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Sample records for heart health program

  1. Heart Health - Brave Heart

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health Brave Heart Past Issues / Winter 2009 Table of Contents For ... you can have a good life after a heart attack." Lifestyle Changes Surviving—and thriving—after such ...

  2. Perspectives of Puerto Rican Adults about Heart Health and a Potential Community Program

    Science.gov (United States)

    Todorova, Irina L. G.; Tejada, Shirley; Castaneda-Sceppa, Carmen

    2014-01-01

    Background: Puerto Ricans are the second largest Hispanic group in the United States, and older adults have significant health disparities. Educational programs that address heart disease risk for this population have rarely been developed and implemented. Purpose: To address this gap, the Heart Healthy Initiative for Puerto Rican adults is being…

  3. Wine and heart health

    Science.gov (United States)

    Health and wine; Wine and heart disease; Preventing heart disease - wine; Preventing heart disease - alcohol ... more often just to lower your risk of heart disease. Heavier drinking can harm the heart and ...

  4. Alcohol and Heart Health

    Science.gov (United States)

    ... Check Recipe Certification Program Nutrition Requirements Heart-Check Professional Resources Contact the Heart-Check Certification Program Simple Cooking and Recipes Dining Out Choosing a Restaurant Deciphering ...

  5. Protein and Heart Health

    Science.gov (United States)

    ... Check Recipe Certification Program Nutrition Requirements Heart-Check Professional Resources Contact the Heart-Check Certification Program Simple Cooking and Recipes Dining Out Choosing a Restaurant Deciphering ...

  6. Dental Health and Heart Health

    Science.gov (United States)

    ... Check Recipe Certification Program Nutrition Requirements Heart-Check Professional Resources Contact the Heart-Check Certification Program Simple Cooking and Recipes Dining Out Choosing a Restaurant Deciphering ...

  7. Mental Health and Heart Health

    Science.gov (United States)

    ... Check Recipe Certification Program Nutrition Requirements Heart-Check Professional Resources Contact the Heart-Check Certification Program Simple Cooking and Recipes Dining Out Choosing a Restaurant Deciphering ...

  8. Protect your heart: a culture-specific multimedia cardiovascular health education program.

    Science.gov (United States)

    Shah, Amy; Clayman, Marla L; Glass, Sara; Kandula, Namratha R

    2015-04-01

    South Asians, the second fastest growing racial/ethnic minority in the United States, have high rates of coronary heart disease. Few coronary heart disease prevention efforts target this population. The authors developed and tested a culture-specific, multimedia coronary heart disease prevention education program in English and Hindi for South Asians. Participants were recruited from community organizations in Chicago, Illinois, between June and October of 2011. Bilingual interviewers used questionnaires to assess participants' knowledge and perceptions before and after the patient education program. The change from pretest score to posttest score was calculated using a paired t test. Linear regression was used to determine the association between posttest scores and education and language. Participants' (N = 112) average age was 41 years, 67% had more than a high school education, and 50% spoke Hindi. Participants' mean pretest score was 15 (SD = 4). After the patient education program, posttest scores increased significantly among all participants (posttest score = 24, SD = 4), including those with limited English proficiency. Lower education was associated with a lower posttest score (β = -2.2, 95% CI [-0.68, -3.83]) in adjusted regression. A culture-specific, multimedia patient education program significantly improved knowledge and perceptions about coronary heart disease prevention among South Asian immigrants. Culturally salient multimedia education may be an effective and engaging way to deliver health information to diverse patient populations.

  9. Perspectives of Puerto Rican Adults about Heart Health and a Potential Community Program.

    Science.gov (United States)

    Todorova, Irina L G; Tejada, Shirley; Castaneda-Sceppa, Carmen

    Puerto Ricans are the second largest Hispanic group in the U.S. and older adults have significant health disparities. Educational programs that address heart disease risk for this population have rarely been developed and implemented. To address this gap, the Heart Healthy Initiative for Puerto Rican adults is being developed. To develop it as a participatory program, the community members were asked about their perspectives. Five focus groups with 28 participants, aged 45-60, were conducted, transcribed and analyzed using Thematic Analysis. In-depth analysis of meanings of health promoting behaviors, in the context of cultural beliefs and values was carried out. The following themes were identified: Health as balance and integration; Health as connection of self, connection with others; Cultural meanings of lifestyle choices; Stresses and struggles. Participants suggested that the program should have significant variety and a holistic perspective, be sensitive to different needs and motivations, stimulate mutual understanding and shared cultural meanings. The program needs to support lifestyle changes which maximally preserve traditions and to introduce multi-level changes. The identified cultural meanings of diet, physical activity and relationships were taken into account to develop the educational curriculum.

  10. Evaluation of HeartSmarts, a Faith-Based Cardiovascular Health Education Program.

    Science.gov (United States)

    Tettey, Naa-Solo; Duran, Pedro A; Andersen, Holly S; Boutin-Foster, Carla

    2017-02-01

    In order to effectively address cardiovascular disease among African Americans, evidence-based health information must be disseminated within a context aligned with the values and beliefs of the population. Faith-based organizations play a critical role in meeting the religious and spiritual needs of many African Americans. Additionally, faith-based organizations can be effective in health promotion. A manual was created by incorporating biblical scriptures relating to health messages drawn from existing health manuals oriented toward African Americans. Lay health educators active in their churches participated in a 12-week training to learn the basics of cardiovascular disease and methods for delivering the program to their congregations' members. After the completion of the training, these lay health educators recruited participants from their respective churches and administered their own 12-week HeartSmarts program. Measurements of participants' systolic and diastolic blood pressure (mmHg), height (in.), weight (lbs.), and waist circumference (in.) were taken, and cardiovascular disease knowledge assessments (based on 20 open-ended questions) were administered at the start and end of the 12-week programs. Fourteen predominantly African American churches in NYC participated. Of the 221 participants, 199 completed the program. There were significant reductions in pretest and posttest total participant averages for systolic BP (4.48 mmHg, p health assessment scores had an average increase of 12.74 correct responses (p health messages and reducing cardiovascular risk among African Americans.

  11. Heart-Health Screenings

    Science.gov (United States)

    ... Tools For Your Heart Health • Watch, Learn & Live Animations Library Subscribe to Heart Insight magazine and monthly ... in Spanish . Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Heart Attack Symptoms ...

  12. [Healthy heart: Results of a community education program on cardiovascular health].

    Science.gov (United States)

    Madridejos Mora, Rosa; Majem Fabres, Lourdes; Puig Acebal, Helena; Sanz Latorre, Inma; Llobet Traveset, Eva; Arce Casas, Mar; Ruiz Morilla, Dolors; Mercadal Dalmau, Angel; Pañart Sánchez, Dani

    2014-11-01

    To improve the knowledge of the population about heart-healthy habits through a training program supplemented by a web site and community activities. A controlled clinical trial with intervention done through participation in the Cardiovascular Health Training Classroom (CHTC) LOCATION: A town of 80,000 inhabitants. both sexes, aged 55 to 70 years, with at least one cardiovascular risk factor (CVRF). The intervention group (IG) consisted of patients who participated in the CHTC. Intervention was carried out through a 20-hour presential group course in which a support web site was offered and complementary activities were organized. Classes were taught by three Primary Care nurses. The primary endpoint was knowledge of CVRF. The secondary variables were age, sex, CVRF, lifestyle, visits to health centers, pharmaceutical use adherence, and satisfaction with the program. Data from patients in the first 10 courses (n=150) were evaluated. A statistically significant improvement was observed in overall knowledge of CVRF in the IG (87.3% to 100%) compared with control group (GC) (84.5% to 92.7%), pcardiovascular health knowledge and promoting some healthy habits. Copyright © 2012 Elsevier España, S.L.U. All rights reserved.

  13. Heart Health: The Heart Truth Campaign 2009

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health The Heart Truth Campaign 2009 Past Issues / Winter 2009 Table ... one of the celebrities supporting this year's The Heart Truth campaign. Both R&B singer Ashanti (center) ...

  14. Heart Health - Heart Disease: Symptoms, Diagnosis, Treatment

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health Heart Disease: Symptoms, Diagnosis, Treatment Past Issues / Winter 2009 ... of this page please turn Javascript on. Most heart attacks happen when a clot in the coronary ...

  15. Effectiveness of health education programs on exercise behavior among patients with heart disease: a systematic review and meta-analysis.

    Science.gov (United States)

    Zhu, Li-Xia; Ho, Shuk-Ching; Wong, Thomas K S

    2013-11-01

    Regular exercise has been shown to be beneficial to patients with heart disease. Previous studies have indicated that health education can effectively increase participants' physical activity. However, no systematic review was conducted to evaluate the effectiveness of health education programs on changing exercise behavior among patients with heart disease. The aim of this study was to examine the effectiveness of health education programs on exercise behavior among heart disease patients. Potential studies were retrieved in the Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, EMbase, PsycINFO, the British Nursing Index and Archive, Science Direct, and ERIC via EBSCOhost. Meta-analysis was done using the random-effect model. Thirty-seven studies were identified. Only 12 studies delivered health education based on various theories/models. Twenty-eight studies were included in the meta-analyses. The results showed that health education had significantly positive effects on exercise adherence (risk ratio = 1.35 to 1.48), exercise duration (SMD = 0.25 to 0.69), exercise frequency (MD = 0.54 to 1.46 session/week), and exercise level (SMD = 0.25), while no significant effects were found on exercise energy expenditure and cognitive exercise behavior. Health education has overall positive effects on changing exercise behavior among heart disease patients. Few theoretical underpinning studies were conducted for changing exercise behavior among heart disease patients. The findings suggest that health education improves exercise behavior for heart disease patients. Health professionals should reinforce health education programs for them. © 2013 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

  16. Pawtucket Heart Health Program Point-of-Purchase Nutrition Education Program in Supermarkets.

    Science.gov (United States)

    Hunt, Mary K.; And Others

    1990-01-01

    Evaluates a point-of-purchase nutrition education program in Pawtucket (Rhode Island). Uses consumer interviews to evaluate the effect of awareness of shelf labels on purchase behavior. Reports increases in shoppers' ability to identify correct shelf labels and in the number of shoppers who were encouraged to buy the identified foods. (FMW)

  17. The role of physicians in a community-wide program for prevention of cardiovascular disease: the Minnesota Heart Health Program.

    Science.gov (United States)

    Mittelmark, M B; Leupker, R V; Grimm, R; Kottke, T E; Blackburn, H

    1988-01-01

    The Minnesota Heart Health Program (MHHP) aims to reduce cardiovascular disease (CVD) morbidity and mortality by reducing risk factors among the mass of residents in three midwestern communities. A major aspect of the program is the involvement of community physicians because they have high credibility as citizen leaders, especially on health issues. In the MHHP, physicians contributed in a number of ways. The initial contacts with physicians resulted in their providing support and introductions to other community leaders, whose active support was also gained. Physicians sit as members of the central Community Advisory Borads of MHHP and serve on the executive committees of these boards. All MHHP issues related to medical practice are brought before Physicians' Advisory Groups in each community for resolution. Primary care physicians attend MHHP continuing education programs. In a survey of 109 physicians in one of the MHHP communities, 95 percent of respondents believed cigarette smoking to be an important risk factor for CVD, but only 15 percent judged themselves to be effective in dealing with patients who smoked. Forty-one percent of respondents said that elevated blood cholesterol is an important risk factor, but only 20 percent felt effective in treating the condition. Only 18 percent of the physicians in the sample believed that a poor eating pattern plays a substantial role in CVD, and 9 percent felt effective in counseling patients about eating habits. This pattern of results indicates the need not only for continuing education about risk factors for CVD, but also for training to improve patient counseling skills. PMID:3136495

  18. Stress and Heart Health

    Science.gov (United States)

    ... It Works Healthy Workplace Food and Beverage Toolkit Stress and Heart Health Updated:Jan 8,2018 When ... therapist in your community. Last reviewed 6/2014 Stress Management • Home • How Does Stress Affect You? Introduction ...

  19. The effectiveness of loyalty rewards to promote the use of an Internet-based heart health program.

    Science.gov (United States)

    Liu, Sam; Hodgson, Corinne; Zbib, Ahmad M; Payne, Ada Y M; Nolan, Robert P

    2014-07-02

    Internet-based health programs have been shown to be effective in reducing risk for cardiovascular disease. However, their rates of enrollment and engagement remain low. It is currently unclear whether rewards from established loyalty programs can serve as a conditioned stimulus to improve the use of a freely available Internet-based program. The objectives of the study were to (1) examine enrollment rates and levels of engagement with the My Health eSupport program between a Conditioned Reward group and a Control group, and (2) investigate the influence of loyalty rewards and participant characteristics on levels of enrollment and program engagement. The study sample (n=142,726) consisted of individuals who were offered enrollment in an Internet-based health intervention (My Health eSupport) after completing the Heart&Stroke Risk Assessment on the Heart and Stroke Foundation website. My Health eSupport programs provided encouragement and tips for lifestyle change. This is a free, self-guided, fully automated program that proactively delivers tailored email messages at 2-week intervals based on the participant's stage of motivational "readiness" and priority for lifestyle change. Participants in the Conditioned Reward group were offered a single exposure of 20 loyalty reward points from the Air Miles loyalty program for completing the Heart&Stroke Risk Assessment (10 reward points) and enrolling in the Internet-based program (10 reward points). Meanwhile, no rewards were given to the Control group participants. All data were collected between February 1, 2011 and February 10, 2012. In total, 51.38% (73,327/142,726) of individuals in the Conditioned Reward group and 48.62% (69,399/142,726) of individuals in the Control group completed the Heart&Stroke Risk Assessment. Subsequently, significantly more individuals from the Conditioned Reward group (52.96%, 38,835/73,327) enrolled in the My Health eSupport program than Controls (4.07%, 2826/69,399). Regression analyses

  20. Evaluating the Fabreville Heart Health Program in Laval, Canada: a dialogue between two paradigms, positivism and constructivism.

    Science.gov (United States)

    Nguyen, Minh Nguyet; Otis, Joanne

    2003-06-01

    As part of the Canadian Federal-Provincial Initiative in Heart Health, the goal of the Fabreville Heart Health Program was to sensitize a district of Laval, Quebec's second most populous city, to heart-healthy behaviours. The program was planned and implemented by a committee composed of Fabreville community leaders and professionals from the Public Health Department. Between 1992 and 1994, intervention objectives were defined by the department in terms of changing individual behaviours associated with cardiovascular risk factors, namely diet, sedentariness and smoking, as well as adapting physical and social environments to facilitate these changes. However, from 1994 to its conclusion in 1997, the program was re-oriented to engage the population in mobilizing their own community and taking charge of interventions themselves. Actions then became dependent on the interests and motivation of Fabreville residents to transform their lifestyles and aspects of their physical environment. The initial evaluation process, based on the positivist paradigm, was designed to measure changes in individual behaviours and certain physical environments, such as an increase in designated non-smoking areas. However, following the re-orientation towards community mobilization, it was decided that evaluation should go beyond the professional production of data to include a process of the collective construction of knowledge. Evaluation methodology then became based on the constructivist paradigm. Yet field constraints such as lack of community involvement in both leadership and process evaluation, and the need to ensure evaluation standards and fulfil sponsor obligations, compelled the Public Health Department to return to using a certain number of positivist methods. The ensuing inter-paradigm dialogue helped broaden the scope of evaluation and contributed to gaining a more in-depth understanding of the processes and outcomes of community mobilization.

  1. (SPartners for Heart Health: a school-based program for enhancing physical activity and nutrition to promote cardiovascular health in 5th grade students

    Directory of Open Access Journals (Sweden)

    Sehnert Scott T

    2008-12-01

    Full Text Available Abstract Background The American Heart Association Position Statement on Cardiovascular Health Promotion in Public Schools encourages school-based interventions for the primary prevention of cardiovascular disease (CVD through risk factor prevention or reduction in children with an emphasis on creating an environment that promotes healthy food choices and physical activity (PA. In an effort to address issues related to CVD risk factors including obesity in Michigan children, a multi-disciplinary team of Michigan State University (MSU faculty, clinicians, and health profession students was formed to "(Spartner" with elementary school physical education (PE teachers and MSU Extension staff to develop and implement a cost-effective, sustainable program aimed at CVD risk factor prevention and management for 5th grade students. This (Spartnership is intended to augment and improve the existing 5th grade PE, health and nutrition curriculum by achieving the following aims: 1 improve the students' knowledge, attitudes and confidence about nutrition, PA and heart health; 2 increase the number of students achieving national recommendations for PA and nutrition; and 3 increase the number of students with a desirable CVD risk factor status based on national pediatric guidelines. Secondary aims include promoting school staff and parental support for heart health to help children achieve their goals and to provide experiential learning and service for MSU health profession students for academic credit. Methods/Design This pilot effectiveness study was approved by the MSU IRB. At the beginning and the end of the school year students undergo a CVD risk factor assessment conducted by MSU medical students and graduate students. Key intervention components include eight lesson plans (conducted bi-monthly designed to promote heart healthy nutrition and PA behaviors conducted by PE teachers with assistance from MSU undergraduate dietetic and kinesiology students

  2. (S)Partners for Heart Health: a school-based program for enhancing physical activity and nutrition to promote cardiovascular health in 5th grade students.

    Science.gov (United States)

    Carlson, Joseph J; Eisenmann, Joey C; Pfeiffer, Karin A; Jager, Kathleen B; Sehnert, Scott T; Yee, Kimbo E; Klavinski, Rita A; Feltz, Deborah L

    2008-12-22

    The American Heart Association Position Statement on Cardiovascular Health Promotion in Public Schools encourages school-based interventions for the primary prevention of cardiovascular disease (CVD) through risk factor prevention or reduction in children with an emphasis on creating an environment that promotes healthy food choices and physical activity (PA). In an effort to address issues related to CVD risk factors including obesity in Michigan children, a multi-disciplinary team of Michigan State University (MSU) faculty, clinicians, and health profession students was formed to "(S)partner" with elementary school physical education (PE) teachers and MSU Extension staff to develop and implement a cost-effective, sustainable program aimed at CVD risk factor prevention and management for 5th grade students. This (S)partnership is intended to augment and improve the existing 5th grade PE, health and nutrition curriculum by achieving the following aims: 1) improve the students' knowledge, attitudes and confidence about nutrition, PA and heart health; 2) increase the number of students achieving national recommendations for PA and nutrition; and 3) increase the number of students with a desirable CVD risk factor status based on national pediatric guidelines. Secondary aims include promoting school staff and parental support for heart health to help children achieve their goals and to provide experiential learning and service for MSU health profession students for academic credit. This pilot effectiveness study was approved by the MSU IRB. At the beginning and the end of the school year students undergo a CVD risk factor assessment conducted by MSU medical students and graduate students. Key intervention components include eight lesson plans (conducted bi-monthly) designed to promote heart healthy nutrition and PA behaviors conducted by PE teachers with assistance from MSU undergraduate dietetic and kinesiology students (Spartners). The final 10 minutes of each lesson

  3. Touching Hearts, Touching Minds: Using Emotion-Based Messaging to Promote Healthful Behavior in the Massachusetts WIC Program

    Science.gov (United States)

    Colchamiro, Rachel; Ghiringhelli, Kara; Hause, Judith

    2010-01-01

    The "Touching Hearts, Touching Minds" initiative was funded through a 2003 United States Department of Agriculture Special Projects grant to revitalize nutrition education and services in the Massachusetts Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Program. The 30 nutrition education materials and…

  4. Healthy Body, Happy Heart: Improve Your Heart Health

    Science.gov (United States)

    ... November 2017 Print this issue Healthy Body, Happy Heart Improve Your Heart Health En español Send us your comments Every moment of the day, your heart is pumping blood throughout your body. In silent ...

  5. Factors Facilitating the Implementation of Church-Based Heart Health Promotion Programs for Older Adults: A Qualitative Study Guided by the Precede-Proceed Model.

    Science.gov (United States)

    Banerjee, Ananya Tina; Kin, R; Strachan, Patricia H; Boyle, Michael H; Anand, Sonia S; Oremus, Mark

    2015-01-01

    To describe the factors facilitating the implementation of heart health promotion programs for older adults in Anglican, United, and Catholic churches. The study used qualitative methods comprising semistructured interviews and focus groups. The interviews and focus groups were conducted in Anglican, Catholic, and United churches located in the Canadian cities of Toronto and Hamilton, Ontario. Twelve ordained pastors and 21 older parishioners who attended church regularly and who had no health conditions were recruited to best explain how churches could be suitable locations for health promotion activities targeting older adults. Twelve semistructured interviews with the pastors and three focus groups with the 21 parishioners were undertaken. A component of the Precede-Proceed model (a model for planning health education and health promotion programs and policies) was applied to the findings after direct content analysis of the data. Participants identified pastor leadership, funding for a parish nurse, community-focused interventions, secured infrastructure, and social support from congregation members as pertinent factors required for implementing health promotion programs in Anglican, United, and Catholic churches. The findings have particular relevance for health promotion and public health because they suggest factors that would be necessary to design church-based heart health promotion programs for older adults at risk of chronic diseases.

  6. Coffee intake and risk of incident diabetes in Puerto Rican men: results from the Puerto Rico Heart Health Program.

    Science.gov (United States)

    Fuhrman, B J; Smit, E; Crespo, C J; Garcia-Palmieri, M R

    2009-06-01

    To study prospectively the association of coffee intake with incident diabetes in the Puerto Rico Heart Health Program cohort, comprising 9824 middle-aged men (aged 35-79 years). Of 9824 men, 3869 did not provide a fasting blood sample at baseline, 1095 had prevalent diabetes and 131 were not given fasting glucose tests at any subsequent study visit. Thus, the present analysis includes 4685 participants. Diabetes was ascertained at baseline and at two study visits between 1968 and 1975 using fasting glucose tests and self-reports of physician-diagnosed diabetes or use of insulin or hypoglycaemic medication. Logistic regression analysis was used to assess the association of coffee intake with risk of incident diabetes while adjusting for covariates (age, BMI, physical activity, smoking, education, alcohol intake, family history of diabetes, intakes of milk and sugar). Five hundred and nineteen participants met the criteria for incident diabetes. Compared with those reporting intake of 1-2 servings of coffee/d, coffee abstainers were at reduced risk (OR = 0.64; 95 % CI 0.43, 0.94). Among coffee drinkers, there was a significant trend of decreasing risk by intake (P = 0.02); intake of >/=4 servings/d was associated with an odds ratio of 0.75 (95 % CI 0.58, 0.97). Study findings support a protective effect of coffee intake on diabetes risk, while also suggesting that abstainers may be at reduced risk.

  7. Fetal programming as a predictor of adult health or disease: the need to reevaluate fetal heart function.

    Science.gov (United States)

    Miranda, Joana O; Ramalho, Carla; Henriques-Coelho, Tiago; Areias, José Carlos

    2017-11-01

    Epidemiologic and experimental evidence suggests that adverse stimuli during critical periods in utero permanently alters organ structure and function and may have persistent consequences for the long-term health of the offspring. Fetal hypoxia, maternal malnutrition, or ventricular overloading are among the major adverse conditions that can compromise cardiovascular development in early life. With the heart as a central organ in fetal adaptive mechanisms, a deeper understanding of the fetal cardiovascular physiology and of the echocardiographic tools to assess both normal and stressed pregnancies would give precious information on fetal well-being and hopefully may help in early identification of special risk groups for cardiovascular diseases later in life. Assessment of cardiac function in the fetus represents an additional challenge when comparing to children and adults, requiring advanced training and a critical approach to properly acquire and interpret functional parameters. This review summarizes the basic fetal cardiovascular physiology and the main differences from the mature postnatal circulation, provides an overview of the particularities of echocardiographic evaluation in the fetus, and finally proposes an integrated view of in utero programming of cardiovascular diseases later in life, highlighting priorities for future clinical research.

  8. Heart Health Tests: MedlinePlus Health Topic

    Science.gov (United States)

    ... Heart Institute) Also in Spanish Heart-Health Screenings (American Heart Association) Picturing the Heart (National Institute of Biomedical Imaging and Bioengineering) Related Issues EKGs and Exercise Stress Tests: When You Need Them for Heart Disease - ...

  9. Guidelines for Better Heart Health

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues Guidelines for Better Heart Health Past Issues / Winter 2007 ... women either had or did not have CVD. Guidelines at a Glance: Prevention should be tailored to ...

  10. "It's Like Backing up Science with Scripture": Lessons Learned from the Implementation of HeartSmarts, a Faith-Based Cardiovascular Disease Health Education Program.

    Science.gov (United States)

    Tettey, Naa-Solo; Duran, Pedro A; Andersen, Holly S; Washington, Niajee; Boutin-Foster, Carla

    2016-06-01

    African-Americans are disproportionately impacted by cardiovascular disease (CVD). Faith-based institutions provide a non-traditional route for health education targeted at African-Americans. This paper describes HeartSmarts, a faith-based CVD education program. Evidence-based literature was used to develop a curriculum, which was tailored by integrating biblical scripture representing aspects of health behaviors. Eighteen church peer-educators were recruited to participate in a 12-week training. They then disseminated the faith-based curriculum to members of their congregations. There were 199 participants of which 137 provided feedback via open-ended surveys indicating that HeartSmarts was well accepted and effective for disseminating CVD health messages while engaging spirituality.

  11. Heart Health: Learn the Truth About Your Heart

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health Learn the Truth About Your Heart Past Issues / Winter 2009 Table of Contents For ... turn Javascript on. Photo: iStock February is American Heart Month. Now is the time to make sure ...

  12. How to Prevent Heart Disease: MedlinePlus Health Topic

    Science.gov (United States)

    ... and your heart (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get How to Prevent ... your heart Stress and your heart Related Health Topics Blood Thinners Cholesterol Heart Diseases Heart Health Tests ...

  13. (S)Partners for Heart Health: a school-based program for enhancing physical activity and nutrition to promote cardiovascular health in 5th grade students

    OpenAIRE

    Carlson, Joseph J; Eisenmann, Joey C; Pfeiffer, Karin A; Jager, Kathleen B; Sehnert, Scott T; Yee, Kimbo E; Klavinski, Rita A; Feltz, Deborah L

    2008-01-01

    Abstract Background The American Heart Association Position Statement on Cardiovascular Health Promotion in Public Schools encourages school-based interventions for the primary prevention of cardiovascular disease (CVD) through risk factor prevention or reduction in children with an emphasis on creating an environment that promotes healthy food choices and physical activity (PA). In an effort to address issues related to CVD risk factors including obesity in Michigan children, a multi-discipl...

  14. Evaluating the effectiveness of psychosocial resilience training for heart health, and the added value of promoting physical activity: a cluster randomized trial of the READY program

    Directory of Open Access Journals (Sweden)

    Pakenham Kenneth I

    2009-11-01

    Full Text Available Abstract Background Depression and poor social support are significant risk factors for coronary heart disease (CHD, and stress and anxiety can trigger coronary events. People experiencing such psychosocial difficulties are more likely to be physically inactive, which is also an independent risk factor for CHD. Resilience training can target these risk factors, but there is little research evaluating the effectiveness of such programs. This paper describes the design and measures of a study to evaluate a resilience training program (READY to promote psychosocial well-being for heart health, and the added value of integrating physical activity promotion. Methods/Design In a cluster randomized trial, 95 participants will be allocated to either a waitlist or one of two intervention conditions. Both intervention conditions will receive a 10 × 2.5 hour group resilience training program (READY over 13 weeks. The program targets five protective factors identified from empirical evidence and analyzed as mediating variables: positive emotions, cognitive flexibility, social support, life meaning, and active coping. Resilience enhancement strategies reflect the six core Acceptance and Commitment Therapy processes (values, mindfulness, defusion, acceptance, self-as-context, committed action and Cognitive Behavior Therapy strategies such as relaxation training and social support building skills. Sessions include psychoeducation, discussions, experiential exercises, and home assignments. One intervention condition will include an additional session and ongoing content promoting physical activity. Measurement will occur at baseline, two weeks post intervention, and at eight weeks follow-up, and will include questionnaires, pedometer step logs, and physical and hematological measures. Primary outcome measures will include self-reported indicators of psychosocial well-being and depression. Secondary outcome measures will include self-reported indicators of

  15. Air Quality and Heart Health: An Emerging Topic for Heart ...

    Science.gov (United States)

    Air Quality and Heart Health: An Emerging Topic for Heart Month: Ambient air particle pollution increases short- and long-term cardiovascular morbidity and mortality. Older-people, those with pre-existing heart disease and lung disease and diabetes are at higher risk. Mechanisms are under investigation and are likely related to oxidative stress, inflammation and effects on autonomic control. Improvements in air pollution levels reduce health impacts and increase life expectancy. Reductions of short-term exposure in those at highest risk are predicted to mitigate adverse health effects. EPA regularly evaluates the standards, health risks and issues improved standards when needed. Public health action is needed along with EPA standards to reduce the public health burden of short- and long-term adverse health effects of air pollution. Health risks remain and need to be addressed through integrated efforts of public health, health care, environmental health, individuals and communities. Presented at Webinar for the National Association of Clean Air Agencies, February 2, 2017, Chapel Hill, NC- This webinar provided an update of environmental health information related to the effects of air pollution and heart and blood vessel disease. Such information is critically important for the Clean Air Agencies to understand as it provides the justification of their actions.

  16. Practical guide on home health in heart failure patients

    DEFF Research Database (Denmark)

    Jaarsma, T.; Larsen, Torben; Stromberg, A.

    2013-01-01

    in this population and specialised heart failure care can save costs and improve the quality of care. However, only a few European countries have implemented specialised home care and offered this to a larger number of patients with heart failure. Method: We developed a guide on Home Health in Heart Failure patients...... from a literature review, a survey of heart failure management programs, the opinion of researchers and practitioners, data from clinical trials and a reflection of an international expert meeting. Results: In integrated home care for heart failure patients, it is advised to consider the following...... components: integrated multidisciplinary care, patient and partner participation, care plans with clear goals of care, patient education, self-care management, appropriate access to care and optimised treatment. Discussion: We summarised the state of the art of home-based care for heart failure patients...

  17. Single-Parent and Working-Parent Heart Health

    Science.gov (United States)

    ... Check Recipe Certification Program Nutrition Requirements Heart-Check Professional Resources Contact the Heart-Check Certification Program Simple Cooking and Recipes Dining Out Choosing a Restaurant Deciphering ...

  18. Pulse Power--A Heart Physiology Program for Children.

    Science.gov (United States)

    Hinson, Curt

    1994-01-01

    Primary grade students at a Delaware elementary school currently participate in the Pulse Power heart physiology program. Students receive mastery instruction and use heart monitors to exercise performance throughout the 6-phase program. Data from homework and from the heart monitors identify student progress, knowledge, and cardiovascular…

  19. The psychology of the heart: Implications for health, physical activity ...

    African Journals Online (AJOL)

    ... for health, physical activity and sport of psychophysiological resonance, coherence and heart rate variability feedback applications involving respiration and facilitation of positive emotion. Keywords: Heart psychology, psychophysiology, resonance, coherence, transcultural context, heart rate variability, biofeedback.

  20. Chamber identity programs drive early functional partitioning of the heart.

    Science.gov (United States)

    Mosimann, Christian; Panáková, Daniela; Werdich, Andreas A; Musso, Gabriel; Burger, Alexa; Lawson, Katy L; Carr, Logan A; Nevis, Kathleen R; Sabeh, M Khaled; Zhou, Yi; Davidson, Alan J; DiBiase, Anthony; Burns, Caroline E; Burns, C Geoffrey; MacRae, Calum A; Zon, Leonard I

    2015-08-26

    The vertebrate heart muscle (myocardium) develops from the first heart field (FHF) and expands by adding second heart field (SHF) cells. While both lineages exist already in teleosts, the primordial contributions of FHF and SHF to heart structure and function remain incompletely understood. Here we delineate the functional contribution of the FHF and SHF to the zebrafish heart using the cis-regulatory elements of the draculin (drl) gene. The drl reporters initially delineate the lateral plate mesoderm, including heart progenitors. Subsequent myocardial drl reporter expression restricts to FHF descendants. We harnessed this unique feature to uncover that loss of tbx5a and pitx2 affect relative FHF versus SHF contributions to the heart. High-resolution physiology reveals distinctive electrical properties of each heart field territory that define a functional boundary within the single zebrafish ventricle. Our data establish that the transcriptional program driving cardiac septation regulates physiologic ventricle partitioning, which successively provides mechanical advantages of sequential contraction.

  1. [Management of heart failure in cardiology and primary care (MICCAP) program: Improving the management of patients with heart failure].

    Science.gov (United States)

    Barrios, V; Escobar, C; Pallares, V; Egocheaga, M I; Lobos, J M; Bover, R; Gómez Doblas, J J; Cosín, J

    2018-03-26

    Despite current treatments, morbidity and mortality of patients with heart failure remain high. The late diagnosis of heart failure, the insufficient heart failure treatment (i.e. not using the appropriate drugs, prescribing lower doses of drugs than recommended, etc.), and a poor coordination between different health care levels, may explain, at least in part, these figures. The Management of Heart Failure in Cardiology and Primary Care (MICCAP) program has been developed with the aim of optimising the integrated management of patients with heart failure between Primary Care and Cardiology, through the improvement of coordination between both health care levels. This includes continuous medical education to reinforce the diagnostic and therapeutic skills of general practitioners in the field of heart failure. The rationale and objectives of the MICCAP program are summarised in this article. Copyright © 2018 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Air Quality and Heart Health: An Emerging Topic for Heart Month

    Science.gov (United States)

    Air Quality and Heart Health: An Emerging Topic for Heart Month: Ambient air particle pollution increases short- and long-term cardiovascular morbidity and mortality. Older-people, those with pre-existing heart disease and lung disease and diabetes are at higher risk. Mechanism...

  3. Program Description: Physical Therapy in a Heart Failure Clinic

    OpenAIRE

    Knocke, Ann

    2012-01-01

    Aerobic exercise and resistance training have been proven to be beneficial for patients with heart failure. Current reimbursement guidelines exclude these patients from our traditional cardiac rehabilitation program, so at Newton Wellesley Hospital a clinic model was developed for the disease management and exercise of heart failure patients.

  4. Building Collaborative Health Promotion Partnerships: The Jackson Heart Study

    Directory of Open Access Journals (Sweden)

    Clifton C. Addison

    2015-12-01

    Full Text Available Building Collaborative Health Promotion Partnerships: The Jackson Heart Study. Background: Building a collaborative health promotion partnership that effectively employs principles of community-based participatory research (CBPR involves many dimensions. To ensure that changes would be long-lasting, it is imperative that partnerships be configured to include groups of diverse community representatives who can develop a vision for long-term change. This project sought to enumerate processes used by the Jackson Heart Study (JHS Community Outreach Center (CORC to create strong, viable partnerships that produce lasting change. Methods: JHS CORC joined with community representatives to initiate programs that evolved into comprehensive strategies for addressing health disparities and the high prevalence of cardiovascular disease (CVD. This collaboration was made possible by first promoting an understanding of the need for combined effort, the desire to interact with other community partners, and the vision to establish an effective governance structure. Results: The partnership between JHS CORC and the community has empowered and inspired community members to provide leadership to other health promotion projects. Conclusion: Academic institutions must reach out to local community groups and together address local health issues that affect the community. When a community understands the need for change to respond to negative health conditions, formalizing this type of collaboration is a step in the right direction.

  5. Healthy Hearts (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    Heart disease is among the leading causes of death worldwide. Combined with stroke, it accounts for one in three deaths. Improving heart health could save millions of lives each year. In this podcast, Dr. Barbara Bowman discusses ways to prevent heart problems.

  6. Healthy Hearts (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2014-10-02

    Heart disease is among the leading causes of death worldwide. Combined with stroke, it accounts for one in three deaths. Improving heart health could save millions of lives each year. In this podcast, Dr. Barbara Bowman discusses ways to prevent heart problems.  Created: 10/2/2014 by MMWR.   Date Released: 10/2/2014.

