase treatment adherence. To assess the effects of provider-, consumer- or carer-directed shared decision making interventions for people of all ages with mental health conditions, on a range of outcomes including: patient satisfaction, clinical outcomes, and health service outcomes. We searched: the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2008, Issue 4), MEDLINE (1950 to November 2008), EMBASE (1980 to November 2008), PsycINFO (1967 to November 2008), CINAHL (1982 to November 2008), British Nursing Index and Archive (1985 to November 2008) and SIGLE (1890 to September 2005 (database end date)). We also searched online trial registers and the bibliographies of relevant papers, and contacted authors of included studies. Randomised controlled trials (RCTs), quasi-randomised controlled trials (q-RCTs), controlled before-and-after studies (CBAs); and interrupted time series (ITS) studies of interventions to increase shared decision making in people with mental health conditions (by DSM or ICD-10 criteria). Data on recruitment methods, eligibility criteria, sample characteristics, interventions, outcome measures, participant flow and outcome data from each study were extracted by one author and checked by another. Data are presented in a narrative

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

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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

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

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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.

Health promotion behaviors and related factors in end stage renal disease patients treated with continuous ambulatory peritoneal dialysis.

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Wechpradit, Apinya; Thaiyuenwong, Jutiporn; Kanjanabuch, Talerngsak

2011-09-01

To present study health promotion behaviors and related factors in end stage renal disease (ESRD) patients treated with continuous ambulatory peritoneal dialysis (CAPD). Questionnaires of Pender to evaluate health promotion behaviors which measure 5 aspects of health-affected behaviors were examined in 90 CAPD patients at dialysis unit of Udornthani Hospital. Results were categorized into 3 groups according to Bloom's scale as follows: high, moderate, and low levels. The data were displayed as ranges or means +/- standard deviation, according to the characteristics of each variable, with a 5% (p cherish health behaviors of the patients.

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

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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...

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.

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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.

Unsuccessfully Treated Hypertension: A Major Public Health Problem With a Potential Solution.

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Furberg, Curt D; Sealey, Jean E; Blumenfeld, Jon D

2017-09-01

About one-half of all hypertensive adults do not have their blood pressure controlled. They are often prescribed medications that conform to national guidelines but they continue to have elevated blood pressure. This public health problem might be improved by applying plasma renin guided therapy. A contributor to the public health problem of unsuccessfully treated hypertension is that the circulating renin-angiotensin system (RAS) is not recognized in treatment guidelines as clinically relevant for the treatment of hypertension or as important as the body salt status for determining blood pressure levels. Another contributor to the problem is the lack of specificity in the package inserts for antihypertensive drugs. They do not specifically state under the heading "Indications" that RAS blockers are primarily most effective in hypertensive subjects with medium and high plasma renin levels; by contrast, natriuretic drugs are most effective in those with low plasma renin levels. Literature review. To address the problem of unsuccessfully treated hypertension, we recommend that the "Indications" section of package inserts for antihypertensive drugs be more specific. The primary indication for RAS blockers ought to be hypertension with medium and high plasma renin levels, and natriuretic agents for those with low plasma renin levels. Similar language ought to be added to treatment guidelines. Additionally, 3 other reasons for lack of blood pressure control also need to be addressed-failure to prescribe antihypertensive drugs to hypertensive subjects, failure of patients to fill prescriptions, and low drug adherence. © American Journal of Hypertension, Ltd 2017. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Impact of periodontal therapy on general health: evidence from insurance data for five systemic conditions.

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Jeffcoat, Marjorie K; Jeffcoat, Robert L; Gladowski, Patricia A; Bramson, James B; Blum, Jerome J

2014-08-01

Treatment of periodontal (gum) disease may lessen the adverse consequences of some chronic systemic conditions. To estimate the effects of periodontal therapy on medical costs and hospitalizations among individuals with diagnosed type 2 diabetes (T2D); coronary artery disease (CAD); cerebral vascular disease (CVD); rheumatoid arthritis (RA); and pregnancy in a retrospective observational cohort study. Insurance claims data from 338,891 individuals with both medical and dental insurance coverage were analyzed in 2011-2013. Inclusion criteria were (1) a diagnosis of at least one of the five specified systemic conditions and (2) evidence of periodontal disease. Subjects were categorized according to whether they had completed treatment for periodontal disease in the baseline year, 2005. Outcomes were (1) total allowed medical costs and (2) number of hospitalizations, per subscriber per year, in 2005-2009. Except in the case of pregnancy, outcomes were aggregated without regard to reported cause. Individuals who were treated and untreated for periodontal disease were compared independently for the two outcomes and five systemic conditions using ANCOVA; age, gender, and T2D status were covariates. Statistically significant reductions in both outcomes (ppregnancy, for which costs were lower by 40.2%, 40.9%, 10.7%, and 73.7%, respectively; results for hospital admissions were comparable. No treatment effect was observed in the RA cohorts. These cost-based results provide new, independent, and potentially valuable evidence that simple, noninvasive periodontal therapy may improve health outcomes in pregnancy and other systemic conditions. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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

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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.

Health-related productivity losses increase when the health condition is co-morbid with psychological distress: findings from a large cross-sectional sample of working Australians.

Science.gov (United States)

Holden, Libby; Scuffham, Paul A; Hilton, Michael F; Ware, Robert S; Vecchio, Nerina; Whiteford, Harvey A

2011-05-31

The health condition of workers is known to impact on productivity outcomes. The relationship between health and productivity is of increasing interest amid the need to increase productivity to meet global financial challenges. Prevalence of psychological distress is also of growing concern in Australia with a two-fold increase in the prevalence of psychological distress in Australia from 1997-2005. We used the cross-sectional data set from the Australian Work Outcomes Research Cost-benefit (WORC) study to explore the impacts of health conditions with and without co-morbid psychological distress, compared to those with neither condition, in a sample of approximately 78,000 working Australians. The World Health Organisation Health and Performance Questionnaire was used which provided data on demographic characteristics, health condition and working conditions. Data were analysed using negative binomial logistic regression and multinomial logistic regression models for absenteeism and presenteeism respectively. For both absenteeism and presenteeism productivity measures there was a greater risk of productivity loss associated when health conditions were co-morbid with psychological distress. For some conditions this risk was much greater for those with co-morbid psychological distress compared to those without. Co-morbid psychological distress demonstrates an increased risk of productivity loss for a range of health conditions. These findings highlight the need for further research to determine whether co-morbid psychological distress potentially exacerbates lost productivity.

Adoption and Use of Internet Technologies in Health Communication: Examining Disparities in Diffusion Patterns, Health Information Sources, and Patient-Provider Encounters

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Massey, Philip Minter

2013-01-01

This dissertation examines the impact of internet technologies on the field of health communication. Access and use of health communication technologies has and will continue to become increasingly important to manage and treat chronic conditions and other ailments, particularly in the context of health care reform that promotes improved quality…

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

Directory of Open Access Journals (Sweden)

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.

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

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

Science.gov (United States)

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.

Prevalence of and Comorbid Health Conditions Associated With Pediatric Prescription Opioid Use in the US.

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Banerjee, Souvik; Roland, Carl L; Willke, Richard; Mardekian, Jack; Garrison, Louis P

Prescription opioids are among the most effective analgesics to treat moderate to severe pain; however, little is known about the use of prescription opioids in children, particularly those receiving an extended-release formulation for the treatment of chronic pain. In this retrospective study, the authors determined the prevalence of prescription opioid use among 7-17-year-old children and associated comorbid health conditions from 2010 to 2013 using Truven Health MarketScan (MarketScan) and Optum Clinformatics DataMart (Optum). The primary end points were prevalence of using any prescription opioids, using only prescription short-acting opioids (SAOs), and at least one prescription of a long-acting opioid (LAO). The prevalence of prescription opioid use among children is non-negligible and has been trending downwards: 6.90% in 2010 and 5.93% in 2013 using MarketScan and a similar trend using Optum: 5.47% in 2010 and 4.51% in 2013. Very few children had claims for LAOs, with only 0.04% (4979 children) in MarketScan and 0.03% (1117 children) in Optum. Given the very small number of children, primarily in the 12-17 age group, who are prescribed LAOs, there is a need to focus on a better understanding of the patterns of SAO use in children.

Health-related productivity losses increase when the health condition is co-morbid with psychological distress: findings from a large cross-sectional sample of working Australians

Directory of Open Access Journals (Sweden)

Vecchio Nerina

2011-05-01

Full Text Available Abstract Background The health condition of workers is known to impact on productivity outcomes. The relationship between health and productivity is of increasing interest amid the need to increase productivity to meet global financial challenges. Prevalence of psychological distress is also of growing concern in Australia with a two-fold increase in the prevalence of psychological distress in Australia from 1997-2005. Methods We used the cross-sectional data set from the Australian Work Outcomes Research Cost-benefit (WORC study to explore the impacts of health conditions with and without co-morbid psychological distress, compared to those with neither condition, in a sample of approximately 78,000 working Australians. The World Health Organisation Health and Performance Questionnaire was used which provided data on demographic characteristics, health condition and working conditions. Data were analysed using negative binomial logistic regression and multinomial logistic regression models for absenteeism and presenteeism respectively. Results For both absenteeism and presenteeism productivity measures there was a greater risk of productivity loss associated when health conditions were co-morbid with psychological distress. For some conditions this risk was much greater for those with co-morbid psychological distress compared to those without. Conclusions Co-morbid psychological distress demonstrates an increased risk of productivity loss for a range of health conditions. These findings highlight the need for further research to determine whether co-morbid psychological distress potentially exacerbates lost productivity.

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...

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

Science.gov (United States)

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

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

Science.gov (United States)

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.

Manipulating the gut microbiota to maintain health and treat disease

Directory of Open Access Journals (Sweden)

Karen P. Scott

2015-02-01

Full Text Available Background: The intestinal microbiota composition varies between healthy and diseased individuals for numerous diseases. Although any cause or effect relationship between the alterations in the gut microbiota and disease is not always clear, targeting the intestinal microbiota might offer new possibilities for prevention and/or treatment of disease. Objective: Here we review some examples of manipulating the intestinal microbiota by prebiotics, probiotics, and fecal microbial transplants. Results: Prebiotics are best known for their ability to increase the number of bifidobacteria. However, specific prebiotics could potentially also stimulate other species they can also stimulate other species associated with health, like Akkermansia muciniphila, Ruminococcus bromii, the Roseburia/Enterococcus rectale group, and Faecalibacterium prausnitzii. Probiotics have beneficial health effects for different diseases and digestive symptoms. These effects can be due to the direct effect of the probiotic bacterium or its products itself, as well as effects of the probiotic on the resident microbiota. Probiotics can influence the microbiota composition as well as the activity of the resident microbiota. Fecal microbial transplants are a drastic intervention in the gut microbiota, aiming for total replacement of one microbiota by another. With numerous successful studies related to antibiotic-associated diarrhea and Clostridium difficile infection, the potential of fecal microbial transplants to treat other diseases like inflammatory bowel disease, irritable bowel syndrome, and metabolic and cardiovascular disorders is under investigation. Conclusions: Improved knowledge on the specific role of gut microbiota in prevention and treatment of disease will help more targeted manipulation of the intestinal microbiota. Further studies are necessary to see the (long term effects for health of these interventions.

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

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.

Travelers' Health: Traveling Safely with Infants and Children

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... for vomiting and diarrhea; see www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/Treating-Dehydration-with-Electrolyte-Solution.aspx . ORS packets are available in the United ...

International child health

DEFF Research Database (Denmark)

Kruse, Alexandra Y; Høgh, Birthe

2007-01-01

International child health has improved. Better healthcare strategies, like IMCI, have contributed implementing basic interventions: vaccinations, nutrition supplement, oral rehydration and antibiotics. But 11 million children still die every year before they turn five, most from infectious...... diseases and neonatal complications, over half associated with malnutrition. Conditions we could prevent and treat. One of UN's Millennium Development Goals is to reduce child mortality. However child health is more than mortality and morbidity indicators, it includes growth and development. Udgivelsesdato...

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

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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

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 ...

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

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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.

The impact of cannabis and cannabinoids for medical conditions on health-related quality of life: A systematic review and meta-analysis.

Science.gov (United States)

Goldenberg, Matthew; Reid, Mark William; IsHak, Waguih William; Danovitch, Itai

2017-05-01

The use of cannabis or cannabinoids to treat medical conditions and/or alleviate symptoms is increasingly common. However, the impact of this use on patient reported outcomes, such as health-related quality of life (HRQoL), remains unclear. We conducted a systematic review and meta-analysis, employing guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We categorized studies based on design, targeted disease condition, and type of cannabis or cannabinoid used. We scored studies based on quality and risk of bias. After eliminating some studies because of poor quality or insufficient data, we conducted meta-analyses of remaining studies based on design. Twenty studies met our pre-defined selection criteria. Eleven studies were randomized controlled trials (RCTs; 2322 participants); the remaining studies were of cohort and cross-sectional design. Studies of cannabinoids were mostly RCTs of higher design quality than studies of cannabis, which utilized smaller self-selected samples in observational studies. Although we did not uncover a significant association between cannabis and cannabinoids for medical conditions and HRQoL, some patients who used them to treat pain, multiple sclerosis, and inflammatory bower disorders have reported small improvements in HRQoL, whereas some HIV patients have reported reduced HRQoL. The relationship between HRQoL and the use of cannabis or cannabinoids for medical conditions is inconclusive. Some patient populations report improvements whereas others report reductions in HRQoL. In order to inform users, practitioners, and policymakers more clearly, future studies should adhere to stricter research quality guidelines and more clearly report patient outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.

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

Science.gov (United States)

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

Potential of human health in the modern conditions

Directory of Open Access Journals (Sweden)

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.

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

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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.

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.

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.

Processing Conditions, Rice Properties, Health and Environment

Directory of Open Access Journals (Sweden)

Nobutaka Nakamura

2011-06-01

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

Protective effect of conditioning agents on Afro-ethnic hair chemically treated with thioglycolate-based straightening emulsion.

Science.gov (United States)

Dias, Tania Cristina de Sá; Baby, André Rolim; Kaneko, Telma Mary; Velasco, Maria Valéria Robles

2008-06-01

Straightening is a chemical process by which excessively curly hair is straightened in an irreversible way. Generally, products are formulated as emulsions with high pH value (9.0-12.0), which, after applied on hair, cause considerable damage, making it dry and fragile. This research work evaluated the protective effect of lauryl PEG/PPG-18/18 methicone, cyclopentasiloxane (and) PEG-12 dimethicone cross-polymer, jojoba oil, and aqua (and) cystine bis-PG propyl silanetriol, as conditioning agents, on Afro-ethnic hair locks treated with thioglycolate-based straightening emulsions by protein loss, combability, and traction to rupture. Standard Afro-ethnic hair locks were prepared following a protocol for straightening emulsion application. Considering the assays performed, the addition of conditioning agents to the straightening emulsion with ammonium thioglycolate benefited the hair fiber, thus diminishing protein loss, protecting the hair thread, and improving resistance to breakage. Jojoba oil and lauryl PEG/PPG-18/18 methicone were the conditioning agents that presented the best results. Straightening emulsions with ammonium thioglycolate containing aqua (and) cystine bis-PG propyl silanetriol and cyclopentasiloxane (and) PEG-12 dimethicone cross-polymer were the ones that provided higher breakage resistance of the thread.

[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.

Characteristic of New Solid-Phase Extraction Sorbent: Activated Carbon Prepared from Rice Husks under Base Treated Condition

OpenAIRE

Afrida Kurnia Putri; Wang-Hsien Ding; Han-Wen Kuo

2012-01-01

A characterization of activated carbon (ACs) prepared from rice husks (RHs) under base treated condition as a new sorbent for solid-phase extraction (SPE) to extract 4-nonylphenol isomers (4-NPs) in water samples has been done. The ACs prepared from RHs usually exhibits low specific surface area due to its high ash content, but in case of its application for SPE, there are other factors need to be considered, such as the existence of functional groups inside the sorbent, that can enhance inte...

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.

Nipple adenoma in a female patient presenting with persistent erythema of the right nipple skin: case report, review of the literature, clinical implications, and relevancy to health care providers who evaluate and treat patients with dermatologic conditions of the breast skin.