  7. Heart Disease Prevention: Does Oral Health Matter?

    Science.gov (United States)

    ... Will taking care of my teeth help prevent heart disease? Answers from Thomas J. Salinas, D.D.S. Taking ... teeth isn't a proven way to prevent heart disease. While there appears to be some connection between ...

  8. The Eurotransplant High-Urgency Heart Transplantation Program: an option for patients in acute heart failure?

    Science.gov (United States)

    Koch, A; Tochtermann, U; Remppis, A; Dengler, T J; Schnabel, P A; Hagl, S; Sack, F U

    2006-09-01

    The Eurotransplant High-Urgency (HU) Heart Transplantation Program allows urgent heart transplants to be carried out in rapidly deteriorating patients with acute-to-chronic heart failure on the elective waiting list. But do the results of HU heart transplantation justify performing primary heart transplantation in these critically ill patients and offer an acceptable outcome? Between 2000 and 2004, 64 heart transplantations (HTx) (32 elective and 32 HU-HTx) were performed in our department. After having been accepted in an auditing process based on HU criteria, intensive care patients in NYHA functional class IV (cardiac index 1.7 l/min/qm BS), in end-organ failure (creatinine 1.5 mg/dl), and with catecholamine dependence (dobutamine 8 microg/kg/min), are given priority with respect to organ allocation, and their data were compared to data from elective patients from the same period. HU requests were accepted in 97 % of cases. Two requests were not accepted, and both patients with contraindications for assist device implantation died within one week. The HU patients were 100 % in NYHA class IV, 93 % of the elective patients were in NYHA class III. Waiting time on the HU list was 13 days, and 7 of these patients died before HTx. Following heart transplantation, survival rates at 30 days and at one year of the HU group were 88 % and 85 % versus 94 % and 93 % in the elective group. This study shows that end-stage heart failure patients in the HU program can be transplanted primarily with good results if an organ is available in time. We are still in the position where the HU program only manages the organ shortage; there are still too many patients on the waiting list who die before receiving a donor organ.

  9. Dobutamine use for arrhythmia induction during electrical programmed heart stimulation

    International Nuclear Information System (INIS)

    Vanegas, Diego I; Perez, Climaco de J; Montenegro, Juan de J; Orjuela, Alejandro

    2006-01-01

    isoproterenol is the traditionally used drug for incrementing arrhythmia induction when this induction is not achieved during electric programmed heart stimulation under basal conditions. Dobutamine is an adrenergic agent, chemical precursor of isoproterenol, which can be an alternative for inducing arrhythmia during electrical programmed heart stimulation (PES). Patients and methods: a retrospective comparative study of the experience with dobutamine for inducing arrhythmia during electrical programmed heart stimulation was performed. The following data were collected: number of studies, data about the patient (medical record, age, gender, and study indication) protocol of programmed electrical stimulation, basal and under dobutamine or isoproterenol, and result of the study. Isoproterenol was used in doses of 1 to 3 micrograms per minute until the basal heart rate was incremented at least in 25%. Dobutamine was used in doses of 10 to 40 micrograms per kg of body weight, until obtaining the same increment in the basal heart rate. Results: 1054 electrophysiological studies were evaluated. In 144 patients (group A) isoproterenol was used and in 140, dobutamine (group B). In A group the mean age was 39.2 ± 16.2 and 58.3% were females. In-group B, mean age was 41.9 ± 18.6 and 51% were females. The most frequent symptom was palpitation and the most commonly induced arrhythmia was AV nodal reentry tachycardia in both groups. The induction of arrhythmia during the electrical programmed heat stimulation under drugs was similar in-group A (isoproterenol) respect to group B (dobutamine). Conclusions: There were no statistical significant differences in the induction of arrhythmia during electrical programmed heart stimulation using dobutamine or isoproterenol. Dobutamine may be safe and may be successfully used as an alternative to isoproterenol for arrhythmia induction during electrical programmed stimulation

  10. The National Heart, Lung, and Blood Institute Small Business Program

    Directory of Open Access Journals (Sweden)

    Kurt W. Marek, PhD

    2016-12-01

    Full Text Available Small companies working to develop products in the cardiovascular space face numerous challenges, from regulatory, intellectual property, and reimbursement barriers to securing funds to keep the lights on and reach the next development milestone. Most small companies that spin out from universities have the scientific knowledge, but product development expertise and business acumen are also needed to be successful. Other challenges include reduced interest in early-stage technologies and limited deal flow for cardiovascular products. The National Heart, Lung, and Blood Institute (NHLBI small business program is a comprehensive ecosystem designed to address these critical challenges and to provide resources and expertise to assist early-stage companies developing cardiovascular and other products within the institute’s mission. This article describes steps that NHLBI has taken to enhance our small business program to more effectively translate basic discoveries into commercial products to benefit patients and public health, including enhancing internal expertise and developing nonfinancial resources to assist small businesses as they develop their products and seek private sector investment and partnership.

  11. Health in adults with congenital heart disease

    NARCIS (Netherlands)

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

    2016-01-01

    Since the introduction of cardiac surgery, the prospects for children born with a cardiac defect have improved spectacularly. Many reach adulthood and the population of adults with congenital heart disease is increasing and ageing. However, repair of congenital heart disease does not mean cure. Many

  12. Health in adults with congenital heart disease.

    Science.gov (United States)

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

    2016-09-01

    Since the introduction of cardiac surgery, the prospects for children born with a cardiac defect have improved spectacularly. Many reach adulthood and the population of adults with congenital heart disease is increasing and ageing. However, repair of congenital heart disease does not mean cure. Many adults with congenital heart disease encounter late complications. Late morbidity can be related to the congenital heart defect itself, but may also be the consequence of the surgical or medical treatment or longstanding alterations in hemodynamics, neurodevelopment and psychosocial development. This narrative review describes the cardiac and non-cardiac long-term morbidity in the adult population with congenital heart disease. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Nuts and Your Heart: Eating Nuts for Heart Health

    Science.gov (United States)

    ... benefits of nuts if they're covered with chocolate, sugar or salt. Here's some nutrition information on ... disease. Clinical Cardiology. 2015;38:570. Ros E. Health benefits of nut consumption. Nutrients. 2010;2:652. Suggested ...

  14. Health service interventions targeting relatives of heart patients

    DEFF Research Database (Denmark)

    Nissen, Nina Konstantin; Madsen, Mette; Olsen Zwisler, Ann-Dorthe

    2008-01-01

    AIMS: Relatives of heart patients experience anxiety, uncertainty, and low quality of life, and the hospitalization of a heart patient is associated with increased risk of death for the partner. Relatives' physical and mental problems may be rectified by activities established by the health...

  15. Heart Check (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2015-09-24

    Heart disease is the leading cause of death worldwide. In the U.S., it’s related to one in four deaths. This podcast discusses heart health.  Created: 9/24/2015 by MMWR.   Date Released: 9/24/2015.

  16. Healthy Hearts (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2014-10-02

    Heart disease is among the leading causes of death worldwide. Combined with stroke, it accounts for nearly one in three deaths. This podcast discusses the importance of improving heart health.  Created: 10/2/2014 by MMWR.   Date Released: 10/2/2014.

  17. Heart Health Tests for Diabetes Patients

    Science.gov (United States)

    ... or fluids in the body. They include: Electrocardiogram ("EKG" or "ECG") This test measures the electrical activity ... Tools & Resources Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Heart Attack Symptoms ...

  18. Fasting Diet: Can It Improve My Heart Health?

    Science.gov (United States)

    ... health? Is it true that occasionally following a fasting diet can reduce my risk of heart disease? ... t sure why, but it seems that regularly fasting — severely restricting food and drink for a 24- ...

  19. Screening for congenital heart malformation in child health centres

    NARCIS (Netherlands)

    R.E. Juttmann (Rikard); J. Hess (Jakob); C.W.N. Looman (Caspar); G.J. van Oortmarssen (Gerrit); P.J. van der Maas (Paul)

    1998-01-01

    textabstractBACKGROUND: Although screening for congenital heart malformations is part of the child health care programme in several countries, there are very few published evaluations of these activities. This report is concerned with the evaluation of this screening at

  20. Screening for congenital heart malformations in child health centres

    OpenAIRE

    Juttmann, Rikard

    1999-01-01

    textabstractThe objective of this thesis is to clarify the effectiveness and the efficiency of screening for congenital heart malformations in Dutch child health centres and the possibilities to optimise this prevention programme. To this end the following main questions will be addressed. 1. Does screening for congenital heart malformations, as actually performed in Dutch child health centres, prevent adverse outcomes of these disorders in the short and long run? What would be the answer to ...

  1. "The Heart Game": Using Gamification as Part of a Telerehabilitation Program for Heart Patients.

    Science.gov (United States)

    Dithmer, Marcus; Rasmussen, Jack Ord; Grönvall, Erik; Spindler, Helle; Hansen, John; Nielsen, Gitte; Sørensen, Stine Bæk; Dinesen, Birthe

    2016-02-01

    The aim of this article is to describe the development and testing of a prototype application ("The Heart Game") using gamification principles to assist heart patients in their telerehabilitation process in the Teledialog project. A prototype game was developed via user-driven innovation and tested on 10 patients 48-89 years of age and their relatives for a period of 2 weeks. The application consisted of a series of daily challenges given to the patients and relatives and was based on several gamification principles. A triangulation of data collection techniques (interviews, participant observations, focus group interviews, and workshop) was used. Interviews with three healthcare professionals and 10 patients were carried out over a period of 2 weeks in order to evaluate the use of the prototype. The heart patients reported the application to be a useful tool as a part of their telerehabilitation process in everyday life. Gamification and gameful design principles such as leaderboards, relationships, and achievements engaged the patients and relatives. The inclusion of a close relative in the game motivated the patients to perform rehabilitation activities. "The Heart Game" concept presents a new way to motivate heart patients by using technology as a social and active approach to telerehabilitation. The findings show the potential of using gamification for heart patients as part of a telerehabilitation program. The evaluation indicated that the inclusion of the patient's spouse in the rehabilitation activities could be an effective strategy. A major challenge in using gamification for heart patients is avoiding a sense of defeat while still adjusting the level of difficulty to the individual patient.

  2. “The Heart Game”: Using Gamification as Part of a Telerehabilitation Program for Heart Patients

    Science.gov (United States)

    Dithmer, Marcus; Grönvall, Erik; Spindler, Helle; Hansen, John; Nielsen, Gitte; Sørensen, Stine Bæk; Dinesen, Birthe

    2016-01-01

    Abstract Objective: The aim of this article is to describe the development and testing of a prototype application (“The Heart Game”) using gamification principles to assist heart patients in their telerehabilitation process in the Teledialog project. Materials and Methods: A prototype game was developed via user-driven innovation and tested on 10 patients 48–89 years of age and their relatives for a period of 2 weeks. The application consisted of a series of daily challenges given to the patients and relatives and was based on several gamification principles. A triangulation of data collection techniques (interviews, participant observations, focus group interviews, and workshop) was used. Interviews with three healthcare professionals and 10 patients were carried out over a period of 2 weeks in order to evaluate the use of the prototype. Results: The heart patients reported the application to be a useful tool as a part of their telerehabilitation process in everyday life. Gamification and gameful design principles such as leaderboards, relationships, and achievements engaged the patients and relatives. The inclusion of a close relative in the game motivated the patients to perform rehabilitation activities. Conclusions: “The Heart Game” concept presents a new way to motivate heart patients by using technology as a social and active approach to telerehabilitation. The findings show the potential of using gamification for heart patients as part of a telerehabilitation program. The evaluation indicated that the inclusion of the patient's spouse in the rehabilitation activities could be an effective strategy. A major challenge in using gamification for heart patients is avoiding a sense of defeat while still adjusting the level of difficulty to the individual patient. PMID:26579590

  3. Heart Health (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    Cardiovascular disease, which includes heart disease, stroke, and high blood pressure, is the leading cause of death in the U.S. This podcast discusses the importance of controlling the risk factors that can lead to heart disease.

  4. Heart Health (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    Cardiovascular disease, which includes heart disease, stroke, and high blood pressure, is the leading cause of death in the U.S. One in 10 U.S. adults have been diagnosed with some form of heart disease. In this podcast, Dr. Matthew Ritchey discusses the four simple steps to prevent heart disease.

  5. Celebrities Gather to Fight Heart Disease

    Science.gov (United States)

    ... Current Issue Past Issues Celebrities Gather to Fight Heart Disease Past Issues / Spring 2007 Table of Contents For ... Kit to offer community education programs on women's heart disease. Organize heart-health screening events and health fairs ...

  6. Health behavior of patients with ischemic heart disease

    Directory of Open Access Journals (Sweden)

    Paweł Węgorowski

    2017-06-01

    Full Text Available Admission By analyzing the available scientific literature, it is possible to define ischemic heart disease as a set of disease symptoms that are a consequence of a chronic state of imbalance between the ability to supply nutrients and oxygen and the real need of myocardial cells for these substances. Adapting life-style behaviors to healthy living is a priority to prevent the onset and development of cardiovascular disease, especially ischemic heart disease, Purpose of research The aim of the study is to determine the health behavior of patients with ischemic heart disease. Materials and methods The study was conducted from 01.08.2015 to 28.12.2015 in a group of 35 people (15 women and 20 men. The research method used in the work is a diagnostic survey, the research technique used was a survey of its own author. Conclusions By analyzing the data collected, it is important to note that patients with coronary heart disease are often associated with health problems such as hypertension, diabetes and abnormal weight. The nutritional habits of the subjects studied can be described as abnormal, particularly the excessive intake of oily meat and too little fish intake. It has also been observed that most of the patients studied have familial predisposition to ischemic heart disease. Discussion Heart attacks occur mostly in people with obesity, diabetes and atherosclerosis. It is also closely related to ischemic heart disease. The health behaviors of patients suffering from Ischemic Heart Disease are moderately satisfactory and therefore the role of a nurse practitioner as a health educator is very difficult but essential in the prevention of ischemic heart disease.

  7. Quality and Health Literacy Demand of Online Heart Failure Information.

    Science.gov (United States)

    Cajita, Maan Isabella; Rodney, Tamar; Xu, Jingzhi; Hladek, Melissa; Han, Hae-Ra

    The ubiquity of the Internet is changing the way people obtain their health information. Although there is an abundance of heart failure information online, the quality and health literacy demand of these information are still unknown. The purpose of this study is to evaluate the quality and health literacy demand (readability, understandability, and actionability) of the heart failure information found online. Google, Yahoo, Bing, Ask.com, and DuckDuckGo were searched for relevant heart failure Web sites. Two independent raters then assessed the quality and health literacy demand of the included Web sites. The quality of the heart failure information was assessed using the DISCERN instrument. Readability was assessed using 7 established readability tests. Finally, understandability and actionability were assessed using the Patient Education Materials Assessment Tool for Print Materials. A total of 46 Web sites were included in this analysis. The overall mean quality rating was 46.0 ± 8.9 and the mean readability score was 12.6 grade reading level. The overall mean understandability score was 56.3% ± 16.2%. Finally, the overall mean actionability score was 34.7% ± 28.7%. The heart failure information found online was of fair quality but required a relatively high health literacy level. Web content authors need to consider not just the quality but also the health literacy demand of the information found in their Web sites. This is especially important considering that low health literacy is likely prevalent among the usual audience.

  8. Heart check: the development and evolution of an organizational heart health assessment.

    Science.gov (United States)

    Golaszewski, Thomas; Fisher, Brian

    2002-01-01

    The purpose of this article is to document the development, testing, and application of an organizational assessment tool used to measure employer support for heart health. Additional information is presented on its future research and applications plan. This article represents the pooling of results from multiple studies using a variety of designs, including pilot tests, cross-sectional analyses, and quasi-experiments. Worksites covering the spectrum of employers across industry types and size, and throughout all of New York State. Over 10,000 New York employees and 1000 New York employers are represented in the multiple phases of this research. Heart Check is a 226-item inventory designed to measure such features in the worksite as organizational foundations, administrative supports, tobacco control, nutrition support, physical activity support, stress management, screening services, and company demographics. Additional side studies used professional judgments and behavioral surveys. As an assessment tool Heart Check shows evidence for reliability and validity. Applications of the instrument show characteristics that define high-scoring companies, quasi standards for New York employers, and, when applied during interventions, positive changes in organizational support levels. A relatively inexpensive, easy-to-use, and metrically tested instrument exists for measuring the construct of organizational support for employee heart health. The instrument shows promise as part of a system to enhance heart health through public health-based interventions in the workplace.

  9. Health Activities Project (HAP): Heart Fitness and Action Module.

    Science.gov (United States)

    Buller, Dave; And Others

    Contained within this Health Activities Project (HAP) learning packet are activities for children in grades 5-8. Design of the activities centers around the idea that students can control their own health and safety. Within the Heart Fitness and Action Module are teacher and student folios describing five activities which involve students in…

  10. Heart Health (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2014-02-27

    Cardiovascular disease, which includes heart disease, stroke, and high blood pressure, is the leading cause of death in the U.S. One in 10 U.S. adults have been diagnosed with some form of heart disease. In this podcast, Dr. Matthew Ritchey discusses the four simple steps to prevent heart disease.  Created: 2/27/2014 by MMWR.   Date Released: 2/27/2014.

  11. Clinic Health Awareness Program Subsystem -

    Data.gov (United States)

    Department of Transportation — Clinic Health Awareness Program Subystem (CHAPS) is a comprehensive system for recording, reporting, and analyzing a patient’s medical information and managing an...

  12. At the heart of soil health

    Science.gov (United States)

    Soil health is receiving resurgent attention with a number of recent national soil health initiatives which are sponsored by cooperators from diverse sectors including agribusiness, commodity groups, governmental organizations, and non-profits. The health of the soil is dependent on its biology. A...

  13. Heart Health (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2014-02-27

    Cardiovascular disease, which includes heart disease, stroke, and high blood pressure, is the leading cause of death in the U.S. This podcast discusses the importance of controlling the risk factors that can lead to heart disease.  Created: 2/27/2014 by MMWR.   Date Released: 2/27/2014.

  14. 'THE UNVEILED HEART' a teaching program in cardiovascular nuclear medicine

    International Nuclear Information System (INIS)

    Itti, Roland; Merabet, Yasmina; Roca, Ramona; Bontemps, Laurence; Itti, Emmanuel

    2004-01-01

    The functional investigation of cardiac diseases using nuclear techniques involves several variables, such as myocardial perfusion, cellular viability or mechanical contraction. The combined, topographical and quantitative assessment of these variables can characterize the functional state of the heart in terms of normal myocardium, ischemia, hibernation or necrosis. The teaching program, 'The Unveiled Heart', has been designed in order to help nuclear physicians or cardiologists approaching these concepts and their implications for diagnosis of coronary artery disease, optimization of therapeutic strategies and prognosis evaluation. Anatomical correlations with coronary angiographic results obtained during balloon occlusion at the time of coronary angioplasty demonstrate the complementary role of imaging techniques and highlight the patient to patient variability of risk areas. A sectorial model derived from a polar projection of the myocardium presents for each sector the probability of involvement of a given coronary artery

  15. The American Heart Association Ideal Cardiovascular Health and Incident Type 2 Diabetes Mellitus Among Blacks: The Jackson Heart Study

    OpenAIRE

    Effoe, Valery S.; Carnethon, Mercedes R.; Echouffo‐Tcheugui, Justin B.; Chen, Haiying; Joseph, Joshua J.; Norwood, Arnita F.; Bertoni, Alain G.

    2017-01-01

    Background: The concept of ideal cardiovascular health (CVH), defined by the American Heart Association primarily for coronary heart disease and stroke prevention, may apply to diabetes mellitus prevention among blacks. Methods and Results: Our sample included 2668 adults in the Jackson Heart Study with complete baseline data on 6 of 7 American Heart Association CVH metrics (body mass index, healthy diet, smoking, total cholesterol, blood pressure, and physical activity). Incident diabetes me...

  16. Healthy hearts--and the universal benefits of being physically active: physical activity and health.

    Science.gov (United States)

    Blair, Steven N; Morris, Jeremy N

    2009-04-01

    Although ancient thinkers suggested that physical activity is good for health, systematic research on the topic did not begin until the middle of the 20th century. Early reports showed that individuals in active occupations had lower rates of heart disease than individuals in sedentary occupations. Investigators then began to evaluate leisure-time physical activity and health and found similar results. Later research used objective measures of cardiorespiratory fitness as the exposure, and found even stronger associations with health outcomes. Recent research has extended the earlier findings on activity or fitness and heart disease to a wide variety of health outcomes. We now know that regular physical activity of 150 minutes/week of moderate intensity physical activity reduces the risk of numerous chronic diseases, preserves health and function (both physical and mental) into old age, and extends longevity. The current challenge is to develop programs and interventions to promote physical activity for all in our increasingly sedentary societies.

  17. The Evaluation of a Regional Faith Community Network's Million Hearts Program.

    Science.gov (United States)

    Cooper, Jennifer; Zimmerman, Wendy

    2016-01-01

    The goal of the Million Hearts initiative is to prevent one million heart attacks and strokes by 2017. Maryland was one state in the Association of State and Territorial Health Official's Million Hearts State Learning Collaborative. Washington County, Maryland formed a collaboration between the County Health Department, Meritus Health System, and the Meritus Health Parish Nurse Coordinator to address hypertension in the county. Within a regional network of 52 faith communities, the Parish Nurse Coordinator recruited 25 faith community nurses to participate in a three-month program. Nurses were trained on proper blood pressure measurement and 22 nurses identified 58 participants engaged in blood pressure self-monitoring and coaching for lifestyle changes. Additionally, nurses took 1,729 blood pressures and provided health education to individuals within their congregations. Fifty-one participants participated in blood pressure self-monitoring and lifestyle coaching with faith community nurses. There was improvement in six out of seven lifestyle areas. Eight-two percent of participants (N = 42) decreased their systolic and/or diastolic blood pressure over three months. Coaching provided by faith community nurses can create an environment of sustained support to promote improved lifestyle and blood pressure changes over time. © 2015 Wiley Periodicals, Inc.

  18. Screening for congenital heart malformations in child health centres

    NARCIS (Netherlands)

    R.E. Juttmann (Rikard)

    1999-01-01

    textabstractThe objective of this thesis is to clarify the effectiveness and the efficiency of screening for congenital heart malformations in Dutch child health centres and the possibilities to optimise this prevention programme. To this end the following main questions will be addressed. 1. Does

  19. Health actions and disease patterns related to coronary heart ...

    African Journals Online (AJOL)

    The health-related behaviour of the Cape Peninsula coloured population, which has been shown to have an adverse coronary heart disease (CHO) risk factor profile, is reported. Private medical services were used most often by participants: 54,1% and 51,6% of males and females respectively had made use of these ...

  20. Salud Para Su Corazon-NCLR: a comprehensive Promotora outreach program to promote heart-healthy behaviors among hispanics.

    Science.gov (United States)

    Balcazar, Hector; Alvarado, Matilde; Hollen, Mary Luna; Gonzalez-Cruz, Yanira; Hughes, Odelinda; Vazquez, Esperanza; Lykens, Kristine

    2006-01-01

    This article describes results of year-1 implementation of the Salud Para Su Corazón (Health For Your Heart)-National Council of la Raza (NCLR) promotora (lay health worker) program for promoting heart-healthy behaviors among Latinos. Findings of this community outreach initiative include data from promotora pledges and self-skill behaviors, cardiovascular disease risk factors of Latino families, family heart-health education delivery, and program costs associated with promotora time. Participation included 29 trained promotoras serving 188 families from three NCLR affiliates in Escondido, California; Chicago, Illinois; and Ojo Caliente, New Mexico. Using several evaluation tools, the results showed that the promotora approach worked based on evidence obtained from the following indicators: changes in promotora's pre-post knowledge and performance skills, progress toward their pledge goals following training, recruiting and teaching families, providing follow-up, and organizing or participating in community events. Strengths and limitations of the promotora model approach are also discussed.

  1. Health Programs for Veterans

    Science.gov (United States)

    ... Accountability & Whistleblower Protection Transparency Media Room Inside the Media Room Public Affairs News Releases Speeches Videos Publications National Observances Veterans Day Memorial Day Celebrating America's Freedoms Special Events Adaptive Sports Program Creative Arts Festival ...

  2. Environmental health program activities

    Science.gov (United States)

    Bergtholdt, C. P.

    1969-01-01

    Activities reported include studies on toxic air contaminants, excessive noise, poor lighting, food sanitation, water pollution, and exposure to nonionizing radiation as health hazards. Formulations for a radiological health manual provide guidance to personnel in the procurement and safe handling of radiation producing equipment and Apollo mission planning. A literature search and development of a water analysis laboratory are outlined to obtain information regarding microbiological problems involving potable water, waste management, and personal hygiene.

  3. Childrens Health Insurance Program (CHIP)

    Data.gov (United States)

    U.S. Department of Health & Human Services — This Web site discusses and provides downloadable data on state and program type, number of children ever enrolled, and the percentage of growth compared to the...

  4. Lessons from Canada's health program.

    Science.gov (United States)

    Terris, M

    1990-01-01

    The Canadian health program is described and analyzed. Positive features include financing through progressive taxation; complete coverage of physician and hospital services; complete absence of deductibles, copayments, and extra charges by physicians and hospitals; lower administrative costs because private insurance companies are excluded from the program; and avoidance of the straitjacket of a single federal program by decentralization to the provinces. Negative features include ever-rising costs due to the almost complete dominance of fee-for-service payment to physicians; failure to monitor the quality of care; and neglect of serious support for preventive services and improved living standards--the two most important determinants of health status. Recommendations are made for a U.S. national health program that would incorporate the positive features of the Canadian program and avoid its deficiencies.

  5. Alaska Dental Health Aide Program.

    Science.gov (United States)

    Shoffstall-Cone, Sarah; Williard, Mary

    2013-01-01

    In 1999, An Oral Health Survey of American Indian and Alaska Native (AI/AN) Dental Patients found that 79% of 2- to 5-year-olds had a history of tooth decay. The Alaska Native Tribal Health Consortium in collaboration with Alaska's Tribal Health Organizations (THO) developed a new and diverse dental workforce model to address AI/AN oral health disparities. This paper describes the workforce model and some experience to date of the Dental Health Aide (DHA) Initiative that was introduced under the federally sanctioned Community Health Aide Program in Alaska. These new dental team members work with THO dentists and hygienists to provide education, prevention and basic restorative services in a culturally appropriate manner. The DHA Initiative introduced 4 new dental provider types to Alaska: the Primary Dental Health Aide, the Expanded Function Dental Health Aide, the Dental Health Aide Hygienist and the Dental Health Aide Therapist. The scope of practice between the 4 different DHA providers varies vastly along with the required training and education requirements. DHAs are certified, not licensed, providers. Recertification occurs every 2 years and requires the completion of 24 hours of continuing education and continual competency evaluation. Dental Health Aides provide evidence-based prevention programs and dental care that improve access to oral health care and help address well-documented oral health disparities.

  6. Alaska Dental Health Aide Program

    Directory of Open Access Journals (Sweden)

    Sarah Shoffstall-Cone

    2013-08-01

    Full Text Available Background. In 1999, An Oral Health Survey of American Indian and Alaska Native (AI/AN Dental Patients found that 79% of 2- to 5-year-olds had a history of tooth decay. The Alaska Native Tribal Health Consortium in collaboration with Alaska’s Tribal Health Organizations (THO developed a new and diverse dental workforce model to address AI/AN oral health disparities. Objectives. This paper describes the workforce model and some experience to date of the Dental Health Aide (DHA Initiative that was introduced under the federally sanctioned Community Health Aide Program in Alaska. These new dental team members work with THO dentists and hygienists to provide education, prevention and basic restorative services in a culturally appropriate manner. Results. The DHA Initiative introduced 4 new dental provider types to Alaska: the Primary Dental Health Aide, the Expanded Function Dental Health Aide, the Dental Health Aide Hygienist and the Dental Health Aide Therapist. The scope of practice between the 4 different DHA providers varies vastly along with the required training and education requirements. DHAs are certified, not licensed, providers. Recertification occurs every 2 years and requires the completion of 24 hours of continuing education and continual competency evaluation. Conclusions. Dental Health Aides provide evidence-based prevention programs and dental care that improve access to oral health care and help address well-documented oral health disparities.

  7. Promoting heart health: an HBCU collaboration with the Living Heart Foundation and the National Football League Retired Players Association.

    Science.gov (United States)

    Valentine, Peggy; Duren-Winfield, Vanessa; Onsomu, Elijah O; Hoover, Eddie L; Cammock, Cheryl E; Roberts, Arthur

    2012-01-01

    Cardiovascular disease continues to be the leading cause of death in the United States and African Americans are disproportionately affected. Cardiovascular disease risk factors such as obesity, hypertension, family history of heart disease, and physical inactivity are often higher in African American young adults. The aim of the current study was to assess cardiovascular disease risk factors at a historically black college and university (HBCU) in North Carolina. A collaborative partnership was established that included Living Heart Foundation, the NFL Retired Players Association and a HBCU. Ninety-one students (77 females and 14 males) aged 18 to 55 years (mean, 24 y, SD = 9 y) were recruited via dissemination of flyers, brochures, mass e-mailing, and announcements. Demographic and medical history data were collected. Stata version 10.1 was used for all analyses. Fifty-three percent of the participants reported having experienced a chronic health condition, 32% were overweight (body mass index [BMI], 25-29.9 kg/m2) and 31% obese (BMI > or = 30 kg/m2). Five percent of females and 23% of males had high-density lipoprotein cholesterol of 40 mg/dL or less, indicative of a risk for developing heart disease. There is an urgent need to intervene among African American college students and address behavioral risk factors for cardiovascular disease. Such interventions may have a major impact on their overall and future health outcomes. Strategies to be employed need to focus on the integration of culturally appropriate healthy lifestyle programs into the curriculum and university health centers. Consultations with stakeholders for ideas and resources should be encouraged.

  8. Intervention Mapping Approach in the Design of an Interactive Mobile Health Application to Improve Self-care in Heart Failure.

    Science.gov (United States)

    Athilingam, Ponrathi; Clochesy, John M; Labrador, Miguel A

    2018-02-01

    Heart failure is a complex syndrome among older adults who may experience and interpret symptoms differently. These differences in symptom interpretation may influence decision-making in symptom management. A well-informed and motivated person may develop the knowledge and skills needed to successfully manage symptoms. Therefore, the patient-centered mobile health application HeartMapp was designed to engage patients with heart failure in self-care management by offering tailored alerts and feedback using mobile phones. The main objective of this article is to describe the six-step intervention mapping approach including (1) the initial needs assessment, (2) proximal program objective, (3) selection of theory-based methods, (4) the translation of objectives into an actual program plan for mobile health intervention, (5) adaptation and implementation plan, and (6) evaluation plan that assisted the team in the development of a conceptual framework and intervention program matrix during the development of HeartMapp. The HeartMapp intervention takes the information, motivation, and behavioral skills model as the theoretical underpinning, with "patient engagement" as the key mediator in achieving targeted and persistent self-care behavioral changes in patients with heart failure. The HeartMapp intervention is proposed to improve self-care management and long-term outcomes.

  9. Improving access to important recovery information for heart patients with low health literacy: reflections on practice-based initiatives.

    Science.gov (United States)

    Naccarella, Lucio; Biuso, Catuscia; Jennings, Amanda; Patsamanis, Harry

    2018-05-29

    Evidence exists for the association between health literacy and heart health outcomes. Cardiac rehabilitation is critical for recovery from heart attack and reducing hospital readmissions. Despite this, literacy. This brief case study reflects and documents practice-based initiatives by Heart Foundation Victoria to improve access to recovery information for patients with low literacy levels. Three key initiatives, namely the Six Steps To Cardiac Recovery resource, the Love Your Heart book and the nurse ambassador program, were implemented informed by mixed methods that assessed need and capacity at the individual, organisational and systems levels. Key outcomes included increased access to recovery information for patients with low health literacy, nurse knowledge and confidence to engage with patients on recovery information, improved education of patients and improved availability and accessibility of information for patients in diverse formats. Given the challenges involved in addressing heart health literacy, multifaceted practice-based approaches are essential to improve access to recovery information for patients with low literacy levels. What is known about the topic? Significant challenges exist for patients with lower health literacy receiving recovery information after a heart attack in hospitals. What does this paper add? This case study provides insights into a practice-based initiative by Heart Foundation Victoria to improve access to recovery information for patients with low literacy levels. What are the implications for practitioners? Strategies to improve recovery through increased heart health literacy must address the needs of patients, nursing staff and the health system within hospitals. Such strategies need to be multifaceted and designed to build the capacity of nurses, heart patients and their carers, as well as support from hospital management.

  10. Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model: A Web-based program designed to evaluate the cost-effectiveness of disease management programs in heart failure.

    Science.gov (United States)

    Reed, Shelby D; Neilson, Matthew P; Gardner, Matthew; Li, Yanhong; Briggs, Andrew H; Polsky, Daniel E; Graham, Felicia L; Bowers, Margaret T; Paul, Sara C; Granger, Bradi B; Schulman, Kevin A; Whellan, David J; Riegel, Barbara; Levy, Wayne C

    2015-11-01

    Heart failure disease management programs can influence medical resource use and quality-adjusted survival. Because projecting long-term costs and survival is challenging, a consistent and valid approach to extrapolating short-term outcomes would be valuable. We developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model, a Web-based simulation tool designed to integrate data on demographic, clinical, and laboratory characteristics; use of evidence-based medications; and costs to generate predicted outcomes. Survival projections are based on a modified Seattle Heart Failure Model. Projections of resource use and quality of life are modeled using relationships with time-varying Seattle Heart Failure Model scores. The model can be used to evaluate parallel-group and single-cohort study designs and hypothetical programs. Simulations consist of 10,000 pairs of virtual cohorts used to generate estimates of resource use, costs, survival, and incremental cost-effectiveness ratios from user inputs. The model demonstrated acceptable internal and external validity in replicating resource use, costs, and survival estimates from 3 clinical trials. Simulations to evaluate the cost-effectiveness of heart failure disease management programs across 3 scenarios demonstrate how the model can be used to design a program in which short-term improvements in functioning and use of evidence-based treatments are sufficient to demonstrate good long-term value to the health care system. The Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model provides researchers and providers with a tool for conducting long-term cost-effectiveness analyses of disease management programs in heart failure. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Heart smart: a multifaceted cardiovascular risk reduction program for grade school students.

    Science.gov (United States)

    Hunter, S M; Johnson, C C; Little-Christian, S; Nicklas, T A; Harsha, D; Arbeit, M L; Webber, L S; Berenson, G S

    1990-05-01

    Abstract Heart Smart Program is a health education intervention for grades kindergarten through six which encourages the acquisition and maintenance of health-enhancing behaviors. These include nutritious eating habits; physical fitness and exercise; saying "no" to cigarette smoking, alcohol, and drugs; and control of stress. Social Cognitive Theory is used to derive the necessary training concepts for children with reinforcement of these concepts occurring in six areas: the curriculum, school lunch, staff development, physical activity, environment, and parental support. The necessary training mechanisms provide mastery experiences, knowledge transfer, role modeling, and emotional and physiological feedback. The program incorporates the influence of the social environment on learning and builds support from parents, teachers and school staff.

  12. Effects of Psychoeducation on Mental Health in Patients With Coronary Heart Disease.

    Science.gov (United States)

    Bashiri, Zahra; Aghajani, Mohammad; Masoudi Alavi, Negin

    2016-05-01

    Patients with coronary heart disease are at high risk for mental health disorders, such as depression and anxiety. Psychoeducation is a well-known intervention for psychiatric patients, but its use has been limited in other health conditions, such as coronary heart disease. The aim of this study was to evaluate the effect of psychoeducation on mental health in coronary heart disease patients. This randomized clinical trial included 70 patients with coronary heart disease at Shahid Beheshti hospital, in Kashan, Iran, in 2014. The patients were randomly assigned into two groups: the experimental group, which received eight sessions of psychoeducation, and the control group, which received routine care. Data were collected with the Goldberg mental health questionnaire (GHQ) and were analyzed using independent and paired t-tests performed with SPSS version 16. The means of overall GHQ scores were significantly decreased post-test in the intervention group, and the differences between the two groups were statistically significant in the overall GHQ scores (P = 0.0001). A significant difference was observed between the mean GHQ scores of the intervention group prior to and after the psychoeducational program (PEP) intervention (30 ± 4.66 vs. 20.50 ± 3.30) (P = 0.0001). No significant changes were observed in the control group pre- and post-test (P = 0.07). Psychoeducation resulted in improved mental health in patients with coronary heart disease. Therefore, it is recommended that this approach be performed as a complementary, effective, non-invasive, low-cost nursing intervention to reduce psychological problems in these patients.

  13. [Health valuations for patients with chronic ischemic heart disease].

    Science.gov (United States)

    Meder, M; Farin, E

    2011-08-01

    The study deals with the question of how patients with chronic ischemic heart disease assess different health situations that can be achieved by rehabilitation. Furthermore it examines which factors influence these health valuations and whether the predictors vary depending on the level of education. The health valuations of n = 331 patients with chronic ischemic heart disease are compiled using visual analogue scales (VAS). In addition to sociodemographic questions, generic and illness-specific scales (SF-12, MacNew) for the health-related quality of life (HRQOL) are used as potential predictors of the health valuations. Additional basic medical data were provided by the physician. Hierarchical regression analyses are conducted; the sociodemographic, medical and HRQOL variables are included stepwise. Since many variables are observed for the regression models, an imputation of missing values is made. The health dimensions "Self-care and domestic life" and "Mobility" are assigned the highest values on the VAS. The lowest preference is assigned to the dimensions "Reduction of symptoms" and "Information about the disease". The differences between the health dimensions are statistically significant. Sociodemographic variables explain up to 3.6% of the variance of health valuations, with level of education and living with a partner being the most important predictors. The medical variables included in the second step explain between 2.1 and 6.8% incremental variance; the most important predictor is the operation performed prior to rehabilitation (bypass, heart valve). The HRQOL variables in the third block provide 7.1-24.9% incremental explanation of variance, by far the highest percentage. This is mainly achieved using the 3 MacNew scales (emotional, social and physical functioning). The overall explanation of variance for the health valuations is 17.1-28.8%. For patients with a higher level of education, the total explanation of variance is about 9.2% higher on

  14. Heart Rates of Elementary Physical Education Students during the Dancing Classrooms Program

    Science.gov (United States)

    Nelson, Larry; Evans, Melissa; Guess, Wendy; Morris, Mary; Olson, Terry; Buckwalter, John

    2011-01-01

    We examined how different types of dance activities, along with their duration, influenced heart rate responses among fifth-grade physical education students (N = 96) who participated in the Dancing Classrooms program. Results indicated that the overall Dancing Classrooms program elicits a moderate cardiovascular heart rate response (M = 124.4…

  15. Kennedy Space Center Coronary Heart Disease Risk Screening Program

    Science.gov (United States)

    Tipton, David A.; Scarpa, Philip J.

    1999-01-01

    The number one cause of death in the U.S. is coronary heart disease (CHD). It is probably a major cause of death and disability in the lives of employees at Kennedy Space Center (KSC) as well. The KSC Biomedical Office used a multifactorial mathematical formula from the Framingham Heart Study to calculate CHD risk probabilities for individuals in a segment of the KSC population that required medical evaluation for job certification. Those assessed to be high-risk probabilities will be targeted for intervention. Every year, several thousand KSC employees require medical evaluations for job related certifications. Most medical information for these evaluations is gathered on-site at one of the KSC or Cape Canaveral Air Station (CCAS) medical clinics. The formula used in the Framingham Heart Study allows calculation of a person's probability of acquiring CHD within 10 years. The formula contains the following variables: Age, Diabetes, Smoking, Left Ventricular Hypertrophy, Blood Pressure (Systolic or Diastolic), Cholesterol, and HDL cholesterol. The formula is also gender specific. It was used to calculate the 10-year probabilities of CHD in KSC employees who required medical evaluations for job certifications during a one-year time frame. This KSC population was profiled and CHD risk reduction interventions could be targeted to those at high risk. Population risk could also be periodically reevaluated to determine the effectiveness of intervention. A 10-year CHD risk probability can be calculated for an individual quite easily while gathering routine medical information. An employee population's CHD risk probability can be profiled graphically revealing high risk segments of the population which can be targeted for risk reduction intervention. The small audience of NASA/contractor physicians, nurses and exercise/fitness professionals at the breakout session received the lecture very well. Approximately one third indicated by a show of hands that they would be

  16. 77 FR 9842 - Health Claim; Phytosterols and Risk of Coronary Heart Disease

    Science.gov (United States)

    2012-02-21

    ... (formerly 2006P-0316)] Health Claim; Phytosterols and Risk of Coronary Heart Disease AGENCY: Food and Drug... concerning the use of the health claim for phytosterols and risk of coronary heart disease (CHD), in a manner... risk of coronary heart disease (CHD) for phytosterol-containing conventional food and dietary...

  17. School Health: Findings from Evaluated Programs.

    Science.gov (United States)

    Public Health Service (DHHS), Rockville, MD. Office of Disease Prevention and Health Promotion.

    This publication presents findings from evaluations of many school health programs from across the United States. Each program includes at least one of the following eight components of a comprehensive school health program: health education, clinical services, counseling and mental health services, school environment, school food programs,…

  18. Occupational Health Services Plans to Make February a Healthy, Heart-y Month | Poster

    Science.gov (United States)

    In celebration of American Heart Month this February, Occupational Health Services is hosting multiple events to promote heart health and raise awareness about heart disease and its associated risks. American Heart Month kicks off on Monday, January 29, when staff will be sponsoring a table outside of the 15th Annual Protective Services Chili Cookoff and holding a raffle for free gym bags to encourage employees to stay active.

  19. Public health program capacity for sustainability: a new framework.

    Science.gov (United States)

    Schell, Sarah F; Luke, Douglas A; Schooley, Michael W; Elliott, Michael B; Herbers, Stephanie H; Mueller, Nancy B; Bunger, Alicia C

    2013-02-01

    Public health programs can only deliver benefits if they are able to sustain activities over time. There is a broad literature on program sustainability in public health, but it is fragmented and there is a lack of consensus on core constructs. The purpose of this paper is to present a new conceptual framework for program sustainability in public health. This developmental study uses a comprehensive literature review, input from an expert panel, and the results of concept-mapping to identify the core domains of a conceptual framework for public health program capacity for sustainability. The concept-mapping process included three types of participants (scientists, funders, and practitioners) from several public health areas (e.g., tobacco control, heart disease and stroke, physical activity and nutrition, and injury prevention). The literature review identified 85 relevant studies focusing on program sustainability in public health. Most of the papers described empirical studies of prevention-oriented programs aimed at the community level. The concept-mapping process identified nine core domains that affect a program's capacity for sustainability: Political Support, Funding Stability, Partnerships, Organizational Capacity, Program Evaluation, Program Adaptation, Communications, Public Health Impacts, and Strategic Planning. Concept-mapping participants further identified 93 items across these domains that have strong face validity-89% of the individual items composing the framework had specific support in the sustainability literature. The sustainability framework presented here suggests that a number of selected factors may be related to a program's ability to sustain its activities and benefits over time. These factors have been discussed in the literature, but this framework synthesizes and combines the factors and suggests how they may be interrelated with one another. The framework presents domains for public health decision makers to consider when developing

  20. Congenital Heart Disease: Guidelines of Care for Children with Special Health Care Needs.

    Science.gov (United States)

    Minnesota State Dept. of Health, Minneapolis. Services for Children with Handicaps.

    These guidelines were written to help families coordinate the health care that may be needed by a child with congenital heart disease. The booklet begins with general information about congenital heart disease. It then discusses the goals of health care, the health care team, the importance of periodic health care, and record keeping procedures.…

  1. A positive perspective of knowledge, attitude, and practices for health-promoting behaviors of adolescents with congenital heart disease.

    Science.gov (United States)

    Huang, Hui-Ru; Chen, Chi-Wen; Chen, Chin-Mi; Yang, Hsiao-Ling; Su, Wen-Jen; Wang, Jou-Kou; Tsai, Pei-Kwei

    2018-03-01

    Health-promoting behaviors could serve as a major strategy to optimize long-term outcomes for adolescents with congenital heart disease. The associations assessed from a positive perspective of knowledge, attitudes, and practice model would potentially cultivate health-promoting behaviors during adolescence. The purpose of this study was to examine the relationships between disease knowledge, resilience, family functioning, and health-promoting behaviors in adolescents with congenital heart disease. A total of 320 adolescents with congenital heart disease who were aged 12-18 years were recruited from pediatric cardiology outpatient departments, and participated in a cross-sectional survey. The participants completed the Leuven Knowledge Questionnaire for Congenital Heart Disease; Haase Adolescent Resilience in Illness Scale; Family Adaptability, Partnership, Growth, Affection, and Resolve; and Adolescent Health Promotion scales. The collected data were analyzed using descriptive statistics and three multiple regression models. Greater knowledge of prevention of complications and higher resilience had a more powerful effect in enhancing health-promoting behaviors. Having symptoms and moderate or severe family dysfunction were significantly more negatively predictive of health-promoting behaviors than not having symptoms and positive family function. The third model explained 40% of the variance in engaging in health-promoting behaviors among adolescents with congenital heart disease. The findings of this study provide new insights into the role of disease knowledge, resilience, and family functioning in the health-promoting behavior of adolescents with congenital heart disease. Continued efforts are required to plan family care programs that promote the acquisition of sufficient disease knowledge and the development of resilience for adolescents with congenital heart disease.

  2. Public Health Service Safety Program

    Energy Technology Data Exchange (ETDEWEB)

    McBride, J R [Southwestern Radiological Health Laboratory, Las Vegas, NV (United States)

    1969-07-01

    Off-Site Radiological Safety Programs conducted on past Plowshare experimental projects by the Southwestern Radiological Health Laboratory for the AEC will be presented. Emphasis will be placed on the evaluation of the potential radiation hazard to off-site residents, the development of an appropriate safety plan, pre- and post-shot surveillance activities, and the necessity for a comprehensive and continuing community relations program. In consideration of the possible wide use of nuclear explosives in industrial applications, a new approach to off-site radiological safety will be discussed. (author)

  3. Public Health Service Safety Program

    International Nuclear Information System (INIS)

    McBride, J.R.

    1969-01-01

    Off-Site Radiological Safety Programs conducted on past Plowshare experimental projects by the Southwestern Radiological Health Laboratory for the AEC will be presented. Emphasis will be placed on the evaluation of the potential radiation hazard to off-site residents, the development of an appropriate safety plan, pre- and post-shot surveillance activities, and the necessity for a comprehensive and continuing community relations program. In consideration of the possible wide use of nuclear explosives in industrial applications, a new approach to off-site radiological safety will be discussed. (author)

  4. Air Quality and Heart Health: Managing an Emerging ...

    Science.gov (United States)

    Dr. Cascio will share with a broad range of federal agencies current understanding of the links between air quality and cardiovascular health. The key facts include that air pollution contributes a high attributable health burden. That certain well-defined vulnerable subpopulations are at higher risk. At-risk populations include those with heart disease, lung disease and diabetes, older adults, children and individuals living in low socioeconomic neighborhoods. There is no established threshold level for safe long-term exposure to air particle pollution, and some of the basic biological mechanisms that account for adverse health effects are now known. This knowledge is giving us insight into how we might mitigate the effects apart from the regulatory efforts to improve overall air quality. Moreover, the work that each State has done to improve air quality has resulted in improved health outcomes including cardiovascular outcomes, and longer lives. The presentation will address: 1) What do we know? 2) Who are the at-risk populations? 3) What can communities do to reduce risk? 4) What can healthcare professionals do to reduce risk of the at-risk population? And 5) What tools are available to help healthcare professionals and their patients reduce exposure and risk from air pollutants? The talk will feature a description of the Air Quality Index and associated EPA tools and health information that can be used by health care providers to educate their at-ris

  5. 3 CFR - State Children's Health Insurance Program

    Science.gov (United States)

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false State Children's Health Insurance Program... Insurance Program Memorandum for the Secretary of Health and Human Services The State Children's Health Insurance Program (SCHIP) encourages States to provide health coverage for uninsured children in families...

  6. Women-Centered and Culturally Responsive Heart Health Promotion Among Indigenous Women in Canada.

    Science.gov (United States)

    Ziabakhsh, Shabnam; Pederson, Ann; Prodan-Bhalla, Natasha; Middagh, Diane; Jinkerson-Brass, Sharon

    2016-11-01

    Most women in Canada confront a combination of bio-psychosocial factors that put them at risk for cardiovascular disease. The challenge for health planners is to address these factors while contextualizing interventions that meet the specific needs of particular social and cultural groupings. The article will discuss a women-centered, group-based heart health pilot initiative designed to engage with indigenous approaches to healing. The nurse practitioners co-led the group with a representative from the indigenous community to balance women-centered practices with more traditional and culturally appropriate ones. In particular, indigenous processes, such as a Talking Circle, combined with indigenous knowledge/content were integrated into the pilot program. The project was evaluated to investigate its outcomes (how the intervention impacted the participants) and processes (how participants perceived the intervention). Evaluation involved analysis of the Talking Circle's content, a focus group, field observations, and self-completed surveys. Most women made changes regarding their diet, some began physical activities, and others focused on better managing their emotional health. Women viewed the group as successful because it embraced both women-centered and culturally appropriate health promotion practices. The intervention created a culturally safe space for learning and transformation. The findings confirm the need for employing culturally relevant, gender-specific approaches to heart health promotion that are situated in and responsive to community needs. © 2016 Society for Public Health Education.

  7. Heart health = urologic health and heart unhealthy = urologic unhealthy: rapid review of lifestyle changes and dietary supplements.

    Science.gov (United States)

    Moyad, Mark A

    2011-08-01

    Almost all aspects of urology are affected positively and negatively by certain lifestyle changes and dietary supplements. Some of these interventions have potential profound impacts independently or in combination with conventional therapy, others have no impact, and some could negatively impact treatment and overall health. The heart-healthiest recommendations have consistently served as the safest and most potentially effective options in urology from benign prostatic hyperplasia, chronic nonbacterial prostatitis, interstitial cystitis, multiple urologic cancers, male infertility, male and female sexual dysfunction, kidney stones, and Peyronie disease. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. The effect of programmed exercise on body compositions and heart rate of 11-13 years-old male students

    Directory of Open Access Journals (Sweden)

    Mohammad H. Dashti

    2011-11-01

    Full Text Available Background: Different forms of physical activities can play a very important role in improving health and physical fitness. The purpose of this study was to examine the effect of the programmed exercise on students’ body compositions and heart rate at rest.Materials and Method: Two groups each consisting of 15students, aged averagely 12.6 years were the subjects of this experimental study. The experimental group in each session took part in an exercise program consisting of 20 minutes of aerobic activity (running, 10 minutes of aerobic exercise, 30 minutes of local training and 5 minutes of free exercise. The experiment last for 24 sessions. Control group didn’t do any special practice. In both groups, weight, fat mass, fat percentage, lean body mass and heart rate were measured during rest period before and after the experiment. Results: Results showed that the fat percentage, weight, fat mass and heart rate had decreased after 8 weeks of programmed exercise in the experimental group unlike the control group. However, no significant difference was observed in lean body mass.Conclusion: The exercise program used in this study may help loosing weight and make the heart stronger

  9. Fatigue, General Health, and Ischemic Heart Disease in Older Adults

    DEFF Research Database (Denmark)

    Ekmann, Anette; Petersen, Inge; Mänty, Minna Regina

    2013-01-01

    Backgrounds.Fatigue has been shown to predict ischemic heart disease (IHD) and mortality in nonsmoking middle-aged men free of cardiovascular disease. The aim of this study was to investigate the predictive value of fatigue for IHD and general health in nondisabled individuals free...... of cardiovascular disease and older than 70 years. METHODS: The study population was drawn from The Longitudinal Study of Aging Danish Twins. In total, 1,696 participants were followed up for 2-10 years by questionnaires and 10-16 years through registries. Kaplan Meier, Cox Proportional Hazard and logistic.......08-2.00) compared with participants without fatigue. CONCLUSION: We concluded that fatigue in nondisabled older adults free of cardiovascular disease is an early predictor for development of subsequent poor general health and IHD....

  10. 76 FR 17139 - Health Center Program

    Science.gov (United States)

    2011-03-28

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Health Center Program AGENCY: Health Resources and Services Administration, HHS. ACTION: Notice of Noncompetitive... Improvement Project (CIP) from Saint Vincent's Catholic Medical Centers (SVCMC) of New York, current grantee...

  11. 76 FR 1441 - Health Center Program

    Science.gov (United States)

    2011-01-10

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Health Center Program AGENCY: Health Resources and Services Administration, HHS. ACTION: Notice of Noncompetitive... for Services (IDS) and a portion of the Capital Improvement Project (CIP) from Saint Vincent's...

  12. Community Health Status Indicators (CHSI) to Combat Obesity, Heart Disease and Cancer

    Data.gov (United States)

    U.S. Department of Health & Human Services — Community Health Status Indicators (CHSI) to combat obesity, heart disease, and cancer are major components of the Community Health Data Initiative. This dataset...

  13. Occupational Health Services Shows Its Support for American Heart Month | Poster

    Science.gov (United States)

    The American Heart Association (AHA) has recognized February as American Heart Month since President Lyndon B. Johnson’s 1964 proclamation made it an annual occurrence. Throughout the month, Occupational Health Services did its part to help educate NCI and Frederick National Lab employees about the dangers of heart disease.

  14. 75 FR 2549 - Health Center Program

    Science.gov (United States)

    2010-01-15

    ... Program AGENCY: Health Resources and Services Administration, HHS ACTION: Notice of Noncompetitive Replacement Award to Regional Health Care Affiliates. SUMMARY: The Health Resources and Services Administration (HRSA) will be transferring Health Center Program (section 330 of the Public Health Service Act...

  15. Heart health risk factors in Punjabi early teens

    Directory of Open Access Journals (Sweden)

    Elizabeth Mary John

    2014-01-01

    Full Text Available Context: India is experiencing an epidemiological health transition characterized by rapid decline in nutritional and parasitic diseases (pre-transitional diseases with an alarming rise in cardiovascular diseases, mainly coronary heart disease and stroke (post-transitional diseases. Many of these risk factors manifesting themselves as diseases in adults can be found during adolescence. Aims: To determine the prevalence of risk factors of heart disease among urban high-school students aged 13-15 yrs in Ludhiana city. Materials and Methods: This cross-sectional study included 330 high school-going early teens aged 13-15 years using a pretested questionnaire. Details regarding food habits, physical activity, and family history were collected along with anthropometric measures and blood pressure recordings. Statistical Analysis Used: Data was analysed using frequencies and proportion. Chi-square was the test of significance. Results: The prevalence of at least one risk factor in the population was 48.5%. Family history with prevalence of at least one coronary artery disease risk factor was of 27.4%, diabetic parents 12.2%, hypertension 17.6%, and heart disease was 1.8%. Physical inactivity as a risk factor showed an overall prevalence of 73%. Nearly 50% of the students consumed some junk food every day. Only 18.2% consume 3-5 servings of fruits per day, 11.2% do not take any fruits at all. Prevalence of overweight was 11.2% and 4.6% of them were obese. Hypertension was seen in 20.1% of subjects. Conclusions: The present generation of early teens are at high risk of future cardiovascular disease and schools and society need to address these issues urgently.

  16. [Effects of integrated disease management program on the outcome of patients with heart failure].

    Science.gov (United States)

    Fan, Hui-hua; Shi, Hao-ying; Jin, Wei; Zhu, Ya-juan; Huang, Dai-ni; Yan, Yi-wen; Zhu, Feng; Li, Hong-li; Liu, Jian; Liu, Shao-wen

    2010-07-01

    To investigate the feasibility and efficacy on the outcome of patients with heart failure of integrated disease management program with heart failure clinic, patient education and telephone follow-up. A total of 145 hospitalized patients with chronic heart failure and LVEF ≤ 45% or patients with LVEF > 45% and NT-proBNP > 1500 ng/L were divided into conventional group (n = 71) and interventional group (n = 74). Patients were followed for 10 to 12 months. Baseline clinical characteristics, LVEF and dose of evidence-based medicine were similar between the 2 groups. During follow-up, the NYHA functional class was higher in conventional group than interventional group (3.2 ± 0.5 vs 1.4 ± 0.5, P management program with heart failure clinic, patient education and telephone follow-up can improve patient compliance to heart failure treatment, improve cardiac function and reduce cardiovascular event rate.

  17. Dental health and management for children with congenital heart disease.

    LENUS (Irish Health Repository)

    FitzGerald, Kirsten

    2010-01-01

    Congenital heart disease (CHD) is one of the most common developmental anomalies. Children with CHD are at increased risk of developing oral disease, and are at increased risk from the systemic effects of oral disease. Recent changes in guidelines related to prophylaxis against infective endocarditis have highlighted the importance of establishing and maintaining oral health for this group of patients. The management of children with CHD can be complex and, unfortunately, many of these children do not receive the care they require. The challenges that these children pose are discussed, and suggestions are made for the appropriate management of these patients and the key role that all those working in primary dental care have to play.

  18. Dental health and management for children with congenital heart disease.

    LENUS (Irish Health Repository)

    FitzGerald, Kirsten

    2012-02-01

    Congenital heart disease (CHD) is one of the most common developmental anomalies. Children with CHD are at increased risk of developing oral disease, and are at increased risk from the systemic effects of oral disease. Recent changes in guidelines related to prophylaxis against infective endocarditis have highlighted the importance of establishing and maintaining oral health for this group of patients. The management of children with CHD can be complex and, unfortunately, many of these children do not receive the care they require. The challenges that these children pose are discussed, and suggestions are made for the appropriate management of these patients and the key role that all those working in primary dental care have to play.

  19. Heart failure with preserved ejection fraction in women : The dutch queen of hearts program

    NARCIS (Netherlands)

    den Ruijter, H.; Pasterkamp, G.; Rutten, F. H.; Lam, C. S P; Chi, C.; Tan, K. H.; van Zonneveld, A. J.; Spaanderman, M.; de Kleijn, D. P V

    2015-01-01

    Heart failure (HF) poses a heavy burden on patients, their families and society. The syndrome of HF comes in two types: with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF). The latter is on the increase and predominantly present in women, especially the older ones. There

  20. Have a Healthy Heart (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    Heart disease continues to be the leading cause of death for both men and women in the U.S. This podcast discusses the importance of decreasing the chances of developing heart disease via a healthy lifestyle.

  1. Clinical holistic medicine: the Dean Ornish program ("opening the heart") in cardiovascular disease.

    Science.gov (United States)

    Ventegodt, Søren; Merrick, Efrat; Merrick, Joav

    2006-02-02

    Dean Ornish of the Preventive Medicine Research Institute in Sausalito, California has created an intensive holistic treatment for coronary heart patients with improved diet (low fat, whole foods, plant based), exercise, stress management, and social support that has proven to be efficient. In this paper, we analyze the rationale behind his cure in relation to contemporary holistic medical theory. In spite of a complex treatment program, the principles seem to be simple and in accordance with holistic medical theories, like the Antonovsky concept of rehabilitating the sense of coherence and the life mission theory for holistic medicine. We believe there is a need for the allocation of resources for further research into the aspects of holistic health and its methods, where positive and significant results have been proven and reproduced at several sites.

  2. Effectiveness and cost of a transitional care program for heart failure: a prospective study with concurrent controls.

    Science.gov (United States)

    Stauffer, Brett D; Fullerton, Cliff; Fleming, Neil; Ogola, Gerald; Herrin, Jeph; Stafford, Pamala Martin; Ballard, David J

    2011-07-25

    Randomized controlled trials have demonstrated the efficacy of nurse-led transitional care programs to reduce readmission rates for patients with heart failure; the effectiveness of these programs in real-world health care systems is less well understood. We performed a prospective study with concurrent controls to test an advanced practice nurse-led transitional care program for patients with heart failure who were 65 years or older and were discharged from Baylor Medical Center Garland (BMCG) from August 24, 2009, through April 30, 2010. We compared the effect of the program on 30-day (from discharge) all-cause readmission rate, length of stay, and 60-day (from admission) direct cost for BMCG with that of other hospitals within the Baylor Health Care System. We also performed a budget impact analysis using costs and reimbursement experience from the intervention. The intervention significantly reduced adjusted 30-day readmission rates to BMCG by 48% during the postintervention period, which was better than the secular reductions seen at all other facilities in the system. The intervention had little effect on length of stay or total 60-day direct costs for BMCG. Under the current payment system, the intervention reduced the hospital financial contribution margin on average $227 for each Medicare patient with heart failure. Preliminary results suggest that transitional care programs reduce 30-day readmission rates for patients with heart failure. This underscores the potential of the intervention to be effective in a real-world setting, but payment reform may be required for the intervention to be financially sustainable by hospitals.

  3. Implementation and Evaluation of a Smartphone-Based Telemonitoring Program for Patients With Heart Failure: Mixed-Methods Study Protocol.

    Science.gov (United States)

    Ware, Patrick; Ross, Heather J; Cafazzo, Joseph A; Laporte, Audrey; Seto, Emily

    2018-05-03

    Meta-analyses of telemonitoring for patients with heart failure conclude that it can lower the utilization of health services and improve health outcomes compared with the standard of care. A smartphone-based telemonitoring program is being implemented as part of the standard of care at a specialty care clinic for patients with heart failure in Toronto, Canada. The objectives of this study are to (1) evaluate the impact of the telemonitoring program on health service utilization, patient health outcomes, and their ability to self-care; (2) identify the contextual barriers and facilitators of implementation at the physician, clinic, and institutional level; (3) describe patient usage patterns to determine adherence and other behaviors in the telemonitoring program; and (4) evaluate the costs associated with implementation of the telemonitoring program from the perspective of the health care system (ie, public payer), hospital, and patient. The evaluation will use a mixed-methods approach. The quantitative component will include a pragmatic pre- and posttest study design for the impact and cost analyses, which will make use of clinical data and questionnaires administered to at least 108 patients at baseline and 6 months. Furthermore, outcome data will be collected at 1, 12, and 24 months to explore the longitudinal impact of the program. In addition, quantitative data related to implementation outcomes and patient usage patterns of the telemonitoring system will be reported. The qualitative component involves an embedded single case study design to identify the contextual factors that influenced the implementation. The implementation evaluation will be completed using semistructured interviews with clinicians, and other program staff at baseline, 4 months, and 12 months after the program start date. Interviews conducted with patients will be triangulated with usage data to explain usage patterns and adherence to the system. The telemonitoring program was launched in

  4. ERDA artificial heart program workshop. Final report, September 1, 1975--August 31, 1976

    International Nuclear Information System (INIS)

    Kantrowitz, A.; Altieri, F.; Beall, A.

    1976-08-01

    The major conclusions of the ERDA Artificial Heart Program Workshop are that the concept of a biologically compatible mechanical device which can totally replace the heart is sound, that such a device is needed as an alternative to cardiac transplantation and that its development is a realistic goal. The major recommendation of the committee is that an ERDA program with primary orientation toward development of a total heart replacement should continue, with assured funding about 50 percent higher than at present, for a minimum of 3 additional years at which time another major review should take place. To achieve better management of the program it is recommended that the present contract effort be reorganized under one prime contractor with responsibility for development and demonstration of the ERDA artificial heart system. The formation of a joint artificial heart advisory committee to improve coordination between ERDA and NHLI is also recommended. The committee suggests future policies and directions which it believes will lead to more effective use of funds available for specific aspects of the program. These include the nuclear heart source, engine, blood pump, biomaterials and overall system reliability. Possible future goals for the program are also proposed

  5. Reliability studies for the nuclear-powered artificial heart program

    International Nuclear Information System (INIS)

    Horita, M.; Zeigler, R.K.

    1976-04-01

    By assuming that the failures of an artificial heart system with a mean life of 10 y can be modeled by a particular probability distribution, both the probability of a failure in the system within t years and the reliability required of each subsystem and component were investigated

  6. Mobile health in adults with congenital heart disease: Current use and future needs

    NARCIS (Netherlands)

    Schuuring, M.J.; A. Backx (Ad); Zwart, R.; Veelenturf, A.H.; D. Robbers-Visser (Daniëlle); M. Groenink (Maarten); A. Abu-Hanna (Ameen); N. Bruining (Nico); M.P. Schijven; B.J.M. Mulder (Barbara); B.J. Bouma (Berto)

    2016-01-01

    textabstractObjective Many adults with congenital heart disease (CHD) are affected lifelong by cardiac events, particularly arrhythmias and heart failure. Despite the care provided, the cardiac event rate remains high. Mobile health (mHealth) brings opportunities to enhance daily monitoring and

  7. Are grown-ups with congenital heart disease willing to participate in an exercise program?

    NARCIS (Netherlands)

    Dontje, Manon L.; Feenstra, Marlies; de Greef, Mathieu; Nieuwland, Wybe; Hoendermis, Elke S.

    2013-01-01

    OBJECTIVE: To examine the willingness of grown-ups with congenital heart disease (GUCH) to participate in the GUCH Training Program-Individualised (GTI), an exercise program specifically designed for GUCH, and to identify factors affecting their willingness to participate. In this cross-sectional

  8. Incorporating Health Education into Employee Assistance Programs.

    Science.gov (United States)

    Miller, Richard E.

    1985-01-01

    Methods of aligning health education with the goals and functions of employee assistance programs are discussed. The role of the health educator in developing these programs is explained in a description of employee assistance program service standards and specific sub-tasks. (DF)

  9. Evaluating a Health Risk Reduction Program.

    Science.gov (United States)

    Nagelberg, Daniel B.

    1981-01-01

    A health risk reduction program at Bowling Green State University (Ohio) tested the efficacy of peer education against the efficacy of returning (by mail) health questionnaire results. A peer health education program did not appear to be effective in changing student attitudes or lifestyles; however, the research methodology may not have been…

  10. Starting a Health Professions Education Graduate Program

    Science.gov (United States)

    Hansman, Catherine A.

    2018-01-01

    This chapter is a case story of the evolution of the Master of Education in Health Professions Education (MEHPE), a collaborative graduate program developed by the Adult Learning and Development program at Cleveland State University and the Cleveland Clinic.

  11. Rehab for the Heart (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2017-08-24

    Each year, nearly 790,000 adults in the U.S. suffer a heart attack. This podcast discusses the importance of getting cardiac rehab after a heart attack.  Created: 8/24/2017 by MMWR.   Date Released: 8/24/2017.

  12. Rehab for the Heart (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    Each year, nearly 790,000 adults in the U.S. suffer a heart attack. For a third of these, it's not their first. Cardiac rehabilitation could have prevented many of these. In this podcast, Dr. Fleetwood Loustalot discusses the importance of getting cardiac rehab after a heart attack.

  13. Have a Healthy Heart (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2015-02-05

    Heart disease continues to be the leading cause of death in the U.S. In this podcast, Dr. Derrick Gervin discusses ways to keep our hearts healthy.  Created: 2/5/2015 by MMWR.   Date Released: 2/5/2015.

  14. Heart Check (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2015-09-24

    Heart disease is the leading cause of death worldwide. It’s related to one in four deaths in the U.S. In this podcast, Jacquie Dozier discusses the importance of maintaining a healthy heart.  Created: 9/24/2015 by MMWR.   Date Released: 9/24/2015.

  15. Have a Healthy Heart (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2015-02-05

    Heart disease continues to be the leading cause of death for both men and women in the U.S. This podcast discusses the importance of decreasing the chances of developing heart disease via a healthy lifestyle.  Created: 2/5/2015 by MMWR.   Date Released: 2/5/2015.

  16. Efficacy of an integrated hospital-primary care program for heart failure: a population-based analysis of 56,742 patients.

    Science.gov (United States)

    Comín-Colet, Josep; Verdú-Rotellar, José María; Vela, Emili; Clèries, Montse; Bustins, Montserrat; Mendoza, Lola; Badosa, Neus; Cladellas, Mercè; Ferré, Sofía; Bruguera, Jordi

    2014-04-01

    The efficacy of heart failure programs has been demonstrated in clinical trials but their applicability in the real world practice setting is more controversial. This study evaluates the feasibility and efficacy of an integrated hospital-primary care program for the management of patients with heart failure in an integrated health area covering a population of 309,345. For the analysis, we included all patients consecutively admitted with heart failure as the principal diagnosis who had been discharged alive from all of the hospitals in Catalonia, Spain, from 2005 to 2011, the period when the program was implemented, and compared mortality and readmissions among patients exposed to the program with the rates in the patients of all the remaining integrated health areas of the Servei Català de la Salut (Catalan Health Service). We included 56,742 patients in the study. There were 181,204 hospital admissions and 30,712 deaths during the study period. In the adjusted analyses, when compared to the 54,659 patients from the other health areas, the 2083 patients exposed to the program had a lower risk of death (hazard ratio=0.92 [95% confidence interval, 0.86-0.97]; P=.005), a lower risk of clinically-related readmission (hazard ratio=0.71 [95% confidence interval, 0.66-0.76]; P<.001), and a lower risk of readmission for heart failure (hazard ratio=0.86 [95% confidence interval, 0.80-0.94]; P<.001). The positive impact on the morbidity and mortality rates was more marked once the program had become well established. The implementation of multidisciplinary heart failure management programs that integrate the hospital and the community is feasible and is associated with a significant reduction in patient morbidity and mortality. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  17. Healthy bread initiative: methods, findings, and theories--Isfahan Healthy Heart Program.

    Science.gov (United States)

    Talaei, Mohammad; Mohammadifard, Noushin; Khaje, Mohammad-Reza; Sarrafzadegan, Nizal; Sajjadi, Firoozeh; Alikhasi, Hasan; Maghroun, Maryam; Iraji, Farhad; Ehteshami, Shahram

    2013-03-01

    The scientific evidences show that the content, baking methods, and types of bread can make health impacts. Bread, as a major part of Iranian diet, demonstrates a significant potential to be targeted as health promotion subject. Healthy Food for Healthy Communities (HFHC) was a project of Isfahan Healthy Heart Program (IHHP), consisting of a wide variety of strategies, like Healthy Bread (HB) Initiative. The HB Initiative was designed to improve the behaviour of both producers and consumers, mainly aiming at making high-fibre, low-salt bread, eliminating the use of baking soda, providing enough rest time for dough before baking (at least one hour), and enough baking time (at least one minute in oven). A workshop was held for volunteer bakers, and a baker-to-baker training protocol under direct supervision was designed for future volunteers. Cereal Organization was persuaded to provide less refined flour that contained more bran. Health messages in support of new breads were disseminated by media and at bakeries by health professionals. Evaluation of the HB Initiative was done using before-after assessments and population surveys. While HB was baked in 1 (0.01%) bakery at baseline, 402 (41%) bakeries in the intervention area joined the HB Initiative in 2009. Soda was completely eliminated and fibre significantly increased from 4 +/- 0.4 g% before study to 12 +/- 0.6 g% after the intervention (p bread decreased from 13 +/- 1.8 g% to 2 +/- 0.5 g% and was expressed as the most important advantage of this initiative by consumers. People who lived in Isfahan city consumed whole bread 6 times more than those who lived in reference area Arak (p breads as a healthy choice that were compatible with local dishes and made a model to solve the longstanding problems of bread. It used various health promotion approaches but was best consistent with Beattie's model.