Science.gov (United States)

Spohn, Gina P; Trotter, Shannon C; Tozbikian, Gary; Povoski, Stephen P

2016-05-20

Nipple adenoma is a very uncommon, benign proliferative process of lactiferous ducts of the nipple. Clinically, it often presents as a palpable nipple nodule, a visible nipple skin erosive lesion, and/or with discharge from the surface of the nipple skin, and is primarily seen in middle-aged women. Resultantly, nipple adenoma can clinically mimic the presentation of mammary Paget's disease of the nipple. The purpose of our current case report is to present a comprehensive review of the available data on nipple adenoma, as well as provide useful information to health care providers (including dermatologists, breast health specialists, and other health care providers) who evaluate patients with dermatologic conditions of the breast skin for appropriately clinically recognizing, diagnosing, and treating patients with nipple adenoma. Fifty-three year old Caucasian female presented with a one year history of erythema and induration of the skin of the inferior aspect of the right nipple/areolar region. Skin punch biopsies showed subareolar duct papillomatosis. The patient elected to undergo complete surgical excision with right central breast resection. Final histopathologic evaluation confirmed nipple adenoma. The patient is doing well 31 months after her definitive surgical therapy. Since nipple adenoma represents a benign proliferative process of the nipple, complete surgical excision is curative. However, the coexistence of nipple adenoma and ipsilateral or contralateral breast cancer is well reported in the literature. The potential for a direct causal link or association of nipple adenoma and breast cancer cannot be fully excluded.

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

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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.

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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.

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.

Does the national health insurance scheme in Ghana reduce household cost of treating malaria in the Kassena-Nankana districts?

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Maxwell Ayindenaba Dalaba

2014-05-01

Full Text Available Introduction: The Government of Ghana introduced the National Health Insurance Scheme (NHIS in 2003 to replace out-of-pocket (OOP payment for health services with the inherent aim of reducing the direct cost of treating illness to households. Objective: To assess the effects of the NHIS in reducing cost of treating malaria to households in the Kassena-Nankana districts of northern Ghana. Methods: We conducted a cross-sectional survey between October 2009 and October 2011 in the Kassena-Nankana districts. A sample of 4,226 households was randomly drawn from the Navrongo Health and Demographic Surveillance System household database and administered a structured interview. The costs of malaria treatment were collected from the patient perspective. Results: Of the 4,226 households visited, a total of 1,324 (31% household members reported fever and 51% (675 reported treatment for malaria and provided information on where they sought care. Most respondents sought malaria treatment from formal health facilities 63% (424, with the remainder either self-medicating with drugs from chemical shops 32% (217 or with leftover drugs or herbs 5% (34. Most of those who sought care from formal health facilities were insured 79% (334. The average direct medical cost of treating malaria was GH¢3.2 (US$2.1 per case with the insured spending less (GH¢2.6/US$1.7 per case than the uninsured (GH¢3.2/US$2.1. The overall average cost (direct and indirect incurred by households per malaria treatment was GH¢20.9 (US$13.9. Though the insured accounted for a larger proportion of admissions at health facilities 76% (31 than the uninsured 24% (10, the average amount households spent on the insured was less (GH¢4/US$2.7 than their uninsured counterparts (GH¢6.4/US$4.3. The difference was not statistically significant (p=0.2330. Conclusion: Even though some insured individuals made OOP payments for direct medical care, there is evidence that the NHIS has a protective effect

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.

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

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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.

Gender-specific mental health care needs of women veterans treated for psychiatric disorders in a Veterans Administration Women's Health Clinic.

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Miller, Laura J; Ghadiali, Nafisa Y

2015-04-01

This pilot study aims to ascertain the prevalence of self-reported premenstrual, perinatal, and perimenopausal influences on mental health, and of gynecologic conditions that could interact with psychiatric conditions, among women veterans receiving psychiatric care within a Veterans Administration (VA) Women's Health Clinic (WHC). Participants included all women veterans (N=68) who received psychiatric evaluations within a VA WHC over a 5-month period. This setting encompasses colocated and coordinated primary care, gynecologic and mental health services. Evaluations included a Women's Mental Health Questionnaire, a psychiatric interview, and medical record review. Deidentified data were extracted from a clinical data repository for this descriptive study. High proportions of study participants reported that their emotional problems intensified premenstrually (42.6%), during pregnancy (33.3%), in the postpartum period (33.3%), or during perimenopause (18.2%). Unintended pregnancy (70.0% of pregnancies) and pregnancy loss (63.5% of women who had been pregnant) were prominent sex-linked stressors. Dyspareunia (22.1% of participants) and pelvic pain (17.6% of participants) were frequent comorbidities. Among women veterans receiving psychiatric care within a VA WHC, there are high rates of self-reported premenstrual, perinatal, and perimenopausal influences on mental health. This population also has substantial comorbidity of psychiatric disorders with dyspareunia and pelvic pain. This underscores the importance of recognizing and addressing women veterans' sex-specific care needs, including interactions among reproductive cycle phases, gynecologic pain, and psychiatric symptoms. The findings support the need for greater awareness of the sex-specific mental health needs of women veterans, and for more definitive studies to further characterize these needs.

Dental and periodontal health, and microbiological and salivary conditions in patients with or without diabetes undergoing haemodialysis.

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Schmalz, Gerhard; Schiffers, Nora; Schwabe, Sandra; Vasko, Radovan; Müller, Gerhard A; Haak, Rainer; Mausberg, Rainer F; Ziebolz, Dirk

2017-06-01

The aim of this cross-sectional study was to evaluate the dental and periodontal health, as well as the microbiological and salivary conditions, of patients with and without diabetes mellitus (DM) who are receiving haemodialysis. One-hundred and fifty-nine haemodialysis patients were included and divided into groups according to the pre-existing diabetes status: DM or no DM. The oral examination included dental findings and assessment of the periodontal situation. The periodontal condition was classified as healthy/mild, moderate or severe periodontitis. Subgingival biofilm samples were analysed using the polymerase chain reaction. The salivary diagnostics included measurement of unstimulated and stimulated salivary flow, pH and buffer capacity. Statistical analyses used Fisher's test, the t-test and the Mann-Whitney U-test (α = 5%). The dental findings showed no significant difference between patients with and without DM (P = 0.44). The prevalence of periodontitis was high (96% in patients with DM and 97% in patients who did not have DM) and there was no significant difference between the groups (P = 0.71). There was a higher prevalence of Porphyromonas gingivalis, Parvimonas micros, Eubacterium nucleatum and Capnocytophaga spp. in patients without DM (P salivary pH was significantly higher in patients without DM (P salivary pH were detected between the groups, the dental and periodontal status was comparable between patients with and without DM. Accordingly, DM appears to have no decisive influence on the oral health in patients treated with haemodialysis who have well-controlled diabetes. © 2017 FDI World Dental Federation.

A population-based study of sport and recreation-related head injuries treated in a Canadian health region.

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Harris, Andrew W; Jones, C Allyson; Rowe, Brian H; Voaklander, Donald C

2012-07-01

To report the rates of SR-related HIs presenting to EDs in a Canadian population-based sample. Descriptive epidemiology study. Using administrative data, sport and recreation-related emergency department presentations for persons 0-35 years of age, from April 1997 through March 2008, were obtained from the Edmonton Zone (formerly the Capital Health Region), Alberta Health Services through the Ambulatory Care Classification System. Of the 3,230,890 visits to the emergency departments of the five hospitals in Edmonton, 63,219 sport and recreation-related injury records and 4935 sport and recreation-head injury records were identified. Head injuries were most frequently treated for the activities of hockey (20.7%), cycling (12.0%), and skiing/snowboarding/sledding. Males accounted for 71.9% (n=3546) and patients less than 18 years of age sustained 3446 (69.8%) sport and recreation-head injuries. Sport and recreation-related head injuries most frequently treated in emergency departments involve common activities such as hockey, cycling, skiing/snowboarding/sledding, and soccer. Males and those less than 18 years of age sustain the majority of sport and recreation-related head injuries treated in emergency departments. These findings underscore the importance of sport-specific policies and safety promotion for the prevention of head injuries, in sports and recreational activities. Copyright © 2011 Sports Medicine Australia. All rights reserved.

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

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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.

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.

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

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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.

Intra-ligamentary autologous conditioned plasma and healing response to treat partial ACL ruptures.

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Koch, Matthias; Matteo, Berardo Di; Eichhorn, Jürgen; Zellner, Johannes; Mayr, Felix; Krutsch, Werner; Achenbach, Leonard; Woehl, Rebecca; Nerlich, Michael; Angele, Peter

2018-05-01

Conservative treatment of partial ACL ruptures is associated with a high failure rate, and often patients undergo ACL reconstruction. ACL preservation by trephination of the ACL origin and application of Autologous Conditioned Plasma (ACP) seems to be an intriguing new treatment option to favour ACL tissue healing and avoid traditional reconstruction. The aim of this study was to describe the mid-term outcomes of this new ACL preserving technique. Twenty-four patients (mean age 41.8 years) affected by partial rupture of one or both ACL bundles were included in the present trial. The partial ACL tears were arthroscopically assessed and classified according to a new five step grading system. All patients were treated by trephination of the femoral ACL stump and intra-ligamentary application of ACP. The postoperative outcome was evaluated by both subjective scores and stability testing up to a mean of 25.1 months' follow-up. Adverse events and failure rate were also documented. Clinical outcome was good to excellent with IKDC subjective 82.7 (SD 11.8), Lysholm 87.6 (SD 8.1), Tegner 5.3 (SD 2.1), Cincinnati 88.7 (SD 14.8). The failure rate (i.e. persisting knee instability assessed clinically or by rolimeter) was 12.5%. At objective measurements, knee joints showed a firm endpoint in Lachman test, negative pivot shift phenomenon and a significant reduction in AP-laxity compared to pre-operative status by rolimeter testing (p = 0.002). Return to sport practice was achieved after mean 4.8 months (SD 4.1). ACL stump trephination and concomitant intra-ligamentary application of ACP revealed promising results at mid-term follow-up to treat partial ACL lesions.

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

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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...

Older adults' use of complementary and alternative medicine for mental health: findings from the 2002 National Health Interview Survey.

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Grzywacz, Joseph G; Suerken, Cynthia K; Quandt, Sara A; Bell, Ronny A; Lang, Wei; Arcury, Thomas A

2006-06-01

To compare complementary and alternative medicine (CAM) use among adults 65 and older with and without self-reported anxiety or depression, and to investigate the prevalence and predictors of CAM use for treatment by persons with anxiety or depression. Cross-sectional survey. Computer-assisted interviews conducted in participants' homes. Subjects included 5827 adults aged 65 and older who participated in the 2002 National Health Interview Survey including the Alternative Health Supplement. None. Overall use of CAM, use of four categories of CAM, and use of 20 CAM modalities. CAM use for treatment of any health condition, and CAM use to treat mental health. Eighty-one and seven tenths percent (81.7%) of older adults with self-reported anxiety or depression who used CAM in the past year, whereas 64.6% of older adults without these conditions used CAM. Differences in CAM use were driven by elevated use of spiritual practices, relaxation techniques, and use of nonvitamin, nonmineral natural products by patients with symptoms of mental conditions. Fewer than 20% of CAM users with self-reported anxiety or depression used CAM for their mental health. Few personal and health-related factors predicted CAM use for treatment among older adults with self-reported anxiety or depression. Older adults with self-reported anxiety or depression were more likely to use spiritual practices, relaxation techniques, and nonvitamin, nonmineral natural products than elders in good mental health. However, for the majority of older adults with self-reported anxiety or depression, CAM was used for purposes other than treating mental health.

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

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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.

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

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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…

Health risk assessment linked to filling coastal quarries with treated dredged seaport sediments

International Nuclear Information System (INIS)

Perrodin, Yves; Donguy, Gilles; Emmanuel, Evens; Winiarski, Thierry

2014-01-01

Dredged seaport sediments raise complex management problems since it is no longer possible to discharge them into the sea. Traditional waste treatments are poorly adapted for these materials in terms of absorbable volumes and cost. In this context, filling quarries with treated sediments appears interesting but its safety regarding human health must be demonstrated. To achieve this, a specific methodology for assessing health risks has been developed and tested on three seaport sediments. This methodology includes the development of a conceptual model of the global scenario studied and the definition of specific protocols for each of its major steps. The approach proposed includes in particular the use of metrological and experimental tools that are new in this context: (i) an experimental lysimeter for characterizing the deposit emissions, and (ii) a geological radar for identifying potential preferential pathways between the sediment deposit and the groundwater. The application of this approach on the three sediments tested for the scenario studied showed the absence of health risk associated with the consumption of groundwater for substances having a “threshold effect” (risk quotient −6 ). - Highlights: • The release of polluted dredged seaport sediments into the sea must be avoided. • Their use after treatment for the filling-up of quarries is proposed by managers. • An original health risk assessment methodology was created to validate this option. • It includes the use of a lysimeter and a georadar for the exposure assessment stage. • The example studied concludes to a health risk linked to arsenic in the groundwater

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

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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.

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.

Factors affecting the periapical healing process of endodontically treated teeth

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Roberto Holland

Full Text Available Abstract Tissue repair is an essential process that reestablishes tissue integrity and regular function. Nevertheless, different therapeutic factors and clinical conditions may interfere in this process of periapical healing. This review aims to discuss the important therapeutic factors associated with the clinical protocol used during root canal treatment and to highlight the systemic conditions associated with the periapical healing process of endodontically treated teeth. The antibacterial strategies indicated in the conventional treatment of an inflamed and infected pulp and the modulation of the host's immune response may assist in tissue repair, if wound healing has been hindered by infection. Systemic conditions, such as diabetes mellitus and hypertension, can also inhibit wound healing. The success of root canal treatment is affected by the correct choice of clinical protocol. These factors are dependent on the sanitization process (instrumentation, irrigant solution, irrigating strategies, and intracanal dressing, the apical limit of the root canal preparation and obturation, and the quality of the sealer. The challenges affecting the healing process of endodontically treated teeth include control of the inflammation of pulp or infectious processes and simultaneous neutralization of unpredictable provocations to the periapical tissue. Along with these factors, one must understand the local and general clinical conditions (systemic health of the patient that affect the outcome of root canal treatment prediction.

Risk factors for impaired health status differ in women and men treated with percutaneous coronary intervention in the drug-eluting stent era

DEFF Research Database (Denmark)

Pedersen, Susanne S.; Ong, Andrew T L; Lemos, Pedro A

2006-01-01

In patients treated with percutaneous coronary intervention (PCI) in the drug-eluting stent era, we compared women's and men's health status 6 and 12 months post-PCI and investigated whether predictors of poor health status at 12 months are similar for women and men....

Mental health needs of children and adolescents at camp: are they being assessed and treated appropriately by the camp nurse?

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Courey, Tamra J

2006-11-01

Increasingly, more children and adolescents are attending camps with mental health concerns. This can pose a challenge for camp nurses who may lack experience in assessment and treatment of mental health issues. To focus on the importance of addressing and treating mental health needs of children and adolescents at camp utilizing the Scope and Standards of Psychiatric Mental Health Nursing Practice. Personal observations, camp nursing experience, and scholarly published literature. It is paramount that mental health needs of children and adolescents at camp are addressed and managed appropriately by the camp nurse. Education of camp nurses and camp administrators is also a vital part of providing care.

Health risk assessment linked to filling coastal quarries with treated dredged seaport sediments.

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Perrodin, Yves; Donguy, Gilles; Emmanuel, Evens; Winiarski, Thierry

2014-07-01

Dredged seaport sediments raise complex management problems since it is no longer possible to discharge them into the sea. Traditional waste treatments are poorly adapted for these materials in terms of absorbable volumes and cost. In this context, filling quarries with treated sediments appears interesting but its safety regarding human health must be demonstrated. To achieve this, a specific methodology for assessing health risks has been developed and tested on three seaport sediments. This methodology includes the development of a conceptual model of the global scenario studied and the definition of specific protocols for each of its major steps. The approach proposed includes in particular the use of metrological and experimental tools that are new in this context: (i) an experimental lysimeter for characterizing the deposit emissions, and (ii) a geological radar for identifying potential preferential pathways between the sediment deposit and the groundwater. The application of this approach on the three sediments tested for the scenario studied showed the absence of health risk associated with the consumption of groundwater for substances having a "threshold effect" (risk quotient risk for substances having a "non-threshold effect", with the notable exception of arsenic (individual risk equal to 3.10(-6)). Copyright © 2014 Elsevier B.V. All rights reserved.

Survival and health care costs until hospital discharge of patients treated with onsite, dispatched or without automated external defibrillator

NARCIS (Netherlands)

Berdowski, Jocelyn; Kuiper, Mathijs J.; Dijkgraaf, Marcel G. W.; Tijssen, Jan G. P.; Koster, Rudolph W.

2010-01-01

Background: This study aimed to determine whether automated external defibrillator (AED) use during resuscitation is associated with lower in-hospital health care costs. Methods: For this observational prospective study, we included all treated out-of-hospital cardiac arrests of suspected cardiac

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.

Health related quality of life patterns in patients treated with interstitial prostate brachytherapy for localized prostate cancer--data from CaPSURE.