  18. Disease-specific health status as a predictor of mortality in patients with heart failure

    DEFF Research Database (Denmark)

    Mastenbroek, Mirjam H; Versteeg, Henneke; Zijlstra, Wobbe P

    2014-01-01

    AIMS: Some, but not all, studies have shown that patient-reported health status, including symptoms, functioning, and health-related quality of life, provides additional information to traditional clinical factors in predicting prognosis in heart failure patients. To evaluate the overall evidence......, the association of disease-specific health status on mortality in heart failure was examined through a systematic review and meta-analysis. METHODS AND RESULTS: Prospective cohort studies that assessed the independent association of disease-specific health status with mortality in heart failure were selected....... Searching PubMed (until March 2013) resulted in 17 articles in the systematic review and 17 studies in the meta-analysis. About half of the studies reported a significant relationship between disease-specific health status and mortality in heart failure, while the remainder found no association. A larger...

  19. 76 FR 9525 - Health Claim; Phytosterols and Risk of Coronary Heart Disease

    Science.gov (United States)

    2011-02-18

    ... coronary heart disease (CHD), in a manner that is consistent with FDA's February 14, 2003, letter of.... FDA-2000-P-0102, FDA-2000-P-0133, and FDA-2006-P-0033] Health Claim; Phytosterols and Risk of Coronary Heart Disease AGENCY: Food and Drug Administration, HHS. ACTION: Extension of enforcement discretion...

  20. A couples’ based self-management program for heart failure: Results of a feasibility study

    Directory of Open Access Journals (Sweden)

    Ranak Trivedi

    2016-08-01

    Full Text Available Background: Heart failure (HF is associated with frequent exacerbations and shortened lifespan. Informal caregivers such as significant others often support self-management in patients with HF. However, existing programs that aim to enhance self-management seldom engage informal caregivers or provide tools that can help alleviate caregiver burden or improve collaboration between patients and their informal caregivers. Objective: To develop and pilot test a program targeting the needs of self-management support among HF patients as well as their significant others. Methods: We developed the Dyadic Health Behavior Change model and conducted semi-structured interviews to determine barriers to self-management from various perspectives. Participants’ feedback was used to develop a family-centered self-management program called SUCCEED: Self-management Using Couples’ Coping EnhancEment in Diseases. The goals of this program are to improve HF self-management, quality of life, communication within couples, relationship quality, and stress and caregiver burden. We conducted a pilot study with 17 Veterans with HF and their significant others to determine acceptability of the program. We piloted psychosocial surveys at baseline and after participants’ program completion to evaluate change in depressive symptoms, caregiver burden, self-management of HF, communication, quality of relationship, relationship mutuality, and quality of life. Results: Of the 17 couples, 14 completed at least 1 SUCCEED session. Results showed high acceptability for each of SUCCEED’s sessions. At baseline, patients reported poor quality of life, clinically significant depressive symptoms, and inadequate self-management of HF. After participating in SUCCEED, patients showed improvements in self-management of HF, communication, and relationship quality, while caregivers reported improvements in depressive symptoms and caregiver burden. Quality of life of both patients and

  1. ARE COMMUNITY –BASED INTERVENTION PROGRAMS EFFECTIVE IN THE YOUTH POPULATION? RESULTS FROM ISFAHAN HEALTHY HEART PROGRAM

    Directory of Open Access Journals (Sweden)

    Hamidreza Roohafza

    2010-11-01

    Full Text Available Abstract    BACKGROUND: Although the relationship between unhealthy lifestyle and development of non-communicable diseases in the youth has been understood but intervention studies to improve lifestyle behaviors in this age group are low. Consequently, this study was performed to highlight important intervention activity of a NCD prevention and health promotion program for young people and to present its main results in Iran.    METHODS: The Youth Intervention Project (YIP as a part of Isfahan Healthy Heart Program (IHHP was carried out on all the youth aged 19-25 years in Isfahan and Najafabad counties as intervention areas and Arak as control area. The target groups could be reached in Red Crescent Society, universities, and garrisons. Multifactorial interventions included healthy nutrition, physical activity, coping with stress, and tobacco cessation by more emphasis on hookah smoking. Also, enforcing no-smoking regulations in teahouses and coffee shops was considered.    RESULTS: After performing multifactorial interventions, the change of fast food consumption frequency was statistically significant in comparison between intervention and control areas (P for trend<0.05. Percentage of individuals with high stress level were more significant in intervention area compared with control area (P for trend<0.05. Smoking was increased among men and women in both areas whereas the increase was higher in control area (P for trend<0.05. Although daily physical activity frequency was increased in intervention areas but it wasn’t significant compared with control area. Also, decreased trend of carbonated drink consumption were not significant in intervention area compared with control area.     CONCLUSION: The lifestyle modification program in the youth was successfully implemented and was shown to have improved some of the youth’s lifestyle behaviors related to healthy lifestyle.      Keywords: Intervention,The youth, Non

  2. CTCF counter-regulates cardiomyocyte development and maturation programs in the embryonic heart.

    Directory of Open Access Journals (Sweden)

    Melisa Gomez-Velazquez

    2017-08-01

    Full Text Available Cardiac progenitors are specified early in development and progressively differentiate and mature into fully functional cardiomyocytes. This process is controlled by an extensively studied transcriptional program. However, the regulatory events coordinating the progression of such program from development to maturation are largely unknown. Here, we show that the genome organizer CTCF is essential for cardiogenesis and that it mediates genomic interactions to coordinate cardiomyocyte differentiation and maturation in the developing heart. Inactivation of Ctcf in cardiac progenitor cells and their derivatives in vivo during development caused severe cardiac defects and death at embryonic day 12.5. Genome wide expression analysis in Ctcf mutant hearts revealed that genes controlling mitochondrial function and protein production, required for cardiomyocyte maturation, were upregulated. However, mitochondria from mutant cardiomyocytes do not mature properly. In contrast, multiple development regulatory genes near predicted heart enhancers, including genes in the IrxA cluster, were downregulated in Ctcf mutants, suggesting that CTCF promotes cardiomyocyte differentiation by facilitating enhancer-promoter interactions. Accordingly, loss of CTCF disrupts gene expression and chromatin interactions as shown by chromatin conformation capture followed by deep sequencing. Furthermore, CRISPR-mediated deletion of an intergenic CTCF site within the IrxA cluster alters gene expression in the developing heart. Thus, CTCF mediates local regulatory interactions to coordinate transcriptional programs controlling transitions in morphology and function during heart development.

  3. CTCF counter-regulates cardiomyocyte development and maturation programs in the embryonic heart

    Science.gov (United States)

    Gomez-Velazquez, Melisa; Badia-Careaga, Claudio; Lechuga-Vieco, Ana Victoria; Nieto-Arellano, Rocio; Rollan, Isabel; Alvarez, Alba; Torroja, Carlos; Caceres, Eva F.; Roy, Anna R.; Galjart, Niels; Sanchez-Cabo, Fatima; Enriquez, Jose Antonio; Gomez-Skarmeta, Jose Luis

    2017-01-01

    Cardiac progenitors are specified early in development and progressively differentiate and mature into fully functional cardiomyocytes. This process is controlled by an extensively studied transcriptional program. However, the regulatory events coordinating the progression of such program from development to maturation are largely unknown. Here, we show that the genome organizer CTCF is essential for cardiogenesis and that it mediates genomic interactions to coordinate cardiomyocyte differentiation and maturation in the developing heart. Inactivation of Ctcf in cardiac progenitor cells and their derivatives in vivo during development caused severe cardiac defects and death at embryonic day 12.5. Genome wide expression analysis in Ctcf mutant hearts revealed that genes controlling mitochondrial function and protein production, required for cardiomyocyte maturation, were upregulated. However, mitochondria from mutant cardiomyocytes do not mature properly. In contrast, multiple development regulatory genes near predicted heart enhancers, including genes in the IrxA cluster, were downregulated in Ctcf mutants, suggesting that CTCF promotes cardiomyocyte differentiation by facilitating enhancer-promoter interactions. Accordingly, loss of CTCF disrupts gene expression and chromatin interactions as shown by chromatin conformation capture followed by deep sequencing. Furthermore, CRISPR-mediated deletion of an intergenic CTCF site within the IrxA cluster alters gene expression in the developing heart. Thus, CTCF mediates local regulatory interactions to coordinate transcriptional programs controlling transitions in morphology and function during heart development. PMID:28846746

  4. CTCF counter-regulates cardiomyocyte development and maturation programs in the embryonic heart.

    Science.gov (United States)

    Gomez-Velazquez, Melisa; Badia-Careaga, Claudio; Lechuga-Vieco, Ana Victoria; Nieto-Arellano, Rocio; Tena, Juan J; Rollan, Isabel; Alvarez, Alba; Torroja, Carlos; Caceres, Eva F; Roy, Anna R; Galjart, Niels; Delgado-Olguin, Paul; Sanchez-Cabo, Fatima; Enriquez, Jose Antonio; Gomez-Skarmeta, Jose Luis; Manzanares, Miguel

    2017-08-01

    Cardiac progenitors are specified early in development and progressively differentiate and mature into fully functional cardiomyocytes. This process is controlled by an extensively studied transcriptional program. However, the regulatory events coordinating the progression of such program from development to maturation are largely unknown. Here, we show that the genome organizer CTCF is essential for cardiogenesis and that it mediates genomic interactions to coordinate cardiomyocyte differentiation and maturation in the developing heart. Inactivation of Ctcf in cardiac progenitor cells and their derivatives in vivo during development caused severe cardiac defects and death at embryonic day 12.5. Genome wide expression analysis in Ctcf mutant hearts revealed that genes controlling mitochondrial function and protein production, required for cardiomyocyte maturation, were upregulated. However, mitochondria from mutant cardiomyocytes do not mature properly. In contrast, multiple development regulatory genes near predicted heart enhancers, including genes in the IrxA cluster, were downregulated in Ctcf mutants, suggesting that CTCF promotes cardiomyocyte differentiation by facilitating enhancer-promoter interactions. Accordingly, loss of CTCF disrupts gene expression and chromatin interactions as shown by chromatin conformation capture followed by deep sequencing. Furthermore, CRISPR-mediated deletion of an intergenic CTCF site within the IrxA cluster alters gene expression in the developing heart. Thus, CTCF mediates local regulatory interactions to coordinate transcriptional programs controlling transitions in morphology and function during heart development.

  5. Rehab for the Heart (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2017-08-24

    Each year, nearly 790,000 adults in the U.S. suffer a heart attack. For a third of these, it’s not their first. Cardiac rehabilitation could have prevented many of these. In this podcast, Dr. Fleetwood Loustalot discusses the importance of getting cardiac rehab after a heart attack.  Created: 8/24/2017 by MMWR.   Date Released: 8/24/2017.

  6. Health behavior of patients with ischemic heart disease

    OpenAIRE

    Paweł Węgorowski; Joanna Michalik; Rafał Zarzeczny; Renata Domżał-Drzewiecka; Grzegorz Nowicki

    2017-01-01

    Admission By analyzing the available scientific literature, it is possible to define ischemic heart disease as a set of disease symptoms that are a consequence of a chronic state of imbalance between the ability to supply nutrients and oxygen and the real need of myocardial cells for these substances. Adapting life-style behaviors to healthy living is a priority to prevent the onset and development of cardiovascular disease, especially ischemic heart disease, Purpose of research T...

  7. Alteration in unhealthy nutrition behaviors in adolescents through community intervention: Isfahan Healthy Heart Program

    Directory of Open Access Journals (Sweden)

    Noushin Mohammadifard

    2013-03-01

    Full Text Available BACKGROUND: Primary prevention of chronic diseases has been suggested to initiate health promotion activities from childhoods. The impact of Isfahan Healthy Heart Program (IHHP, a comprehensive community trial, on unhealthy snacks and fast food intake changes was evaluated in Iranian adolescents between 2001 and 2007. METHODS: Healthy Heart Promotion from Childhood (HHPC as one of the IHHP interventional projects was conducted in adolescents aged 11-18 years, selected randomly by multistage random sampling. Isfahan and Najafabad districts were intervention areas (IA and Arak district was reference area (RA. The baseline and post-intervention surveys were conducted on 1941 and 1997 adolescents, respectively. Healthy lifestyle interventions were performed during the 2nd phase of the study targeting about 410000 students in urban and rural areas of the IA via education, environmental and legislation activities. Dietary intake was assessed annually using a fifty-item food frequency questionnaire in both communities. RESULTS: The interaction of year×area demonstrated that the consumption of unhealthy snacks decreased significantly in middle school boys of RA compared to IA (P for interaction=0.01. However, middle school girls (P for interaction = 0.002 and both sexes of high school students in IA showed a significant reduction in fast food consumption against RA (P for interaction < 0.001. CONCLUSION: The HHPC interventions made some improvement in fast food consumption. It did not show significant decrease regarding unhealthy snacks in adolescents. Proper and higher dose of interventions may be effective in achieving this goal.   Keywords: Nutrition, Dietary Behaviour, Adolescent, Lifestyle, Community Trial

  8. Factors that determine the effectiveness of screening for congenital heart malformations at child health centres

    NARCIS (Netherlands)

    R.E. Juttmann (Rikard); J. Hess (Jakob); C.W.N. Looman (Caspar); P.J. van der Maas (Paul)

    2000-01-01

    textabstractBACKGROUND: The actual yield from current screening for clinically significant congenital heart malformations in Dutch child health care is far from optimal. In this study factors that determine the effectiveness of this screening are identified and

  9. Keep Baby’s Heart Healthy (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    Congenital heart defects are the most common type of birth defect in the U.S. This podcast discusses the importance of pregnant women talking with their health care providers about ways to increase chances of having a healthy baby.

  10. Take the Pressure off Your Heart (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    Heart disease and stroke are leading causes of death in the U.S. High blood pressure, or hypertension, can lead to both. In this podcast, Dr. Fleetwood Loustalot discusses the health consequences of hypertension.

  11. Psychometric properties of HeartQoL, a core heart disease-specific health-related quality of life questionnaire, in Danish implantable cardioverter defibrillator recipients

    DEFF Research Database (Denmark)

    Zangger, Graziella; Zwisler, Ann-Dorthe; Kikkenborg Berg, Selina

    2018-01-01

    disease-specific health-related quality of life questionnaire, in implantable cardioverter defibrillator recipients. Design This study involved cross-sectional and test-retest study designs. Method Implantable cardioverter defibrillator recipients in the cross-sectional study completed the Heart......QoL, the Short-Form 36 Health Survey, and the Hospital Anxiety and Depression Scale. The HeartQoL structure, construct-related validity (convergent and discriminative) and reliability (internal consistency) were assessed. HeartQoL reproducibility (test-retest) was assessed in an independent sample of implantable...... psychometric attributes of validity and reliability in this implantable cardioverter defibrillator population. This study adds support for the HeartQoL as a core heart-specific health-related quality of life questionnaire in a broad group of patients with heart disease including implantable cardioverter...

  12. Program Planning in Health Professions Education

    Science.gov (United States)

    Schmidt, Steven W.; Lawson, Luan

    2018-01-01

    In this chapter, the major concepts from program planning in adult education will be applied to health professions education (HPE). Curriculum planning and program planning will be differentiated, and program development and planning will be grounded in a systems thinking approach.

  13. Early life environment and social determinants of cardiac health in children with congenital heart disease.

    Science.gov (United States)

    Wong, Peter; Denburg, Avram; Dave, Malini; Levin, Leo; Morinis, Julia Orkin; Suleman, Shazeen; Wong, Jonathan; Ford-Jones, Elizabeth; Moore, Aideen M

    2018-04-01

    Congenital heart disease is a significant cause of infant mortality. Epidemiology and social context play a crucial role in conditioning disease burden and modulating outcomes, while diagnosis and treatment remain resource intensive. This review will address the role of social demographics, environmental exposure, epigenetics and nutrition in the aetiology of congenital heart disease. We then discuss the determinant effect of social factors on the provision and outcomes of care for congenital heart disease and implications for practice. It is our hope that enhanced knowledge of the intersection of social determinants of health and congenital heart disease will facilitate effective preventative strategies at the individual and population levels to optimize heart health outcomes across the life course.

  14. Hearts and Minds: Honors Programs in North American Christian Institutions

    Science.gov (United States)

    Bratt, Kenneth

    2010-01-01

    For readers outside North America, the concept of "honors education" may be confusing (since the word honours features in British and Commonwealth degree titles) or obscure (bringing to mind associations with aristocratic privilege or elitist competition). But in the United States the development of honors programs in colleges, and later honors…

  15. The Minneapolis Heart Institute Foundation Summer Research Internship Program: the benefits of preprofessional experience for prospective physicians.

    Science.gov (United States)

    Willenbring, Benjamin D; McKee, Katherine C; Wilson, Betsy V; Henry, Timothy D

    2008-08-01

    There is a distinct shortage of preprofessional opportunities for undergraduate premedical students. During the last 7 summers, the Minneapolis Heart Institute Foundation Summer Research Internship Program has exposed interested students to cardiology and clinical research. The goals of the internship program are threefold: to bring students in contact with the medical profession, to offer experiences in the various disciplines of cardiology, and to introduce students to clinical research. The success of the program can be measured by its influence on participants' academic pursuits and scholarly contributions. Of the 65 internship alumni, 52 are studying to become physicians and most of the others are in health-related fields. Interns have also contributed abstracts and manuscripts to peer-reviewed journals and presented their research at major conferences.

  16. Kennedy Space Center environmental health program

    International Nuclear Information System (INIS)

    Marmaro, G.M.; Cardinale, M.A.; Summerfield, B.R.; Tipton, D.A.

    1992-01-01

    The Kennedy Space Center's environmental health organization is responsible for programs which assure its employees a healthful workplace under diverse and varied working conditions. These programs encompass the disciplines of industrial hygiene, radiation protection (health physics), and environmental sanitation/pollution control. Activities range from the routine, such as normal office work, to the highly specialized, such as the processing of highly toxic and hazardous materials

  17. Randomised controlled trial of a secondary prevention program for myocardial infarction patients ('ProActive Heart': study protocol. Secondary prevention program for myocardial infarction patients

    Directory of Open Access Journals (Sweden)

    Taylor C Barr

    2009-05-01

    Full Text Available Abstract Background Coronary heart disease (CHD is a significant cause of health and economic burden. Secondary prevention programs play a pivotal role in the treatment and management of those affected by CHD although participation rates are poor due to patient, provider, health system and societal-level barriers. As such, there is a need to develop innovative secondary prevention programs to address the treatment gap. Telephone-delivered care is convenient, flexible and has been shown to improve behavioural and clinical outcomes following myocardial infarction (MI. This paper presents the design of a randomised controlled trial to evaluate the efficacy of a six-month telephone-delivered secondary prevention program for MI patients (ProActive Heart. Methods 550 adult MI patients have been recruited over a 14 month period (December 2007 to January 2009 through two Brisbane metropolitan hospitals, and randomised to an intervention or control group (n = 225 per group. The intervention commences within two weeks of hospital discharge delivered by study-trained health professionals ('health coaches' during up to 10 × 30 minute scripted telephone health coaching sessions. Participants also receive a ProActive Heart handbook and an educational resource to use during the health coaching sessions. The intervention focuses on appropriate modification of CHD risk factors, compliance with pharmacological management, and management of psychosocial issues. Data collection occurs at baseline or prior to commencement of the intervention (Time 1, six months follow-up or the completion of the intervention (Time 2, and at 12 months follow-up for longer term outcomes (Time 3. Primary outcome measures include quality of life (Short Form-36 and physical activity (Active Australia Survey. A cost-effective analysis of the costs and outcomes for patients in the intervention and control groups is being conducted from the perspective of health care costs to the

  18. Introduction to:Forest health monitoring program

    Science.gov (United States)

    Mark J. Ambrose

    2009-01-01

    This annual technical report is a product of the Forest Health Monitoring (FHM) Program. The report provides information about a variety of issues relating to forest health at a national scale. FHM national reports have the dual focus of presenting analyses of the latest available data and showcasing innovative techniques for analyzing forest health data. The report is...

  19. Addressing Health Inequities: Coronary Heart Disease Training within Learning Disabilities Services

    Science.gov (United States)

    Holly, Deirdre; Sharp, John

    2014-01-01

    People with learning disabilities are at increased risk of coronary heart disease (CHD). Research suggests this may be due to inequalities in health status and inequities in the way health services respond to need. Little is known about the most effective way to improve health outcomes for people with learning disabilities. A previously developed…

  20. Linking evidence to action on social determinants of health using Urban HEART in the Americas.

    Science.gov (United States)

    Prasad, Amit; Groot, Ana Maria Mahecha; Monteiro, Teofilo; Murphy, Kelly; O'Campo, Patricia; Broide, Emilia Estivalet; Kano, Megumi

    2013-12-01

    To evaluate the experience of select cities in the Americas using the Urban Health Equity Assessment and Response Tool (Urban HEART) launched by the World Health Organization in 2010 and to determine its utility in supporting government efforts to improve health equity using the social determinants of health (SDH) approach. The Urban HEART experience was evaluated in four cities from 2010-2013: Guarulhos (Brazil), Toronto (Canada), and Bogotá and Medellín (Colombia). Reports were submitted by Urban HEART teams in each city and supplemented by first-hand accounts of key informants. The analysis considered each city's networks and the resources it used to implement Urban HEART; the process by which each city identified equity gaps and prioritized interventions; and finally, the facilitators and barriers encountered, along with next steps. In three cities, local governments spearheaded the process, while in the fourth (Toronto), academia initiated and led the process. All cities used Urban HEART as a platform to engage multiple stakeholders. Urban HEART's Matrix and Monitor were used to identify equity gaps within cities. While Bogotá and Medellín prioritized among existing interventions, Guarulhos adopted new interventions focused on deprived districts. Actions were taken on intermediate determinants, e.g., health systems access, and structural SDH, e.g., unemployment and human rights. Urban HEART provides local governments with a simple and systematic method for assessing and responding to health inequity. Through the SDH approach, the tool has provided a platform for intersectoral action and community involvement. While some areas of guidance could be strengthened, Urban HEART is a useful tool for directing local action on health inequities, and should be scaled up within the Region of the Americas, building upon current experience.

  1. Linking evidence to action on social determinants of health using Urban HEART in the Americas

    Directory of Open Access Journals (Sweden)

    Amit Prasad

    2013-12-01

    Full Text Available OBJECTIVE: To evaluate the experience of select cities in the Americas using the Urban Health Equity Assessment and Response Tool (Urban HEART launched by the World Health Organization in 2010 and to determine its utility in supporting government efforts to improve health equity using the social determinants of health (SDH approach METHODS: The Urban HEART experience was evaluated in four cities from 2010-2013: Guarulhos (Brazil, Toronto (Canada, and Bogotá and Medellín (Colombia. Reports were submitted by Urban HEART teams in each city and supplemented by first-hand accounts of key informants. The analysis considered each city's networks and the resources it used to implement Urban HEART; the process by which each city identified equity gaps and prioritized interventions; and finally, the facilitators and barriers encountered, along with next steps RESULTS: In three cities, local governments spearheaded the process, while in the fourth (Toronto, academia initiated and led the process. All cities used Urban HEART as a platform to engage multiple stakeholders. Urban HEART's Matrix and Monitor were used to identify equity gaps within cities. While Bogotá and Medellín prioritized among existing interventions, Guarulhos adopted new interventions focused on deprived districts. Actions were taken on intermediate determinants, e.g., health systems access, and structural SDH, e.g., unemployment and human rights CONCLUSIONS: Urban HEART provides local governments with a simple and systematic method for assessing and responding to health inequity. Through the SDH approach, the tool has provided a platform for intersectoral action and community involvement. While some areas of guidance could be strengthened, Urban HEART is a useful tool for directing local action on health inequities, and should be scaled up within the Region of the Americas, building upon current experience.

  2. Telemonitoring and Mobile Phone-Based Health Coaching Among Finnish Diabetic and Heart Disease Patients: Randomized Controlled Trial.

    Science.gov (United States)

    Karhula, Tuula; Vuorinen, Anna-Leena; Rääpysjärvi, Katja; Pakanen, Mira; Itkonen, Pentti; Tepponen, Merja; Junno, Ulla-Maija; Jokinen, Tapio; van Gils, Mark; Lähteenmäki, Jaakko; Kohtamäki, Kari; Saranummi, Niilo

    2015-06-17

    There is a strong will and need to find alternative models of health care delivery driven by the ever-increasing burden of chronic diseases. The purpose of this 1-year trial was to study whether a structured mobile phone-based health coaching program, which was supported by a remote monitoring system, could be used to improve the health-related quality of life (HRQL) and/or the clinical measures of type 2 diabetes and heart disease patients. A randomized controlled trial was conducted among type 2 diabetes patients and heart disease patients of the South Karelia Social and Health Care District. Patients were recruited by sending invitations to randomly selected patients using the electronic health records system. Health coaches called patients every 4 to 6 weeks and patients were encouraged to self-monitor their weight, blood pressure, blood glucose (diabetics), and steps (heart disease patients) once per week. The primary outcome was HRQL measured by the Short Form (36) Health Survey (SF-36) and glycosylated hemoglobin (HbA1c) among diabetic patients. The clinical measures assessed were blood pressure, weight, waist circumference, and lipid levels. A total of 267 heart patients and 250 diabetes patients started in the trial, of which 246 and 225 patients concluded the end-point assessments, respectively. Withdrawal from the study was associated with the patients' unfamiliarity with mobile phones—of the 41 dropouts, 85% (11/13) of the heart disease patients and 88% (14/16) of the diabetes patients were familiar with mobile phones, whereas the corresponding percentages were 97.1% (231/238) and 98.6% (208/211), respectively, among the rest of the patients (P=.02 and P=.004). Withdrawal was also associated with heart disease patients' comorbidities—40% (8/20) of the dropouts had at least one comorbidity, whereas the corresponding percentage was 18.9% (47/249) among the rest of the patients (P=.02). The intervention showed no statistically significant benefits over

  3. Impact of the Heart WATCH Program on Patients at Risk of Developing Metabolic Syndrome, Prediabetes or Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    Jennifer Fink

    2015-04-01

    Full Text Available Purpose: Metabolic syndrome is a set of metabolic risk factors associated with increased risk of developing cardiovascular disease and type 2 diabetes mellitus. We retrospectively evaluated the effectiveness of a lifestyle modification program (Heart WATCH geared toward reducing development of chronic disease in women deemed at risk for metabolic syndrome, prediabetes and/or cardiovascular disease. Methods: Our institution’s Heart WATCH program consists of screening sessions with a multidisciplinary team (physician/nurse, nutritionist and psychologist, a minimum of three visits with a nurse practitioner and weekly follow-up phone calls for a 14-week period. Sociodemographic variables were obtained at initial visit. Biometric testing indices and self-reported clinical and behavioral health measures were recorded pre- and postintervention, and compared using paired t-tests or McNemar’s test as appropriate. Results: Heart WATCH enrolled 242 women from November 2006 to April 2014, and 193 (80% completed all phases of the 14-week lifestyle intervention. Postintervention, participants demonstrated improved health status in all areas and improved significantly in the following areas: diet/nutrition (P=0.014, exercise (P<0.001, stress (P<0.0001, quality of life (P=0.003, weight (P<0.0001, waist circumference (P=0.01 and total cholesterol (P=0.019. Clinically meaningful improvements were realized by participants who moved to a healthier classification in a number of vital signs and blood panel indices. Conclusions: These findings suggest the “elevated risk profile” for women with components of metabolic syndrome can be reversed through a lifestyle program focused on reducing risk factors associated with cardiovascular disease and prediabetes. Future research is needed to determine mechanisms of risk reduction as well as optimal patient-centered and culturally appropriate approaches to weight management.

  4. The American Heart Association Ideal Cardiovascular Health and Incident Type 2 Diabetes Mellitus Among Blacks: The Jackson Heart Study.

    Science.gov (United States)

    Effoe, Valery S; Carnethon, Mercedes R; Echouffo-Tcheugui, Justin B; Chen, Haiying; Joseph, Joshua J; Norwood, Arnita F; Bertoni, Alain G

    2017-06-21

    The concept of ideal cardiovascular health (CVH), defined by the American Heart Association primarily for coronary heart disease and stroke prevention, may apply to diabetes mellitus prevention among blacks. Our sample included 2668 adults in the Jackson Heart Study with complete baseline data on 6 of 7 American Heart Association CVH metrics (body mass index, healthy diet, smoking, total cholesterol, blood pressure, and physical activity). Incident diabetes mellitus was defined as fasting glucose ≥126 mg/dL, physician diagnosis, use of diabetes mellitus drugs, or glycosylated hemoglobin ≥6.5%. A summary CVH score from 0 to 6, based on presence/absence of ideal CVH metrics, was derived for each participant. Cox regression was used to estimate adjusted hazard ratios. Mean age was 55 years (65% women) with 492 incident diabetes mellitus events over 7.6 years (24.6 cases/1000 person-years). Three quarters of participants had only 1 or 2 ideal CVH metrics; no participant had all 6. After adjustment for demographic factors (age, sex, education, and income) and high-sensitivity C-reactive protein, each additional ideal CVH metric was associated with a 17% diabetes mellitus risk reduction (hazard ratio, 0.83; 95% CI, 0.74-0.93). The association was attenuated with further adjustment for homeostasis model assessment for insulin resistance (hazard ratio, 0.89; 95% CI, 0.79-1.00). Compared with participants with 1 or no ideal CVH metric, diabetes mellitus risk was 15% and 37% lower in those with 2 and ≥3 ideal CVH metrics, respectively. The AHA concept of ideal CVH is applicable to diabetes mellitus prevention among blacks. These associations were largely explained by insulin resistance. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  5. On the Move to Better Heart Health for African Americans

    Science.gov (United States)

    ... low-fat (1%) milk. ❑ Prepare a heart healthy lunch the night before. Include fruits, vegetables, and small portions of leftovers. ❑ Take a piece of fruit ... broil, or grill instead of frying. • Use a small amount of vegetable oil instead of lard or ... to your lunch. • Add vegetables and beans to soups and casseroles. ■ ...

  6. Characteristics, quality of care, and in-hospital outcomes of Asian-American heart failure patients: Findings from the American Heart Association Get With The Guidelines-Heart Failure Program.

    Science.gov (United States)

    Qian, Feng; Fonarow, Gregg C; Krim, Selim R; Vivo, Rey P; Cox, Margueritte; Hannan, Edward L; Shaw, Benjamin A; Hernandez, Adrian F; Eapen, Zubin J; Yancy, Clyde W; Bhatt, Deepak L

    2015-01-01

    Because little was previously known about Asian-American patients with heart failure (HF), we compared clinical profiles, quality of care, and outcomes between Asian-American and non-Hispanic white HF patients using data from the American Heart Association Get With The Guidelines-Heart Failure (GWTG-HF) program. We analyzed 153,023 HF patients (149,249 whites, 97.5%; 3774 Asian-Americans, 2.5%) from 356 U.S. centers participating in the GWTG-HF program (2005-2012). Baseline characteristics, quality of care metrics, in-hospital mortality, discharge to home, and length of stay were examined. Relative to white patients, Asian-American HF patients were younger, more likely to be male, uninsured or covered by Medicaid, and recruited in the western region. They had higher prevalence of diabetes, hypertension, and renal insufficiency, but similar ejection fraction. Overall, Asian-American HF patients had comparable quality of care except that they were less likely to receive aldosterone antagonists at discharge (relative risk , 0.88; 95% confidence interval , 0.78-0.99), and anticoagulation for atrial fibrillation (RR, 0.91; 95% CI, 0.85-0.97) even after risk adjustment. Compared with white patients, Asian-American patients had comparable risk adjusted in-hospital mortality (RR, 1.11; 95% CI, 0.91-1.35), length of stay>4 days (RR, 1.01; 95% CI, 0.95-1.08), and were more likely to be discharged to home (RR, 1.08; 95% CI, 1.06-1.11). Despite some differences in clinical profiles, Asian-American patients hospitalized with HF receive very similar quality of care and have comparable health outcomes to their white counterparts. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. [Efficacy of a multidisciplinary care management program for patients admitted at hospital because of heart failure (ProMIC)].

    Science.gov (United States)

    Domingo, Cristina; Aros, Fernando; Otxandategi, Agurtzane; Beistegui, Idoia; Besga, Ariadna; Latorre, Pedro María

    2018-02-26

    To assess the efficacy of the ProMIC, multidisciplinary program for patients admitted at hospital because of heart failure (HF) programme, in reducing the HF-related readmission rate. Quasi-experimental research with control group. Twelve primary health care centres and 3 hospitals from the Basque Country. Aged 40 years old or above patients admitted for HF with a New York Heart Association functional class II to IV. Patients in the intervention group carried out the ProMIC programme, a structured clinical intervention based on clinical guidelines and on the chronic care model. Control group received usual care. The rate of readmission for HF and health-related quality of life RESULTS: One hundred fifty five patients were included in ProMIC group and 129 in control group. 45 rehospitalisation due to heart failure happened in ProMIC versus 75 in control group (adjusted hazard ratio=0.59, CI 95%: 0.36-0.98; P=.049). There were significant differences in specific quality of life al 6 months. No significant differences were found in rehospitalisation due to all causes, due to cardiovascular causes, visits to emergency room, mortality, the combined variable of these events, the functional capacity or quality of life at 12 months of follow up. ProMIC reduces significantly heart failure rehospitalisation and improve quality of life al 6 months of follow up. No significant differences were found in the rests of variables. Copyright © 2018 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Effect of exercise training on sports enjoyment and leisure-time spending in adolescents with complex congenital heart disease: the moderating effect of health behavior and disease knowledge

    NARCIS (Netherlands)

    Dulfer, Karolijn; Duppen, Nienke; Blom, Nico A.; van Dijk, Arie P. J.; Helbing, Wim A.; Verhulst, Frank C.; Utens, Elisabeth M. W. J.

    2014-01-01

    The aim of this study was to evaluate the effects of a standardized exercise program on sports enjoyment and leisure-time spending in adolescents with congenital heart disease and to know what the moderating impact of their baseline health behavior and disease knowledge is. Included were 93

  9. Is reporting on interventions a weak link in understanding how and why they work? A preliminary exploration using community heart health exemplars

    Directory of Open Access Journals (Sweden)

    Kurtz Donna

    2008-05-01

    Full Text Available Abstract Background The persistent gap between research and practice compromises the impact of multi-level and multi-strategy community health interventions. Part of the problem is a limited understanding of how and why interventions produce change in population health outcomes. Systematic investigation of these intervention processes across studies requires sufficient reporting about interventions. Guided by a set of best processes related to the design, implementation, and evaluation of community health interventions, this article presents preliminary findings of intervention reporting in the published literature using community heart health exemplars as case examples. Methods The process to assess intervention reporting involved three steps: selection of a sample of community health intervention studies and their publications; development of a data extraction tool; and data extraction from the publications. Publications from three well-resourced community heart health exemplars were included in the study: the North Karelia Project, the Minnesota Heart Health Program, and Heartbeat Wales. Results Results are organized according to six themes that reflect best intervention processes: integrating theory, creating synergy, achieving adequate implementation, creating enabling structures and conditions, modifying interventions during implementation, and facilitating sustainability. In the publications for the three heart health programs, reporting on the intervention processes was variable across studies and across processes. Conclusion Study findings suggest that limited reporting on intervention processes is a weak link in research on multiple intervention programs in community health. While it would be premature to generalize these results to other programs, important next steps will be to develop a standard tool to guide systematic reporting of multiple intervention programs, and to explore reasons for limited reporting on intervention

  10. Is reporting on interventions a weak link in understanding how and why they work? A preliminary exploration using community heart health exemplars.

    Science.gov (United States)

    Riley, Barbara L; MacDonald, JoAnne; Mansi, Omaima; Kothari, Anita; Kurtz, Donna; vonTettenborn, Linda I; Edwards, Nancy C

    2008-05-20

    The persistent gap between research and practice compromises the impact of multi-level and multi-strategy community health interventions. Part of the problem is a limited understanding of how and why interventions produce change in population health outcomes. Systematic investigation of these intervention processes across studies requires sufficient reporting about interventions. Guided by a set of best processes related to the design, implementation, and evaluation of community health interventions, this article presents preliminary findings of intervention reporting in the published literature using community heart health exemplars as case examples. The process to assess intervention reporting involved three steps: selection of a sample of community health intervention studies and their publications; development of a data extraction tool; and data extraction from the publications. Publications from three well-resourced community heart health exemplars were included in the study: the North Karelia Project, the Minnesota Heart Health Program, and Heartbeat Wales. Results are organized according to six themes that reflect best intervention processes: integrating theory, creating synergy, achieving adequate implementation, creating enabling structures and conditions, modifying interventions during implementation, and facilitating sustainability. In the publications for the three heart health programs, reporting on the intervention processes was variable across studies and across processes. Study findings suggest that limited reporting on intervention processes is a weak link in research on multiple intervention programs in community health. While it would be premature to generalize these results to other programs, important next steps will be to develop a standard tool to guide systematic reporting of multiple intervention programs, and to explore reasons for limited reporting on intervention processes. It is our contention that a shift to more inclusive reporting of

  11. Population-based metabolic syndrome risk score and its determinants: The Isfahan Healthy Heart Program

    Directory of Open Access Journals (Sweden)

    Mohsen Hosseini

    2014-01-01

    Full Text Available Background: Metabolic syndrome (MetSy, an important predisposing factor for the most of noncommunicable diseases, has become a global pandemic. Given different definitions used for the MetSy, recently using a score termed "continuous MetSy risk score (CMetSyS" is recommended. The aim of this study was to provide a CMetSyS in a population-based sample of Iranian adults and to assess its determinants. Materials and Methods: We used the data of the baseline survey of a community trial entitled "the Isfahan health heart program." The MetSy was defined according to the Revised National Cholesterol Education Program Third Adult Treatment Panel. All probable predictive models and their predictive performance were provided using leave-one-out cross-validated logistic regression and the receiver operation characteristic curve methods. Multiple linear regression was performed to assess factors associated with the CMetSyS. Results: The study population consisted of 8313 persons (49.9% male, mean age 38.54 ± 15.86 years. The MetSy was documented in 1539 persons (21.86%. Triglycerides and waist circumference were the best predictive components, and fasting plasma glucose had the lowest area under curve (AUC. The AUC for our best model was 95.36 (94.83-95.83%. The best predictive cutoff for this risk score was −1.151 with 89% sensitivity and 87.93% specificity. Conclusion: We provided four population-based leave-one-out cross-validated risk score models, with moderate to perfect predictive performance to identify the MetSy in Iranian adults. The CMetSyS had significant associations with high sensitive C-reactive protein, body mass index, leisure time, and workplace physical activity as well as age and gender.

  12. Impacts on power reactor health physics programs

    International Nuclear Information System (INIS)

    Meyer, B.A.

    1991-01-01

    The impacts on power reactor health physics programs form implementing the revised 10 CFR Part 20 will be extensive and costly. Every policy, program, procedure and training lesson plan involving health physics will require changes and the subsequent retraining of personnel. At each power reactor facility, hundreds of procedures and thousands of people will be affected by these changes. Every area of a power reactor health physics program will be affected. These areas include; ALARA, Respiratory Protection, Exposure Control, Job Coverage, Dosimetry, Radwaste, Effluent Accountability, Emergency Planning and Radiation Worker Training. This paper presents how power reactor facilities will go about making these changes and gives possible examples of some of these changes and their impact on each area of power reactor health physics program

  13. Worksite health promotion programs in college settings

    Science.gov (United States)

    Hill-Mey, Patricia E.; Kumpfer, Karol L.; Merrill, Ray M.; Reel, Justine; Hyatt-Neville, Beverly; Richardson, Glenn E.

    2015-01-01

    The purpose of this paper is to describe the multifaceted nature and benefits of worksite health promotion programs (WHPPs), with emphasis on the college setting. An assessment of the peer-reviewed literature was conducted of articles published since 2000. Several search engines were accessed and selected key words were used. Most studies examining WHPPs have focused on return on investment and productivity. Research that targets the softer side-benefits of health promotion programs in the workplace is less available. Although the college setting offers some advantages for implementing health promotion programs. They may also have unique challenges due to their large and diverse employee population. There is little research to show the effectiveness and unique challenges of college-based health promotion programs. PMID:25861657

  14. Psychometric properties of HeartQoL, a core heart disease-specific health-related quality of life questionnaire, in Danish implantable cardioverter defibrillator recipients

    DEFF Research Database (Denmark)

    Zangger, Graziella; Zwisler, Ann-Dorthe; Kikkenborg Berg, Selina

    2017-01-01

    Background Patient-reported health-related quality of life is increasingly used as an outcome measure in clinical trials and as a performance measure to evaluate quality of care. The objective of this study was to assess the psychometric properties of the Danish HeartQoL questionnaire, a core heart...... disease-specific health-related quality of life questionnaire, in implantable cardioverter defibrillator recipients. Design This study involved cross-sectional and test-retest study designs. Method Implantable cardioverter defibrillator recipients in the cross-sectional study completed the Heart......QoL, the Short-Form 36 Health Survey, and the Hospital Anxiety and Depression Scale. The HeartQoL structure, construct-related validity (convergent and discriminative) and reliability (internal consistency) were assessed. HeartQoL reproducibility (test-retest) was assessed in an independent sample of implantable...

  15. Healthy Bread Initiative: Methods, Findings, and Theories—Isfahan Healthy Heart Program

    Science.gov (United States)

    Talaei, Mohammad; Khaje, Mohammad-Reza; Sarrafzadegan, Nizal; Sajjadi, Firoozeh; Alikhasi, Hasan; Maghroun, Maryam; Iraji, Farhad; Ehteshami, Shahram

    2013-01-01

    The scientific evidences show that the content, baking methods, and types of bread can make health impacts. Bread, as a major part of Iranian diet, demonstrates a significant potential to be targeted as health promotion subject. Healthy Food for Healthy Communities (HFHC) was a project of Isfahan Healthy Heart Program (IHHP), consisting of a wide variety of strategies, like Healthy Bread (HB) Initiative. The HB Initiative was designed to improve the behaviour of both producers and consumers, mainly aiming at making high-fibre, low-salt bread, eliminating the use of baking soda, providing enough rest time for dough before baking (at least one hour), and enough baking time (at least one minute in oven). A workshop was held for volunteer bakers, and a baker-to-baker training protocol under direct supervision was designed for future volunteers. Cereal Organization was persuaded to provide less refined flour that contained more bran. Health messages in support of new breads were disseminated by media and at bakeries by health professionals. Evaluation of the HB Initiative was done using before-after assessments and population surveys. While HB was baked in 1 (0.01%) bakery at baseline, 402 (41%) bakeries in the intervention area joined the HB Initiative in 2009. Soda was completely eliminated and fibre significantly increased from 4±0.4 g% before study to 12±0.6 g% after the intervention (p<0.001). The preparation and baking times remarkably increased. Wastage of bread decreased from 13±1.8 g% to 2±0.5 g% and was expressed as the most important advantage of this initiative by consumers. People who lived in Isfahan city consumed whole bread 6 times more than those who lived in reference area Arak (p<0.001). The HB Initiative managed to add new breads as a healthy choice that were compatible with local dishes and made a model to solve the long-standing problems of bread. It used various health promotion approaches but was best consistent with Beattie's model. PMID

  16. Predictors of health-related quality of life in children with chronic heart disease.

    Science.gov (United States)

    Niemitz, Mandy; Gunst, Diana C M; Hövels-Gürich, Hedwig H; Hofbeck, Michael; Kaulitz, Renate; Galm, Christoph; Berger, Felix; Nagdyman, Nicole; Stiller, Brigitte; Borth-Bruhns, Thomas; Konzag, Ines; Balmer, Christian; Goldbeck, Lutz

    2017-10-01

    Chronic paediatric heart disease is often associated with residual symptoms, persisting functional restrictions, and late sequelae for psychosocial development. It is, therefore, increasingly important to evaluate the health-related quality of life of children and adolescents with chronic heart disease. The aim of this study was to determine medical and socio-demographic variables affecting health-related quality of life in school-aged children and adolescents with chronic heart disease. Patients and methods The Pediatric Cardiac Quality of Life Inventory was administered to 375 children and adolescents and 386 parental caregivers. Medical information was obtained from the charts. The socio-demographic information was provided by the patients and caregivers. Greater disease severity, low school attendance, current cardiac medication, current parental employment, uncertain or limited prognosis, history of connection to a heart-lung machine, number of nights spent in a hospital, and need for treatment in a paediatric aftercare clinic independently contributed to lower health-related quality of life (self-report: R2=0.41; proxy-report: R2=0.46). High correlations between self-reports and parent-proxy reports indicated concordance regarding the evaluation of a child's health-related quality of life. Beyond medical treatment, integration into school is important to increase health-related quality of life in children and adolescents surviving with chronic heart disease. Regular screening of health-related quality of life is recommended to identify patients with special needs.

  17. Health literacy and mortality: a cohort study of patients hospitalized for acute heart failure.

    Science.gov (United States)

    McNaughton, Candace D; Cawthon, Courtney; Kripalani, Sunil; Liu, Dandan; Storrow, Alan B; Roumie, Christianne L

    2015-04-29

    More than 30% of patients hospitalized for heart failure are rehospitalized or die within 90 days of discharge. Lower health literacy is associated with mortality among outpatients with chronic heart failure; little is known about this relationship after hospitalization for acute heart failure. Patients hospitalized for acute heart failure and discharged home between November 2010 and June 2013 were followed through December 31, 2013. Nurses administered the Brief Health Literacy Screen at admission; low health literacy was defined as Brief Health Literacy Screen ≤9. The primary outcome was all-cause mortality. Secondary outcomes were time to first rehospitalization and, separately, time to first emergency department visit within 90 days of discharge. Cox proportional hazards models determined their relationships with health literacy, adjusting for age, gender, race, insurance, education, comorbidity, and hospital length of stay. For the 1379 patients, average age was 63.1 years, 566 (41.0%) were female, and 324 (23.5%) had low health literacy. Median follow-up was 20.7 months (interquartile range 12.8 to 29.6 months), and 403 (29.2%) patients died. Adjusted hazard ratio [aHR] for death among patients with LHL was 1.32 (95%confidence interval [CI] 1.05, 1.66, P=0.02) compared to BHLS>9 [corrected].Within 90 days of discharge, there were 415 (30.1%) rehospitalizations and 201 (14.6%) emergency department visits, with no evident association with health literacy. Lower health literacy was associated with increased risk of death after hospitalization for acute heart failure. There was no evident relationship between health literacy and 90-day rehospitalization or emergency department visits. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  18. [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.

  19. Identification and Progression of Heart Disease Risk Factors in Diabetic Patients from Longitudinal Electronic Health Records

    Directory of Open Access Journals (Sweden)

    Jitendra Jonnagaddala

    2015-01-01

    Full Text Available Heart disease is the leading cause of death worldwide. Therefore, assessing the risk of its occurrence is a crucial step in predicting serious cardiac events. Identifying heart disease risk factors and tracking their progression is a preliminary step in heart disease risk assessment. A large number of studies have reported the use of risk factor data collected prospectively. Electronic health record systems are a great resource of the required risk factor data. Unfortunately, most of the valuable information on risk factor data is buried in the form of unstructured clinical notes in electronic health records. In this study, we present an information extraction system to extract related information on heart disease risk factors from unstructured clinical notes using a hybrid approach. The hybrid approach employs both machine learning and rule-based clinical text mining techniques. The developed system achieved an overall microaveraged F-score of 0.8302.

  20. Relationship of Health Literacy of Heart Failure Patients and Their Family Members on Heart Failure Knowledge and Self-Care.

    Science.gov (United States)

    Wu, Jia-Rong; Reilly, Carolyn M; Holland, James; Higgins, Melinda; Clark, Patricia C; Dunbar, Sandra B

    2017-02-01

    We explored the relationships among patients' and family members' (FMs) health literacy, heart failure (HF) knowledge, and self-care behaviors using baseline data from HF patients and their FMs ( N = 113 pairs) in a trial of a self-care intervention. Measures included Rapid Estimate of Adult Literacy in Medicine, Atlanta HF Knowledge Test, a heart failure Medication Adherence Scale, and sodium intake (24-hr urine and 3-day food record). Patients with low health literacy (LHL) were more likely to have lower HF knowledge ( p < .001) and trended to poorer medication adherence ( p = .077) and higher sodium intake ( p = .072). When FMs had LHL, FMs were more likely to have lower HF knowledge ( p = .001) and patients trended toward higher sodium intake ( p = .067). When both patients and FMs had LHL, lowest HF knowledge and poorest medication adherence were observed ( p < .027). The health literacy of both patient and FM needs to be considered when designing interventions to foster self-care.

  1. Salud Para Su Corazon (Health for Your Heart) Community Health Worker Model

    Science.gov (United States)

    Balcazar, H.; Alvarado, M.; Ortiz, G.

    2012-01-01

    This article describes 6 Salud Para Su Corazon (SPSC) family of programs that have addressed cardiovascular disease risk reduction in Hispanic communities facilitated by community health workers (CHWs) or Promotores de Salud (PS). A synopsis of the programs illustrates the designs and methodological approaches that combine community-based participatory research for 2 types of settings: community and clinical. Examples are provided as to how CHWs can serve as agents of change in these settings. A description is presented of a sustainability framework for the SPSC family of programs. Finally, implications are summarized for utilizing the SPSC CHW/PS model to inform ambulatory care management and policy. PMID:21914992

  2. The National Heart Failure Project: a health care financing administration initiative to improve the care of Medicare beneficiaries with heart failure.

    Science.gov (United States)

    Masoudi, F A; Ordin, D L; Delaney, R J; Krumholz, H M; Havranek, E P

    2000-01-01

    This is the second in a series describing Health Care Financing Administration (HCFA) initiatives to improve care for Medicare beneficiaries with heart failure. The first article outlined the history of HCFA quality-improvement projects and current initiatives to improve care in six priority areas: heart failure, acute myocardial infarction, stroke, pneumonia, diabetes, and breast cancer. This article details the objectives and design of the Medicare National Heart Failure Quality Improvement Project (NHF), which has as its goal the improvement of inpatient heart failure care. (c)2000 by CHF, Inc.

  3. The Environmental Science and Health Effects Program

    International Nuclear Information System (INIS)

    Michael Gurevich; Doug Lawson; Joe Mauderly

    2000-01-01

    The goal of the Environmental Science and Health Effect Program is to conduct policy-relevant research that will help us understand atmospheric impacts and potential health effects that may be caused by the use of petroleum-based fuels and alternative transportation fuels from mobile sources

  4. Introduction to: The Forest Health monitoring program

    Science.gov (United States)

    Barbara L. Conkling

    2011-01-01

    The National Forest Health Monitoring (FHM) Program of the Forest Service, U.S. Department of Agriculture, produces an annual technical report on forest health as one of its products. The report is organized using the Criteria and Indicators for the Conservation and Sustainable Management of Temperate and Boreal Forests (Montréal Process Working Group 2007) as a...

  5. THE SCHOOL HEALTH AND SAFETY PROGRAM.

    Science.gov (United States)

    1963

    INVOLVING INDIVIDUALS AS WELL AS ORGANIZATIONS, THE PROGRAM AIMED AT THE OPTIMUM HEALTH OF ALL CHILDREN, AND IMPROVEMENT OF HEALTH AND SAFETY STANDARDS WITHIN THE COMMUNITY. EACH OF THE CHILDREN WAS URGED TO HAVE A SUCCESSFUL VACCINATION FOR SMALL POX, THE DPT SERIES AND BOOSTER, THE POLIO SERIES, AND CORRECTIONS OF ALL DENTAL DEFECTS AND…

  6. The Environmental Science and Health Effects Program

    Energy Technology Data Exchange (ETDEWEB)

    Michael Gurevich; Doug Lawson; Joe Mauderly

    2000-04-10

    The goal of the Environmental Science and Health Effect Program is to conduct policy-relevant research that will help us understand atmospheric impacts and potential health effects that may be caused by the use of petroleum-based fuels and alternative transportation fuels from mobile sources.

  7. Pregnancy-related Health Behavior of Women with Congenital Heart Disease : Room for Behavioral Change Interventions

    NARCIS (Netherlands)

    Moons, Philip; Budts, Werner; Costermans, Els; Huyghe, Els; Pieper, Petronella G.; Drenthen, Wim

    2009-01-01

    Background. Pregnancy in women with congenital heart disease is associated with maternal and neonatal complications. In order to reduce risks for unfavorable outcomes, pregnant women need to adopt specific health behaviors. We investigated the pregnancy-related health behavior of women with

  8. Does Uninsurance Affect the Health Outcomes of the Insured? Evidence from Heart Attack Patients in California

    NARCIS (Netherlands)

    Meltem Daysal, N.

    2012-01-01

    Abstract: In this paper, I examine the impact of uninsured patients on the health of the insured, focusing on one health outcome - the in-hospital mortality rate of insured heart attack patients. I employ panel data models using patient discharge and hospital financial data from California

  9. Thoughts about death and perceived health status in elderly patients with heart failure

    NARCIS (Netherlands)

    Stroemberg, Anna; Jaarsma, Tiny

    Aim: To explore thoughts about death and perceived health status in elderly patients with heart failure during a 6 month period after a deterioration needing hospitalisation. Methods: A descriptive, mixed methods design was used. Health was measured with EuroQol-5D, thoughts about death with

  10. Workplace Participatory Occupational Health/Health Promotion Program

    Science.gov (United States)

    Zhang, Yuan; Flum, Marian; Kotejoshyer, Rajashree; Fleishman, Jane; Henning, Robert; Punnett, Laura

    2018-01-01

    Nursing home employees experience high physical and psychosocial workloads, resulting in poor health outcomes. An occupational health/health promotion program, designed to facilitate employee participation, was initiated in three nursing homes. The aim of the current study was to evaluate facilitators and barriers of the program after 3-year implementation. Focus groups with employees and in-depth interviews with top and middle managers were conducted. The Social Ecological Model was used to organize the evaluation. Facilitators and barriers were reported from both managers’ and employees’ perspectives, and were categorized as intrapersonal, interpersonal, institutional, and corporate level. Management support, financial resources, and release time for participation were identified as the three most important factors. Supports from multiple levels including both human and environment, and managers and employees, are important for a successful participatory occupational health/health promotion program. PMID:26977705

  11. Can health promotion programs save Medicare money?

    Directory of Open Access Journals (Sweden)

    Ron Z Goetzel

    2007-04-01

    Full Text Available Ron Z Goetzel1, David Shechter2, Ronald J Ozminkowski1, David C Stapleton3, Pauline J Lapin4, J Michael McGinnis5, Catherine R Gordon6, Lester Breslow71Institute for Health and Productivity Studies, Cornell University, Washington, DC; 2Health and Productivity Research, Thomson Medstat, Santa Barbara, CA; 3Cornell Institute for Policy Research, Cornell University, Washington, DC; 4Office of Research, Development, and Information, Centers for Medicare and Medicaid Services, Baltimore, MD; 5National Academy of Sciences, Institute of Medicine, The National Academies, Washington, DC; 6Office of the Director, Centers for Disease Control and Prevention, Washington, DC; 7UCLA School of Public Health, Dept. of Health Services, Los Angeles, CA, USAAbstract: The impact of an aging population on escalating US healthcare costs is influenced largely by the prevalence of chronic disease in this population. Consequently, preventing or postponing disease onset among the elderly has become a crucial public health issue. Fortunately, much of the total burden of disease is attributable to conditions that are preventable. In this paper, we address whether well-designed health promotion programs can prevent illness, reduce disability, and improve the quality of life. Furthermore, we assess evidence that these programs have the potential to reduce healthcare utilization and related expenditures for the Medicare program. We hypothesize that seniors who reduce their modifiable health risks can forestall disability, reduce healthcare utilization, and save Medicare money. We end with a discussion of a new Senior Risk Reduction Demonstration, which will be initiated by the Centers for Medicare and Medicaid Services in 2007, to test whether risk reduction programs developed in the private sector can achieve health improvements among seniors and a positive return on investment for the Medicare program.Keywords: health promotion, return on investment, Medicare, financial

  12. Effects of eHealth physical activity encouragement in adolescents with complex congenital heart disease

    DEFF Research Database (Denmark)

    Klausen, Susanne Hwiid; Andersen, Lars L; Søndergaard, Lars

    2016-01-01

    OBJECTIVE: To assess benefit and harms of adding an eHealth intervention to health education and individual counseling in adolescents with congenital heart disease. DESIGN: Randomized clinical trial. SETTING: Denmark. PATIENTS: A total of 158 adolescents aged 13-16years with no physical activity...... restrictions after repaired complex congenital heart disease. INTERVENTIONS: PReVaiL consisted of individually tailored eHealth encouragement physical activity for 52weeks. All patients received 45min of group-based health education and 15min of individual counseling involving patients' parents. OUTCOMES......·kg(-1)·min(-1) (95% CI -2.66 to 1.36). Between-group differences at 1year in physical activity, generic health-related quality of life, and disease-specific quality of life were not statistically significant. CONCLUSIONS: Adding a tailored eHealth intervention to health education and individual...

  13. Heart and liver T2* assessment for iron overload using different software programs

    Energy Technology Data Exchange (ETDEWEB)

    Fernandes, Juliano L. [University of Campinas, Unicamp, Campinas (Brazil); Radiologia Clinica de Campinas, Campinas (Brazil); Cardiology, Department of Internal Medicine, Campinas, SP (Brazil); Sampaio, Erika Fontana; Coelho, Otavio R. [University of Campinas, Unicamp, Campinas (Brazil); Verissimo, Monica; Pereira, Fabricio B. [Centro Infantil Boldrini, Campinas (Brazil); Silva, Jose Alvaro da; Figueiredo, Gabriel S. de; Kalaf, Jose M. [Radiologia Clinica de Campinas, Campinas (Brazil)

    2011-12-15

    To assess the level of agreement and interchangeability among different software programs for calculation of T2* values for iron overload. T2* images were analysed in 60 patients with thalassaemia major using the truncation method in three software programs. Levels of agreement were assessed using Pearson correlation and Bland-Altman plots. Categorical classification for levels of iron concentration by each software program was also compared. For the heart, all correlation coefficients were significant among the software programs (P < 0.001 for all coefficients). The mean differences and 95% limits of agreement were 0.2 (-4.73 to 5.0); 0.1 (-4.0 to 3.9); and -0.1 (-4.3 to 4.8). For the liver all correlations were also significant with P < 0.001. Bland-Altman plots showed differences of -0.02 (-0.7 to 0.6); 0.01 (-0.4 to 0.4); and -0.02 (-0.6 to 0.6). There were no significant differences in clinical classification among the software programs. All tools used in this study provided very good agreement among heart and liver T2* values. The results indicate that interpretation of T2* data is interchangeable with any of the software programs tested. (orig.)

  14. 76 FR 49707 - Food Labeling; Health Claim; Phytosterols and Risk of Coronary Heart Disease; Reopening of the...

    Science.gov (United States)

    2011-08-11

    ... Risk of Coronary Heart Disease; Reopening of the Comment Period AGENCY: Food and Drug Administration... reconsider its proposed amendments to the phytosterols and risk of coronary heart disease health [[Page 49708... December 8, 2010, proposing to amend regulations on plant sterol/ stanol esters and risk of coronary heart...

  15. A Perspective on Promoting Diversity in the Biomedical Research Workforce: The National Heart, Lung, and Blood Institute's PRIDE Program.

    Science.gov (United States)

    Boyington, Josephine E A; Maihle, Nita J; Rice, Treva K; Gonzalez, Juan E; Hess, Caryl A; Makala, Levi H; Jeffe, Donna B; Ogedegbe, Gbenga; Rao, Dabeeru C; Dávila-Román, Victor G; Pace, Betty S; Jean-Louis, Girardin; Boutjdir, Mohamed

    2016-07-21

    Aspiring junior investigators from groups underrepresented in the biomedical sciences face various challenges as they pursue research independence. However, the biomedical research enterprise needs their participation to effectively address critical research issues such as health disparities and health inequities. In this article, we share a research education and mentoring initiative that seeks to address this challenge: Programs to Increase Diversity among Individuals Engaged in Health Related Research (PRIDE), funded by the National Heart, Lung, and Blood Institute (NHLBI). This longitudinal research-education and mentoring program occurs through summer institute programs located at US-based academic institutions. Recruited participants are exposed to didactic and lab-based research-skill enhancement experiences, with year-round mentoring over the course of two years. Mentor-mentee matching is based on shared research interests to promote congruence and to enhance skill acquisition. Program descriptions and sample narratives of participants' perceptions of PRIDE's impact on their career progress are showcased. Additionally, we highlight the overall program design and structure of four of seven funded summer institutes that focus on cardiovascular disease, related conditions, and health disparities. Mentees' testimonials about the value of the PRIDE mentoring approach in facilitating career development are also noted. Meeting the clinical and research needs of an increasingly diverse US population is an issue of national concern. The PRIDE initiative, which focuses on increasing research preparedness and professional development of groups underrepresented in the biomedical research workforce, with an emphasis on mentoring as the critical approach, provides a robust model that is impacting the careers of future investigators.

  16. Health, safety and environmental research program

    International Nuclear Information System (INIS)

    Dinner, P.J.

    1983-01-01

    This report outlines the Health, Safety and Environmental Research Program being undertaken by the CFFTP. The Program objectives, relationship to other CFFTP programs, implementation plans and expected outputs are stated. Opportunities to build upon the knowledge and experience gained in safely managing tritium in the CANDU program, by addressing generic questions pertinent to tritium safety for fusion facilities, are identified. These opportunities exist across a broad spectrum of issues covering the anticipated behaviour of tritium in fusion facilities, the surrounding environment and in man

  17. Tests That Can Help Protect Your Heart Health

    Science.gov (United States)

    ... Red Dress ® , and Red Dress ® are registered trademarks of U.S. Department of Health and Human Services. National Wear Red Day ® is a registered trademark of the U.S. Department of Health and Human ...

  18. Positive Affect and Health Behaviors Across 5 Years in Patients With Coronary Heart Disease: The Heart and Soul Study.

    Science.gov (United States)

    Sin, Nancy L; Moskowitz, Judith Tedlie; Whooley, Mary A

    2015-01-01

    Positive psychological states are linked to superior health and longevity, possibly due to behavioral factors. We evaluated cross-sectional and 5-year associations between positive affect and health behaviors in patients with coronary heart disease (CHD). Outpatients with CHD reported positive affect, physical activity, sleep quality, medication adherence, cigarette smoking, and alcohol use at baseline (n = 1022) and 5 years later (n = 662). Covariates in regression analyses included demographics, cardiac disease severity, and depressive symptoms. At baseline, higher positive affect (per 1 standard deviation) was associated with better health behaviors: physical activity (odds ratio [OR] = 1.52, 95% 95% confidence interval [CI] = 1.30-1.77, p positive affect did not predict health behaviors at follow-up, accounting for baseline behaviors. However, increases in positive affect across 5 years co-occurred with improvements in physical activity (B = 0.023, standard error [SE] = 0.008, p = .002), sleep quality (B = 0.011, SE = 0.005, p = .039), and medication adherence (B = 0.014, SE = 0.004, p Positive affect was associated with health behaviors among patients with CHD. Efforts to sustain or enhance positive affect may be promising for promoting better health behaviors.

  19. Comorbid Mental Health Symptoms and Heart Diseases: Can Health Care and Mental Health Care Professionals Collaboratively Improve the Assessment and Management?

    Science.gov (United States)

    Ai, Amy L.; Rollman, Bruce L.; Berger, Candyce S.

    2010-01-01

    On the basis of current epidemiological and clinical research, this article describes how mental health symptoms are associated with heart disease, a major chronic condition that occurs primarily in middle and late life. The article describes the culturally and historically important link between heart and mind. It then describes depression and…

  20. The effects of a disease management program on self-reported health behaviors and health outcomes: evidence from the "Florida: a healthy state (FAHS)" Medicaid program.

    Science.gov (United States)

    Morisky, Donald E; Kominski, Gerald F; Afifi, Abdelmonem A; Kotlerman, Jenny B

    2009-06-01

    Premature morbidity and mortality from chronic diseases account for a major proportion of expenditures for health care cost in the United States. The purpose of this study was to measure the effects of a disease management program on physiological and behavioral health indicators for Medicaid patients in Florida. A two-year prospective study of 15,275 patients with one or more chronic illnesses (congestive heart failure, hypertension, diabetes, or asthma) was undertaken. Control of hypertension improved from baseline to Year 1 (adjusted odds ratio = 1.60, p management program benefited in terms of controlling hypertension, asthma symptoms, and cholesterol and blood glucose levels.

  1. Application of HEART technique in health care system and accuracy of its results

    Directory of Open Access Journals (Sweden)

    Mohammad Beiruti

    2016-12-01

    Full Text Available Introduction: Human error is considered as a crucial challenge in occupational settings. Health care system is amongst occupational environments with high rate of human errors. Numerous preceding studies noted that more than 2/3 of medical errors are preventable. Accordingly, different methods are suggested to evaluate human errors, especially in nuclear industries. The aim of this study was to evaluate the application and accuracy of HEART technique in medical health system. Material and Method:  This qualitative study was conducted in surgical intensive care units of a hospital in Shiraz city. All nurses recorded errors were categorized regarding the given tasks and then all tasks were ranked based on the number of errors. The probability of nurses’ tasks error was estimated through AHP-HEART method and the resultant ranking was compared with the recorded errors. Additionally, the prioritization of contributing factors to errors, determined by AHP and AHP-HEART methods, was compared employing Pearson statistical test. Results: Based on the results, there was a concordance in the rate of nurses’ error determined by HEART method and the recorded errors. However, no significant correlation was between errors contributing factors determined by AHP and AHP-HEART methods. Conclusion: This study suggested that although HEART technique was successful to rank the tasks considering the magnitude of error probability, but the coefficients of error producing conditions should be customized for nurses’ tasks in order to provide appropriate control measures.

  2. Quality of life predicts outcome in a heart failure disease management program.

    LENUS (Irish Health Repository)

    O'Loughlin, Christina

    2012-02-01

    BACKGROUND: Chronic heart failure (HF) is associated with a poor Health Related Quality of Life (HRQoL). HRQoL has been shown to be a predictor of HF outcomes however, variability in the study designs make it difficult to apply these findings to a clinical setting. The aim of this study was to establish if HRQoL is a predictor of long-term mortality and morbidity in HF patients followed-up in a disease management program (DMP) and if a HRQoL instrument could be applied to aid in identifying high-risk patients within a clinical context. METHODS: This is a retrospective analysis of HF patients attending a DMP with 18+\\/-9 months follow-up. Clinical and biochemical parameters were recorded on discharge from index HF admission and HRQoL measures were recorded at 2 weeks post index admission. RESULTS: 225 patients were enrolled into the study (mean age=69+\\/-12 years, male=61%, and 78%=systolic HF). In multivariable analysis, all dimensions of HRQoL (measured by the Minnesota Living with HF Questionnaire) were independent predictors of both mortality and readmissions particularly in patients <80 years. A significant interaction between HRQoL and age (Total((HRQoL))age: p<0.001) indicated that the association of HRQoL with outcomes diminished as age increased. CONCLUSIONS: These data demonstrate that HRQoL is a predictor of outcome in HF patients managed in a DMP. Younger patients (<65 years) with a Total HRQoL score of > or =50 are at high risk of an adverse outcome. In older patients > or =80 years HRQoL is not useful in predicting outcome.

  3. THE CORRELATION BETWEEN LIPID PROFILE AND STRESS LEVELS IN PART CENTRAL IRAN: ISFAHAN HEALTHY HEART PROGRAM

    Directory of Open Access Journals (Sweden)

    Maryam Shahnam

    2010-12-01

    Full Text Available Abstract            Background: Previous studies suggest that mental status may influence serum lipid levels. This study was conducted on adult population living in rural and urban areas in Central Iran to assess the correlation between stress level and lipid profile disorders.Methods: Data was extracted from final evaluation of Isfahan Healthy Heart Program (IHHP in 2008. Multistage and random cluster methods were used for sampling. The study population consisted of 9752 adults aged ≥19 years living in three districts namely Isfahan, Arak and Najaf Abad. Demographic data, age and sex were recorded. Blood samples were taken to determine the lipid levels including total cholesterol (TC, low-density lipoprotein cholesterol (LDL-C, low levels of high-density lipoprotein cholesterol (HDL-C and triglycerides. Stress levels were assessed using the General Health Questionnaire. Logistic regression and chi-square tests were used for statistical analysis.Results: The odds ratios of high stress in individuals with high levels of TC, LDL-C and low levels of HDL-C compared to normal individuals after adjustment for age and sex were as follows respectively: 1.05 (1.02,1.15, 1.06 (1.02,1.18, 1.06 (1.01,1.17.Conclusion: Intervention activities towards reduction of stress levels at the community level may be useful as part of the strategy for cardiovascular disease prevention. Keywords: Cholesterol, Triglycerides, Stress, Questionnaire, Adult

  4. Target Heart Rates

    Science.gov (United States)

    ... Check Recipe Certification Program Nutrition Requirements Heart-Check Professional Resources Contact the Heart-Check Certification Program Simple Cooking and Recipes Dining Out Choosing a Restaurant Deciphering ...

  5. Caffeine and Heart Disease

    Science.gov (United States)

    ... Check Recipe Certification Program Nutrition Requirements Heart-Check Professional Resources Contact the Heart-Check Certification Program Simple Cooking and Recipes Dining Out Choosing a Restaurant Deciphering ...

  6. A genome resource to address mechanisms of developmental programming: determination of the fetal sheep heart transcriptome.

    Science.gov (United States)

    Cox, Laura A; Glenn, Jeremy P; Spradling, Kimberly D; Nijland, Mark J; Garcia, Roy; Nathanielsz, Peter W; Ford, Stephen P

    2012-06-15

    The pregnant sheep has provided seminal insights into reproduction related to animal and human development (ovarian function, fertility, implantation, fetal growth, parturition and lactation). Fetal sheep physiology has been extensively studied since 1950, contributing significantly to the basis for our understanding of many aspects of fetal development and behaviour that remain in use in clinical practice today. Understanding mechanisms requires the combination of systems approaches uniquely available in fetal sheep with the power of genomic studies. Absence of the full range of sheep genomic resources has limited the full realization of the power of this model, impeding progress in emerging areas of pregnancy biology such as developmental programming. We have examined the expressed fetal sheep heart transcriptome using high-throughput sequencing technologies. In so doing we identified 36,737 novel transcripts and describe genes, gene variants and pathways relevant to fundamental developmental mechanisms. Genes with the highest expression levels and with novel exons in the fetal heart transcriptome are known to play central roles in muscle development. We show that high-throughput sequencing methods can generate extensive transcriptome information in the absence of an assembled and annotated genome for that species. The gene sequence data obtained provide a unique genomic resource for sheep specific genetic technology development and, combined with the polymorphism data, augment annotation and assembly of the sheep genome. In addition, identification and pathway analysis of novel fetal sheep heart transcriptome splice variants is a first step towards revealing mechanisms of genetic variation and gene environment interactions during fetal heart development.

  7. Evaluation of the Effect of Educating Self Care Behavior of Heart failure Patients on Economy of Health

    Directory of Open Access Journals (Sweden)

    Maryam Seraji

    2016-08-01

    Full Text Available Heart disease is the most costly reason for hospitalization. The purpose of this research was evaluation of the influence of teaching self care behavior for heart failure patients on economy of health in hospitals in the city of Zahedan of Iran in the year 2012.This study was quasi-experimental with a control group in the CCU and Post CCU wards of the hospitals of the city of Zahedan in 2012. The patients were randomly and conveniently placed in two groups of intervention (70 individuals and control (70. The intervention group received an educational package and three months after discharge, both groups were evaluated using interview and phone follow-up as well as coding system (HIS, frequency of admissions and clinic visits and expenditures partaken. Next using descriptive and analytic statistical tests and the SPSS software version 18, the data was analyzed. the results showed that in the intervention group the percent of attendance to the clinic for health check up on an outpatient basis (visit and EKG was 25% in three months before intervention and reached 41/6% at three months after intervention. Percent hospitalization in the CCU three months before intervention was 33/3% and reached 13/3% at three months after intervention and the percent change was 20%. Self care teaching program for patients with Heart failureleads to decreased hospitalization and as a result decreased treatment expenditures

  8. Effect of multidisciplinary disease management for hospitalized heart failure under a national health insurance programme.