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Downs, Tracy M; Sadetsky, Natalia; Pasta, David J; Grossfeld, Gary D; Kane, Christopher J; Mehta, Shilpa S; Carroll, Peter R; Lubeck, Deborah P

2003-11-01

We measured the impact brachytherapy monotherapy (BMT) has on general and disease specific health related quality of life (HRQOL) compared to patients treated with radical prostatectomy (RP). We studied 419 men with newly diagnosed prostate cancer who enrolled in CaPSURE (Cancer of the Prostate Strategic Urological Research Endeavor) data base whose primary treatment was brachytherapy monotherapy (92) or radical prostatectomy (327). The validated RAND 36-Item Health Survey and the UCLA Prostate Cancer Index were used to measure HRQOL before treatment and at 6-month intervals during the first 2 years after treatment. Patients treated with BMT or RP did not differ greatly in general HRQOL after treatment. Both treatment groups showed early functional impairment in most general domains with scores returning to or approaching baseline in most domains 18 to 24 months after treatment. Patients treated with BMT had significantly higher urinary function scores at 0 to 6 months after treatment (84.5, SD 18.7) than patients treated with RP (63.3, SD 26.6). Urinary bother scores at 0 to 6 months after treatment were not significantly different between patients treated with BMT (67.7, SD 31.2) and those treated with RP (67.4, SD 29.1). Both treatment groups had decreases in sexual function that did not return to pretreatment levels. Overall BMT and RP are well tolerated procedures that cause mild changes in general HRQOL. Disease specific HRQOL patterns are different in patients treated with BMT or RP. Baseline and serial HRQOL measurements after treatment can provide valuable information regarding expected quality of life outcome after treatment for localized prostate cancer.

Anemia and nutritional status of infants from two to five months of age treated in facilities of the Ministry of Health of Peru, 2012

OpenAIRE

Gómez-Guizado, Guillermo; Centro Nacional de Alimentación y Nutrición, Instituto Nacional de Salud. Lima, Perú. Médico cirujano especialista en Epidemiologia de Campo; Munares-García, Oscar; Centro Nacional de Alimentación y Nutrición, Instituto Nacional de Salud. Lima, Perú. Facultad de Medicina, Universidad Nacional Mayor de San Marcos. Lima, Perú. licenciado en Obstetricia, magíster en Salud Pública

2014-01-01

Objectives. Determine the characteristics of the levels of anemia in infants from two to five months of age treated in facilities of the Ministry of Health of Peru during 2012. Materials and methods. This cross-sectional study uses the nutritional status information system of the National Center for Food and Nutrition, National Institute of Health of Peru in 2012. Records of 7,513 infants from two to five months of age treated in small outpatient clinics, centers and hospitals of the Ministry...

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

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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

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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

Global warming potential of material fractions occurring in source-separated organic household waste treated by anaerobic digestion or incineration under different framework conditions

DEFF Research Database (Denmark)

Naroznova, Irina; Møller, Jacob; Scheutz, Charlotte

2016-01-01

This study compared the environmental profiles of anaerobic digestion (AD) and incineration, in relation to global warming potential (GWP), for treating individual material fractions that may occur in source-separated organic household waste (SSOHW). Different framework conditions representative...

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...

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

Directory of Open Access Journals (Sweden)

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.

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

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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.

Reproducibility of NMR analysis of urine samples: impact of sample preparation, storage conditions, and animal health status.

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Schreier, Christina; Kremer, Werner; Huber, Fritz; Neumann, Sindy; Pagel, Philipp; Lienemann, Kai; Pestel, Sabine

2013-01-01

Spectroscopic analysis of urine samples from laboratory animals can be used to predict the efficacy and side effects of drugs. This employs methods combining (1)H NMR spectroscopy with quantification of biomarkers or with multivariate data analysis. The most critical steps in data evaluation are analytical reproducibility of NMR data (collection, storage, and processing) and the health status of the animals, which may influence urine pH and osmolarity. We treated rats with a solvent, a diuretic, or a nephrotoxicant and collected urine samples. Samples were titrated to pH 3 to 9, or salt concentrations increased up to 20-fold. The effects of storage conditions and freeze-thaw cycles were monitored. Selected metabolites and multivariate data analysis were evaluated after (1)H NMR spectroscopy. We showed that variation of pH from 3 to 9 and increases in osmolarity up to 6-fold had no effect on the quantification of the metabolites or on multivariate data analysis. Storage led to changes after 14 days at 4°C or after 12 months at -20°C, independent of sample composition. Multiple freeze-thaw cycles did not affect data analysis. Reproducibility of NMR measurements is not dependent on sample composition under physiological or pathological conditions.

Reproducibility of NMR Analysis of Urine Samples: Impact of Sample Preparation, Storage Conditions, and Animal Health Status

Directory of Open Access Journals (Sweden)

Christina Schreier

2013-01-01

Full Text Available Introduction. Spectroscopic analysis of urine samples from laboratory animals can be used to predict the efficacy and side effects of drugs. This employs methods combining 1H NMR spectroscopy with quantification of biomarkers or with multivariate data analysis. The most critical steps in data evaluation are analytical reproducibility of NMR data (collection, storage, and processing and the health status of the animals, which may influence urine pH and osmolarity. Methods. We treated rats with a solvent, a diuretic, or a nephrotoxicant and collected urine samples. Samples were titrated to pH 3 to 9, or salt concentrations increased up to 20-fold. The effects of storage conditions and freeze-thaw cycles were monitored. Selected metabolites and multivariate data analysis were evaluated after 1H NMR spectroscopy. Results. We showed that variation of pH from 3 to 9 and increases in osmolarity up to 6-fold had no effect on the quantification of the metabolites or on multivariate data analysis. Storage led to changes after 14 days at 4°C or after 12 months at −20°C, independent of sample composition. Multiple freeze-thaw cycles did not affect data analysis. Conclusion. Reproducibility of NMR measurements is not dependent on sample composition under physiological or pathological conditions.

Treating malnutrition in the community.

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Dera, Merceline; Woodham, Diane

2016-11-02

Malnutrition is a clinical and public health problem. It has adverse effects on the physical and psycho-social wellbeing of individuals by predisposing to disease, negatively affecting its outcome and reducing the likelihood of independence. An estimated 3 million people in the UK are affected by malnutrition, most of whom live in the community ( BAPEN, 2011 ). Despite the scale of this problem, it remains under-detected, under-treated, underresourced and often overlooked by those involved in the care of at risks individuals such as the elderly. In most cases malnutrition is a treatable condition that can be managed by optimising food intake and using oral nutritional supplements (ONS) where necessary. The main focus of this article is on the dangers of malnutrition for older people in the community and the use of ONS in the treatment and management of malnutrition.

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

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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

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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.

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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.

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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.

Health economics of treating haemophilia A with inhibitors.

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Knight, C

2005-11-01

Haemophilia is a rare, inherited blood disorder in which blood clotting is impaired such that patients suffer from excessive internal and external bleeding. At present there is no cure for haemophilia A and patients require expensive, life-long treatment involving clotting factor replacement therapy. Treatment costs are perceived to be higher for patients who have developed inhibitory antibodies to factor VIII, the standard therapy for haemophilia A. However, initial cost analyses suggest that clotting factor therapy with alternative haemostatic agents, such as recombinant activated factor VII or activated prothrombin complex concentrate, is no more expensive for the majority of haemophilia A patients with inhibitors than for those without inhibitors. With the availability of effective alternative haemostatic agents, orthopaedic surgery for haemophilia A patients with inhibitors is now a clinical option, and initial cost analyses suggest this may be a cost-effective treatment strategy for patients with inhibitors whose quality of life (QoL) is severely impaired by joint arthropathy. In an era of finite healthcare resourcing it is important to determine whether new treatments justify higher unit costs compared with standard therapies and whether such higher costs are justified from an individual perspective in terms of improved QoL, and from a societal perspective in terms of improved productivity and reduced overall healthcare costs. This paper examines current data on the health economics of treating haemophilia A patients with inhibitors, focusing on the overall costs of clotting factor replacement therapy and the cost consequences of joint replacement.

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

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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.

Body condition scores at calving and their association with dairy cow performance and health in semiarid environment under two cooling systems

Directory of Open Access Journals (Sweden)

Mohamed A.B. Mandour

2015-02-01

Full Text Available Under tropical environments cow’s body condition at calving may influence productivity and health performance. Therefore, the current research evaluated the impact of body condition score (BCS at calving on milk production traits and health problems of primiparous and multiparous cows raised under two cooling systems in semi-arid environment. Milk yield parameters and health disorders data at different parities were obtained from 1700 Holstein cows, which were managed under Korral Kool (KKC and fan (FC cooling systems in Saudi Arabia. The results revealed that KKC system induced high level of milk production improvement (305TM, days in milk, daily milk yield (P<0.05 compared to FC, especially in multiparous cows. There was an advantage of the high BCS group under KKC system over the FC system for peak yield and period. Cows from both cooling systems having moderate BCS outdid the other groups for total milk yield. Low BCS primiparous cows reared under KKC system were the most to suffer from stillbirth (18%, and calving ease (26.1% in winter, while high BCS were the most to be treated for mastitis (8.5% in summer. On the other hand, spring calved multiparous cows raised under FC system suffered more from lameness (21.57% - high BCS and milk fever (4.4% - moderate BCS. Further, cows having moderate BCS kept under KKC system had the highest incidence of lameness (62.2%, and abomasum displacement (4.4%. In conclusion, achieving correct BCS at calving and cooling system is important to avoid calving subsequent lactation performance and metabolic disease losses.

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...

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

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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

Methods for treating a metathesis feedstock with metal alkoxides

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Cohen, Steven A.; Anderson, Donde R.; Wang, Zhe; Champagne, Timothy M.; Ung, Thay A.

2018-04-17

Various methods are provided for treating and reacting a metathesis feedstock. In one embodiment, the method includes providing a feedstock comprising a natural oil, chemically treating the feedstock with a metal alkoxide under conditions sufficient to diminish catalyst poisons in the feedstock, and, following the treating, combining a metathesis catalyst with the feedstock under conditions sufficient to metathesize the feedstock.

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

Science.gov (United States)

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

Directory of Open Access Journals (Sweden)

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.

The Ripple Effect of Title IX on Women's Health Issues: Treating an Increasingly Active Population.

Science.gov (United States)

Mees, Patricia D

2003-04-01

Perhaps no area in sports medicine has changed as dramatically in the last 30 years as women's health. Title IX of the Education Amendments of 1972 prohibited discrimination on the basis of sex in all curricular and extracurricular activities at educational institutions that receive federal funding. Before 1972, many assumed that women were not interested in sports and that there was no need to provide programs for girls and women, and most primary care physicians had little experience in treating female athletes and other active women.

Expanding the Application of Group Interventions: Emergence of Groups in Health Care Settings

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Drum, David; Becker, Martin Swanbrow; Hess, Elaine

2011-01-01

Changes in the health care arena and within the specialty of group work are contributing to the increased utilization of groups in health care settings. Psychoeducational, theme, and interpersonal therapy groups are highlighted for their contributions to treating challenging health conditions. An understanding of the evolution of these group…

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

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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.

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

Science.gov (United States)

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

Preservation of Ceriporiopsis subvermispora and Lentinula edodes treated wheat straw under anaerobic conditions

NARCIS (Netherlands)

Mao, Lei; Sonnenberg, Anton S.M.; Hendriks, Wouter H.; Cone, John W.

2018-01-01

BACKGROUND: No attention has been paid so far to the preservation of fungal-treated lignocellulose for longer periods. In the present study, we treated wheat straw (WS) with the white-rot fungi Ceriporiopsis subvermispora and Lentinula edodes for 8weeks and assessed changes in pH, chemical

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

Science.gov (United States)

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

Medical condition and care of undocumented migrants in ambulatory clinics in Tel Aviv, Israel: assessing unmet needs.

Science.gov (United States)

Mor, Zohar; Raveh, Yuval; Lurie, Ido; Leventhal, Alex; Gamzu, Roni; Davidovitch, Nadav; Benari, Orel; Grotto, Itamar

2017-07-14

Approximately 150,000 undocumented migrants (UM) who are medically uninsured reside in Israel, including ~50,000 originating from the horn of Africa (MHA). Free medical-care is provided by two walk-in clinics in Tel-Aviv. This study aims to compare the medical complaints of UM from different origins, define their community health needs and assess gaps between medical needs and available services. This cross-sectional study included a random sample of 610 UM aged 18-64 years, who were treated in these community clinics between 2008 and 2011. The study compared UM who had complex medical conditions which necessitated referral to more equipped medical settings with UM having mild/simple medical conditions, who were treated at the clinics. MHA were younger, unemployed and more commonly males compared with UM originating from other countries. MHA also had longer referral-delays and visited the clinics less frequently. UM with complex medical conditions were more commonly females, had chronic diseases and demonstrated longer referral-delays than those who had mild/simple medical conditions. The latter more commonly presented with complained of respiratory, muscular and skeletal discomfort. In multivariate analysis, the variables which predicted complex medical conditions included female gender, chronic illnes and self-referral to the clinics. The ambulatory clinics were capable of responding to mild/simple medical conditions. Yet, the health needs of women and migrants suffering from complex medical conditions and chronic diseases necessitated referrals to secondary/tertiary medical settings, while jeopardizing the continuity of care. The health gaps can be addressed by a more holistic social approach, which includes integration of UM in universal health insurance.

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

Science.gov (United States)

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…

The prevalence and ingredient cost of chronic comorbidity in the Irish elderly population with medication treated type 2 diabetes: A retrospective cross-sectional study using a national pharmacy claims database

Directory of Open Access Journals (Sweden)

O’Shea Miriam

2013-01-01

Full Text Available Abstract Background Comorbidity in patients with diabetes is associated with poorer health and increased cost. The aim of this study was to investigate the prevalence and ingredient cost of comorbidity in patients ≥ 65 years with and without medication treated type 2 diabetes using a national pharmacy claims database. Methods The Irish Health Service Executive Primary Care Reimbursement Service pharmacy claims database, which includes all prescribing to individuals covered by the General Medical Services scheme, was used to identify the study population (≥ 65 years. Patients with medication treated type 2 diabetes (T2DM were identified using the prescription of oral anti-hyperglycaemic agents alone or in combination with insulin as a proxy for disease diagnosis. The prevalence and ingredient prescribing cost of treated chronic comorbidity in the study population with and without medication treated T2DM were ascertained using a modified version of the RxRiskV index, a prescription based comorbidity index. The association between T2DM and comorbid conditions was assessed using logistic regression adjusting for age and sex. Bootstrapping was used to ascertain the mean annual ingredient cost of treated comorbidity. Statistical significance at p  Results In 2010, 43165 of 445180 GMS eligible individuals (9.7% were identified as having received medication for T2DM. The median number of comorbid conditions was significantly higher in those with T2DM compared to without (median 5 vs. 3 respectively; p  Conclusions Individuals with T2DM were more likely to have a higher number of treated comorbid conditions than those without and this was associated with higher ingredient costs. This has important policy and economic consequences for the planning and provision of future health services in Ireland, given the expected increase in T2DM and other chronic conditions.

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

Foot Conditions among Homeless Persons: A Systematic Review

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To, Matthew J.; Brothers, Thomas D.; Van Zoost, Colin

2016-01-01

Introduction Foot problems are common among homeless persons, but are often overlooked. The objectives of this systematic review are to summarize what is known about foot conditions and associated interventions among homeless persons. Methods A literature search was conducted on MEDLINE (1966–2016), EMBASE (1947–2016), and CINAHL (1982–2016) and complemented by manual searches of reference lists. Articles that described foot conditions in homeless persons or associated interventions were included. Data were independently extracted on: general study characteristics; participants; foot assessment methods; foot conditions and associated interventions; study findings; quality score assessed using the Downs and Black checklist. Results Of 333 articles screened, 17 articles met criteria and were included in the study. Prevalence of any foot problem ranged from 9% to 65% across study populations. Common foot-related concerns were corns and calluses, nail pathologies, and infections. Foot pathologies related to chronic diseases such as diabetes were identified. Compared to housed individuals across studies, homeless individuals were more likely to have foot problems including tinea pedis, foot pain, functional limitations with walking, and improperly-fitting shoes. Discussion Foot conditions were highly prevalent among homeless individuals with up to two thirds reporting a foot health concern, approximately one quarter of individuals visiting a health professional, and one fifth of individuals requiring further follow-up due to the severity of their condition. Homeless individuals often had inadequate foot hygiene practices and improperly-fitting shoes. These findings have service provision and public health implications, highlighting the need for evidence-based interventions to improve foot health in this population. An effective interventional approach could include optimization of foot hygiene and footwear, provision of comprehensive medical treatment, and

Foot Conditions among Homeless Persons: A Systematic Review.