    Science.gov (United States)

    Mao, Chun-Tai; Liu, Min-Hui; Hsu, Kuang-Hung; Fu, Tieh-Cheng; Wang, Jong-Shyan; Huang, Yu-Yen; Yang, Ning-I; Wang, Chao-Hung

    2015-09-01

    Multidisciplinary disease management programmes (MDPs) for heart failure have been shown to be effective in Western countries. However, it is not known whether they improve outcomes in a high population density country with a national health insurance programme. In total, 349 patients hospitalized because of heart failure were randomized into control and MDP groups. All-cause death and re-hospitalization related to heart failure were analyzed. The median follow-up period was approximately 2 years. Mean patient age was 60 years; 31% were women; and 50% of patients had coronary artery disease. MDP was associated with fewer all-cause deaths [hazard ratio (HR) = 0.49, 95% confidence interval (CI) = 0.27-0.91, P = 0.02] and heart failure-related re-hospitalizations (HR = 0.44, 95% CI = 0.25-0.77, P = 0.004). MDP was still associated with better outcomes for all-cause death (HR = 0.53, 95% CI = 0.29-0.98, P = 0.04) and heart failure-related re-hospitalization (HR = 0.46, 95% CI = 0.26-0.81, P = 0.007), after adjusting for age, diuretics, diabetes mellitus, chronic kidney disease, hypertension, sodium, and albumin. However, MDPs' effect on all-cause mortality and heart failure-related re-hospitalization was significantly attenuated after adjusting for angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers or β-blockers. A stratified analysis showed that MDP combined with guideline-based medication had synergistic effects. MDP is effective in lowering all-cause mortality and re-hospitalization rates related to heart failure under a national health insurance programme. MDP synergistically improves the effectiveness of guidelines-based medications for heart failure.

  9. Improving Defense Health Program Medical Research Processes

    Science.gov (United States)

    2017-08-08

    research , including a Business Cell; 87 Research Development, 88 Research Oversight, 89 and Research Compliance offices;90 and the Center...needed for DHP medical research , such as the Army’s Clinical and Translational Research Program Office, 38 the Navy’s Research Methods Training Program... research stated, “key infrastructure for a learning health system will encompass three core elements: data networks, methods , and workforce.” 221

  10. Effects of a 14-month low-cost maintenance training program in patients with chronic systolic heart failure

    DEFF Research Database (Denmark)

    Prescott, Eva; Hjardem-Hansen, Rasmus; Ørkild, Bodil

    2009-01-01

    Exercise training is known to be beneficial in chronic heart failure (CHF) patients but there is a lack of studies following patient groups for longer duration with maintenance training programs to defer deconditioning.......Exercise training is known to be beneficial in chronic heart failure (CHF) patients but there is a lack of studies following patient groups for longer duration with maintenance training programs to defer deconditioning....

  11. P01.03. It Takes HEART: A Multifaceted Weight-loss Program for People Living With HIV

    OpenAIRE

    Gandhi, Vani; Lawrence, Nina

    2013-01-01

    Focus Areas: Integrative Approaches to Care, Supporting Behavioral Change HEART is a program designed to foster healthy habits in obese HIV-infected patients. HEART stands for: Healthy foods Eating mindfully, eating smaller meals, eating slowly Activity such as walking, aerobics, yoga Relaxation with meditation, reading, music, journaling Time spent together as a group supporting each other's progress The 2012 program consisted of 8 intensive weekly sessions followed by monthly meetings. The ...

  12. Can health promotion programs save Medicare money?

    Science.gov (United States)

    Goetzel, Ron Z; Shechter, David; Ozminkowski, Ronald J; Stapleton, David C; Lapin, Pauline J; McGinnis, J Michael; Gordon, Catherine R; Breslow, Lester

    2007-01-01

    The impact of an aging population on escalating US healthcare costs is influenced largely by the prevalence of chronic disease in this population. Consequently, preventing or postponing disease onset among the elderly has become a crucial public health issue. Fortunately, much of the total burden of disease is attributable to conditions that are preventable. In this paper, we address whether well-designed health promotion programs can prevent illness, reduce disability, and improve the quality of life. Furthermore, we assess evidence that these programs have the potential to reduce healthcare utilization and related expenditures for the Medicare program. We hypothesize that seniors who reduce their modifiable health risks can forestall disability, reduce healthcare utilization, and save Medicare money. We end with a discussion of a new Senior Risk Reduction Demonstration, which will be initiated by the Centers for Medicare and Medicaid Services in 2007, to test whether risk reduction programs developed in the private sector can achieve health improvements among seniors and a positive return on investment for the Medicare program. PMID:18044084

  13. Training program attracts work and health researchers

    DEFF Research Database (Denmark)

    Skakon, Janne

    2007-01-01

    Each year in Canada, the costs of disability arising from work-related causes – including workers’ compensation and health-care costs – exceed $6.7 billion. Despite the significant financial and social impacts of worker injury and illness, only a small fraction of Canadian researchers are dedicated...... to examining work disability prevention issues. An innovative program that attracts international students, the Work Disability Prevention Canadian Institutes of Health Research (CIHR) Strategic Training Program, aims to build research capacity in young researchers and to create a strong network that examines...

  14. Coaching patients On Achieving Cardiovascular Health (COACH): a multicenter randomized trial in patients with coronary heart disease.

    Science.gov (United States)

    Vale, Margarite J; Jelinek, Michael V; Best, James D; Dart, Anthony M; Grigg, Leeanne E; Hare, David L; Ho, Betty P; Newman, Robert W; McNeil, John J

    Disease management programs in which drugs are prescribed by dietitians or nurses have been shown to improve the coronary risk factor profile in patients with coronary heart disease. However, those disease management programs in which drugs are not prescribed by allied health professionals have not improved coronary risk factor status. The objective of the Coaching patients On Achieving Cardiovascular Health (COACH) study was to determine whether dietitians or nurses who did not prescribe medications could coach patients with coronary heart disease to work with their physicians to achieve the target levels for their total cholesterol (TC) and other risk factors. Multicenter randomized controlled trial in which 792 patients from 6 university teaching hospitals underwent a stratified randomization by cardiac diagnosis within each hospital: 398 were assigned to usual care plus The COACH Program and 394 to usual care alone. Patients in The COACH Program group received regular personal coaching via telephone and mailings to achieve the target levels for their particular coronary risk factors. There was one coach per hospital. The primary outcome was the change in TC (DeltaTC) from baseline (in hospital) to 6 months after randomization. Secondary outcomes included measurement of a wide range of physical, nutritional, and psychological factors. The analysis was performed by intention to treat. The COACH Program achieved a significantly greater DeltaTC than usual care alone: the mean DeltaTC was 21 mg/dL (0.54 mmol/L) (95% confidence interval [CI], 16-25 mg/dL [0.42-0.65 mmol/L]) in The COACH Program vs 7 mg/dL (0.18 mmol/L) (95% CI, 3-11 mg/dL [0.07-0.29 mmol/L]) in the usual care group (PCOACH Program group than in the usual care group. Coaching produced substantial improvements in most of the other coronary risk factors and in patient quality of life. Coaching, delivered as The COACH Program, is a highly effective strategy in reducing TC and many other coronary risk

  15. Health Literacy and Health Outcomes in Very Old Patients With Heart Failure.

    Science.gov (United States)

    León-González, Rocío; García-Esquinas, Esther; Paredes-Galán, Emilio; Ferrero-Martínez, Ana Isabel; González-Guerrero, José Luis; Hornillos-Calvo, Mercedes; Menéndez-Colino, Rocío; Torres-Torres, Ivett; Galán, María Concepción; Torrente-Carballido, Marta; Olcoz-Chiva, Mayte; Rodríguez-Pascual, Carlos; Rodríguez-Artalejo, Fernando

    2018-03-01

    Health literacy (HL) has been associated with lower mortality in heart failure (HF). However, the results of previous studies may not be generalizable because the research was conducted in relatively young and highly-educated patients in United States settings. This study assessed the association of HL with disease knowledge, self-care, and all-cause mortality among very old patients, with a very low educational level. This prospective study was performed in 556 patients (mean age, 85 years), with high comorbidity, admitted for HF to the geriatric acute-care unit of 6 hospitals in Spain. About 74% of patients had less than primary education and 71% had preserved systolic function. Health literacy was assessed with the Short Assessment of Health Literacy for Spanish-speaking Adults questionnaire, knowledge of HF with the DeWalt questionnaire, and HF self-care with the European Heart Failure Self-Care Behaviour Scale. Disease knowledge progressively increased with HL; compared with being in the lowest (worse) tertile of HL, the multivariable beta coefficient (95%CI) of the HF knowledge score was 0.60 (0.01-1.19) in the second tertile and 0.87 (0.24-1.50) in the highest tertile, P-trend = .008. However, no association was found between HL and HF self-care. During the 12 months of follow-up, there were 189 deaths. Compared with being in the lowest tertile of HL, the multivariable HR (95%CI) of mortality was 0.84 (0.56-1.27) in the second tertile and 0.99 (0.65-1.51) in the highest tertile, P-trend = .969. No association was found between HL and 12-month mortality. This could be partly due to the lack of a link between HL and self-care. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  16. Relation of Perceived Health Competence to Physical Activity in Patients With Coronary Heart Disease.

    Science.gov (United States)

    Bachmann, Justin M; Mayberry, Lindsay S; Wallston, Kenneth A; Huang, Shi; Roumie, Christianne L; Muñoz, Daniel; Patel, Niral J; Kripalani, Sunil

    2018-05-01

    Physical inactivity is highly associated with mortality, especially in patients with coronary heart disease. We evaluated the effect of perceived health competence, a patient's belief in his or her ability to achieve health-related goals, on cumulative physical activity levels in the Mid-South Coronary Heart Disease Cohort Study. The Mid-South Coronary Heart Disease Cohort Study consists of 2,587 outpatients (32% were female) with coronary heart disease at an academic medical center network in the United States. Cumulative physical activity was quantified in metabolic equivalent (MET)-minutes per week with the International Physical Activity Questionnaire. We investigated associations between the 2-item Perceived Health Competence Scale (PHCS-2) and MET-minutes/week after adjusting for co-morbidities and psychosocial factors with linear regression. Nearly half of participants (47%) exhibited low physical activity levels (Perceived health competence was highly associated with physical activity after multivariable adjustment. A nonlinear relation was observed, with the strongest effect on physical activity occurring at lower levels of perceived health competence. There was effect modification by gender (p = 0.03 for interaction). The relation between perceived health competence and physical activity was stronger in women compared with men; an increase in the PHCS-2 from 3 to 4 was associated with a 73% increase in MET-minutes/week in women (95% confidence interval 43% to 109%, p perceived health competence was strongly associated with less physical activity in patients with coronary heart disease and may represent a potential target for behavioral interventions. Published by Elsevier Inc.

  17. Heart failure severity, inappropriate ICD therapy, and novel ICD programming: a MADIT-RIT substudy.

    Science.gov (United States)

    Daimee, Usama A; Vermilye, Katherine; Rosero, Spencer; Schuger, Claudio D; Daubert, James P; Zareba, Wojciech; McNitt, Scott; Polonsky, Bronislava; Moss, Arthur J; Kutyifa, Valentina

    2017-12-01

    The effects of heart failure (HF) severity on risk of inappropriate implantable cardioverter-defibrillator (ICD) therapy have not been thoroughly investigated. We aimed to study the association between HF severity and inappropriate ICD therapy in MADIT-RIT. MADIT-RIT randomized 1,500 patients to three ICD programming arms: conventional (Arm A), high-rate cut-off (Arm B: ≥200 beats/min), and delayed therapy (Arm C: 60-second delay for ≥170 beats/min). We evaluated the association between New York Heart Association (NYHA) class III (n = 256) versus class I-II (n = 251) and inappropriate ICD therapy in Arm A patients with ICD-only and cardiac resynchronization therapy with defibrillator (CRT-D). We additionally assessed benefit of novel ICD programming in Arms B and C versus Arm A by NYHA classification. In Arm A, the risk of inappropriate therapy was significantly higher in those with NYHA III versus NYHA I-II for both ICD (hazard ratio [HR] = 2.55, confidence interval [CI]: 1.51-4.30, P programming significantly reduced inappropriate therapy in patients with both NYHA III (Arm B vs Arm A: HR = 0.08, P programming with high-rate cut-off or delayed detection reduces inappropriate ICD therapies in both mild and moderate HF. © 2017 Wiley Periodicals, Inc.

  18. Heart Truth

    Science.gov (United States)

    ... health! Get a free badge or banner to post to your website or blog. Are you at risk for heart disease? Here's how to find out . Planning to use The Heart Truth logo? Check out our logo guidelines and downloads. ...

  19. Computer Programming Languages for Health Care

    Science.gov (United States)

    O'Neill, Joseph T.

    1979-01-01

    This paper advocates the use of standard high level programming languages for medical computing. It recommends that U.S. Government agencies having health care missions implement coordinated policies that encourage the use of existing standard languages and the development of new ones, thereby enabling them and the medical computing community at large to share state-of-the-art application programs. Examples are based on a model that characterizes language and language translator influence upon the specification, development, test, evaluation, and transfer of application programs.

  20. Shock from heart device often triggers further health care needs

    Science.gov (United States)

    ... Branding Guidelines Copyright Permissions Embargo/Recording Policies Linking Policy Public Service Announcements Resources About Us Consumer Health Care AHA/ASA Watch and Learn Medical Illustration Library (copyrighted materials for viewing only - may be licensed ...

  1. Do heart failure disease management programs make financial sense under a bundled payment system?

    Science.gov (United States)

    Eapen, Zubin J; Reed, Shelby D; Curtis, Lesley H; Hernandez, Adrian F; Peterson, Eric D

    2011-05-01

    Policy makers have proposed bundling payments for all heart failure (HF) care within 30 days of an HF hospitalization in an effort to reduce costs. Disease management (DM) programs can reduce costly HF readmissions but have not been economically attractive for caregivers under existing fee-for-service payment. Whether a bundled payment approach can address the negative financial impact of DM programs is unknown. Our study determined the cost-neutral point for the typical DM program and examined whether published HF DM programs can be cost saving under bundled payment programs. We used a decision analytic model using data from retrospective cohort studies, meta-analyses, 5 randomized trials evaluating DM programs, and inpatient claims for all Medicare beneficiaries discharged with an HF diagnosis from 2001 to 2004. We determined the costs of DM programs and inpatient care over 30 and 180 days. With a baseline readmission rate of 22.9%, the average cost for readmissions over 30 days was $2,272 per patient. Under base-case assumptions, a DM program that reduced readmissions by 21% would need to cost $477 per patient to be cost neutral. Among evaluated published DM programs, 2 of the 5 would increase provider costs (+$15 to $283 per patient), whereas 3 programs would be cost saving (-$241 to $347 per patient). If bundled payments were broadened to include care over 180 days, then program saving estimates would increase, ranging from $419 to $1,706 per patient. Proposed bundled payments for HF admissions provide hospitals with a potential financial incentive to implement DM programs that efficiently reduce readmissions. Copyright © 2011 Mosby, Inc. All rights reserved.

  2. Mental Health and Mental Disorder Recommendation Programs.

    Science.gov (United States)

    Ruchiwit, Manyat

    2017-12-01

    The characteristic differences among the Greater Mekong Subregion (GMS) countries in terms of trade and investment, society and cultural values, medical information and technology, and the living and working environment have become major health problems in terms of mental disorders. The purpose of this article is to identify the gaps in those aspects, to propose mental health and mental disorder recommendation programs, and to recommend policies for policy makers and research investors. A comparative analysis and literature review of existing policy, including overviews of previous research were used to generate a synthesis of the existing knowledge of the mental health and mental disorder recommendation programs. The review results recommend mental health and mental disorder programs for policy makers, research investors, and stakeholders in order to strengthen the directions for implementing these programs in the future. The healthcare provision in each country will not be limited only to its citizens; the healthcare markets and target groups are likely to expand to the neighboring countries in the context of changes in domestic and international factors, which have both positive and negative impacts according to the political, economic, and social situations of the influencing countries.

  3. School Oral Health Program in Kuwait.

    Science.gov (United States)

    Ariga, Jitendra; Al-Mutawa, Sabiha; Nazar, Huda

    2014-01-01

    The School Oral Health Program (SOHP), Kuwait, is a joint venture between the Ministry of Health, Kuwait, and Forsyth Institute, Cambridge, Mass., USA. This program provides oral health education, prevention and treatment to almost 280,000 public school children in Kuwait. Services are delivered through a system of center- and school-based clinics and preventive mobile teams. One of the recent developments is the effective use of portable dental units for the delivery of preventive care to children in schools without the need for children to go to dental clinics. Preventive procedures performed under this program are the biannual application of fluoride varnish and the placement of pit and fissure sealants on newly erupted permanent molars and premolars. During recent years, the SOHP has improved its coverage of children, with prevention up to 80%. This has resulted in a considerable reduction in treatment needs, which is evident from the reduced number of composite restorations performed under this program during the last 6 years. This indicates that the disease level is on a decline, which can be confirmed from the results of the ongoing National Oral Health Survey on Kuwaiti school children. © 2013 S. Karger AG, Basel.

  4. 78 FR 24756 - Health Center Program

    Science.gov (United States)

    2013-04-26

    ...'s funded section 330 grant application. Genesee County Community Mental Health (GCCMH)--now Genesee... operations of the grant program since its award in June 2012. On January 1, 2013, the State of Michigan... care services on the County of Genesee's behalf and has indicated an ability to continue operations...

  5. Keep Baby’s Heart Healthy (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2016-02-04

    Congenital heart defects are the most common type of birth defect in the U.S. This podcast discusses the importance of pregnant women talking with their health care providers about ways to increase chances of having a healthy baby.  Created: 2/4/2016 by MMWR.   Date Released: 2/4/2016.

  6. Health-related quality of life and anemia in hospitalized patients with heart failure

    NARCIS (Netherlands)

    Kraai, I. H.; Luttik, M. L. A.; Johansson, P.; De Jong, R. M.; Van Veldhuisen, D. J.; Hillege, H. L.; Jaarsma, T.

    2012-01-01

    Background: Anemia is a serious and highly prevalent co-morbidity in chronic heart failure (HF) patients. Its influence on health-related quality of life (HR-QoL) has rarely been studied, and no data is available regarding the role it plays in hospitalized HF patients. Methods: Baseline data from

  7. Foundations for Health Promotion with Youth: A Review of Observations from the Bogalusa Heart Study.

    Science.gov (United States)

    Nicklas, Theresa; And Others

    1995-01-01

    Presents findings from the Bogalusa Heart Study that describe the early natural history of coronary artery disease and hypertensive cardiovascular disease, noting the benefits of early, regular, comprehensive school health education. A discussion of cholesterol, hypertension, diabetes, obesity, smoking, oral contraception, drinking, and diet…

  8. Health-related quality of life and anemia in hospitalized patients with heart failure

    NARCIS (Netherlands)

    Kraai, Imke H.; Luttik, Marie Louise; Johansson, P.; van Veldhuisen, Dirk J.; Hillege, Hans L.; de Jong, Remco; Jaarsma, Tiny

    2012-01-01

    BACKGROUND: Anemia is a serious and highly prevalent co-morbidity in chronic heart failure (HF) patients. Its influence on health-related quality of life (HR-QoL) has rarely been studied, and no data is available regarding the role it plays in hospitalized HF patients. METHODS: Baseline data from

  9. Take the Pressure off Your Heart (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2016-06-02

    Heart disease and stroke are leading causes of death in the U.S. High blood pressure, or hypertension, can lead to both. In this podcast, Dr. Fleetwood Loustalot discusses the health consequences of hypertension.  Created: 6/2/2016 by MMWR.   Date Released: 6/2/2016.

  10. Mental Health Problems in Parents of Children with Congenital Heart Disease

    NARCIS (Netherlands)

    Kolaitis, Gerasimos A.; Meentken, Maya G.; Utens, Elisabeth M. W. J.

    2017-01-01

    This review will provide a concise description of mental health problems in parents of children with a (non-syndromic) congenital heart disease (CHD) during different stressful periods. Predictors of these problems and also implications for clinical practice will be mentioned. Having a child with

  11. Health actions and disease patterns related to coronary heart ...

    African Journals Online (AJOL)

    1990-07-21

    Jul 21, 1990 ... The health-related behaviour of the Cape Peninsula coloured population, which ... cholesterolaemia, yet their knowledge of the prudent diet was poor and ..... and socio-economic standing, the number of people per habit- able room .... facilities to motivate and assist smokers in their attempts to stop smoking ...

  12. Reducing Health Inequities in the United States: Insights and Recommendations from the National Heart, Lung, and Blood Institute’s Health Inequities Think Tank Meeting

    Science.gov (United States)

    Sampson, Uchechukwu K.A.; Kaplan, Robert M.; Cooper, Richard S.; Diez Roux, Ana V.; Marks, James S.; Engelgau, Michael M.; Peprah, Emmanuel; Mishoe, Helena; Boulware, L. Ebony; Felix, Kaytura L.; Califf, Robert M.; Flack, John M.; Cooper, Lisa A.; Gracia, J. Nadine; Henderson, Jeffrey A.; Davidson, Karina W.; Krishnan, Jerry A.; Lewis, Tené T.; Sanchez, Eduardo; Luban, Naomi L.; Vaccarino, Viola; Wong, Winston F.; Wright, Jackson T.; Meyers, David; Ogedegbe, Olugbenga G.; Presley-Cantrell, Letitia; Chambers, David A.; Belis, Deshirée; Bennett, Glen C.; Boyington, Josephine E; Creazzo, Tony L.; de Jesus, Janet M.; Krishnamurti, Chitra; Lowden, Mia R.; Punturieri, Antonello; Shero, Susan T.; Young, Neal S.; Zou, Shimian; Mensah, George A.

    2016-01-01

    The National, Heart, Lung, and Blood Institute convened a Think Tank meeting to obtain insight and recommendations regarding the objectives and design of the next generation of research aimed at reducing health inequities in the United States. The panel recommended several specific actions, including: 1) Embrace broad and inclusive research themes; 2) Develop research platforms that optimize the ability to conduct informative and innovative research, and promote systems science approaches; 3) Develop networks of collaborators and stakeholders, and launch transformative studies that can serve as benchmarks; 4) Optimize the use of new data sources, platforms, and natural experiments; and 5) develop unique transdisciplinary training programs to build research capacity. Confronting health inequities will require engaging multiple disciplines and sectors (including communities), using systems science, and intervening through combinations of individual, family, provider, health system, and community-targeted approaches. Details of the panel’s remarks and recommendations are provided in this report. PMID:27470459

  13. Effects of a System Thinking-Based Simulation Program for Congestive Heart Failure.

    Science.gov (United States)

    Kim, Hyeon-Young; Yun, Eun Kyoung

    2018-03-01

    This study evaluated a system thinking-based simulation program for the care of patients with congestive heart failure. Participants were 67 undergraduate nursing students from a nursing college in Seoul, South Korea. The experimental group was given a 4-hour system-thinking program and a 2-hour simulation program, whereas the control group had a 4-hour case study and a 2-hour simulation program. There were significant improvements in critical thinking in both groups, but no significant group differences between educational methods (F = 3.26, P = .076). Problem-solving ability in the experimental group was significantly higher than in the control group (F = 5.04, P = .028). Clinical competency skills in the experimental group were higher than in the control group (t = 2.12, P = .038). A system thinking-based simulation program is a more effective learning method in terms of problem-solving ability and clinical competency skills compared to the existing simulation program. Further research using a longitudinal study is needed to test the long-term effect of the intervention and apply it to the nursing curriculum.

  14. 77 FR 59931 - Single Source Program Expansion Supplement Award to Area Health Education Centers (AHEC) Program...

    Science.gov (United States)

    2012-10-01

    ... Program Expansion Supplement Award to Area Health Education Centers (AHEC) Program Grantee; Exception to... Competition--Single Source Program Expansion Supplement Award to Area Health Education Centers (AHEC) Program... supplement award to the University of Guam School of Nursing, an Area Health Education Center (AHEC) Program...

  15. 75 FR 48815 - Medicaid Program and Children's Health Insurance Program (CHIP); Revisions to the Medicaid...

    Science.gov (United States)

    2010-08-11

    ... Parts 431, 447, and 457 Medicaid Program and Children's Health Insurance Program (CHIP); Revisions to... 431, 447, and 457 [CMS-6150-F] RIN 0938-AP69 Medicaid Program and Children's Health Insurance Program... final rule implements provisions from the Children's Health Insurance Program Reauthorization Act of...

  16. Long-term impact of a chronic disease management program on hospital utilization and cost in an Australian population with heart disease or diabetes.

    Science.gov (United States)

    Hamar, G Brent; Rula, Elizabeth Y; Coberley, Carter; Pope, James E; Larkin, Shaun

    2015-04-22

    To evaluate the longitudinal value of a chronic disease management program, My Health Guardian (MHG), in reducing hospital utilization and costs over 4 years. The MHG program provides individualized support via telephonic nurse outreach and online tools for self-management, behavior change and well-being. In follow up to an initial 18-month analysis of MHG, the current study evaluated program impact over 4 years. A matched-cohort analysis retrospectively compared MHG participants with heart disease or diabetes (treatment, N = 4,948) to non-participants (comparison, N = 28,520) on utilization rates (hospital admission, readmission, total bed days) and hospital claims cost savings. Outcomes were evaluated using regression analyses, controlling for remaining demographic, disease, and pre-program admissions or cost differences between the study groups. Over the 4 year period, program participation resulted in significant reductions in hospital admissions (-11.4%, P hospital claims was $3,549 over 4-years; savings values for each program year were significant and increased with time (P = 0.003 to P hospital utilization and costs for individuals with heart disease or diabetes and demonstrate the increasing program effect with continued participation over time.

  17. Cocoa and heart health: a historical review of the science.

    Science.gov (United States)

    Pucciarelli, Deanna L

    2013-09-26

    The medicinal use of cocoa has a long history dating back almost five hundred years when Hernán Cortés's first experienced the drink in Mesoamerica. Doctors in Europe recommended the beverage to patients in the 1700s, and later American physicians followed suit and prescribed the drink in early America--ca. 1800s. This article delineates the historic trajectory of cocoa consumption, the linkage between cocoa's bioactive-mechanistic properties, paying special attention to nitric oxides role in vasodilation of the arteries, to the current indicators purporting the benefits of cocoa and cardiovascular health.

  18. Cocoa and Heart Health: A Historical Review of the Science

    Science.gov (United States)

    Pucciarelli, Deanna L.

    2013-01-01

    The medicinal use of cocoa has a long history dating back almost five hundred years when Hernán Cortés’s first experienced the drink in Mesoamerica. Doctors in Europe recommended the beverage to patients in the 1700s, and later American physicians followed suit and prescribed the drink in early America―ca. 1800s. This article delineates the historic trajectory of cocoa consumption, the linkage between cocoa’s bioactive-mechanistic properties, paying special attention to nitric oxides role in vasodilation of the arteries, to the current indicators purporting the benefits of cocoa and cardiovascular health. PMID:24077240

  19. Cocoa and Heart Health: A Historical Review of the Science

    Directory of Open Access Journals (Sweden)

    Deanna L. Pucciarelli

    2013-09-01

    Full Text Available The medicinal use of cocoa has a long history dating back almost five hundred years when Hernán Cortés’s first experienced the drink in Mesoamerica. Doctors in Europe recommended the beverage to patients in the 1700s, and later American physicians followed suit and prescribed the drink in early America—ca. 1800s. This article delineates the historic trajectory of cocoa consumption, the linkage between cocoa’s bioactive-mechanistic properties, paying special attention to nitric oxides role in vasodilation of the arteries, to the current indicators purporting the benefits of cocoa and cardiovascular health.

  20. Mental Health and Stressful Life Events in Coronary Heart Disease Patients and Non- Patients

    Directory of Open Access Journals (Sweden)

    Samaneh Nateghian

    2008-07-01

    Full Text Available "nObjective: "n The main goal of this study is to compare stressful life events and mental health in coronary heart disease (CHD patients and non-patients. "nMethod: In this research, 120 participants (n=68 male, n= 52 female were divided into two groups of patients (n=60 and non-patients (n=60. They were selected from Vali Asr Hospital of Meshginshahr (Iran and completed the  General Health Questionnaire (GHQ and Stressful Life Events Inventory . "nResults: Data was analyzed using independent t-test. The results showed significant differences between CHD patients and non-patients in mental health and stressful life events. CHD patients showed high rates of physical symptoms and anxiety of GHQ . "nConclusion: CHD patients reported more stressful life events. Therefore, it can be inferred that psychological factors are important in coronary heart disease.

  1. Knowledge and Oral Health Attitudes among Parents of Children with Congenital Heart Disease.

    Science.gov (United States)

    Suvarna, Reshma; Rai, Kavita; Hegde, Amitha M

    2011-01-01

    Congenital heart disease (CHD) is a devastating complex of diseases resulting from defects of development. It affects more than 1 of every 100 live births. Early preventive dental care should be adjusted to the special needs of these children in their first years of life. Knowledge of parental attitudes and experiences of dental care are therefore important. Aim : This study was done to assess the knowledge and attitudes among parents of children with congenital heart disease towards oral health and dental care. Materials and methods : Parents (n = 105) of children with congenital heart disease of an age ranging from 0 to 16 years were included in the study. A questionnaire was used to assess the knowledge and oral health attitudes. Results : The parents' knowledge was fair but the oral health attitudes were not very satisfactory. The parents in this study also recognized the importance of oral health for the well-being of rest of the body. Conclusion : The results of this study indicate that parents' and children's attitudes toward oral health and dental care need to be improved.

  2. Assessment of American Heart Association's Ideal Cardiovascular Health Metrics Among Employees of a Large Healthcare Organization: The Baptist Health South Florida Employee Study.

    Science.gov (United States)

    Ogunmoroti, Oluseye; Younus, Adnan; Rouseff, Maribeth; Spatz, Erica S; Das, Sankalp; Parris, Don; Aneni, Ehimen; Holzwarth, Leah; Guzman, Henry; Tran, Thinh; Roberson, Lara; Ali, Shozab S; Agatston, Arthur; Maziak, Wasim; Feldman, Theodore; Veledar, Emir; Nasir, Khurram

    2015-07-01

    Healthcare organizations and their employees are critical role models for healthy living in their communities. The American Heart Association (AHA) 2020 impact goal provides a national framework that can be used to track the success of employee wellness programs with a focus on improving cardiovascular (CV) health. This study aimed to assess the CV health of the employees of Baptist Health South Florida (BHSF), a large nonprofit healthcare organization. HRAs and wellness examinations can be used to measure the cardiovascular health status of an employee population. The AHA's 7 CV health metrics (diet, physical activity, smoking, body mass index, blood pressure, total cholesterol, and blood glucose) categorized as ideal, intermediate, or poor were estimated among employees of BHSF participating voluntarily in an annual health risk assessment (HRA) and wellness fair. Age and gender differences were analyzed using χ(2) test. The sample consisted of 9364 employees who participated in the 2014 annual HRA and wellness fair (mean age [standard deviation], 43 [12] years, 74% women). Sixty (1%) individuals met the AHA's definition of ideal CV health. Women were more likely than men to meet the ideal criteria for more than 5 CV health metrics. The proportion of participants meeting the ideal criteria for more than 5 CV health metrics decreased with age. A combination of HRAs and wellness examinations can provide useful insights into the cardiovascular health status of an employee population. Future tracking of the CV health metrics will provide critical feedback on the impact of system wide wellness efforts as well as identifying proactive programs to assist in making substantial progress toward the AHA 2020 Impact Goal. © 2015 Wiley Periodicals, Inc.

  3. Reducing personal exposure to particulate air pollution improves cardiovascular health in patients with coronary heart disease.

    Science.gov (United States)

    Langrish, Jeremy P; Li, Xi; Wang, Shengfeng; Lee, Matthew M Y; Barnes, Gareth D; Miller, Mark R; Cassee, Flemming R; Boon, Nicholas A; Donaldson, Ken; Li, Jing; Li, Liming; Mills, Nicholas L; Newby, David E; Jiang, Lixin

    2012-03-01

    Air pollution exposure increases cardiovascular morbidity and mortality and is a major global public health concern. We investigated the benefits of reducing personal exposure to urban air pollution in patients with coronary heart disease. In an open randomized crossover trial, 98 patients with coronary heart disease walked on a predefined route in central Beijing, China, under different conditions: once while using a highly efficient face mask, and once while not using the mask. Symptoms, exercise, personal air pollution exposure, blood pressure, heart rate, and 12-lead electrocardiography were monitored throughout the 24-hr study period. Ambient air pollutants were dominated by fine and ultrafine particulate matter (PM) that was present at high levels [74 μg/m³ for PM(2.5) (PM with aerodynamic diamater reduced maximal ST segment depression (-142 vs. -156 μV, p = 0.046) over the 24-hr period. When the face mask was used during the prescribed walk, mean arterial pressure was lower (93 ± 10 vs. 96 ± 10 mmHg, p = 0.025) and heart rate variability increased (high-frequency power: 54 vs. 40 msec², p = 0.005; high-frequency normalized power: 23.5 vs. 20.5 msec, p = 0.001; root mean square successive differences: 16.7 vs. 14.8 msec, p = 0.007). However, mask use did not appear to influence heart rate or energy expenditure. Reducing personal exposure to air pollution using a highly efficient face mask appeared to reduce symptoms and improve a range of cardiovascular health measures in patients with coronary heart disease. Such interventions to reduce personal exposure to PM air pollution have the potential to reduce the incidence of cardiovascular events in this highly susceptible population.

  4. Power of Peer Support to Change Health Behavior to Reduce Risks for Heart Disease and Stroke for African American Men in a Faith-Based Community.

    Science.gov (United States)

    Lee, Sohye; Schorr, Erica; Hadidi, Niloufar Niakosari; Kelley, Robin; Treat-Jacobson, Diane; Lindquist, Ruth

    2018-02-01

    Peer support has powerful potential to improve outcomes in a program of health behavior change; yet, how peer support is perceived by participants, its role, and how it contributes to intervention efficacy is not known, especially among African Americans. The purpose of this study was to identify the subjectively perceived experience and potential contributions of peer support to the outcomes of a peer group behavioral intervention designed to change health behavior to reduce risks for heart disease and stroke in African American men in a faith-based community. A peer support group intervention was implemented to increase health knowledge and to improve health behaviors in line with the American Heart Association's Life Simple 7 domains (get active, control cholesterol, eat better, manage blood pressure, lose weight, reduce blood sugar, and stop smoking). Fourteen peer group sessions and eight follow-up interviews with program participants were recorded, transcribed, and analyzed. Seven key themes emerged, including (1) enhancing access to health behavior information and resources, (2) practicing and applying problem-solving skills with group feedback and support, (3) discussing health behavior challenges and barriers, (4) sharing health behavior changes, (5) sharing perceived health outcome improvements and benefits, (6) feelings of belonging and being cared for, and (7) addressing health of family and community. Qualitative findings revealed a positive perception of peer support and greater understanding of potential reasons why it may be an effective strategy for African American men.