Science.gov (United States)

To, Matthew J; Brothers, Thomas D; Van Zoost, Colin

2016-01-01

Foot problems are common among homeless persons, but are often overlooked. The objectives of this systematic review are to summarize what is known about foot conditions and associated interventions among homeless persons. A literature search was conducted on MEDLINE (1966-2016), EMBASE (1947-2016), and CINAHL (1982-2016) and complemented by manual searches of reference lists. Articles that described foot conditions in homeless persons or associated interventions were included. Data were independently extracted on: general study characteristics; participants; foot assessment methods; foot conditions and associated interventions; study findings; quality score assessed using the Downs and Black checklist. Of 333 articles screened, 17 articles met criteria and were included in the study. Prevalence of any foot problem ranged from 9% to 65% across study populations. Common foot-related concerns were corns and calluses, nail pathologies, and infections. Foot pathologies related to chronic diseases such as diabetes were identified. Compared to housed individuals across studies, homeless individuals were more likely to have foot problems including tinea pedis, foot pain, functional limitations with walking, and improperly-fitting shoes. Foot conditions were highly prevalent among homeless individuals with up to two thirds reporting a foot health concern, approximately one quarter of individuals visiting a health professional, and one fifth of individuals requiring further follow-up due to the severity of their condition. Homeless individuals often had inadequate foot hygiene practices and improperly-fitting shoes. These findings have service provision and public health implications, highlighting the need for evidence-based interventions to improve foot health in this population. An effective interventional approach could include optimization of foot hygiene and footwear, provision of comprehensive medical treatment, and addressing social factors that lead to increased risk

Health risk assessment linked to filling coastal quarries with treated dredged seaport sediments

Energy Technology Data Exchange (ETDEWEB)

Perrodin, Yves, E-mail: yves.perrodin@entpe.fr [Université de Lyon, ENTPE, UMR CNRS 5023, Laboratoire LEHNA, 2 rue Maurice Audin, 69518 Vaulx-en-Velin (France); Donguy, Gilles [Université de Lyon, ENTPE, UMR CNRS 5023, Laboratoire LEHNA, 2 rue Maurice Audin, 69518 Vaulx-en-Velin (France); Emmanuel, Evens [Laboratoire de Qualité de l' Eau et de l' Environnement, Université Quisqueya, BP 796 Port-au-Prince (Haiti); Winiarski, Thierry [Université de Lyon, ENTPE, UMR CNRS 5023, Laboratoire LEHNA, 2 rue Maurice Audin, 69518 Vaulx-en-Velin (France)

2014-07-01

Dredged seaport sediments raise complex management problems since it is no longer possible to discharge them into the sea. Traditional waste treatments are poorly adapted for these materials in terms of absorbable volumes and cost. In this context, filling quarries with treated sediments appears interesting but its safety regarding human health must be demonstrated. To achieve this, a specific methodology for assessing health risks has been developed and tested on three seaport sediments. This methodology includes the development of a conceptual model of the global scenario studied and the definition of specific protocols for each of its major steps. The approach proposed includes in particular the use of metrological and experimental tools that are new in this context: (i) an experimental lysimeter for characterizing the deposit emissions, and (ii) a geological radar for identifying potential preferential pathways between the sediment deposit and the groundwater. The application of this approach on the three sediments tested for the scenario studied showed the absence of health risk associated with the consumption of groundwater for substances having a “threshold effect” (risk quotient < 1), and an acceptable risk for substances having a “non-threshold effect”, with the notable exception of arsenic (individual risk equal to 3.10{sup −6}). - Highlights: • The release of polluted dredged seaport sediments into the sea must be avoided. • Their use after treatment for the filling-up of quarries is proposed by managers. • An original health risk assessment methodology was created to validate this option. • It includes the use of a lysimeter and a georadar for the exposure assessment stage. • The example studied concludes to a health risk linked to arsenic in the groundwater.

Development of lucerne (Medicago sativa L.) treated with mineral fertilizer and manure at optimal and water deficit conditions.

Science.gov (United States)

Vasileva, V; Kostov, O; Vasilev, E

2006-01-01

A study on the effect of different rates of mineral fertilizer and manure on yield parameters of lucerne under optimal and water deficit conditions was carried out. Leached chernozem soil and lucerne cultivar Victoria were used. The soil was treated with ammonium nitrate and fully matured cattle manure. The plants were grown under optimum moisture content of 80% and 40% of field capacity. The water deficit stress decreased top and root biomass by 11-75% and 3-29% at mineral and organic fertilization, respectively. The applied mineral and organic N strongly depressed nodules development. Both mineral fertilizer and organic manure at dose of 210 mg N kg(-1) soil completely inhibited the appearance of nodules. Next to nitrogen, water deficit stress further inhibited the development of nodules. Nitrogen fertilization increased seed productivity in the two experimental moisture conditions. The water deficit stress decreased seed productivity by 18 to 33% as compared to optimum conditions. The plant treatments with manure were much more resistant to water deficit and recovering ability of plants was faster as compared to treatments with mineral fertilizer. The application of manure stimulates development of drought-stress tolerance in lucerne. However, the results obtained can be considered for the soil type and experimental conditions used.

Evaluate, assess, treat: development and evaluation of the EAT framework to increase effective communication regarding sensitive oral-systemic health issues.

Science.gov (United States)

DeBate, R D; Cragun, D; Gallentine, A A; Severson, H H; Shaw, T; Cantwell, C; Christiansen, S; Koerber, A; Hendricson, W; Tomar, S L; McCormack Brown, K; Tedesco, L A

2012-11-01

Oral healthcare providers are likely to encounter a number of sensitive oral/systemic health issues whilst interacting with patients. The purpose of the current study was to develop and evaluate a framework aimed at oral healthcare providers to engage in active secondary prevention of eating disorders (i.e. early detection of oral manifestations of disordered eating behaviours, patient approach and communication, patient-specific oral treatment, and referral to care) for patients presenting with signs of disordered eating behaviours. The EAT Framework was developed based on the Brief Motivational Interviewing (B-MI) conceptual framework and comprises three continuous steps: Evaluating, Assessing, and Treating. Using a group-randomized control design, 11 dental hygiene (DH) and seven dental (D) classes from eight institutions were randomized to either the intervention or control conditions. Both groups completed pre- and post-intervention assessments. Hierarchical linear models were conducted to measure the effects of the intervention whilst controlling for baseline levels. Statistically significant improvements from pre- to post-intervention were observed in the Intervention group compared with the Control group on knowledge of eating disorders and oral findings, skills-based knowledge, and self-efficacy (all P oral/systemic health issues. Because the EAT Framework was developed by translating B-MI principles and procedures, the framework can be easily adopted as a non-confrontational method for patient communication. © 2012 John Wiley & Sons A/S.

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.

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

Science.gov (United States)

Hu, Sydney X; Luk, Andrew; Leong, Carmen; U, Cecilia; Van, Florence

2013-06-01

The Macau economy and employment of residents rely heavily on the gaming industry. It is important that the working conditions in casinos are not harmful to the health of the casino employees. This study examines the correlations between work conditions, unhealthy lifestyles and occupational health problems amongst casino croupiers in Macau. Its findings will provide casino managers and policy makers with evidence and awareness of the workplace health risks for the casino workers. The data were gathered by a questionnaire survey of 1,042 croupiers, which represents roughly 5 % of the croupier population in Macau. Work conditions were measured by worker satisfaction towards the biological, chemical and physical elements in their work environments. Unhealthy lifestyles were measured by practices of excessive drinking, smoking, electronic game playing and addictive substance use as well as gambling. Occupational health problems were measured by experiences of work related illnesses or symptoms. Results showed that high percentages of respondents were dissatisfied with the work conditions. On average each croupier experienced 10 work related health problems in the past 7 days. Over 5 % of the respondents drank more than three glasses of alcohol a day, 24 % smoked cigarettes, 12 % took addictive substances, 14 % gambled in the past 7 days. The analysis showed that dissatisfaction with work conditions did not correlate with unhealthy lifestyles but were strongly and significantly correlated with stress-related occupational health problems (R = 0.377-0.479, P related policies can be introduced.

Leisure as a resource for successful aging by older adults with chronic health conditions.

Science.gov (United States)

Hutchinson, Susan L; Nimrod, Galit

2012-01-01

Drawing on the model of Selective Optimization with Compensation (SOC) (Baltes & Baltes, 1990), the purpose of this article is to examine leisure-related goals of older adults with chronic conditions and the strategies they use to not only successfully manage their chronic health conditions but live well with them. Semi-structured in-person interviews were conducted with 18 community-dwelling older adults (nine males, nine females, ages 58-87 years) with a variety of chronic conditions. Inductive and deductive within and cross-case thematic analyses resulted in descriptions of changes and continuity in participants' leisure participation following the onset of their chronic condition and construction of four themes: drawing on existing resources for continued involvement, setting leisure-based goals, using strategies to get more out of life, and more than managing: living a life of meaning. Implications for promoting successful aging are discussed, specifically the benefits of incorporating information and skill-building to help older adults recognize that leisure can be a resource for healthy aging and self-managing their chronic health condition.

Are you treating youngsters who are or should be receiving mental health services?

Science.gov (United States)

Waldman, H B

1996-01-01

Psychiatrists now recognize that the disorders of children are serious, treatable conditions and as precursors of adult psychopathology. These conditions can seriously influence the patient's behavior when undergoing dental treatment. The dentist will probably assume that the behavior problems are directly related to the nature of the dental service, rather than particular underlying personality characteristics of preschool and school-age children. It is important that practitioners recognize and understand these conditions as they attempt to provide adequate treatment. No national epidemiological studies have been conducted in this country that would provide valid indicators of either the prevalence or incidence of mental disorders among children. Local studies, however, have been done that diagnosable disorders in children range from 17.6 percent to 22 percent, including 3 percent to 5 percent who have severe emotional or behavioral problems. The prevalence of many mental disorders is greater in males than in females, ranging from a ratio of 2:1 to 9:1. Lifetime prevalence of mental disorders, first diagnosed in infancy, childhood, and adolescence range as high as 15,000 cases per 100,000 persons. It is important for the dentist to recognize that (1) even the youngest of children seen in a dental practice may be in need of mental health services, (2) management problems may stem from mental health problems, and (3) families are unaware or unwilling to admit that a child may need help.

Health condition and residual life of deteriorating technical systems

Energy Technology Data Exchange (ETDEWEB)

Reinertsen, Rune

1998-12-31

Many offshore installations in the Norwegian Sector of the North Sea approach the end of their useful life. The same is true of many power plants and technical systems in general. This thesis describes the theory and improves the methods for the determination of the health condition and residual life of technical systems. Rather than developing new methods it discusses new ways of using existing statistical methods. The main contributions are: (1) A survey of the literature of diagnosis, prediction and life extension for deteriorating technical systems, (2) A discussion of some consequences of selecting the wrong life model, (3) A description of problems related to the determination of mean residual life of non-repairable technical systems, (4) Presentation of the concept of `technical health` to describe the soundness of a system exposed to failure mechanisms, (5) A model for predicting the technical health and residual life of a corroding system, (6) Recommends requirements and methods for using expert knowledge in safety and reliability analysis, (7) A general inspection strategy for system fault diagnosis by using Shannon entropy, (8) Points out weaknesses and strengths of risk measures used in the offshore industry today. 237 refs., 23 figs., 6 tabs.

Health condition and residual life of deteriorating technical systems

Energy Technology Data Exchange (ETDEWEB)

Reinertsen, Rune

1997-12-31

Many offshore installations in the Norwegian Sector of the North Sea approach the end of their useful life. The same is true of many power plants and technical systems in general. This thesis describes the theory and improves the methods for the determination of the health condition and residual life of technical systems. Rather than developing new methods it discusses new ways of using existing statistical methods. The main contributions are: (1) A survey of the literature of diagnosis, prediction and life extension for deteriorating technical systems, (2) A discussion of some consequences of selecting the wrong life model, (3) A description of problems related to the determination of mean residual life of non-repairable technical systems, (4) Presentation of the concept of `technical health` to describe the soundness of a system exposed to failure mechanisms, (5) A model for predicting the technical health and residual life of a corroding system, (6) Recommends requirements and methods for using expert knowledge in safety and reliability analysis, (7) A general inspection strategy for system fault diagnosis by using Shannon entropy, (8) Points out weaknesses and strengths of risk measures used in the offshore industry today. 237 refs., 23 figs., 6 tabs.

Early-life conditions and health at older ages: The mediating role of educational attainment, family and employment trajectories.

Science.gov (United States)

Arpino, Bruno; Gumà, Jordi; Julià, Albert

2018-01-01

We examine to what extent the effect of early-life conditions (health and socioeconomic status) on health in later life is mediated by educational attainment and life-course trajectories (fertility, partnership, employment). Using data from the Survey of Health, Ageing and Retirement in Europe (N = 12,034), we apply, separately by gender, multichannel sequence analysis and cluster analysis to obtain groups of similar family and employment histories. The KHB method is used to disentangle direct and indirect effects of early-life conditions on health. Early-life-conditions indirectly impact on health in later life as result of their influence on education and family and employment trajectories. For example, between 22% and 42% of the effect of low parental socio-economic status at childhood on the three considered health outcomes at older age is explained by educational attainment for women. Even higher percentages are found for men (35% - 57%). On the contrary, the positive effect of poor health at childhood on poor health at older ages is not significantly mediated by education and life-course trajectories. Education captures most of the mediating effect of parental socio-economic status. More specifically, between 66% and 75% of the indirect effect of low parental socio-economic status at childhood on the three considered health outcomes at older age is explained by educational attainment for women. Again, higher percentages are found for men (86% - 93%). Early-life conditions, especially socioeconomic status, influence family and employment trajectories indirectly through their impact on education. We also find a persistent direct impact of early-life conditions on health at older ages. Our findings demonstrate that early-life experiences influence education and life-course trajectories and health in later life, suggesting that public investments in children are expected to produce long lasting effects on people's lives throughout the different phases of their

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

Developing Sustainable Workplaces with Leadership: Feedback about Organizational Working Conditions to Support Leaders in Health-Promoting Behavior

Directory of Open Access Journals (Sweden)

Paul Jiménez

2017-10-01

Full Text Available Organizations should support leaders in promoting their employees’ health in every possible way to achieve a sustainable workplace. A good way to support leaders could include getting feedback about their health-promoting behavior from their employees. The present study introduces an instrument (Health-Promoting Leadership Conditions; HPLC that enables the provision of feedback about the leaders’ efforts to create health-promoting working conditions in seven key aspects: health awareness, workload, control, reward, community, fairness and value-fit. The instrument was used in employee surveys and in an online study, obtaining a sample of 430 participants. The results showed that all seven key aspects of health-promoting leadership can be assigned to a main factor of health-promoting leadership. In addition, the HPLC shows high construct validity with dimensions of stress, resources and burnout (Recovery-Stress- Questionnaire for Work [RESTQ-Work] and Maslach Burnout Inventory General Survey [MBI-GS]. The results indicate that the HPLC can be used as a basis on which to assess health-promoting leadership behavior with a focus on changing working conditions. By getting feedback about their leadership behavior from their employees, leaders can identify their potential and fields for improvement for supporting their employees’ health and developing a sustainable workplace.

Dandruff: How to Treat

Medline Plus

Full Text Available ... C. Fox Award and Lectureship Grants from outside organizations Health Volunteers Overseas Grant Honorary International Society Meeting ... complex. The most effective way to treat and control dandruff is to use dandruff shampoo and scalp ...

Catalogue of systems for the monitoring of working conditions relating to health and safety

NARCIS (Netherlands)

Prins, R.; Verboon, F.

1991-01-01

In this Catalogue a number of systems or instruments for Monitoring Working Conditions and workers Health and Safety have been described. The general aim of the project was three-fold: - to obtain an overall assessment of the existing instruments for identifying risk factors and working conditions

Hospital-based education support for students with chronic health conditions.

Science.gov (United States)

Hopkins, Liza J

2016-04-01

Objective To examine the evidence for best practice in educational support to hospitalised students and describe the existing supports available across each Australian state and territory. Methods A descriptive approach to the diversity of current practice and a review of the published evidence for best practice. Results We have constructed a model of best-practice in education support to hospitalised students. We found that education support services in each state met some of the criteria for best practice, but no one state service met all of the criteria. Conclusions All Australian states and territories make provision for hospitalised students to continue with their education, however the services in some states are closer to the best-practice model than others. What is known about the topic? It is well known that children and young people living with health conditions are at higher risk of educational underachievement and premature disengagement from school than their healthy peers. Although each state and territory across Australia offers some form of educational support to students during periods of hospitalisation, this support differs widely in each jurisdiction in fundamentals such as which students are eligible for support, where the support is delivered, how it is delivered and who coordinates the support. Published evidence in the literature suggests that the elements of good practice in education support have been well identified but, in practice, lack of policy direction can hinder the implementation of coordinated support. What does this paper add? This paper draws together the different models in place to support students in hospital in each state and territory and identifies the common issues that are faced by hospital education support services, as well as identifying areas where practice differs across settings. It also identifies the elements of good practice from the literature and links the elements of theory and practice to present a model of

Motivational factors in discussing sexual health with young people with chronic conditions or disabilities

NARCIS (Netherlands)

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

2014-01-01

The objective of this study was to identify determinants of professionals’ intention to use the new board game SeCZ TaLK to facilitate sexual health discussions with young people with chronic health conditions and disabilities, and to gauge whether intention led to actual use. A cross-sectional

Housing conditions affecting interior moisture levels: links to mould growth and children's respiratory health

Energy Technology Data Exchange (ETDEWEB)

Wells, John A. [Crosier Kilgour and Partners Ltd. (Canada)], email: john.w@ckpeng.com; Polyzois, Dimos [Department of Civil Engineering, University of Manitoba (Canada)], email: polyzoi@cc.umanitoba.ca; Polyzoi, Eleoussa [Faculty of Education, University of Winnipeg (Canada)], email: l.polyzoi@uwinnipeg.ca

2011-07-01

Previous research has demonstrated that a person's respiratory health is affected by high indoor moisture content in their house. The aim of this paper is to provide a better understanding of the link between housing conditions and respiratory health, so that strategies can be implemented to improve the quality of life of children. This study was carried out through the completion of a survey by 3,423 parents in Winnipeg, Canada, the collection of 715 air samples from the residences of 715 parents, and an engineering audit of their homes. This study showed that a strong relationship exists between building moisture content and common home maintenance and that routine maintenance is efficient in significantly reducing the growth of mould which impacts children's respiratory health. This paper provided useful information on the relation between housing conditions and respiratory health problems and the rest of the study will aim at determining which building conditions impact mould growth most.

The impact of IMF conditionality on government health expenditure: A cross-national analysis of 16 West African nations.

Science.gov (United States)

Stubbs, Thomas; Kentikelenis, Alexander; Stuckler, David; McKee, Martin; King, Lawrence

2017-02-01

How do International Monetary Fund (IMF) policy reforms-so-called 'conditionalities'-affect government health expenditures? We collected archival documents on IMF programmes from 1995 to 2014 to identify the pathways and impact of conditionality on government health spending in 16 West African countries. Based on a qualitative analysis of the data, we find that IMF policy reforms reduce fiscal space for investment in health, limit staff expansion of doctors and nurses, and lead to budget execution challenges in health systems. Further, we use cross-national fixed effects models to evaluate the relationship between IMF-mandated policy reforms and government health spending, adjusting for confounding economic and demographic factors and for selection bias. Each additional binding IMF policy reform reduces government health expenditure per capita by 0.248 percent (95% CI -0.435 to -0.060). Overall, our findings suggest that IMF conditionality impedes progress toward the attainment of universal health coverage. Copyright © 2016 Elsevier Ltd. All rights reserved.

Health Care Autonomy in Children with Chronic Conditions: Implications for Self Care and Family Management

Science.gov (United States)

Beacham, Barbara L.; Deatrick, Janet A.

2013-01-01

Synopsis Health care autonomy typically occurs during late adolescence but health care providers and families often expect children with chronic health conditions to master self-care earlier. Few studies have examined the development of health care autonomy as it pertains to self-care and family management. This review will link the three concepts and discuss implications for families and health care providers. Case studies are provided as exemplars to highlight areas where intervention and research is needed. PMID:23659815

Assessment of students’ health condition by indicators of adaptation potential, biological age and bio-energetic reserves of organism

Directory of Open Access Journals (Sweden)

O.V. Martyniuk

2015-06-01

Full Text Available Purpose: to assess students’ health condition by indicators of adaptation potential, biological age and express-assessment. Material: in the research 47 first and second year girl students participated, who belonged to main health group. Results: we distributed the girl students into three groups: 14.89% of them were included in group with “safe” health condition; 34.04% - in group of “third state”; 51.06% were related to group with “ dangerous” health condition. We established that dangerous level was characterized by energy potential of below middle and low level. It is accompanied by accelerated processes of organism’s age destructions and tension of regulation mechanisms. Conclusions: the received results permit to further develop and generalize the data of students’ health’s assessment by indicators of adaptation potentials, biological age and physical health’s condition.

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

Health conditions and lifestyle risk factors of adults living in Puerto Rico: a cross-sectional study.

Science.gov (United States)

Mattei, Josiemer; Tamez, Martha; Ríos-Bedoya, Carlos F; Xiao, Rui S; Tucker, Katherine L; Rodríguez-Orengo, José F

2018-04-12

Puerto Rico is experiencing an economic and healthcare crisis, yet there are scarce recent and comprehensive reports on the population's health profile. We aimed to describe prevalent risk factors and health conditions of adults living in Puerto Rico and assess their interrelationship. Participants (n = 380) aged 30-75y recruited from a 2015 convenience sample in primary care clinics in the San Juan, Puerto Rico metropolitan area answered cross-sectional interviewer-administered questionnaires on sociodemographic characteristics, lifestyle behaviors, self-reported medically-diagnosed diseases, health services, and psychosocial factors. Anthropometric measures were obtained. Logistic regression models assessed factors associated with having ≥2 cardiometabolic conditions or ≥ 2 chronic diseases. Most participants had completed ≥college education (57%), had household income diabetes (21%). Higher odds of having ≥2 cardiometabolic conditions (37%) was observed among participants aged ≥50y, with sedentary physical activity, and self-rated fair/poor diet. Odds of having ≥2 chronic diseases (62%) were higher among ≥50y, sleeping difficulties, > 2 h/day television, and self-rated fair/poor diet. Participants obtained (79%) and trusted (92%) health information from physicians. While most participants with a cardiometabolic condition reported receiving medical recommendations on diet (> 73%) and physical activity (> 67%), fewer followed them ( 73%). Participants following medical recommendations were more likely to report healthy vs. poor behaviors (90% vs. 75%, self-rated diet); (73% vs. 56%, physical activity). Adults living in Puerto Rico have multiple lifestyles risk factors and high prevalence of chronic diseases, namely cardiometabolic and psychological conditions. Comprehensive epidemiological studies are needed to identify contributors to chronic disease, including lifestyle behaviors. Concerted multi-level public health and clinical

After Some Breast Cancer Treatments, Risk for Other Health Conditions May Rise

Science.gov (United States)

... Skin Care Dining & Beverage Personal Care Services Sports & Outdoors Frequently Asked Questions 25th Anniversary Campaign Donors Share ... did not track how severe the co-existing health conditions were. What ... cases, the benefit of taking these treatments outweighs the potential risk ...

Researchers´ perceptions on their health and working conditions in Antioquia, Colombia

Directory of Open Access Journals (Sweden)

Silvia P. Díaz M

Full Text Available Objective: to analyze how male and female scientific researchers working at public and private universities in Antioquia (Colombia perceive their health and working conditions. Methodology: a qualitative study conducted through interviews and a literature review. Participants belonged to research groups classified as A1, A, and B, according to the standards issued by Colciencias (Colombia’s national Department of Science, Technology and Innovation. Results: researchers perceive the relationship between their work and health as a blend of work-related demands, challenges, and personal and collective rewards. Demands on intellectual productivity are high; there is a mismatch between the actual time devoted to work and the time established in the work plans negotiated with the administration for every semester. In some points of the research process, these factors overload the daily work schedules, thus causing physical pain, stress, and malaise. Nevertheless, researchers find their work worthy because of the passion that research arouses in them. Discussion: The high demands defined within the framework of the National System for Science and Technology (Spanish acronym: SNCT have created a field in which intellectual productivity takes priority over the researchers’ health conditions.

Working conditions and health of personnel dealing with ionizing radiation sources

International Nuclear Information System (INIS)

Gus'kova, A.K.

1978-01-01

Analyzed are the results of investigations dedicated to evaluation of working and health conditions of personnel engaged at powerful charged-particle accelerators, in the production of radionuclides, different stages of mining and enrichment of pyrochlore ore, maintenance of radio engineering and radio-physical equipment, those engaged on geological and geophysical research, operators of control desks and apparatuses at nuclear reactors. Observation of separate people has been carried out in control groups numbering 200-250 people. It has been found that the annual levels of irradiation doses are not in excess of maximum permissible doses (MPD), however in cases of long work service the total dose amounts to 150 rem (for 15-20 years). Changes in personnel health conditions are analyzed as dependent on the total irradiation dose. Apart from irradiation, the personnel health is also affected by other factors, specifically: unfavorable meteofactors, working regime etc. Specialized medical control was found to be inexpedient for people whose irradiation level was 1/3 of MPD. However for people whose irradiation level ranges from 1/3 to 1 MPD it is advisable to keep the current volume of oriented medical observation. A special attention in this case should be given to control systems, bronchopulmonary system and the state of cutaneous covering depending on the character of irradiation effects. Problems requiring further comprehensive studies are enumerated

Dandruff: How to Treat

Medline Plus

Full Text Available ... skin, hair, and nails Skin dictionary Camp Discovery Good Skin Knowledge lesson plans and ... Dandruff: How to treat Dandruff is a common scalp condition in which small pieces of dry ...

Discrimination among adults with craniofacial conditions.

Science.gov (United States)

Roberts, Rachel M

2014-01-01

The primary goal of this study was to establish the level of perceived discrimination experienced by adults with congenital craniofacial conditions in Australia and to examine predictors of discrimination. Specifically, this study tested whether social support mediates the relationship between discrimination and health. Adults (n = 93) who had been treated at the Australian Craniofacial Unit, Women's and Children's Hospital, Adelaide for congenital craniofacial conditions (not including cleft lip and/or palate) completed questionnaires examining satisfaction with life, quality of life, anxiety and depression, self-esteem, satisfaction with social support, and satisfaction with appearance. A substantial minority of adults with congenital craniofacial conditions reported that they experience discrimination almost every day in a range of areas. Higher reports of discrimination were related to older age, being male, and less education. Other factors related to higher discrimination included lower levels of satisfaction with life, self-esteem, satisfaction with appearance and mental quality of life, as well as higher levels of anxiety and depression. Social support partially mediated the relationship between discrimination and mental health outcomes. The current study shows that discrimination experiences continue into adulthood confirming the importance of ensuring patients are well supported both by psychosocial services as well as within their own social support networks.

Actively Negotiating the Mind-Body Divide: How Clozapine-Treated Schizophrenia Patients Make Health for Themselves.

Science.gov (United States)

Brown, Julia E H; Dennis, Simone

2017-09-01

It is well recognised that antipsychotic treatments impact the whole body, not just the target area of the brain. For people with refractory schizophrenia on clozapine, the gold standard antipsychotic treatment in England and Australia, the separation of mental and physical regimes of health is particularly pronounced, resulting in multiple, compartmentalised treatment registers. Clinicians often focus on the mental health aspects of clozapine use, using physical indicators to determine whether treatment can continue. Our observations of 59 participants in England and Australia over 18 months revealed that patients did not observe this hierarchisation of mental treatments and physical outcomes. Patients often actively engaged in the management of their bodily symptoms, leading us to advance the figure of the active, rather than passive, patient. In our paper, we do not take the position that the facility for active management is a special one utilised only by these patients. We seek instead to draw attention to what is currently overlooked as an ordinary capacity to enact some sort of control over life, even under ostensibly confined and confining circumstances. We argue that clozapine-treated schizophrenia patients utilise the clinical dichotomy between mental and physical domains of health to rework what health means to them. This permits patients to actively manage their own phenomenological 'life projects' (Rapport, I am Dynamite: an Alternative Anthropology of Power, Routledge, London 2003), and forces us to reconsider the notion of clinical giveness of what health means. This making of one's own meanings of health may be critical to the maintenance of a sense of self.

The assessment of chronic health conditions on work performance, absence, and total economic impact for employers.

Science.gov (United States)

Collins, James J; Baase, Catherine M; Sharda, Claire E; Ozminkowski, Ronald J; Nicholson, Sean; Billotti, Gary M; Turpin, Robin S; Olson, Michael; Berger, Marc L

2005-06-01

The objective of this study was to determine the prevalence and estimate total costs for chronic health conditions in the U.S. workforce for the Dow Chemical Company (Dow). Using the Stanford Presenteeism Scale, information was collected from workers at five locations on work impairment and absenteeism based on self-reported "primary" chronic health conditions. Survey data were merged with employee demographics, medical and pharmaceutical claims, smoking status, biometric health risk factors, payroll records, and job type. Almost 65% of respondents reported having one or more of the surveyed chronic conditions. The most common were allergies, arthritis/joint pain or stiffness, and back or neck disorders. The associated absenteeism by chronic condition ranged from 0.9 to 5.9 hours in a 4-week period, and on-the-job work impairment ranged from a 17.8% to 36.4% decrement in ability to function at work. The presence of a chronic condition was the most important determinant of the reported levels of work impairment and absence after adjusting for other factors (P < 0.000). The total cost of chronic conditions was estimated to be 10.7% of the total labor costs for Dow in the United States; 6.8% was attributable to work impairment alone. For all chronic conditions studied, the cost associated with performance based work loss or "presenteeism" greatly exceeded the combined costs of absenteeism and medical treatment combined.

Sex differences in health status and rehabilitation outcomes in patients with atrial fibrillation treated with ablation

DEFF Research Database (Denmark)

Wagner, Mette Kirstine; Zwisler, Ann-Dorthe Olsen; Risom, Signe Stelling

2018-01-01

(EHRA) score I-II had a positive effect of rehabilitation. CONCLUSION: The results suggest that sex differences exist in self-reported health after rehabilitation in patients ablated for AF. Patients with an I-II EHRA score seem more likely to gain from the rehabilitation programme compared with those......BACKGROUND: Increased physical capacity after comprehensive rehabilitation in patients with atrial fibrillation (AF) undergoing ablation has been found in the CopenHeartRFA trial. The purpose of this study was to investigate: (a) sex differences in health status, psychological distress and quality...... of life, (b) sex differences in rehabilitation outcomes and (c) predictors of effect of rehabilitation. METHODS: We conducted an exploratory analysis of data from the randomized CopenHeartRFA trial, where patients treated with ablation were randomized with 1:1 to comprehensive rehabilitation consisting...

Al-hijamah and oral honey for treating thalassemia, conditions of iron overload, and hyperferremia: toward improving the therapeutic outcomes

Science.gov (United States)

El Sayed, Salah Mohamed; Baghdadi, Hussam; Abou-Taleb, Ashraf; Mahmoud, Hany Salah; Maria, Reham A; Ahmed, Nagwa S; Helmy Nabo, Manal Mohamed

2014-01-01

Iron overload causes iron deposition and accumulation in the liver, heart, skin, and other tissues resulting in serious tissue damages. Significant blood clearance from iron and ferritin using wet cupping therapy (WCT) has been reported. WCT is an excretory form of treatment that needs more research efforts. WCT is an available, safe, simple, economic, and time-saving outpatient modality of treatment that has no serious side effects. There are no serious limitations or precautions to discontinue WCT. Interestingly, WCT has solid scientific and medical bases (Taibah mechanism) that explain its effectiveness in treating many disease conditions differing in etiology and pathogenesis. WCT utilizes an excretory physiological principle (pressure-dependent excretion) that resembles excretion through renal glomerular filtration and abscess evacuation. WCT exhibits a percutaneous excretory function that clears blood (through fenestrated skin capillaries) and interstitial fluids from pathological substances without adding a metabolic or detoxification burden on the liver and the kidneys. Interestingly, WCT was reported to decrease serum ferritin (circulating iron stores) significantly by about 22.25% in healthy subjects (in one session) and to decrease serum iron significantly to the level of causing iron deficiency (in multiple sessions). WCT was reported to clear blood significantly of triglycerides, low-density lipoprotein (LDL) cholesterol, total cholesterol, uric acid, inflammatory mediators, and immunoglobulin antibodies (rheumatoid factor). Moreover, WCT was reported to enhance the natural immunity, potentiate pharmacological treatments, and to treat many different disease conditions. There are two distinct methods of WCT: traditional WCT and Al-hijamah (WCT of prophetic medicine). Both start and end with skin sterilization. In traditional WCT, there are two steps, skin scarification followed by suction using plastic cups (double S technique); Al-hijamah is a three

Association between mental health conditions and rehospitalization, mortality, and functional outcomes in patients with stroke following inpatient rehabilitation.