  5. A trial-based economic evaluation of 2 nurse-led disease management programs in heart failure

    NARCIS (Netherlands)

    Postmus, Douwe; Pari, Anees A. Abdul; Jaarsma, Tiny; Luttik, Marie Louise; van Veldhuisen, Dirk J.; Hillege, Hans L.; Buskens, Erik

    2011-01-01

    Background Although previously conducted meta-analyses suggest that nurse-led disease management programs in heart failure (HF) can improve patient outcomes, uncertainty regarding the cost-effectiveness of such programs remains. Methods To compare the relative merits of 2 variants of a nurse-led

  6. Disease management in the treatment of patients with chronic heart failure who have universal access to health care: a randomized controlled trial.

    Science.gov (United States)

    Kalter-Leibovici, Ofra; Freimark, Dov; Freedman, Laurence S; Kaufman, Galit; Ziv, Arnona; Murad, Havi; Benderly, Michal; Silverman, Barbara G; Friedman, Nurit; Cukierman-Yaffe, Tali; Asher, Elad; Grupper, Avishay; Goldman, Dorit; Amitai, Miriam; Matetzky, Shlomi; Shani, Mordechai; Silber, Haim

    2017-05-01

    The efficacy of disease management programs in improving the outcome of heart failure patients remains uncertain and may vary across health systems. This study explores whether a countrywide disease management program is superior to usual care in reducing adverse health outcomes and improving well-being among community-dwelling adult patients with moderate-to-severe chronic heart failure who have universal access to advanced health-care services and technologies. In this multicenter open-label trial, 1,360 patients recruited after hospitalization for heart failure exacerbation (38%) or from the community (62%) were randomly assigned to either disease management or usual care. Disease management, delivered by multi-disciplinary teams, included coordination of care, patient education, monitoring disease symptoms and patient adherence to medication regimen, titration of drug therapy, and home tele-monitoring of body weight, blood pressure and heart rate. Patients assigned to usual care were treated by primary care practitioners and consultant cardiologists. The primary composite endpoint was the time elapsed till first hospital admission for heart failure exacerbation or death from any cause. Secondary endpoints included the number of all hospital admissions, health-related quality of life and depression during follow-up. Intention-to-treat comparisons between treatments were adjusted for baseline patient data and study center. During the follow-up, 388 (56.9%) patients assigned to disease management and 387 (57.1%) assigned to usual care had a primary endpoint event. The median (range) time elapsed until the primary endpoint event or end of study was 2.0 (0-5.0) years among patients assigned to disease management, and 1.8 (0-5.0) years among patients assigned to usual care (adjusted hazard ratio, 0.908; 95% confidence interval, 0.788 to 1.047). Hospital admissions were mostly (70%) unrelated to heart failure. Patients assigned to disease management had a better

  7. A Systematic Review of mHealth-Based Heart Failure Interventions.

    Science.gov (United States)

    Cajita, Maan Isabella; Gleason, Kelly T; Han, Hae-Ra

    2016-01-01

    The popularity of mobile phones and similar mobile devices makes it an ideal medium for delivering interventions. This is especially true with heart failure (HF) interventions, in which mHealth-based HF interventions are rapidly replacing their telephone-based predecessors. This systematic review examined the impact of mHealth-based HF management interventions on HF outcomes. The specific aims of the systematic review are to (1) describe current mHealth-based HF interventions and (2) discuss the impact of these interventions on HF outcomes. PubMed, CINAHL Plus, EMBASE, PsycINFO, and Scopus were systematically searched for randomized controlled trials or quasi-experimental studies that tested mHealth interventions in people with HF using the terms Heart Failure, Mobile Health, mHealth, Telemedicine, Text Messaging, Texting, Short Message Service, Mobile Applications, and Mobile Apps. Ten articles, representing 9 studies, were included in this review. The majority of the studies utilized mobile health technology as part of an HF monitoring system, which typically included a blood pressure-measuring device, weighing scale, and an electrocardiogram recorder. The impact of the mHealth interventions on all-cause mortality, cardiovascular mortality, HF-related hospitalizations, length of stay, New York Heart Association functional class, left ventricular ejection fraction, quality of life, and self-care were inconsistent at best. Further research is needed to conclusively determine the impact of mHealth interventions on HF outcomes. The limitations of the current studies (eg, inadequate sample size, quasi-experimental design, use of older mobile phone models, etc) should be taken into account when designing future studies.

  8. Adapting heart failure guidelines for nursing care in home health settings: challenges and solutions.

    Science.gov (United States)

    Radhakrishnan, Kavita; Topaz, Maxim; Masterson Creber, Ruth

    2014-07-01

    Nurses provide most of home health services for patients with heart failure, and yet there are no evidence-based practice guidelines developed for home health nurses. The purpose of this article was to review the challenges and solutions for adapting generally available HF clinical practice guidelines to home health nursing. Appropriate HF guidelines were identified and home health nursing-relevant guidelines were extracted by the research team. In addition, a team of nursing academic and practice experts evaluated the extracted guidelines and reached consensus through Delphi rounds. We identified 172 recommendations relevant to home health nursing from the American Heart Association and Heart Failure Society of America guidelines. The recommendations were divided into 5 groups (generic, minority populations, normal ejection fraction, reduced ejection fraction, and comorbidities) and further subgroups. Experts agreed that 87% of the recommendations selected by the research team were relevant to home health nursing and rejected 6% of the selected recommendations. Experts' opinions were split on 7% of guideline recommendations. Experts mostly disagreed on recommendations related to HF medication and laboratory prescription as well as HF patient assessment. These disagreements were due to lack of patient information available to home health nurses as well as unclear understanding of scope of practice regulations for home health nursing. After 2 Delphi rounds over 8 months, we achieved 100% agreement on the recommendations. The finalized guideline included 153 recommendations. Guideline adaptation projects should include a broad scope of nursing practice recommendations from which home health agencies can customize relevant recommendations in accordance with available information and state and agency regulations.

  9. Peer tutoring programs in health professions schools.

    Science.gov (United States)

    Santee, Jennifer; Garavalia, Linda

    2006-06-15

    Peer tutoring programs may be one method of maintaining quality of pharmacy education in the face of growing student enrollment and a small faculty body. A critical review of the literature was performed to ascertain whether peer tutoring programs improve or maintain the academic performance of health care professional students. Various electronic databases and abstracts from past American Association of Colleges of Pharmacy's annual meetings were searched to identify pertinent research. Only those articles with quantitative data, an experimental design, and comparative statistical analysis were included for review. Most studies found that peer tutoring had a positive impact on academic performance. These results may not be readily generalizable as there were numerous methodological flaws and limited descriptions of the programs and participants. Studies with better designs and more detail are needed to answer definitively whether peer tutoring is of benefit. Details of what resources were required should be included in the study to allow the reader to determine the feasibility of the intervention.

  10. Blue-collar workplaces: a setting for reducing heart health inequalities in New Zealand?

    Science.gov (United States)

    Novak, Brad; Bullen, Chris; Howden-Chapman, Philippa; Thornley, Simon

    2007-09-07

    To review the evidence for the effectiveness of workplaces as settings for cardiovascular health promotion and reduction of heart health inequalities in New Zealand. Literature review and structured appraisal of 154 articles meeting inclusion criteria, of which one review and three trials addressed cardiovascular interventions specifically, and four systematic reviews addressed the effectiveness of workplace health promotion programmes generally. The reviewed studies showed that workplaces have good potential as settings for health promotion. We found mixed but largely supportive evidence that workplace interventions can lead to improvements in health outcomes, workplace environments, lifestyles, and productivity. Workplace programmes that ranked highest in both clinical and cost-effectiveness targeted industries employing large numbers of blue-collar workers, tackled multiple risk factors, intervened at both individual and environmental levels and incorporated occupational safety components. Such programmes appear to offer a substantial return on investment for employers in other countries, but local evidence is lacking. Employers and workers in blue-collar industries should be encouraged to participate in comprehensive heart health promotion programmes as a strategy for reducing existing socioeconomic and ethnic disparities in health. However, high-quality evidence of improved employee health and productivity is needed from well-designed New Zealand-based research to ensure that these programmes are optimally configured for effectiveness and attractive to employers and employees alike.

  11. An operational health physics quality assurance program

    International Nuclear Information System (INIS)

    Costigan, S.A.; McAtee, J.L. III; Somers, W.M.; Huchton, R.L.

    1996-01-01

    DOE Order 5700.6C, Quality Assurance, stipulates QA requirements for all DOE activities. This order is now codified as 10CFR830.120, Nuclear Safety Management, Quality Assurance Requirements, which is applicable to DOE nuclear facilities. A Quality Assurance Management Plan (QAMP) was developed by the Health Physics Operations Group (ESH-1) at Los Alamos National Laboratory (LANL). The goal of the ESH-1 QAMP is to ensure that operational radiation protection activities meet the criteria outlined in DOE Order 5700.6C, DOE-ER-STD-6001-92 and 10CFR830.120. The ten required elements are QA Program, Personal Training and Qualifications, Quality Improvement, Documents and Records, Work Processes, Design, Procurement, Inspection and Acceptance Testing, Management Assessment and Independent Assessment. The QAMP has been useful for the development of QAMPs at nuclear facilities and has helped ensure uniformity of institutional requirements where Health Physics services are deployed to facilities. To implement a subset of QAMP requirements, a Quality Assurance Self-Evaluation Program (QASE) was established. This program provides a novel self-audit mechanism for the formal identification and correction of non-conforming items related to Operational Health Physics. Additionally, the QASE is a useful management tool for Radiological Control Technician Supervisors and staff and provides a tracking mechanism for ongoing problem areas. Data have been Collected for two calendar years on a number of concerns that fall into four general categories: radiological posting and labeling, instrumentation, monitoring requirements, and radiological documents/records

  12. Heart Health Risk Assessment System: A Nonintrusive Proposal Using Ontologies and Expert Rules

    Directory of Open Access Journals (Sweden)

    Teresa Garcia-Valverde

    2014-01-01

    Full Text Available According to the World Health Organization, the world’s leading cause of death is heart disease, with nearly two million deaths per year. Although some factors are not possible to change, there are some keys that help to prevent heart diseases. One of the most important keys is to keep an active daily life, with moderate exercise. However, deciding what a moderate exercise is or when a slightly abnormal heart rate value is a risk depends on the person and the activity. In this paper we propose a context-aware system that is able to determine the activity the person is performing in an unobtrusive way. Then, we have defined ontology to represent the available knowledge about the person (biometric data, fitness status, medical information, etc. and her current activity (level of intensity, heart rate recommended for that activity, etc.. With such knowledge, a set of expert rules based on this ontology are involved in a reasoning process to infer levels of alerts or suggestions for the users when the intensity of the activity is detected as dangerous for her health. We show how this approach can be accomplished by using only everyday devices such as a smartphone and a smartwatch.

  13. 76 FR 4350 - Health Information Technology Extension Program

    Science.gov (United States)

    2011-01-25

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Information Technology Extension Program ACTION: Public Notice. SUMMARY: This notice announces changes to the Health Information Technology Extension... of the National Coordinator for Health Information Technology, 200 Independence Ave, SW., Suite 729D...

  14. Congenital Critical Heart Defect Screening in a Health Area of the Community of Valencia (Spain: A Prospective Observational Study

    Directory of Open Access Journals (Sweden)

    Elena Cubells

    2018-01-01

    Full Text Available Despite the progress in the fetal echocardiographic detection of congenital critical heart defects and neonatal physical examination, a significant number of newborn infants are discharged and readmitted to the hospital in severe condition due to cardiac failure or collapse. The aim of this study was to assess the incidence of undetected critical congenital heart disease (CCHD by a pulse oximetry-screening program in the maternity wards of hospitals with Perinatal Services in a specific geographic area. This is a prospective observational study performed in in the health area corresponding to the city of Valencia. Eligible infants were consecutively admitted newborn infants in the maternities of the participating hospitals with negative fetal echocardiography after normal physical examination in the delivery room. All patients were screened following a specific pulse oximetry protocol before discharge. A total of 8856 newborn infants were screened. A total of three babies presented with severe congenital cardiac malformation and two babies presented with early onset sepsis. Sensitivity was 100% and specificity was 99.97%, with a positive predictive value of 60% and negative predictive value of 100%. Pulse oximetry screening programs in the early neonatal period constitute a valuable tool to avoid inadvertent hospital discharge of severe cardiac malformations and the subsequent life-threatening complications derived.

  15. Lung health and heart rate variability changes in salt workers.

    Science.gov (United States)

    Glad Mohesh, M I; Sundaramurthy, A

    2016-04-01

    India is the third largest salt producing country in the World, with a global annual production of 230 million tonnes. Large number of salt workers get employed in these salt milling plants risking their life from the effects of salt. Recent foreign evidences reported that these salt workers are exposed to aerosol salt particles that disturb their lung and cardiovascular autonomic control. To compare the status of lung health, cardiovascular autonomic control and biochemical changes in a group of salt industry workers with that of the age-matched normal subjects. Volunteers of both sexes (25-35 years) were divided into Group I (n=10) controls and Group II (n=10) non-brine salt workers in salt milling plants. From fasting blood sample, complete blood count, plasma electrolyte and lipid profile estimation were done. After resting for 15min, blood pressure and lead II ECG were recorded. Spirometry was done using RMS Helios spirometer. Data collected were later analysed using GraphPad Prism 5.0 with statistical significance set at p4.0, 112.8±1.7, pindustry has shown a little or no impact on the respiratory system, however there are changes in the blood and cardiovascular system, which need to be further studied to understand the long-term influences of salt in this population. Copyright © 2015 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

  16. The MacNew Heart Disease health-related quality of life instrument: A summary

    Directory of Open Access Journals (Sweden)

    Guyatt Gordon

    2004-01-01

    Full Text Available Abstract Background The measurement of health, the effects of disease, and the impact of health care include not only an indication of changes in disease frequency and severity but also an estimate of patients' perception of health status before and after treatment. One of the more important developments in health care in the past decade may be the recognition that the patient's perspective is as legitimate and valid as the clinician's in monitoring health care outcomes. This has lead to the development of instruments to quantify the patients' perception of their health status before and after treatment. Methods We review evidence supporting the measurement properties of the MacNew Heart Disease Health-related Quality of Life [MacNew] Questionnaire which was designed to evaluate how daily activities and physical, emotional, and social functioning are affected by coronary heart disease and its treatment. Results Reliability was demonstrated by using internal consistency and the intraclass correlation coefficients for the three domains in the Dutch, English, Farsi, German, and Spanish versions of the MacNew. With internal consistency and intraclass correlation coefficients =>0.73, reliability is high. Validity of the MacNew was examined with factor analysis and three core underlying factors, physical, emotional, and social, were identified, explaining 63.0 – 66.5% of the observed variance and replicated in the translations with psychometric data. Construct validity of the MacNew was further demonstrated by extensive substantiation of the logical relationships, defined a priori, between items and other comparison tools. The MacNew is responsive and sensitive to changes in HRQL following various interventions for patients with heart disease with 11 of 13 effect size statistics >0.80. Taking an average of 10 minutes or less to complete, the respondent-burden for the MacNew is low and its acceptability is demonstrated by response rates of over 90

  17. Heart and lung organ offer acceptance practices of transplant programs are associated with waitlist mortality and organ yield.

    Science.gov (United States)

    Wey, Andrew; Valapour, Maryam; Skeans, Melissa A; Salkowski, Nicholas; Colvin, Monica; Kasiske, Bertram L; Israni, Ajay K; Snyder, Jon J

    2018-04-19

    Variation in heart and lung offer acceptance practices may affect numbers of transplanted organs and create variability in waitlist mortality. To investigate these issues, offer acceptance ratios, or adjusted odds ratios, for heart and lung transplant programs individually and for all programs within donation service areas (DSAs) were estimated using offers from donors recovered July 1, 2016-June 30, 2017. Logistic regressions estimated the association of DSA-level offer acceptance ratios with donor yield and local placement of organs recovered in the DSA. Competing risk methodology estimated the association of program-level offer acceptance ratios with incidence and rate of waitlist removals due to death or becoming too sick to undergo transplant. Higher DSA-level offer acceptance was associated with higher yield (odds ratios [ORs]: lung, 1.04 1.11 1.19 ; heart, 1.09 1.21 1.35 ) and more local placement of transplanted organs (ORs: lung, 1.01 1.12 1.24 ; heart, 1.47 1.69 1.93 ). Higher program-level offer acceptance was associated with lower incidence of waitlist removal due to death or becoming too sick to undergo transplant (hazard ratios [HRs]: heart, 0.80 0.86 0.93 ; lung, 0.67 0.75 0.83 ), but not with rate of waitlist removal (HRs: heart, 0.91 0.98 1.06 ; lung, 0.89 0.99 1.10 ). Heart and lung offer acceptance practices affected numbers of transplanted organs and contributed to program-level variability in the probability of waitlist mortality. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  18. Costs of the 'Hartslag Limburg' community heart health intervention

    Directory of Open Access Journals (Sweden)

    Ruland Erik

    2006-03-01

    Full Text Available Abstract Background Little is known about the costs of community programmes to prevent cardiovascular diseases. The present study calculated the economic costs of all interventions within a Dutch community programme called Hartslag Limburg, in such a way as to facilitate generalisation to other countries. It also calculated the difference between the economic costs and the costs incurred by the coordinating institution. Methods Hartslag Limburg was a large-scale community programme that consisted of many interventions to prevent cardiovascular diseases. The target population consisted of all inhabitants of the region (n = 180.000. Special attention was paid to reach persons with a low socio-economic status. Costs were calculated using the guidelines for economic evaluation in health care. An overview of the material and staffing input involved was drawn up for every single intervention, and volume components were attached to each intervention component. These data were gathered during to the implementation of the intervention. Finally, the input was valued, using Dutch price levels for 2004. Results The economic costs of the interventions that were implemented within the five-year community programme (n = 180,000 were calculated to be about €900,000. €555,000 was spent on interventions to change people's exercise patterns, €250,000 on improving nutrition, €50,000 on smoking cessation, and €45,000 on lifestyle in general. The coordinating agency contributed about 10% to the costs of the interventions. Other institutions that were part of the programme's network and external subsidy providers contributed the other 90% of the costs. Conclusion The current study calculated the costs of a community programme in a detailed and systematic way, allowing the costs to be easily adapted to other countries and regions. The study further showed that the difference between economic costs and the costs incurred by the coordinating agency can be very

  19. 42 CFR 441.106 - Comprehensive mental health program.

    Science.gov (United States)

    2010-10-01

    ... health and public welfare resources; including— (i) Community mental health centers; (ii) Nursing homes... 42 Public Health 4 2010-10-01 2010-10-01 false Comprehensive mental health program. 441.106... Comprehensive mental health program. (a) If the plan includes services in public institutions for mental...

  20. Evolution of patients with heart disease after cardiopulmonary rehabilitation program: case report

    Directory of Open Access Journals (Sweden)

    Saulo Fabrin

    Full Text Available Abstract Introduction: Recovery and maintenance of patients suffering from heart and respiratory diseases using the cardiopulmonary rehabilitation program (CPRP help maintain their functionality and improve the activities of daily living (ADLs carried out according to their functional limitations. Objective: To investigate the efficacy of a CPRP in a patient with cardiopulmonary disease, following a 5-month training program. Methods: A 66-year-old female patient, body weight 78 kg, height 1.55 m, diagnosed with acute myocardial infarction and bronchial asthma underwent a six-minute walk test (6MWT to measure exercise tolerance; the Wells Bench was used to measure the flexibility of the posterior chain and lower limbs (LL, and a hand-held dynamometer (HHD was used to measure upper limb strength (ULS.Vital sign measurements include blood pressure (BP, heart rate (HR, respiratory rate (RR, oxygen saturation (SpO2 as well as dyspnea and LL fatigue (modified Borg scale at rest, during and after 5-month CPRP. Results: An increase of 145 meters during the cardiopulmonary rehabilitation program i.e. 30% of walk distance (WD in the 6MWT (pre = 345, post = 490m. There was an increase of 32% in flexibility (pre = 13, post = 19cm; in right upper limb (pre = 26, post = 60 kgf and left lower limb strength (pre = 28, post = 72kgf, there was an increase of 57% and 61%, respectively. Conclusion: The CPRP proved to be effective in increasing exercise capacity, upper limb strength and flexibility of the posterior chain and lower limbs.

  1. Digital health intervention as an adjunct to a workplace health program in hypertension.

    Science.gov (United States)

    Senecal, Conor; Widmer, R Jay; Johnson, Matthew P; Lerman, Lilach O; Lerman, Amir

    2018-05-30

    Hypertension is a common and difficult-to-treat condition; digital health tools may serve as adjuncts to traditional pharmaceutical and lifestyle-based interventions. Using a retrospective observational study we sought to evaluate the effect of a desktop and mobile digital health intervention (DHI) as an adjunct to a workplace health program in those previously diagnosed with hypertension. As part of a workplace health program, 3330 patients were identified as previously diagnosed with hypertension. A DHI was made available to participants providing motivational and educational materials assisting in the management of hypertension. We evaluated changes in blood pressure, weight, and body mass index (BMI) between users and nonusers based on login frequency to the DHI using multivariate regression through the five visits over the course of 1 year. One thousand six hundred twenty-two (49%) participants logged into the application at least once. DHI users had significant greater improvements in systolic blood pressure (SBP; -2.79 mm Hg), diastolic blood pressure (-2.12 mm Hg), and BMI (-0.23 kg/m 2 ) at 1 year. Increased login frequency was significantly correlated with reductions in SBP, diastolic blood pressure, weight, and BMI (P ≤ .014). This large, observational study provides evidence that a DHI as an adjunct to a workplace health program is associated with greater improvement in blood pressure and BMI at 1 year. This study adds to the growing body of evidence that DHIs may be useful in augmenting the treatment of hypertension in addition to traditional management with pharmaceuticals and lifestyle changes. Copyright © 2018 American Heart Association. Published by Elsevier Inc. All rights reserved.

  2. Physical fitness and health education program at NASA Headquarters

    Science.gov (United States)

    Angotti, Cathy

    1993-01-01

    The topics discussed include the following: policy procedures to enter the NASA Headquarters Physical Fitness and Health Program; eligibility; TDY eligibility; health promotions offered; and general facility management.

  3. A health equity impact assessment umbrella program (AAPRISS) to tackle social inequalities in health: program description.

    Science.gov (United States)

    Lang, Thierry; Bidault, Elsa; Villeval, Mélanie; Alias, François; Gandouet, Benjamin; Servat, Martine; Theis, Ivan; Breton, Eric; Haschar-Noé, Nadine; Grosclaude, Pascale

    2016-09-01

    The failure to simultaneously address two objectives (increasing the average health of the population and reducing health inequalities) may have led to what has been observed in France so far: an overall decrease in mortality and increase in inequality. The Apprendre et Agir pour Réduire les Inégalités Sociales de Santé (AAPRISS) methodology is to analyze and modify interventions that are already underway in terms of their potential impact on health inequalities. It relies on partnership between researchers and actors in the health field, as well as policy makers. In this paper, we describe the program and discuss its feasibility and acceptability. This program is not a single intervention, but a process aiming at assessing and reshaping existing health programs, therefore acting as a kind of meta-intervention. The program develops scientific and methodological support stemming from co-construction methods aimed at increasing equity within the programs. Stakeholders from prevention policy-making and the health care system, as well as researchers, collaborate in defining interventions, monitoring their progress, and choosing indicators, methods and evaluation procedures. The target population is mainly the population of the greater Toulouse area. The steps of the process are described: (1) establishment of AAPRISS governance and partnerships; (2) inclusion of projects; and (3) the projects' process. Many partners have rallied around this program, which has been shown to be feasible and acceptable by partners and health actors. A major challenge is understanding each partner's expectations in terms of temporality of interventions, expected outcomes, assessment methods and indicators. Analyzing the projects has been quite feasible, and some modifications have been implemented in them in order to take inequalities in health into account. © The Author(s) 2015.

  4. Service learning in Guatemala: using qualitative content analysis to explore an interdisciplinary learning experience among students in health care professional programs

    OpenAIRE

    Fries, Kathleen S; Bowers, Donna M; Gross, Margo; Frost, Lenore

    2013-01-01

    Kathleen S Fries,1 Donna M Bowers,2 Margo Gross,3 Lenore Frost31Nursing Program, 2Department of Physical Therapy and Human Movement Science, 3Graduate Program in Occupational Therapy, College of Health Professions, Sacred Heart University, Fairfield, CT, USAIntroduction: Interprofessional collaboration among health care professionals yields improved patient outcomes, yet many students in health care programs have limited exposure to interprofessional collaboration in the classroom and in clin...

  5. [Anxiety, depression, health-related control beliefs, and their association with health behavior in patients with ischemic heart disease].

    Science.gov (United States)

    Rafael, Beatrix; Konkolÿ Thege, Barna; Kovács, Péter; Balog, Piroska

    2015-05-17

    Psychological and lifestyle factors affect the development and outcome of heart disease considerably. The aims of the authors were to examine health control, level of anxiety and depression and to analyse their relationship with health behaviour in patients with ischemic heart disease. The present cross-sectional study involved 116 patients who took part in residential cardiac rehabilitation (56.9% men, mean age: 57.65±8.22 years). 30.9% of the patients reported elevated anxiety and 21.9% increased depressive symptomatology. Social-external control belief was the strongest among respondents. Further, anxiety and depression were negatively associated with healthy diet and the frequency of exercise. Patients with stronger social-external control beliefs were more likely to seek medical attention if they suspected a disease. It is important to assess psychological risk factors linked to cardiovascular diseases in cardiac rehabilitation departments and to initiate psychological interventions if indicated.

  6. Effect of Educational Program on Quality of Life of Patients with Heart Failure: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Mohammad Khajegodary

    2013-02-01

    Full Text Available Introduction: Heart failure is one of the most common cardiovascular diseases which decrease the quality of life. Most of the factors influencing the quality of life can be modified with educational interventions. Therefore, this study examined the impact of a continuous training program on quality of life of patients with heart failure. Methods: This randomized clinical trial study was conducted during May to August 2011. Forty four participants with heart failure referred to Shahid Madani's polyclinics of Tabriz were selected through convenient sampling method and were randomly allocated to two groups. The intervention group (n = 22 received ongoing training including one-to-one teaching, counseling sessions and phone calls over 3 months. The control group (n = 22 received routine care program. Data on quality of life was collected using the Minnesota Living with Heart Failure Questionnaire at baseline as well as three months later. Results: The statistical tests showed significant differences in the physical, emotional dimensions and total quality of life in intervention group. But in control group, no significant differences were obtained. There was not any significant association in demographic characteristics and quality of life. Conclusion: Ongoing training programs can be effective in improving quality of life of patients with heart failure. Hence applying ongoing educational program as a non-pharmacological intervention can help to improve the quality of life of these patients.

  7. Effect of educational program on quality of life of patients with heart failure: a randomized clinical trial.

    Science.gov (United States)

    Lakdizaji, Sima; Hassankhni, Hadi; Mohajjel Agdam, Alireza; Khajegodary, Mohammad; Salehi, Rezvanieh

    2013-03-01

    Heart failure is one of the most common cardiovascular diseases which decrease the quality of life. Most of the factors influencing the quality of life can be modified with educational interventions. Therefore, this study examined the impact of a continuous training program on quality of life of patients with heart failure. This randomized clinical trial study was conducted during May to August 2011. Forty four participants with heart failure referred to Shahid Madani's polyclinics of Tabriz were selected through convenient sampling method and were randomly allocated to two groups. The intervention group (n = 22) received ongoing training including one-to-one teaching, counseling sessions and phone calls over 3 months. The control group (n = 22) received routine care program. Data on quality of life was collected using the Minnesota Living with Heart Failure Questionnaire at baseline as well as three months later. The statistical tests showed significant differences in the physical, emotional dimensions and total quality of life in intervention group. But in control group, no significant differences were obtained. There was not any significant association in demographic characteristics and quality of life. Ongoing training programs can be effective in improving quality of life of patients with heart failure. Hence applying ongoing educational program as a non-pharmacological intervention can help to improve the quality of life of these patients.

  8. Men's and Women's Health Beliefs Differentially Predict Coronary Heart Disease Incidence in a Population-Based Sample

    Science.gov (United States)

    Korin, Maya Rom; Chaplin, William F.; Shaffer, Jonathan A.; Butler, Mark J.; Ojie, Mary-Jane; Davidson, Karina W.

    2013-01-01

    Objective: To examine gender differences in the association between beliefs in heart disease preventability and 10-year incidence of coronary heart disease (CHD) in a population-based sample. Methods: A total of 2,688 Noninstitutionalized Nova Scotians without prior CHD enrolled in the Nova Scotia Health Study (NSHS95) and were followed for 10…

  9. Healthy Start: a comprehensive health education program for preschool children.

    Science.gov (United States)

    Williams, C L; Squillace, M M; Bollella, M C; Brotanek, J; Campanaro, L; D'Agostino, C; Pfau, J; Sprance, L; Strobino, B A; Spark, A; Boccio, L

    1998-01-01

    Healthy Start is a 3-year demonstration and education research project designed to evaluate the effectiveness of a multidimensional cardiovascular (CV) risk reduction intervention in preschool centers over a 3-year period of time. Two primary interventions are employed. The first is the preschool food service intervention program designed to reduce the total fat in preschool meals and snacks to less than 30% of calories and reduce the saturated fat to less than 10% of calories. The second major intervention is a comprehensive preschool health education curriculum, focused heavily on nutrition. Effectiveness of the intervention will be determined through evaluation of changes in dietary intake of preschool children at school meals and snacks, especially with respect to intake of total and saturated fat. Evaluation of the education component will include assessment of program implementation by teachers, assessment of changes in nutrition knowledge by preschool children, and assessment of changes in home meals that children consume (total and saturated fat content). Blood cholesterol will be evaluated semiannually to evaluate changes that may be due to modification of dietary intake. Growth and body fatness will also be assessed. While substantial efforts have targeted CV risk reduction and health education for elementary school children, similar efforts aimed at preschool children have been lacking. The rationale for beginning CV risk reduction programs for preschool children is based upon the premise that risk factors for heart disease are prevalent by 3 years of age and tend to track over time, most commonly hypercholesterolemia and obesity, both related to nutrition. Since the behavioral antecedents for nutritional risk factors begin to be established very early in life, it is important to develop and evaluate new educational initiatives such as Healthy Start, aimed at the primary prevention of cardiovascular risk factors in preschool children. The purpose of this

  10. 77 FR 23193 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program-Stage 2; Corrections

    Science.gov (United States)

    2012-04-18

    ..., 413, and 495 [CMS-0044-CN] RIN 0938-AQ84 Medicare and Medicaid Programs; Electronic Health Record... proposed rule entitled ``Medicare and Medicaid Programs; Electronic Health Record Incentive Program--Stage... (77 FR 13698), the proposed rule entitled ``Medicare and Medicaid Programs; Electronic Health Record...

  11. 75 FR 63480 - Medicaid Program: Implementation of Section 614 of the Children's Health Insurance Program...

    Science.gov (United States)

    2010-10-15

    ... Children's Health Insurance Program Reauthorization Act of 2009 for Adjustments to the Federal Medical... section 614 of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), Public Law... Medicaid program and required by Section 614 of the Children's Health Insurance Program Reauthorization Act...

  12. Post-discharge heart failure monitoring program in Turkey: Hit-PoinT

    Science.gov (United States)

    Çavuşoğlu, Yüksel; Zoghi, Mehdi; Eren, Mehmet; Bozçalı, Evin; Kozdağ, Güliz; Şentürk, Tunay; Alicik, Güray; Soylu, Korhan; Sarı, İbrahim; Berilgen, Rida; Temizhan, Ahmet; Gencer, Erkan; Orhan, Ahmet Lütfü; Polat, Veli; Kaderli, Aysel Aydın; Aktoz, Meryem; Zengin, Halit; Aksoy, Mehmet; Selçuk, Mehmet Timur; Ergene, Oktay; Soran, Özlem

    2017-01-01

    Objective: The aim of this study was to assess the efficacy and feasibility of an enhanced heart failure (HF) education with a 6-month telephone follow- up program in post-discharge ambulatory HF patients. Methods: The Hit-Point trial was a multicenter, randomized, controlled trial of enhanced HF education with a 6-month telephone follow-up program (EHFP) vs routine care (RC) in patients with HF and reduced ejection fraction. A total of 248 patients from 10 centers in various geographical areas were randomized: 125 to EHFP and 123 to RC. Education included information on adherence to treatment, symptom recognition, diet and fluid intake, weight monitoring, activity and exercise training. Patients were contacted by telephone after 1, 3, and 6 months. The primary study endpoint was cardiovascular death. Results: Although all-cause mortality didn’t differ between the EHFP and RC groups (p=NS), the percentage of cardiovascular deaths in the EHFP group was significantly lower than in the RC group at the 6-month follow up (5.6% vs. 8.9%, p=0.04). The median number of emergency room visits was one and the median number of all cause hospitalizations and heart failure hospitalizations were zero. Twenty-tree percent of the EHFP group and 35% of the RC group had more than a median number of emergency room visits (p=0.05). There was no significant difference regarding the median number of all–cause or heart failure hospitalizations. At baseline, 60% of patients in EHFP and 61% in RC were in NYHA Class III or IV, while at the 6-month follow up only 12% in EHFP and 32% in RC were in NYHA Class III or IV (p=0.001). Conclusion: These results demonstrate the potential clinical benefits of an enhanced HF education and follow up program led by a cardiologist in reducing cardiovascular deaths and number of emergency room visits with an improvement in functional capacity at 6 months in post-discharge ambulatory HF patients. PMID:27488754

  13. Health effects of unemployment benefit program generosity.

    Science.gov (United States)

    Cylus, Jonathan; Glymour, M Maria; Avendano, Mauricio

    2015-02-01

    We assessed the impact of unemployment benefit programs on the health of the unemployed. We linked US state law data on maximum allowable unemployment benefit levels between 1985 and 2008 to individual self-rated health for heads of households in the Panel Study of Income Dynamics and implemented state and year fixed-effect models. Unemployment was associated with increased risk of reporting poor health among men in both linear probability (b=0.0794; 95% confidence interval [CI]=0.0623, 0.0965) and logistic models (odds ratio=2.777; 95% CI=2.294, 3.362), but this effect is lower when the generosity of state unemployment benefits is high (b for interaction between unemployment and benefits=-0.124; 95% CI=-0.197, -0.0523). A 63% increase in benefits completely offsets the impact of unemployment on self-reported health. Results suggest that unemployment benefits may significantly alleviate the adverse health effects of unemployment among men.

  14. ABCC-JNIH Adult Health Study Hiroshima, 1958 to 1959. Hypertension and ischemic heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Switzer, S

    1963-11-12

    The interrelations of hypertension, ischemic heart disease, blood lipid levels and ionizing irradiation were investigated among 1051 male and 1872 female members of the ABCC-JNIH Adult Health Study. No significant effect of ionizing irradiation upon the cardiovascular system were detected. No major difference in age-sex specific mean blood pressures between Adult Health Study subjects and a suitable American comparison group was found. An accelerated course with fulminating vascular deterioration was suspected in only 1% of the hypertensive subjects. As a result, advanced retinopathy and renal failure were rarely seen. Electrocardiographic evidence of left ventricular hypertrophy occurred in 7.2% of the hypertensive subjects in this study, and was readily correlated with ambient systolic blood pressure. Evidences of ischemic heart disease and congestive failure were rare and distinctly less common than in American males unselected as to blood pressure levels. In contrast, mortality statistics indicate cerebrovascular disease to be at least as common in Japan as in the United States. Adult Health Study data exhibit low serum cholesterol concentrations by Western standards and elevated levels are predominantly limited to the obese. Both factors appear of importance in the occasional hypertensive subject with ischemic heart disease. The therapeutic implication of this observation is briefly discussed. 57 references, 10 tables.

  15. Rheumatic heart disease in pregnancy: How can health services adapt to the needs of Indigenous women? A qualitative study.