Science.gov (United States)

Dossa, Almas; Glickman, Mark E; Berlowitz, Dan

2011-11-15

Limited evidence exists regarding the association of pre-existing mental health conditions in patients with stroke and stroke outcomes such as rehospitalization, mortality, and function. We examined the association between mental health conditions and rehospitalization, mortality, and functional outcomes in patients with stroke following inpatient rehabilitation. Our observational study used the 2001 VA Integrated Stroke Outcomes database of 2162 patients with stroke who underwent rehabilitation at a Veterans Affairs Medical Center. Separate models were fit to our outcome measures that included 6-month rehospitalization or death, 6-month mortality post-discharge, and functional outcomes post inpatient rehabilitation as a function of number and type of mental health conditions. The models controlled for patient socio-demographics, length of stay, functional status, and rehabilitation setting. Patients had an average age of 68 years. Patients with stroke and two or more mental health conditions were more likely to be readmitted or die compared to patients with no conditions (OR: 1.44, p = 0.04). Depression and anxiety were associated with a greater likelihood of rehospitalization or death (OR: 1.33, p = 0.04; OR:1.47, p = 0.03). Patients with anxiety were more likely to die at six months (OR: 2.49, p = 0.001). Patients with stroke with pre-existing mental health conditions may need additional psychotherapy interventions, which may potentially improve stroke outcomes post-hospitalization.

[Health and working conditions of high school and university teachers in Mendoza: between commitment and emotional distress].

Science.gov (United States)

Collado, Patricia Alejandra; Soria, Cecilia Beatriz; Canafoglia, Eliana; Collado, Sandra Alicia

2016-01-01

With the objective of analyzing aspects related to the perception of working conditions and their impact on health in the teachers and professors who work for the Universidad Nacional de Cuyo (UNCuyo) in Mendoza, Argentina, this work analyzes the results of the Primer Censo de Condiciones y Salud Laboral [First Census on Health and Working Conditions]. The census was conducted in late 2013 in two academic units (one at the high school level and the other at the university level), including 193 educators. The exploration set out to characterize the teaching staff and the conditions affecting their health, primarily with respect to psycho-social health. In order to do, so a self-administered questionnaire was applied, the dimensions of which were discussed in sensitivity workshops with educators who helped to formulate the data collection instrument. Among the primary results emerge the physical and emotional burnout of these highly skilled workers, owing to the combined effect of their committed response to the demands of their work and the deterioration (both material and symbolic) of the conditions in which they carry out that work.

Research Priorities to Advance the Health and Health Care of Older Adults with Multiple Chronic Conditions.

Science.gov (United States)

Tisminetzky, Mayra; Bayliss, Elizabeth A; Magaziner, Jay S; Allore, Heather G; Anzuoni, Kathryn; Boyd, Cynthia M; Gill, Thomas M; Go, Alan S; Greenspan, Susan L; Hanson, Leah R; Hornbrook, Mark C; Kitzman, Dalane W; Larson, Eric B; Naylor, Mary D; Shirley, Benjamin E; Tai-Seale, Ming; Teri, Linda; Tinetti, Mary E; Whitson, Heather E; Gurwitz, Jerry H

2017-07-01

To prioritize research topics relevant to the care of the growing population of older adults with multiple chronic conditions (MCCs). Survey of experts in MCC practice, research, and policy. Topics were derived from white papers, funding announcements, or funded research projects relating to older adults with MCCs. Survey conducted through the Health Care Systems Research Network (HCSRN) and Claude D. Pepper Older Americans Independence Centers (OAICs) Advancing Geriatrics Infrastructure and Network Growth Initiative, a joint endeavor of the HCSRN and OAICs. Individuals affiliated with the HCSRN or OAICs and national MCC experts, including individuals affiliated with funding agencies having MCC-related grant portfolios. A "top box" methodology was used, counting the number of respondents selecting the top response on a 5-point Likert scale and dividing by the total number of responses to calculate a top box percentage for each of 37 topics. The highest-ranked research topics relevant to the health and healthcare of older adults with MCCs were health-related quality of life in older adults with MCCs; development of assessment tools (to assess, e.g., symptom burden, quality of life, function); interactions between medications, disease processes, and health outcomes; disability; implementation of novel (and scalable) models of care; association between clusters of chronic conditions and clinical, financial, and social outcomes; role of caregivers; symptom burden; shared decision-making to enhance care planning; and tools to improve clinical decision-making. Study findings serve to inform the development of a comprehensive research agenda to address the challenges relating to the care of this "high-need, high-cost" population and the healthcare delivery systems responsible for serving it. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Concurrent Medical Conditions and Health Care Use and Needs among Children with Learning and Behavioral Developmental Disabilities, National Health Interview Survey, 2006-2010

Science.gov (United States)

Schieve, Laura A.; Gonzalez, Vanessa; Boulet, Sheree L.; Visser, Susanna N.; Rice, Catherine E.; Braun, Kim Van Naarden; Boyle, Coleen A.

2012-01-01

Studies document various associated health risks for children with developmental disabilities (DDs). Further study is needed by disability type. Using the 2006-2010 National Health Interview Surveys, we assessed the prevalence of numerous medical conditions (e.g. asthma, frequent diarrhea/colitis, seizures), health care use measures (e.g. seeing a…

Investigation of the role of the calvin cycle and C1 metabolism during HCHO metabolism in gaseous HCHO-treated petunia under light and dark conditions using 13C-NMR.

Science.gov (United States)

Sun, Huiqun; Zhang, Wei; Tang, Lijuan; Han, Shuang; Wang, Xinjia; Zhou, Shengen; Li, Kunzhi; Chen, Limei

2015-01-01

It has been shown that formaldehyde (HCHO) absorbed by plants can be assimilated through the Calvin cycle or C1 metabolism. Our previous study indicated that Petunia hybrida could effectively eliminate HCHO from HCHO-polluted air. To understand the roles of C1 metabolism and the Calvin cycle during HCHO metabolism and detoxification in petunia plants treated with gaseous H(13)CHO under light and dark conditions. Aseptically grown petunia plants were treated with gaseous H(13)CHO under dark and light conditions. The metabolites generated from HCHO detoxification in petunia were investigated using (13)C-NMR. [2-(13)C]glycine (Gly) was generated via C1 metabolism and [U-(13)C]glucose (Gluc) was produced through the Calvin cycle simultaneously in petunia treated with low-level gaseous H(13)CHO under light conditions. Generation of [2-(13)C]Gly decreased whereas [U-(13) C]Gluc and [U-(13)C]fructose (Fruc) production increased greatly under high-level gaseous H(13)CHO stress in the light. In contrast, [U-(13)C]Gluc and [U-(13)C] Fruc production decreased greatly and [2-(13)C]Gly generation increased significantly under low-level and high-level gaseous H(13)CHO stress in the dark. C1 metabolism and the Calvin cycle contributed differently to HCHO metabolism and detoxification in gaseous H(13CHO-treated petunia plants. As the level of gaseous HCHO increased, the role of C1 metabolism decreased and the role of the Calvin cycle increased under light conditions. However, opposite changes were observed in petunia plants under dark conditions. Copyright © 2015 John Wiley & Sons, Ltd.

Mental-Health Conditions, Barriers to Care, and Productivity Loss Among Officers in An Urban Police Department

Science.gov (United States)

Fox, Justin; Desai, Mayur M.; Britten, Karissa; Lucas, Georgina; Luneau, Renee; Rosenthal, Marjorie S.

2014-01-01

Background Police officers are frequently exposed to situations that can negatively impact their mental health. Methods We conducted this study of an urban police department to determine 1) the prevalence of post-traumatic stress disorder (PTSD), depression, and alcohol abuse; 2) patterns of and barriers to mental-health services utilization; and 3) the impact these conditions have on productivity loss. Results Among 150 officers, PTSD (24%), depression (9%), and alcohol abuse (19%) were common. Only 46.7% had ever sought mental-health services; the most commonly cited barriers to accessing services were concerns regarding confidentiality and the potential “negative career impact.” Officers with mental-health conditions had higher productivity loss (5.9% vs 3.4%, P police officers are common, and costly, yet most officers had never accessed mental-health services; many due to modifiable risk factors. PMID:23155671

The outcome of health anxiety in primary care. A two-year follow-up study on health care costs and self-rated health.

Science.gov (United States)

Fink, Per; Ørnbøl, Eva; Christensen, Kaj Sparle

2010-03-24

patients with a well-defined medical condition. Severe Health anxiety was found to be a disturbing and persistent condition. It is costly for the health care system and must be taken seriously, i.e. diagnosed and treated. This study supports the validity of recently introduced new criteria for Health anxiety.

The outcome of health anxiety in primary care. A two-year follow-up study on health care costs and self-rated health.

Directory of Open Access Journals (Sweden)

Per Fink

significantly less health care costs than the group of patients with a well-defined medical condition. CONCLUSIONS/SIGNIFICANCE: Severe Health anxiety was found to be a disturbing and persistent condition. It is costly for the health care system and must be taken seriously, i.e. diagnosed and treated. This study supports the validity of recently introduced new criteria for Health anxiety.

Association between employment status and self-rated health: Korean working conditions survey.

Science.gov (United States)

Kwon, Kimin; Park, Jae Bum; Lee, Kyung-Jong; Cho, Yoon-Sik

2016-01-01

This research was conducted with an aim of determining the association between employment status and self-rated health. Using the data from the Third Korean Working Conditions Survey conducted in 2011, We included data from 34,783 respondents, excluding employers, self-employed workers, unpaid family workers, others. Self-rated health was compared according to employment status and a logistic regression analysis was performed. Among the 34,783 workers, the number of permanent and non-permanent workers was 27,564 (79.2 %) and 7,219 (20.8 %). The risk that the self-rated health of non-permanent workers was poor was 1.20 times higher when both socio-demographic factors, work environment and work hazards were corrected. In this study, perceived health was found to be worse in the non-permanent workers than permanent workers. Additional research should investigate whether other factors mediate the relationship between employment status and perceived health.

Learning to Promote Health at an Emergency Care Department: Identifying Expansive and Restrictive Conditions

Science.gov (United States)

Gustavsson, Maria; Ekberg, Kerstin

2015-01-01

This article reports on the findings of a planned workplace health promotion intervention, and the aim is to identify conditions that facilitated or restricted the learning to promote health at an emergency care department in a Swedish hospital. The study had a longitudinal design, with interviews before and after the intervention and follow-up…

Periodontal health through public health - the case for oral health promotion

DEFF Research Database (Denmark)

Watt, Richard G; Petersen, Poul E

2012-01-01

these factors but also must recognize and act upon the distal underlying influences that determine and pattern these identified risks. Recognition also needs to be placed on the interlinking and common risk factors shared by periodontal diseases and other chronic conditions. A complementary range of public......Periodontal diseases are highly prevalent, particularly amongst socially disadvantaged populations, impact on quality of life and are costly to treat. Clinical treatments and chairside preventive approaches alone will never adequately address this problem. Indeed in many parts of the developing...... world clinical care and chairside prevention are both unaffordable and inappropriate for the control of periodontal diseases. A paradigm shift away from the individualized treatment approach to a population public health model is needed to promote periodontal health and, in particular to address social...

Sensitivity analysis of bridge health index to element failure and element conditions.

Science.gov (United States)

2009-11-01

Bridge Health Index (BHI) is a bridge performance measure based on the condition of the bridge elements. It : is computed as the ratio of remaining value of the bridge structure to the initial value of the structure. Since it : is expressed as a perc...

Health care autonomy in children with chronic conditions: implications for self-care and family management.

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Beacham, Barbara L; Deatrick, Janet A

2013-06-01

Health care autonomy typically occurs during late adolescence but health care providers and families often expect children with chronic health conditions to master self-care earlier. Few studies have examined the development of health care autonomy as it pertains to self-care and family management. This review links the 3 concepts and discusses the implications for families and health care providers. Case studies are provided as exemplars to highlight areas where intervention and research is needed. Copyright © 2013 Elsevier Inc. All rights reserved.

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

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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

Thirty Years of Orphan Drug Legislation and the Development of Drugs to Treat Rare Seizure Conditions: A Cross Sectional Analysis

OpenAIRE

D?ring, Jan Henje; Lampert, Anette; Hoffmann, Georg F.; Ries, Markus

2016-01-01

Background Epilepsy is a serious chronic health condition with a high morbidity impairing the life of patients and afflicted families. Many epileptic conditions, especially those affecting children, are rare disorders generating an urgent medical need for more efficacious therapy options. Therefore, we assessed the output of the US and European orphan drug legislations. Methods Quantitative analysis of the FDA and EMA databases for orphan drug designations according to STrengthening the Repor...

Oral health in patients treated by positive airway pressure for obstructive sleep apnea: a population-based case-control study.

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Carra, M C; Thomas, F; Schmitt, A; Pannier, B; Danchin, N; Bouchard, Ph

2016-03-01

Recent epidemiological evidence suggests that patients with obstructive sleep apnea (OSA) have an increased risk of periodontal disease. Little is known about the oral health of OSA patients treated by continuous or bi-level positive airway pressure (CPAP/BiPAP). The aim of this population-based case-control study was to compare oral health variables (amount of plaque, calculus, gingival inflammation, and masticatory function) between CPAP/BiPAP users and control subjects. The study population was retrieved from a French cohort examined between 2012 and 2013 at the Centre d'Investigations Préventives et Cliniques of Paris. Cases were selected if they reported to be treated by CPAP/BiPAP; controls were age-, gender-, and BMI-matched based on a 1:2 ratio. Univariate and logistic regression analyses were performed for group comparisons. Over a total of 20,436 subjects, 287 CPAP/BiPAP users (mean age (SD) 57.6 years (11.5); 76.3 % males) who underwent medical and dental examinations were compared with 574 matched controls (no OSA, no CPAP/BiPAP). CPAP/BiPAP users reported significantly higher prevalence of diabetes (15.6 vs. 10.3 %; p = 0.012; odds ratio (OR) 1.68), history of hypertension (36.5 vs. 26.1 %; p = 0.003; OR 1.62), cardiovascular diseases (14.1 vs. 8.8 %; p = 0.029; OR 1.69), and sleep complaints (59 vs. 34.4 %; p = 0.0001; OR 2.75). CPAP/BiPAP users also showed higher levels of depression and stress compared to controls. However, no group difference was observed for the amount of dental plaque, calculus, gingival inflammation, and masticatory function. Oral health of OSA patients treated by CPAP/BiPAP is comparable to that of matched controls in terms of amount of plaque, gingival inflammation, and masticatory function.

Chromosomal Conditions

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... and more. Stony Point, NY 10980 Close X Home > Complications & Loss > Birth defects & other health conditions > Chromosomal conditions Chromosomal conditions ... Disorders See also: Genetic counseling , Your family health history Last reviewed: February, 2013 ... labor & premature birth The newborn intensive care unit (NICU) Birth defects & ...

Predicting the impact of chronic health conditions on workplace productivity and accidents: results from two US Department of Energy national laboratories.

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Frey, Jodi Jacobson; Osteen, Philip J; Berglund, Patricia A; Jinnett, Kimberly; Ko, Jungyai

2015-04-01

Examine associations of chronic health conditions on workplace productivity and accidents among US Department of Energy employees. The Health and Work Performance Questionnaire-Select was administered to a random sample of two Department of Energy national laboratory employees (46% response rate; N = 1854). The majority (87.4%) reported having one or more chronic health conditions, with 43.4% reporting four or more conditions. A population-attributable risk proportions analysis suggests improvements of 4.5% in absenteeism, 5.1% in presenteeism, 8.9% in productivity, and 77% of accidents by reducing the number of conditions by one level. Depression was the only health condition associated with all four outcomes. Results suggest that chronic conditions in this workforce are prevalent and costly. Efforts to prevent or reduce condition comorbidity among employees with multiple conditions can significantly reduce costs and workplace accident rates.

Public health system readiness to treat malaria in Odisha State of India.

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Hussain, Mohammad A; Dandona, Lalit; Schellenberg, David

2013-10-02

Early diagnosis and prompt treatment is a cornerstone of malaria control. In India, artemisinin combination therapy (ACT) became the first-line treatment for falciparum malaria and rapid diagnostic test (RDTs) kits were recommended for use at the grass-root level in the new malaria treatment policy (2010). Odisha State contributes about one-fourth of the total Indian malaria burden and 40% of falciparum infection. The present study assessed the health system readiness to deploy RDTs and ACT for malaria control across the State. Data collection was carried out from February to July 2012. Five of Odisha's 30 districts were selected through stratified random sampling, with stratification based on the phased roll-out of ACT and RDT. Two administrative 'blocks' were selected randomly in each district and data collected through health facility, auxiliary nurse midwives (ANMs) and accredited social health activist (ASHAs) assessments. Key informant interviews were conducted with individuals involved in the implementation of the malaria control programme. Of the 220 ANMs interviewed, 51.4% had been trained in malaria case management, including the use of ACT and RDT. A high proportion of ANM (80%) and AHSA (77%) had the necessary level of knowledge to be able to use RDT for malaria diagnosis. The proportion of ASHAs trained on malaria case management was 88.9% (209/235). However, 71% of ANM and 55% of ASHAs usually referred falciparum-positive patients to the health facility for treatment, the major reason for referral being the non-availability of drugs at the ANM and ASHA level. The relatively high level of knowledge about how to diagnose and treat malaria at the grass-root level was undermined by the poor availability of RDTs, ACT and primaquine tablets. This was associated with an unnecessarily high referral rate and potential delays in the treatment of this potentially life-threatening infection. Improvements in the supply chain for RDTs and ACT could dramatically

Electrolyte Concentrates Treat Dehydration

Science.gov (United States)

2009-01-01

Wellness Brands Inc. of Boulder, Colorado, exclusively licensed a unique electrolyte concentrate formula developed by Ames Research Center to treat and prevent dehydration in astronauts returning to Earth. Marketed as The Right Stuff, the company's NASA-derived formula is an ideal measure for athletes looking to combat dehydration and boost performance. Wellness Brands also plans to expand with products that make use of the formula's effective hydration properties to help treat conditions including heat stroke, altitude sickness, jet lag, and disease.

Provoked Vestibulodynia and the Health Care Implications of Comorbid Pain Conditions.

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Lester, Robynn A; Brotto, Lori A; Sadownik, Leslie A

2015-11-01

Sexual pain secondary to provoked vestibulodynia (PVD) is a chronic pain condition affecting up to 16% of women. Women with PVD may report other chronic pain conditions. The goals of this study were (1) to identify the prevalence of self-reported chronic pain conditions in a sample of women with a diagnosis of PVD and seeking treatment, and (2) to compare demographic and clinical characteristics and health care needs of women with PVD alone and women with PVD and two or more self-reported chronic pain conditions. We assessed the characteristics of 236 women with PVD alone and 55 women with PVD and comorbid chronic pain using a standardized questionnaire, the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Pain Vigilance and Awareness Questionnaire, and the Female Sexual Distress Scale. Compared with women with PVD alone, women with PVD and other concurrent pain reported a significantly longer duration of pain, pain radiating to other parts of the vulva, and pain interfering in a variety of daily activities. This group was also significantly more likely to have seen more gynaecologists, and to have had more office visits with their gynaecologist than women with PVD alone. They were more likely to have tried anticonvulsants, antidepressants, and stress/relaxation therapy for their PVD and were also more likely to have allergies and skin sensitivities. Finally, this group of women had higher symptoms of depression, trait anxiety, and showed a trend towards more pain vigilance. Taken together, these findings suggest that physicians caring for women with PVD and concurrent chronic pain must be alert to the potentially greater health needs among this subsample of women.

Selective Mutism: Treating the Silent Child

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Shott, Elizabeth F.; Warren, Mary Ellen

2011-01-01

Infant mental health specialists are increasingly expected to treat complex mental health disorders in very young children. Selective mutism is an anxiety disorder which can lead to functional impairment across home, preschool, and community settings. The authors share their experiences with Keylah, a preschooler with significant social anxiety…

Hypertension and hyperlipidemia management in patients treated at community health centers.

Science.gov (United States)

Kirchhoff, Anne C; Drum, Melinda L; Zhang, James X; Schlichting, Jennifer; Levie, Jessica; Harrison, James F; Lippold, Susan A; Schaefer, Cynthia T; Chin, Marshall H

2008-01-01

OBJECTIVE: Community health centers (HCs) provide care for millions of medically underserved Americans with disproportionate burdens of hypertension and hyperlipidemia. For both conditions, treatment guidelines recently became more stringent and quality improvement (QI) efforts have intensified. We assessed hypertension and hyperlipidemia management in HCs during this time of guideline revision and increased QI efforts. DESIGN: Cross-sectional chart review. SETTING AND PARTICIPANTS: Eleven Midwestern HCs for 2000 and 9 for 2002 provided audit data from 2,976 randomly chosen patients with hypertension and/or hyperlipidemia. MEASUREMENT: Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC VI/VII) and National Cholesterol Education Program Adult Treatment Panel (NCEP-ATP III) guidelines were used to assess management of these conditions. RESULTS: Hypertension (2000, N=808; 2002, N=692) and hyperlipidemia (2000, N=774; 2002, N=702) outcomes improved for specific clinical subgroups. Hypertensive patients with 1 or more cardiovascular risk factors demonstrated significant improvement (34% vs. 45% controlled at risk factors (39% vs. 58% controlled at risk groups; however, ongoing QI is necessary.

Role and working conditions of nurses in public health in Mexico and Peru: a binational qualitative study.

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De Córdova, Maria Isabel Peñarrietade; Mier, Nelda; Quirarte, Nora Hilda Gonzales; Gómez, Tranquilina Gutiérrez; Piñones, Socorro; Borda, Alejandro

2013-11-01

This exploratory study conducted in Mexico and Peru investigated nurses' perceptions about their role in public health and working conditions. Health reform efforts in many countries are redefining the role of health professionals in public health. Little is known about the role of nurses working in public health contexts in Latin America. Fourteen focus groups were conducted in Mexico and Peru with 82 nurses working in government-sponsored community health centres. Data were analysed using a content analysis technique. Themes identified were: nurses' job descriptions in public health settings; organisational factors influencing the nurses' work, and influence of academic and social image factors. Management barriers and limited training influences the role and working conditions of public health nurses in Mexico and Peru. The professional role of nurses working in public health in Latin America is not well defined because of the health-care system infrastructure and the lack of a clear public health nurse job description. Further research is needed to better understand the role of public health nurses and strengthen their training, particularly in relation to nursing management encompassing abilities for decision-making processes and public health program planning and evaluation. © 2012 John Wiley & Sons Ltd.

Health warnings on tobacco packaging in Italy: do they describe all possible smoking-related conditions?

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Vittoria Colamesta

2014-06-01

Full Text Available This report aims to evaluate the adherence between the health warnings on tobacco products in Italy and the smoking-related conditions known in the scientific literature. The Legislative Decree 2003 and 2012 established the general and the additional warnings on tobacco packaging. Regarding the smoking-related conditions, the health damages presented in the Centers for Disease Control and Prevention (CDC report are reported. Also a narrative review was performed. Respiratory and cardiovascular diseases, adverse reproductive outcomes and childhood neurobehavioral disorders are well reported in the textual health warning. Also there is at least one message indicating that the exposure of secondhand smoke is harmful. Conversely, several smoking-related cancers and other adverse health effects (diabetes, hip fractures, low bone density in postmenopausal women, rheumatoid arthritis, mental decline, acne and allergy, etc are not considered. The health warnings represent an important mean for communicating that may change smokers’ attitudes and behaviours, therefore, it’s important to implement them, also considering the introduction of graphical warnings, to maintain their effectiveness over time.

Forest health conditions in North America

International Nuclear Information System (INIS)

Tkacz, Borys; Moody, Ben; Castillo, Jaime Villa; Fenn, Mark E.

2008-01-01

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

Treatment patterns, health care resource utilization, and costs in Japanese adults with attention-deficit hyperactivity disorder treated with atomoxetine

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Imagawa H

2018-02-01

Full Text Available Hideyuki Imagawa,1 Saurabh P Nagar,2 William Montgomery,3 Tomomi Nakamura,1 Masayo Sato,1 Keith L Davis2 1Medical Development Unit Japan, Eli Lilly Japan K.K., Kobe, Japan; 2RTI Health Solutions, Research Triangle Park, NC, USA; 3Global Patient Outcomes and Real World Evidence, Eli Lilly Australia, NSW, Australia Objective: To describe the characteristics and medication treatment patterns of adult patients with attention-deficit/hyperactivity disorder (ADHD prescribed atomoxetine in Japan. Materials and methods: A retrospective analysis of insurance claims data was conducted using the Japan Medical Data Center database. Adults (≥18 years with ADHD who had ≥1 atomoxetine claim from January 1, 2013 to December 31, 2014, and ≥180 to ≤900 days of follow-up were included. First atomoxetine claim defined the index date. Patient characteristics included age, gender, and comorbid conditions. Treatment patterns assessed included rates of atomoxetine discontinuation, switching, persistence, adherence (assessed via the medication possession ratio, and use of concomitant medications. Results: A total of 457 adults met all the inclusion criteria. Mean (SD age was 32.7 (10.4 years, and 61.0% of patients were male. Nearly 72.0% of the patients had at least one comorbid mental health condition in the baseline period; depression (43.8% and insomnia (40.7% were the most common mental health comorbidities. Most common physical comorbidities were chronic obstructive pulmonary disease (14.4% and diabetes (12.9%. Non-ADHD-specific psychotropics were prescribed to 59.7% of patients during the baseline period and to 65.9% during the follow-up period; 6.6% were prescribed non-ADHD-specific psychotropics concomitantly with atomoxetine. Overall, 40.0% of adults discontinued atomoxetine during the entire follow-up period and 65.9% were persistent with atomoxetine therapy at 3 months post-index date. Mean (SD atomoxetine medication possession ratio was 0.57 (0

Psychosocial functioning in adults with congenital craniofacial conditions.

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Roberts, R M; Mathias, J L

2012-05-01

To examine the psychosocial functioning of adults with congenital craniofacial conditions relative to normative data. Single sample cross-sectional design. The Australian Craniofacial Unit, Women's and Children's Hospital, Adelaide, which is one of the main craniofacial treatment centers in Australia. Adults (N  =  93) with congenital craniofacial conditions (excluding cleft lip/palate) who were treated in the Australian Craniofacial Unit. All participants completed self-report scales assessing health-related quality of life (SF-36); life satisfaction, anxiety, and depression (HADS); self-esteem (Rosenberg); appearance-related concerns; perceived social support; and social anxiety. Overall, participants were very similar in psychosocial function to the general population. However, adults with craniofacial conditions were less likely to be married and have children (females), were more likely to be receiving a disability pension, and reported more appearance-related concerns and less social support from friends. They also reported more limitations in both their social activities, due to physical or emotional problems, and usual role activities, because of emotional problems, as well as poorer mental health. These results give cause to be very positive about the long-term outcomes of children who are undergoing treatment for craniofacial conditions, while also identifying specific areas that interventions could target.

[Health-related quality of life and conditions of health in non-institutionalised elderly people in Cali, Colombia].

Science.gov (United States)

Ramírez-Vélez, Róbinson; Agredo, Ricardo A; Jerez, Alejandra M; Chapal, Liliam Y

2008-01-01

Studying the quality of life and conditions of health for non-institutionalised elderly patients. This was a cross-sectional study of elderly people aged over 65 years having no physical or psychic limitation disturbing communication between patient and doctor. The patients filled out the validated Spanish versión of the SF-12 health survey. Social-demographic and anthropometric variables were collected from clinical histories or patient interviews. Mean age was 69,2+/-6,4 (69,8-74,3 95 % Cl, prisk factors, these being more pronounced on physical scales and slightly so on mental scales. Assessing subjective quality of life should become an every-day tool in our clinical practice.

Treating Cushing's Disease in Dogs

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... For Consumers Consumer Updates Treating Cushing's Disease in Dogs Share Tweet Linkedin Pin it More sharing options ... FDA Consumer Health Information Your 9-year old dog has been drinking a lot more lately and ...

Technical issues and conservation conditions of medicines in the primary health care of the Brazilian Unified Health System

Science.gov (United States)

Costa, Ediná Alves; Araújo, Patrícia Sodré; Pereira, Marcelo Tavares; Souto, Ana Cristina; Souza, Gisélia Santana; Guerra, Augusto Afonso; Acurcio, Francisco de Assis; Guibu, Ione Aquemi; Alvares, Juliana; Costa, Karen Sarmento; Karnikowski, Margô Gomes de Oliveira; Soeiro, Orlando Mario; Leite, Silvana Nair

2017-01-01

ABSTRACT OBJECTIVE To characterize the technical issues and conditions of medicines conservation in Primary Health Care of Brazilian regions, responsible for pharmacy/dispensing unit profile; environmental, storage, and dose fractioning conditions; inventory control and waste management; fire and electrical failure safety items; transportation problems; advertising regulation; and pharmacovigilance. METHODS This article is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços (National Survey on Access, Use and Promotion of Rational Use of Medicines – Services)–, a cross-sectional and exploratory study, of evaluative nature, consisting of an information survey within a representative sample of municipalities, stratified by Brazilian regions, which constitute the study domains, and a sample of Primary Health Care services. Pharmaceutical services (PS) were directly observed with photographic record and face-to-face interviews with those responsible for the dispensing of medicines and over the telephone with those responsible for pharmaceutical services. Data were processed with the SPSS® software version 21. RESULTS The investigated dimensions showed relevant deficiencies and inequalities between the regions, generally more favorable in the Southeast and Midwest regions and weaker in the Northeast and North regions. We verified non-compliance with technical requirements and conditions essential to the conservation of medicines, which may interfere with the maintenance of stability and, thus, on their quality, efficacy, and safety. The regulation of advertising/promotion of medicines is still incipient and there is some progress in the structuring of mechanisms regarding pharmacovigilance. CONCLUSIONS The sanitary situation of medicines in Brazilian Primary Health Care is alarming due to the violation of the specific sanitary legislation for dispensing establishments and due to a wide range of

[Impacts on physical and mental health of patients with polycystic ovary syndrome treated with electroacupuncture:a randomized controlled trial].

Science.gov (United States)

Jin, Chunlan; Pang, Ran; Huang, Jianmei; Jing, Xianghong; Wu, Zhongchao; Zhao, Jiping

2016-06-12

To explore the impacts on physical and mental health of the patients with polycystic ovary syndrome (PCOS) treated with electroacupuncture (EA) or Diane 35. Seventy-two patients of PCOS were randomized into an acupuncture group and a western medication group, 36 cases in each group. In the acupuncture group, acupuncture was applied to relieving liver stagnation and regulating qi activity at Ganshu (BL 18), Danzhong (CV 17), Qimen (LR 14), Zhongwan (CV 4), Tianshu (ST 25), Guanyuan (CV 4), Zigong (EX-CA 1), Sanyinjiao (SP 6), Zusanli (ST 36) and Taichong (LR 3). After qi arrival, the electric stimulation was added for 30 min. Acupuncture treatment was given 3 times a week. In the western medication group, Diane 35 was taken since the 5th day of menstruation and lasted for 21 days. The cycle of treatment was 3 months in the two groups. Before treatment and at the end of treatment, the symptom scores were evaluated and the self-report symptom inventory, symptom checklist-90 (SCL-90) was used for the mental health evaluation and the comparison was made between the two groups. Compared with those before treatment in the same group, the symptom scores were reduced significantly after treatment in the two groups (both P medication group (all P <0.05). EA with relieving liver stagnation and regulating qi activity reduces the symptom scores of PCOS and SCL-90 scores, acting on regulating both physical and mental conditions. The effects achieved with acupuncture are better than those with Diane 35.

EVALUATION OF LABOR CONDITIONS BY PUBLIC HEALTH WORKERS IN THE RUSSIAN FAR EAST

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Yu. V. Kirik

2018-01-01

Full Text Available The aim of the study is to analyze the conditions and organization of work of public health workers of state medical organizations in the Far East of Russia according to a medical and sociological survey. Materials and methods. A questionnaire survey was chosen. There are 835 people took part in the poll. To gather social information, three groups of respondents were selected: 1 senior and middle managers, 2 heads of structural units; 3 doctors, various clinical specialties, included in the reserve of management personnel. The collection of statistical data was conducted in 2015- 2017. Statistical analysis of the data was carried out using the methods of calculating relative values, calculating the average values, and ANOVA. Results. According to the obtained results, all groups of respondents believe that present healthcare industry in Russia is developed satisfactorily. Participants in the survey estimate the current state of resources of public health institutions rather low. According to the survey results, health workers give an unsatisfactory assessment of the technical condition of the buildings of medical organizations, of the provision of doctors and middle medical personnel. Among the proposed motivational factors of labor activity, healthcare workers and give a satisfactory assessment of such factors as: the discipline of work, the amount of work, the safety in the workplace, the stability of the workplace and interpersonal relations with colleagues. Opinion of medical workers does not coincide in the assessment of factors: wages, technical support of the workplace, the volume of document circulation, the opportunity for professional development, self-realization and career growth. Senior and middle managers assess these factors as «satisfactory», doctors give an assessment of «unsatisfactory». Heads of structural subdivisions assess the factors of technical support for the workplace, the size of wages and volume of document

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

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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.

Health-Related Quality of Life of Young Adults Treated with Recombinant Human Growth Hormone during Childhood.

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Grit Sommer

Full Text Available Since recombinant human growth hormone (rhGH became available in 1985, the spectrum of indications has broadened and the number of treated patients increased. However, long-term health-related quality of life (HRQoL after childhood rhGH treatment has rarely been documented. We assessed HRQoL and its determinants in young adults treated with rhGH during childhood.For this study, we retrospectively identified former rhGH patients in 11 centers of paediatric endocrinology, including university hospitals and private practices. We sent a questionnaire to all patients treated with rhGH for any diagnosis, who were older than 18 years, and who resided in Switzerland at time of the survey. Three hundred participants (58% of 514 eligible returned the questionnaire. Mean age was 23 years; 56% were women; 43% had isolated growth hormone deficiency, or idiopathic short stature; 43% had associated diseases or syndromes, and 14% had growth hormone deficiency after childhood cancer. Swiss siblings of childhood cancer survivors and the German norm population served as comparison groups. HRQoL was assessed using the Short Form-36. We found that the Physical Component Summary of healthy patients with isolated growth hormone deficiency or idiopathic short stature resembled that of the control group (53.8 vs. 54.9. Patients with associated diseases or syndromes scored slightly lower (52.5, and former cancer patients scored lowest (42.6. The Mental Component Summary was similar for all groups. Lower Physical Component Summary was associated with lower educational level (coeff. -1.9. Final height was not associated with HRQoL.In conclusion, HRQoL after treatment with rhGH in childhood depended mainly on the underlying indication for rhGH treatment. Patients with isolated growth hormone deficiency/idiopathic short stature or patients with associated diseases or syndromes had HRQoL comparable to peers. Patients with growth hormone deficiency after childhood cancer were

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.

Characteristic of New Solid-Phase Extraction Sorbent: Activated Carbon Prepared from Rice Husks under Base Treated Condition

Directory of Open Access Journals (Sweden)

Afrida Kurnia Putri

2012-10-01

Full Text Available A characterization of activated carbon (ACs prepared from rice husks (RHs under base treated condition as a new sorbent for solid-phase extraction (SPE to extract 4-nonylphenol isomers (4-NPs in water samples has been done. The ACs prepared from RHs usually exhibits low specific surface area due to its high ash content, but in case of its application for SPE, there are other factors need to be considered, such as the existence of functional groups inside the sorbent, that can enhance interaction of non-polar sorbent with analyte in the water matrices. In this case, silanol groups from ash content may affect the extraction efficiency for 4-NPs. The ACs made from RHs were chemically impregnated with ZnCl2 and carbonized at 800oC. To investigate the role of silica, three types of ACs were prepared, i.e., untreated ACs (AC–Si, contain silica, base treated ACs (AC–B–Si, remain some silica inside, and ACs made by base treated RHs (AC–B, no silica, the surface area obtained from these treatments were 1352 m2/g, 1666 m2/g, and 1712m2/g respectively.  ACs made by base treatment has the highest surface area (related to BET, which indicat that silica removal process promotes the formation of open pore system on ACs and enhances the surface area of ACs. However, extraction efficiency measured by GC-MS in SPE process showed the reversal trends (i.e., AC–Si= 32.08%, AC–B–Si= 82.63%, AC–B=51.78%, among them the AC–B–Si sorbent reveal the best performance in SPE process. It is indicated that although silica usually exhibits low specific surface area, but control presence of silica as a polar functional group has a positive influence in the interaction between non-polar sorbent and 4-NPs.

Recent advances in understanding and treating COPD related to α1-antitrypsin deficiency.

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Henao, Maria Paula; Craig, Timothy J

2016-12-01

Alpha-1-antitrypsin deficiency (AATD) is an orphan disease that predisposes individuals to COPD and liver disease. The following is a comprehensive review of AATD from epidemiology to treatment for physicians who treat COPD or asthma. Areas covered: In this comprehensive review of alpha-1-antitrypsin deficiency, we describe the historical perspective, genetics, epidemiology, clinical presentation and symptoms, screening and diagnosis, and treatments of the condition. Expert commentary: The two most important directions for advancing the understanding of AATD involve improving detection of the condition, especially in asymptomatic patients, and advancing knowledge of treatments directed specifically at AATD-related conditions. With regard to treatment for AATD-related conditions, research must continue to explore the implications and importance of augmentation therapy as well as consider new implementations that may prove more successful taking into consideration not only factors of pulmonary function and liver health, but also product availability and financial viability.

[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.

Study on light water reactor fuel behavior under reactivity initiated accident condition in TREAT

International Nuclear Information System (INIS)

Ohnishi, Nobuaki; Ishijima, Kiyomi; Ochiai, Masaaki; Tanzawa, Sadamitsu; Uemura, Mutsumi

1981-05-01

This report reviews the results of the fuel failure experiments performed in TREAT in the U.S.A. simulating Reactivity Initiated Accidents. One of the main purposes of the TREAT experiments is the study of the fuel failure behavior, and the other is the study of the molten fuel-water coolant interaction and the consequent hydrogen behavior. This report mainly shows the results of the TREAT experiments studying the fuel failure behavior in Light Water Reactor, and then it describes the fuel failure threshold and the fuel failure mechanism, considering the results of the photographic experiments of the fuel failure behavior with transparent capsules. (author)

Best Medications to Treat Fibromyalgia

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... open('/content/cro/en/health/prescription-drugs/best-buy-drugs/Evaluating_Prescription_Drugs_Used_to_Treat_Fibromyalgia.print. ... price, we have chosen three Consumer Reports Best Buy Drugs as initial options to consider if you and ...

Musculoskeletal health conditions among older populations in urban slums in sub-Saharan Africa.

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Aboderin, Isabella; Nanyonjo, Agnes

2017-04-01

Debate on the burden of musculoskeletal (MSK) conditions in lower and middle income countries is intensifying; yet, little knowledge so far exists on patterns and impacts of such conditions among general or older adult populations in sub-Saharan Africa (SSA). The objectives of this study are to examine the prevalence, potential predictors, and sequelae of MSK among older adults residing in two low resource informal urban settlements or "slums" in Nairobi Kenya. Data on older adults aged 60 years and over from two unrelated cross-sectional surveys on the older slum populations are used: a 2006/7 survey on the social, health, and overall well-being of older people (sample N = 831), and a 2016 survey on realities and impacts of long-term care and social protection for older adults (sample n = 1026). Uni and multivariate regressions on the 2006/7 data are employed to examine relationships of back pain and symptoms of arthritis with sex, age, wealth, unemployment, diagnoses of hypertension, and diabetes; and with indicators of subjective well-being and functional ability. Descriptive frequencies and chi-squared tests of association are used on 2016 data to identify the overall prevalence and locations of activity limiting MSK pain, and sex differences in these. Prevalence of past month back pain and past 2 week symptoms of arthritis was 44% and 42.6%, respectively. Respective prevalence of past month activity limiting back pain and joint pain was 13.9% and 22.7%. A total of 42.6% of slum residents with a current health problem report MSK as the most severe problem. In multivariate regressions, female sex, unemployment, and diagnosis of hypertension are predictive of back pain and symptoms of arthritis. Both conditions are associated with raised odds of having lower quality of life, poorer life satisfaction, and depressive symptoms, and with mobility impairments and self-care difficulties. MSK conditions are salient, and a likely key cause of impaired subjective well

Secondary health conditions and quality of life in persons living with spinal cord injury for at least ten years

NARCIS (Netherlands)

Adriaansen, Jacinthe J. E.; Ruijs, Laura E. M.; van Koppenhagen, Casper F.; van Asbeck, Floris W. A.; Snoek, Govert J.; van Kuppevelt, Dirk; Visser-Meily, Johanna M. A.; Post, Marcel W. M.

2016-01-01

OBJECTIVES: To describe the prevalence of secondary health conditions among persons with long-term spinal cord injury, and the relationship between these secondary health conditions and quality of life. DESIGN: Multicentre, cross-sectional study. SUBJECTS: Individuals (n = 282) with traumatic or

Hospital care for mental health and substance abuse conditions in Parkinson's disease.

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Willis, Allison W; Thibault, Dylan P; Schmidt, Peter N; Dorsey, E Ray; Weintraub, Daniel

2016-12-01

The objective of this study was to examine mental health conditions among hospitalized individuals with Parkinson's disease in the United States. This was a serial cross-sectional study of hospitalizations of individuals aged ≥60 identified in the Nationwide Inpatient Sample dataset from 2000 to 2010. We identified all hospitalizations with a diagnosis of PD, alcohol abuse, anxiety, bipolar disorder, depression, impulse control disorders, mania, psychosis, substance abuse, and attempted suicide/suicidal ideation. National estimates of each mental health condition were compared between hospitalized individuals with and without PD. Hierarchical logistic regression models determined which inpatient mental health diagnoses were associated with PD, adjusting for demographic, payer, geographic, and hospital characteristics. We identified 3,918,703 mental health and substance abuse hospitalizations. Of these, 2.8% (n = 104, 437) involved a person also diagnosed with PD. The majority of mental health and substance abuse patients were white (86.9% of PD vs 83.3% of non-PD). Women were more common than men in both groups (male:female prevalence ratio, PD: 0.78, 0.78-0.79, non-PD: 0.58, 0.57-0.58). Depression (adjusted odds ratio 1.32, 1.31-1.34), psychosis (adjusted odds ratio 1.25, 1.15-1.33), bipolar disorder (adjusted odds ratio 2.74, 2.69-2.79), impulse control disorders (adjusted odds ratio 1.51, 1.31-1.75), and mania (adjusted odds ratio 1.43, 1.18-1.74) were more likely among PD patients, alcohol abuse was less likely (adjusted odds ratio 0.26, 0.25-0.27). We found no PD-associated difference in suicide-related care. PD patients have unique patterns of acute care for mental health and substance abuse. Research is needed to guide PD treatment in individuals with pre-existing psychiatric illnesses, determine cross provider reliability of psychiatric diagnoses in PD patients, and inform efforts to improve psychiatric outcomes. © 2016 International Parkinson and

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

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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…

Work and health conditions of nursing staff in palliative care and hospices in Germany

Science.gov (United States)

Schröder, Christina; Bänsch, Alexander; Schröder, Harry

2004-01-01

Aims of this representative study were to assess the relevant differences between the work and organisational characteristics as well as the subjective resources and health status of nurses occupied in hospice care, compared to nurses from palliative stations. Further, the assessment of the predictive correlations between the work situation of this nurses as a factor influencing their health and perceived strains was also a leading intention. Method: In a written survey conducted in Germany in 2001, 820 nursing staff of 113 palliative stations and stationary hospices were included. A qualified diagnostic procedure for the assessment of health promoting work was implemented. In order of obtaining a secure comparison, a sample of 320 nurses working in 12 homes for old people in Saxony was also considered. Results: The nurses referred generally to favourable working conditions, still they informed about deficiencies in the perceived participation, organizational benefits and experienced gratification. Hospice nurses experienced overall more favourable work conditions than palliative nurses or than the staff of homes for old people (regarding identification with the institution, organizational benefits, accurate gratification and little time pressure during work). Hospice personnel were psychologically and physically healthier than the staff of palliative stations. Important predictors for health stability that could be assessed by multiple regression analysis were: positively evaluated work contents, the identification with the institution, little time pressure and a positive working atmosphere. Conclusions: The assessed organisational framework is generally more favourable in the institutions of professional terminal care than in common hospitals and homes for old people. Therefore, the conditions in hospices could have a modelling function for the inner-institutional work organisation and for the anchorage of the intrinsic motivation of nurses in the health care

An Analysis of health conditions in municipalities of Paraná

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Ovídio Cesar Barbosa

2015-12-01

Full Text Available The objective of the study is to analyze the health conditions in the municipal districts checking which of them best optimize the available resources, consequently offering more and better services to the population. In this approach, first was characterized the public health in Brazil, in the state of Paraná and in its municipalities. We build a Performance Indicator for each county in the state (PI and used variables representing mortality and longevity - infant mortality, mortality up to five years, life expectancy and probability of achieving 60 years. Regarding variables, those relating to health spending, the analysis period was from 2007 to 2010, the population information refer to the 2010 Census and the related infrastructure and health of the population, were collected at the DATASUS. The work includes all municipalities in the state of Paraná. By analyzing the results it was found that there are municipalities that can equate better their inputs and thus provide better service to its population, consequently your ID is better. Another aspect to consider is that the municipalities considered Big City are less dependent on current transfers both the state and the Union, which also have better PI. The city of Colombo was the one with the best performance indicator, while the municipalities of Cruzmaltina and Cantagalo have the worst state ID.

Skin Condition Finder

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... SKIN CONDITIONS HEALTH TOPICS FOR PROFESSIONALS Rash and Skin Condition Finder 1 Select Age Group Infant Child ... Toe Toe Webspace Toe Nail CLOSE About the Skin Condition Finder Have a health question or concern? ...

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.

Socioeconomic inequalities in health in the working population: the contribution of working conditions

NARCIS (Netherlands)

C.Th.M. Schrijvers (Carola); H. van de Mheen (Dike); K. Stronks (Karien); J.P. Mackenbach (Johan)

1998-01-01

textabstractBACKGROUND: The aim was to study the impact of different categories of working conditions on the association between occupational class and self-reported health in the working population. METHODS: Data were collected through a postal survey conducted in 1991

[Informal sellers' health status and working conditions in the Bazurto market in Cartagena].

Science.gov (United States)

Gómez-Palencia, Isabel P; Castillo-Ávila, Irma Y; Banquez-Salas, Annia P; Castro-Ortega, Audrey J; Lara-Escalante, Hilda R

2012-06-01

Determining informal sellers' health status and working conditions in the Bazurto market in Cartagena. The target population consisted of informal sellers working in the Bazurto market; sample size consisted of 584 sellers. A check-list was used to describe their working conditions. A "health disorders" test and neurotoxic symptoms scale (Q16) were used to determine health status and the body mass index (BMI) for determining nutritional status. 583 sellers participated in the study, having an average age of 39 years (38-40 95 %CI). 87.8 % (512) of the participants were exposed to constant noise, 84.9 % (495) worked in places having high temperatures, 74.1 % (432) were exposed to dust, and 69.8 % (407) did not use personal protective equipment. They were working 10 hours a day on average. 71 % (414) suffered from physical exhaustion, 72.4 % (422) had headaches, 63.7 % (371) had back pain and 62.7 % (365) suffered from pains in their legs. The target population's physical environment was inadequate, they worked for too many hours and some workplaces were dangerous. The informal sellers' symptoms included back pain, headaches, leg pain, eye strain and physical fatigue.

The characteristics of hospital emergency department visits made by people with mental health conditions who had dental problems.

Science.gov (United States)

Nalliah, Romesh P; Da Silva, John D; Allareddy, Veerasathpurush

2013-06-01

There is a paucity of knowledge regarding nationally representative estimates of hospital-based emergency department (ED) visits for dental problems made by people with mental health conditions. The authors conducted a study to provide nationwide estimates of hospital-based ED visits attributed to dental caries, pulpal and periapical lesions, gingival and periodontal lesions and mouth cellulitis/abscess made by people with mental health conditions. The authors used the Nationwide Emergency Department Sample, which is a component of the Healthcare Cost and Utilization Project sponsored by the Agency for Healthcare Research and Quality. ED visits attributable to dental caries, pulpal and periapical lesions, gingival and periodontal lesions and mouth cellulitis/abscess were identified by the emergency care provider by using diagnostic codes in International Classification of Diseases, Ninth Revision, Clinical Modification. The authors examined outcomes, including hospital charges. They used simple descriptive statistics to summarize the data. In 2008, people with mental health conditions made 15,635,253 visits to hospital-based ED in the United States. A diagnosis of dental caries, pulpal and periapical lesions, gingival and periodontal lesions and mouth cellulitis/abscess represented 63,164 of these ED visits. The breakdown of the ED visits was 34,574 with dental caries, 25,352 with pulpal and periapical lesions, 9,657 with gingival and periodontal lesions, and 2,776 with mouth cellulitis/abscess. The total charge for ED visits in the United States was $55.46 million in 2008. In 2008, people with mental health conditions made 63,164 visits to hospital-based EDs and received a diagnosis of dental caries, pulpal and periapical lesions, gingival and periodontal lesions or mouth cellulitis/abscess. These ED visits incurred substantial hospital charges. Programs designed to reduce the number of ED visits made by this population for common dental problems could have a

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

Science.gov (United States)

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.