    Science.gov (United States)

    Belton, Suzanne; Kruske, Sue; Jackson Pulver, Lisa; Sherwood, Juanita; Tune, Kylie; Carapetis, Jonathan; Vaughan, Geraldine; Peek, Michael; McLintock, Claire; Sullivan, Elizabeth

    2017-11-06

    To study rheumatic heart disease health literacy and its impact on pregnancy, and to identify how health services could more effectively meet the needs of pregnant women with rheumatic heart disease. Researchers observed and interviewed a small number of Aboriginal women and their families during pregnancy, childbirth and postpartum as they interacted with the health system. An Aboriginal Yarning method of relationship building over time, participant observations and interviews with Aboriginal women were used in the study. The settings were urban, island and remote communities across the Northern Territory. Women were followed interstate if they were transferred during pregnancy. The participants were pregnant women and their families. We relied on participants' abilities to tell their own experiences so that researchers could interpret their understanding and perspective of rheumatic heart disease. Aboriginal women and their families rarely had rheumatic heart disease explained appropriately by health staff and therefore lacked understanding of the severity of their illness and its implications for childbearing. Health directives in written and spoken English with assumed biomedical knowledge were confusing and of limited use when delivered without interpreters or culturally appropriate health supports. Despite previous studies documenting poor communication and culturally inadequate care, health systems did not meet the needs of pregnant Aboriginal women with rheumatic heart disease. Language-appropriate health education that promotes a shared understanding should be relevant to the gender, life-stage and social context of women with rheumatic heart disease. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  16. Effects of Yoga on Stress, Stress Adaption, and Heart Rate Variability Among Mental Health Professionals--A Randomized Controlled Trial.

    Science.gov (United States)

    Lin, Shu-Ling; Huang, Ching-Ya; Shiu, Shau-Ping; Yeh, Shu-Hui

    2015-08-01

    Mental health professionals experiencing work-related stress may experience burn out, leading to a negative impact on their organization and patients. The aim of this study was to examine the effects of yoga classes on work-related stress, stress adaptation, and autonomic nerve activity among mental health professionals. A randomized controlled trial was used, which compared the outcomes between the experimental (e.g., yoga program) and the control groups (e.g., no yoga exercise) for 12 weeks. Work-related stress and stress adaptation were assessed before and after the program. Heart rate variability (HRV) was measured at baseline, midpoint through the weekly yoga classes (6 weeks), and postintervention (after 12 weeks of yoga classes). The results showed that the mental health professionals in the yoga group experienced a significant reduction in work-related stress (t = -6.225, p control group revealed no significant changes. Comparing the mean differences in pre- and posttest scores between yoga and control groups, we found the yoga group significantly decreased work-related stress (t = -3.216, p = .002), but there was no significant change in stress adaptation (p = .084). While controlling for the pretest scores of work-related stress, participants in yoga, but not the control group, revealed a significant increase in autonomic nerve activity at midpoint (6 weeks) test (t = -2.799, p = .007), and at posttest (12 weeks; t = -2.099, p = .040). Because mental health professionals experienced a reduction in work-related stress and an increase in autonomic nerve activity in a weekly yoga program for 12 weeks, clinicians, administrators, and educators should offer yoga classes as a strategy to help health professionals reduce their work-related stress and balance autonomic nerve activities. © 2015 The Authors. Worldviews on Evidence-Based Nursing published by Wiley Periodicals, Inc. on behalf of Society for Worldviews on Evidence-Based Nursing.

  17. Adolescents' with congenital heart disease and their parents' experiences of a nurse-led transition program. An interpretive phenomenological

    Science.gov (United States)

    Thomet, Corina; Lindenberg, Carina; Schwerzmann, Markus; Spichiger, Elisabeth

    2018-02-01

    Background: Up to 90 % of patients with congenital heart disease (CHD) now reach adulthood. To avoid lapses in care during the change from pediatric to adult care, a nurse-led transition program (TP) was implemented at a Swiss University Hospital. Aim: This study explored the experiences and expectations of adolescents with CHD and their parents regarding a nurse-led TP. Method: This qualitative study used an interpretive, phenomenological approach. Individual interviews were conducted with seven adolescent CHD patients in the transition period and their parents (six mothers, two fathers). Analysis followed an iterative process. Results: For most study participants, the transfer from pediatric to adult medicine as part of the TP went smoothly. They experienced the TP positively. Patients valued the provision of a constant contact person to provide CHD-related information; parents welcomed the support of an informed, neutral clinician for their children. To varying degrees, adolescents were willing to take over self-responsibility; conversely, parents found it difficult to turn their responsibility over to their children. Parents wished to give the adolescent as much time as needed to act responsibility on their own. Conclusions: A transition program is a key element for establishing a continuous care in adolescents with a chronic disease. It facilitates the parents' process of allowing their youths to assume increasing responsibility for their own health.

  18. How federalism shapes public health financing, policy, and program options.

    Science.gov (United States)

    Ogden, Lydia L

    2012-01-01

    In the United States, fiscal and functional federalism strongly shape public health policy and programs. Federalism has implications for public health practice: it molds financing and disbursement options, including funding formulas, which affect allocations and program goals, and shapes how funding decisions are operationalized in a political context. This article explores how American federalism, both fiscal and functional, structures public health funding, policy, and program options, investigating the effects of intergovernmental transfers on public health finance and programs.

  19. Health risk assessment for program managers

    International Nuclear Information System (INIS)

    Jump, R.A.; Williamson, D.S.

    1994-01-01

    This paper presents the findings of a sensitivity analysis into the independent variables that determine the levels of health risks posed by buried plutonium and americium at a typical contaminated site in an arid region. Environmental Restoration Program Managers often must make decisions concerning cleanup levels, remediation alternatives, schedules, cost estimates, etc. based upon extraordinarily safe assumptions about risk assessment calculation inputs. This study reveals to the Program Manager which variables are major drivers to the calculated levels of risk posed by transuranic radionuclides and which ones have second order effects or less. The findings of this study should indicate which inputs should be the focus of attention during negotiations with regulators and of further empirical investigation

  20. 78 FR 4593 - Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in...

    Science.gov (United States)

    2013-01-22

    ...'s Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans...-2334-P] RIN 0938-AR04 Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health... 2010 (collectively referred to as the Affordable Care Act), and the Children's Health Insurance Program...

  1. Using Administrative Mental Health Indicators in Heart Failure Outcomes Research: Comparison of Clinical Records and International Classification of Disease Coding.

    Science.gov (United States)

    Bender, Miriam; Smith, Tyler C

    2016-01-01

    Use of mental indication in health outcomes research is of growing interest to researchers. This study, as part of a larger research program, quantified agreement between administrative International Classification of Disease (ICD-9) coding for, and "gold standard" clinician documentation of, mental health issues (MHIs) in hospitalized heart failure (HF) patients to determine the validity of mental health administrative data for use in HF outcomes research. A 13% random sample (n = 504) was selected from all unique patients (n = 3,769) hospitalized with a primary HF diagnosis at 4 San Diego County community hospitals during 2009-2012. MHI was defined as ICD-9 discharge diagnostic coding 290-319. Records were audited for clinician documentation of MHI. A total of 43% (n = 216) had mental health clinician documentation; 33% (n = 164) had ICD-9 coding for MHI. ICD-9 code bundle 290-319 had 0.70 sensitivity, 0.97 specificity, and kappa 0.69 (95% confidence interval 0.61-0.79). More specific ICD-9 MHI code bundles had kappas ranging from 0.44 to 0.82 and sensitivities ranging from 42% to 82%. Agreement between ICD-9 coding and clinician documentation for a broadly defined MHI is substantial, and can validly "rule in" MHI for hospitalized patients with heart failure. More specific MHI code bundles had fair to almost perfect agreement, with a wide range of sensitivities for identifying patients with an MHI. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Space Station Freedom Environmental Health Care Program

    Science.gov (United States)

    Richard, Elizabeth E.; Russo, Dane M.

    1992-01-01

    The paper discusses the environmental planning and monitoring aspects of the Space Station Freedom (SSF) Environmental Health Care Program, which encompasses all phases of the SSF assembly and operation from the first element entry at MB-6 through the Permanent Manned Capability and beyond. Environmental planning involves the definition of acceptability limits and monitoring requirements for the radiation dose barothermal parameters and potential contaminants in the SSF air and water and on internal surfaces. Inflight monitoring will be implemented through the Environmental Health System, which consists of five subsystems: Microbiology, Toxicology, Water Quality, Radiation, and Barothermal Physiology. In addition to the environmental data interpretation and analysis conducted after each mission, the new data will be compared to archived data for statistical and long-term trend analysis and determination of risk exposures. Results of these analyses will be used to modify the acceptability limits and monitoring requirements for the future.

  3. Sharing Health Information and Influencing Behavioral Intentions: The Role of Health Literacy, Information Overload, and the Internet in the Diffusion of Healthy Heart Information.

    Science.gov (United States)

    Crook, Brittani; Stephens, Keri K; Pastorek, Angie E; Mackert, Michael; Donovan, Erin E

    2016-01-01

    Low health literacy remains an extremely common and problematic issue, given that individuals with lower health literacy are more likely to experience health challenges and negative health outcomes. In this study, we use the first three stages of the innovation-decision process found in the theory of diffusion of innovations (Rogers, 2003). We incorporate health literacy into a model explaining how perceived health knowledge, information sharing, attitudes, and behavior are related. Results show that health information sharing explains 33% of the variance in behavioral intentions, indicating that the communicative practice of sharing information can positively impact health outcomes. Further, individuals with high health literacy tend to share less information about heart health than those with lower health literacy. Findings also reveal that perceived heart-health knowledge operates differently than health literacy to predict health outcomes.

  4. Canagliflozin and Heart Failure in Type 2 Diabetes Mellitus: Results From the CANVAS Program (Canagliflozin Cardiovascular Assessment Study).

    Science.gov (United States)

    Rådholm, Karin; Figtree, Gemma; Perkovic, Vlado; Solomon, Scott D; Mahaffey, Kenneth W; de Zeeuw, Dick; Fulcher, Greg; Barrett, Terrance D; Shaw, Wayne; Desai, Mehul; Matthews, David R; Neal, Bruce

    2018-03-11

    BACKGROUND : Canagliflozin is a sodium glucose cotransporter 2 inhibitor that reduces the risk of cardiovascular events. We report the effects on heart failure and cardiovascular death overall, in those with and without a baseline history of heart failure, and in other participant subgroups. METHODS : The CANVAS Program (Canagliflozin Cardiovascular Assessment Study) enrolled 10 142 participants with type 2 diabetes mellitus and high cardiovascular risk. Participants were randomly assigned to canagliflozin or placebo and followed for a mean of 188 weeks. The primary end point for these analyses was adjudicated cardiovascular death or hospitalized heart failure. RESULTS : Participants with a history of heart failure at baseline (14.4%) were more frequently women, white, and hypertensive and had a history of prior cardiovascular disease (all P failure was reduced in those treated with canagliflozin compared with placebo (16.3 versus 20.8 per 1000 patient-years; hazard ratio [HR], 0.78; 95% confidence interval [CI], 0.67-0.91), as was fatal or hospitalized heart failure (HR, 0.70; 95% CI, 0.55-0.89) and hospitalized heart failure alone (HR, 0.67; 95% CI, 0.52-0.87). The benefit on cardiovascular death or hospitalized heart failure may be greater in patients with a prior history of heart failure (HR, 0.61; 95% CI, 0.46-0.80) compared with those without heart failure at baseline (HR, 0.87; 95% CI, 0.72-1.06; P interaction =0.021). The effects of canagliflozin compared with placebo on other cardiovascular outcomes and key safety outcomes were similar in participants with and without heart failure at baseline (all interaction P values >0.130), except for a possibly reduced absolute rate of events attributable to osmotic diuresis among those with a prior history of heart failure ( P =0.03). CONCLUSIONS : In patients with type 2 diabetes mellitus and an elevated risk of cardiovascular disease, canagliflozin reduced the risk of cardiovascular death or hospitalized heart

  5. Effect of a multidisciplinary supportive program for family caregivers of patients with heart failure on caregiver burden, quality of life, and depression: A randomized controlled study.

    Science.gov (United States)

    Hu, Xiaolin; Dolansky, Mary A; Su, Yonglin; Hu, Xiuying; Qu, Moying; Zhou, Lingjuan

    2016-10-01

    Caregivers of patients with heart failure experience burden and negative health outcomes. Adequate support for family caregivers improves their well-being and the quality of care provided to the patients. However, little is known about the benefits of interventions for caregivers of patients with heart failure in China. To test the effects of a multidisciplinary supportive program for family caregivers on caregiver burden, quality of life, and depression. A randomized controlled design with repeated measures was used in this study. A total of 118 participants were randomized into experimental (n=59) and control groups (n=59) from May to December 2014 in one hospital in Chengdu, People's Republic of China. Participants in the experimental group received a 3-month multidisciplinary supportive program, consisting of three 60-min sessions of group classes, three 30-min peer support groups, and regular telephone follow-ups and consultations, while participants in the control group received usual care only. Outcomes were caregiver burden, quality of life, and depression. Data were collected at baseline, post-test (3 months after discharge), and 3 months after post-test (6 months after discharge). The repeated measures analysis of variance was used to examine the effects of groups, changes over time, and time-group interaction on outcome variables. There were significant improvements in caregiver burden, mental health, and depression after post-test and 3 months after post-test in the experimental group. However, there was no significant improvement in caregivers' physical health at either 3 or 6 months following discharge. A multidisciplinary supportive program for caregivers of heart failure patients had positive effects and provides a unique perspective of an intervention considering Chinese culture and customs. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Exploratory study into the awareness of heart diseases among Emirati women (UAE) and their health seeking behaviour- a qualitative study.

    Science.gov (United States)

    Khan, Sarah; Khoory, Ayesha; Al Zaffin, Dhabia; Al Suwaidi, Meera

    2016-11-07

    Cardiovascular diseases were the leading cause of death in women in the United Arab Emirates (UAE) in 2010. The UAE is expected to experience a tripling of heart diseases in the next two decades as risk factors for heart diseases increase. Research shows that first year survival rates of younger women suffering from a heart attack are lower than in men. Women present with a wider range of symptoms for heart diseases than men; non-recognition of atypical symptoms may explain the delay in seeking treatment and poor prognosis following heart diseases in women. No known study on awareness of heart diseases among women has been carried out in the Middle Eastern region. Social constructionist and interpretivist epistemological approaches have been considered in this qualitative study to explore the awareness of heart diseases and the health seeking behavior of Emirati women. Convenience sampling was used to recruit 41 Emirati women. Three focus groups and six in-depth semi-structured interviews were conducted to obtain data. Thematic content analysis was applied to the data following transcription and translation of recordings. Emirati women had limited knowledge on heart diseases. Women were generally unaware of the atypical symptoms, commonly experienced by women however they identified most risk factors associated with heart diseases. Lack of awareness of disease severity and symptoms, sociocultural influences and distrust in the healthcare system were considered the main barriers to seeking prompt treatment. This study clearly identified gaps and inaccuracies in knowledge of heart diseases, which could contribute to delayed health seeking action and possibly poorer prognosis among Emirati women. Absence of initiatives to educate women on cardiovascular diseases in UAE has erroneously deemed it a less serious concern among Emirati women. The findings from this study provide clear indications of the need to increase accountability of the healthcare system and to

  7. Health insurers promoting employee wellness: strategies, program components and results.

    Science.gov (United States)

    Murphy, Brigid M; Schoenman, Julie A; Pirani, Hafiza

    2010-01-01

    To examine health insurance companies' role in employee wellness. Case studies of eight insurers. Wellness activities in work, clinical, online, and telephonic settings. Senior executives and wellness program leaders from Blue Cross Blue Shield health insurers and from one wellness organization. Telephone interviews with 20 informants. Health insurers were engaged in wellness as part of their mission to promote health and reduce health care costs. Program components included the following: education, health risk assessments, incentives, coaching, environmental consultation, targeted programming, onsite biometric screening, professional support, and full-time wellness staff. Programs relied almost exclusively on positive incentives to encourage participation. Results included participation rates as high as 90%, return on investment ranging from $1.09 to $1.65, and improved health outcomes. Health insurers have expertise in developing, implementing, and marketing health programs and have wide access to employers and their employees' health data. These capabilities make health insurers particularly well equipped to expand the reach of wellness programming to improve the health of many Americans. By coupling members' medical data with wellness-program data, health insurers can better understand an individual's health status to develop and deliver targeted interventions. Through program evaluation, health insurers can also contribute to the limited but growing evidence base on employee wellness programs.

  8. Epigenomic programing: a future way to health?

    Directory of Open Access Journals (Sweden)

    Boris A. Shenderov

    2014-05-01

    Full Text Available It is now generally accepted that the ‘central genome dogma’ (i.e. a causal chain going from DNA to RNA to proteins and downstream to biological functions should be replaced by the ‘fluid genome dogma’, that is, complex feed-forward and feed-back cycles that interconnect organism and environment by epigenomic programing – and reprograming – throughout life and at all levels, sometimes also down the generations. The epigenomic programing is the net sum of interactions derived from own metabolism and microbiota as well as external factors such as diet, pharmaceuticals, environmental compounds, and so on. It is a growing body of results indicating that many chronic metabolic and degenerative disorders and diseases – often called ‘civilization diseases’ – are initiated and/or influenced upon by non-optimal epigenomic programing, often taking place early in life. In this context, the first 1,000 days of life – from conception into early infancy – is often called the most important period of life. The following sections present some major mechanisms for epigenomic programing as well as some factors assumed to be of importance. The need for more information about own genome and metagenome, as well as a substantial lack of adequate information regarding dietary and environmental databases are also commented upon. However, the mere fact that we can influence epigenomic health programing opens up the way for prophylactic and therapeutic interventions. The authors underline the importance of creating a ‘Human Gut Microbiota and Epigenomic Platform’ in order to facilitate interdisciplinary collaborations among scientists and clinicians engaged in host microbial ecology, nutrition, metagenomics, epigenomics and metabolomics as well as in disease epidemiology, prevention and treatment.

  9. Epigenomic programing: a future way to health?

    Science.gov (United States)

    Shenderov, Boris A; Midtvedt, Tore

    2014-01-01

    It is now generally accepted that the 'central genome dogma' (i.e. a causal chain going from DNA to RNA to proteins and downstream to biological functions) should be replaced by the 'fluid genome dogma', that is, complex feed-forward and feed-back cycles that interconnect organism and environment by epigenomic programing - and reprograming - throughout life and at all levels, sometimes also down the generations. The epigenomic programing is the net sum of interactions derived from own metabolism and microbiota as well as external factors such as diet, pharmaceuticals, environmental compounds, and so on. It is a growing body of results indicating that many chronic metabolic and degenerative disorders and diseases - often called 'civilization diseases' - are initiated and/or influenced upon by non-optimal epigenomic programing, often taking place early in life. In this context, the first 1,000 days of life - from conception into early infancy - is often called the most important period of life. The following sections present some major mechanisms for epigenomic programing as well as some factors assumed to be of importance. The need for more information about own genome and metagenome, as well as a substantial lack of adequate information regarding dietary and environmental databases are also commented upon. However, the mere fact that we can influence epigenomic health programing opens up the way for prophylactic and therapeutic interventions. The authors underline the importance of creating a 'Human Gut Microbiota and Epigenomic Platform' in order to facilitate interdisciplinary collaborations among scientists and clinicians engaged in host microbial ecology, nutrition, metagenomics, epigenomics and metabolomics as well as in disease epidemiology, prevention and treatment.

  10. Long term health care consumption and cost expenditure in systolic heart failure.

    Science.gov (United States)

    Mejhert, Märit; Lindgren, Peter; Schill, Owe; Edner, Magnus; Persson, Hans; Kahan, Thomas

    2013-04-01

    The prevalence, health care consumption, and mortality increase in elderly patients with heart failure. This study aimed to analyse long term cost expenditure and predictors of health care consumption in these patients. We included 208 patients aged 60 years or older and hospitalised with heart failure (NYHA class II-IV and left ventricular systolic dysfunction); 58% were men, mean age 76 years, and mean ejection fraction 0.34. Data on all hospital admissions, discharge diagnoses, lengths of stay, and outpatient visits were collected from the National Board of Health and Welfare. We obtained data of all health care consumption for each individual. After 8-12 years of prospective follow up 72% were dead (median survival 4.6 years). Main drivers of health care expenditure were non-cardiac (40%) and cardiac (29%) hospitalizations, and visits to primary care centres (16%), and hospital outpatient clinics (15%). On average, health care expenditures were € 36,447 per patient during follow up. The average yearly cost per patient was about 5,700€, in contrast to the estimated consumption of primary and hospital care in the general population: € 1,956 in 65-74 year olds and € 2,701 in 75-84 year olds. Poor quality of life (Nottingham Health Profile) was the strongest independent predictor of total health care consumption and costs (pheart failure are at least two-fold higher than in the general population. Quality of life is a strong independent predictor of health care consumption. Copyright © 2012 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  11. ISFAHAN HEALTHY HEART PROGRAM:A COMPREHENSIVE INTEGRATED COMMUNITY-BASED PROGRAM FOR CARDIOVASCULAR DISEASE PREVENTION AND CONTROL. DESIGN, METHODS AND INITIAL EXPERIENCE 2000-2001

    Directory of Open Access Journals (Sweden)

    N MOHAMMADI FARD

    2002-03-01

    Full Text Available Isfahan Healthy Heart Program (IHHP is a five to six year comprehensive integrated community based program for preventing and controlling of cardiovascular diseases (CVD via reducing CVD risk factors and improvement of cardiovascular healthy behavior in target population. IHHP has been started in 1999 and will be last since 2004. Primary survey was done to collect baseline data from interventional (Isfahan and Najafabad Cities and reference (Arak communities. In a multistage sampling method, we select randomly 5 to 10 percent of households in clusters. Then individuals aged equal or higher than 19 years old were selected for entering to survey. In this way, data from 12600 individuals (6300 in interventional counties and 6300 in reference county was collected and stratified due to their living area (urban vs. rural and different age and sex groups. Cardiovascular risk factors (Hypercholesterolemia, Smoking, Hypertension, Diabetes Mellitus, Obesity were investigated by laboratory tests (Lipid profile, FBS, OGTT, physical exam and standard questionnaires, in all ones. Nutritional habits, socioeconomic states, physical activity profiles and other healthy behaviors regarding to cardiovascular disease were assessed by validated questionnaires via interviewing to all individuals. Twelve leads electrocardiogram was done in all persons older than 35 years old. The prevalence of CVDs and distribution of CVD risk factors were estimated in this phase. In the 2nd phase, based on primary survey findings, we arranged a series of teams (worksite, children, women, health personnel, high risk patients, nutrition for planning and implementation of program through interventional community for a 5-year period. Every team has its own target population and objectives and monitors its process during the study. At intervals (annually, some local and small surveys with a random sampling will be conducted to assess and monitor the program and its potency to cope with

  12. Portable Heart Rate Detector Based on Photoplethysmography with Android Programmable Devices for Ubiquitous Health Monitoring System

    Directory of Open Access Journals (Sweden)

    Chi Kin Lao

    2013-01-01

    Full Text Available In this paper, a miniature portable heart rate detector system is implemented by modern hardware ICs and simple sensor circuit with software executable on both PC and Android platform. The biosignal is first extracted via photoplethysmography (PPG principle into electric signal. Then a microprocessor is used to covert biosignal from analog to digital format, suitably for feeding into an RF module (nRF24L01 for RF transmission. On the receiver end, the computer and/or smart phone can analyze the data using a robust algorithm that can detect peaks of the PPG waveform, hence to calculating the heart rate. Some application software running on Windows and Android phone have been developed to display heart rate information and time domain waveform to users for health care monitoring. In the future, pure Bluetooth technology will be used for wireless personal communications instead of RF modules. At the same time, the data can be sent to computer console using existing available networks (3G, 4G, WiFi, etc. for health database logging purpose.

  13. Cardiovascular Health in African Americans: A Scientific Statement From the American Heart Association.

    Science.gov (United States)

    Carnethon, Mercedes R; Pu, Jia; Howard, George; Albert, Michelle A; Anderson, Cheryl A M; Bertoni, Alain G; Mujahid, Mahasin S; Palaniappan, Latha; Taylor, Herman A; Willis, Monte; Yancy, Clyde W

    2017-11-21

    Population-wide reductions in cardiovascular disease incidence and mortality have not been shared equally by African Americans. The burden of cardiovascular disease in the African American community remains high and is a primary cause of disparities in life expectancy between African Americans and whites. The objectives of the present scientific statement are to describe cardiovascular health in African Americans and to highlight unique considerations for disease prevention and management. The primary sources of information were identified with PubMed/Medline and online sources from the Centers for Disease Control and Prevention. The higher prevalence of traditional cardiovascular risk factors (eg, hypertension, diabetes mellitus, obesity, and atherosclerotic cardiovascular risk) underlies the relatively earlier age of onset of cardiovascular diseases among African Americans. Hypertension in particular is highly prevalent among African Americans and contributes directly to the notable disparities in stroke, heart failure, and peripheral artery disease among African Americans. Despite the availability of effective pharmacotherapies and indications for some tailored pharmacotherapies for African Americans (eg, heart failure medications), disease management is less effective among African Americans, yielding higher mortality. Explanations for these persistent disparities in cardiovascular disease are multifactorial and span from the individual level to the social environment. The strategies needed to promote equity in the cardiovascular health of African Americans require input from a broad set of stakeholders, including clinicians and researchers from across multiple disciplines. © 2017 American Heart Association, Inc.

  14. The Practice of Health Program Evaluation.

    Science.gov (United States)

    Lewis, Sarah R

    2017-11-01

    The Practice of Health Program Evaluation provides an overview of the evaluation process for public health programs while diving deeper to address select advanced concepts and techniques. The book unfolds evaluation as a three-phased process consisting of identification of evaluation questions, data collection and analysis, and dissemination of results and recommendations. The text covers research design, sampling methods, as well as quantitative and qualitative approaches. Types of evaluation are also discussed, including economic assessment and systems research as relative newcomers. Aspects critical to conducting a successful evaluation regardless of type or research design are emphasized, such as stakeholder engagement, validity and reliability, and adoption of sound recommendations. The book encourages evaluators to document their approach by developing an evaluation plan, a data analysis plan, and a dissemination plan, in order to help build consensus throughout the process. The evaluative text offers a good bird's-eye view of the evaluation process, while offering guidance for evaluation experts on how to navigate political waters and advocate for their findings to help affect change.

  15. ASTDD Synopses of State Oral Health Programs - Selected indicators

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2011-2017. The ASTDD Synopses of State Oral Health Programs contain information useful in tracking states’ efforts to improve oral health and contributions to...

  16. ASTDD Synopses of State Oral Health Programs - Selected indicators

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2011-2017. The ASTDD Synopses of State Oral Health Programs contain information useful in tracking states’ efforts to improve oral health and contributions to...

  17. The impact of smoking status on the health status of heart failure patients.

    LENUS (Irish Health Repository)

    Conard, Mark W

    2012-02-01

    Smoking is a major risk factor for the development of heart failure (HF). Yet, little is known about smoking\\'s effects on the health status of established HF patients. HF patients were recruited from outpatient clinics across North America. The Kansas City Cardiomyopathy Questionnaire (KCCQ) was used to assess disease-specific health status. Smoking behaviors were classified as never having smoked, prior smoker, and as having smoked within the past 30 days. Risk-adjusted multivariable regression was used to evaluate the association of smoking status with baseline and 1-year KCCQ overall summary scores. Smoking was not associated with baseline health status. However, a significant effect was observed on 1-year health status among outpatients with HF with current smokers reporting significantly lower KCCQ scores than never smokers or ex-smokers. These findings highlight an additional adverse consequence of smoking in HF patients not previously discussed.

  18. Effectiveness and Factors Determining the Success of Management Programs for Patients With Heart Failure: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Oyanguren, Juana; Latorre García, Pedro María; Torcal Laguna, Jesús; Lekuona Goya, Iñaki; Rubio Martín, Susana; Maull Lafuente, Elena; Grandes, Gonzalo

    2016-10-01

    Heart failure management programs reduce hospitalizations. Some studies also show reduced mortality. The determinants of program success are unknown. The aim of the present study was to update our understanding of the reductions in mortality and readmissions produced by these programs, elucidate their components, and identify the factors determining program success. Systematic literature review (1990-2014; PubMed, EMBASE, CINAHL, Cochrane Library) and manual search of relevant journals. The studies were selected by 3 independent reviewers. Methodological quality was evaluated in a blinded manner by an external researcher (Jadad scale). These results were pooled using random effects models. Heterogeneity was evaluated with the I 2 statistic, and its explanatory factors were determined using metaregression analysis. Of the 3914 studies identified, 66 randomized controlled clinical trials were selected (18 countries, 13 535 patients). We determined the relative risks to be 0.88 for death (95% confidence interval [95%CI], 0.81-0.96; P < .002; I 2 , 6.1%), 0.92 for all-cause readmissions (95%CI, 0.86-0.98; P < .011; I 2 , 58.7%), and 0.80 for heart failure readmissions (95%CI, 0.71-0.90; P < .0001; I 2 , 52.7%). Factors associated with program success were implementation after 2001, program location outside the United States, greater baseline use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, a higher number of intervention team members and components, specialized heart failure cardiologists and nurses, protocol-driven education and its assessment, self-monitoring of signs and symptoms, detection of deterioration, flexible diuretic regimen, early care-seeking among patients and prompt health care response, psychosocial intervention, professional coordination, and program duration. We confirm the reductions in mortality and readmissions with heart failure management programs. Their success is associated with various structural and

  19. Referral to a Commercial Weight Management Program in Patients With Coronary Heart Disease: A PILOT STUDY IN THE NETHERLANDS

    NARCIS (Netherlands)

    Minneboo, Madelon; Peters, Ron J. G.; Miller-Kovach, Karen; Lemmens, Jeanine; Bucx, Jeroen J. J.

    2015-01-01

    To quantify the impact of a commercial weight management program on weight change in obese patients with coronary heart disease. An observational, single-center pilot study in the Netherlands. Forty-five patients diagnosed with a recent acute coronary syndrome and a body mass index of >30 kg/m2 were

  20. Cardiovascular Health and Incident Hypertension in Blacks: JHS (The Jackson Heart Study).

    Science.gov (United States)

    Booth, John N; Abdalla, Marwah; Tanner, Rikki M; Diaz, Keith M; Bromfield, Samantha G; Tajeu, Gabriel S; Correa, Adolfo; Sims, Mario; Ogedegbe, Gbenga; Bress, Adam P; Spruill, Tanya M; Shimbo, Daichi; Muntner, Paul

    2017-08-01

    Several modifiable health behaviors and health factors that comprise the Life's Simple 7-a cardiovascular health metric-have been associated with hypertension risk. We determined the association between cardiovascular health and incident hypertension in JHS (the Jackson Heart Study)-a cohort of blacks. We analyzed participants without hypertension or cardiovascular disease at baseline (2000-2004) who attended ≥1 follow-up visit in 2005 to 2008 or 2009 to 2012 (n=1878). Body mass index, physical activity, diet, cigarette smoking, blood pressure (BP), total cholesterol, and fasting glucose were assessed at baseline and categorized as ideal, intermediate, or poor using the American Heart Association's Life's Simple 7 definitions. Incident hypertension was defined at the first visit wherein a participant had systolic BP ≥140 mm Hg, diastolic BP ≥90 mm Hg, or self-reported taking antihypertensive medication. The percentage of participants with ≤1, 2, 3, 4, 5, and 6 ideal Life's Simple 7 components was 6.5%, 22.4%, 34.4%, 25.2%, 10.0%, and 1.4%, respectively. No participants had 7 ideal components. During follow-up (median, 8.0 years), 944 (50.3%) participants developed hypertension, including 81.3% with ≤1 and 11.1% with 6 ideal components. The multivariable-adjusted hazard ratios (95% confidence interval) for incident hypertension comparing participants with 2, 3, 4, 5, and 6 versus ≤1 ideal component were 0.80 (0.61-1.03), 0.58 (0.45-0.74), 0.30 (0.23-0.40), 0.26 (0.18-0.37), and 0.10 (0.03-0.31), respectively ( P trend hypertension risk. © 2017 American Heart Association, Inc.

  1. Assessing the consequences of gestational diabetes mellitus on offspring's cardiovascular health: MySweetHeart Cohort study protocol, Switzerland.

    Science.gov (United States)

    Di Bernardo, Stefano; Mivelaz, Yvan; Epure, Adina Mihaela; Vial, Yvan; Simeoni, Umberto; Bovet, Pascal; Estoppey Younes, Sandrine; Chiolero, Arnaud; Sekarski, Nicole

    2017-11-14

    Gestational diabetes mellitus (GDM) is a state of glucose intolerance with onset during pregnancy. GDM carries prenatal and perinatal risks as well as long-term risks for the mother and her child. GDM may be involved in the foetal programming of long-term cardiovascular health. However, evidence is sparse and the effect of GDM on cardiovascular health is unknown. To address these issues, we will conduct MySweetHeart Cohort study. The objectives are to assess the effect of GDM on offspring's cardiovascular health early in life by using surrogate markers of cardiovascular disease and atherosclerosis. This is a cohort study of 100 offspring of women with GDM and 100 offspring of women without GDM. At inclusion, a baseline assessment of the mothers will be conducted through means of self-report questionnaires, a researcher-administrated interview, blood pressure and anthropometric measurements, and a maternal blood sampling. Between the 30th and 34th weeks of gestation, a foetal echography will be performed to assess the foetal cardiac structure and function, the fetomaternal circulation and the hepatic volume. At birth, maternal and neonatal characteristics will be assessed. An echocardiography will be performed to assess cardiac structure and function 2-7 days after birth; carotid intima-media thickness will be also measured to assess vascular structure. MySweetHeart Cohort is linked to MySweetHeart Trial (clinicaltrials.gov/ct2/show/NCT02890693), a randomised controlled trial assessing the effect of a multidimensional interdisciplinary lifestyle and psychosocial intervention to improve the cardiometabolic and mental health of women with GDM and their offspring. A long-term follow-up of children is planned. Ethical approval has been obtained through the state Human Research Ethics Committee of the Canton de Vaud (study number 2016-00745). We aim to disseminate the findings through regional, national and international conferences and through peer-reviewed journals

  2. Attitudes of heart failure patients and health care providers towards mobile phone-based remote monitoring.

    Science.gov (United States)

    Seto, Emily; Leonard, Kevin J; Masino, Caterina; Cafazzo, Joseph A; Barnsley, Jan; Ross, Heather J

    2010-11-29

    Mobile phone-based remote patient monitoring systems have been proposed for heart failure management because they are relatively inexpensive and enable patients to be monitored anywhere. However, little is known about whether patients and their health care providers are willing and able to use this technology. The objective of our study was to assess the attitudes of heart failure patients and their health care providers from a heart function clinic in a large urban teaching hospital toward the use of mobile phone-based remote monitoring. A questionnaire regarding attitudes toward home monitoring and technology was administered to 100 heart failure patients (94/100 returned a completed questionnaire). Semi-structured interviews were also conducted with 20 heart failure patients and 16 clinicians to determine the perceived benefits and barriers to using mobile phone-based remote monitoring, as well as their willingness and ability to use the technology. The survey results indicated that the patients were very comfortable using mobile phones (mean rating 4.5, SD 0.6, on a five-point Likert scale), even more so than with using computers (mean 4.1, SD 1.1). The difference in comfort level between mobile phones and computers was statistically significant (Pmobile phones to view health information (mean 4.4, SD 0.9). Patients and clinicians were willing to use the system as long as several conditions were met, including providing a system that was easy to use with clear tangible benefits, maintaining good patient-provider communication, and not increasing clinical workload. Clinicians cited several barriers to implementation of such a system, including lack of remuneration for telephone interactions with patients and medicolegal implications. Patients and clinicians want to use mobile phone-based remote monitoring and believe that they would be able to use the technology. However, they have several reservations, such as potential increased clinical workload, medicolegal

  3. Aldosterone Inhibits the Fetal Program and Increases Hypertrophy in the Heart of Hypertensive Mice

    Science.gov (United States)

    Azibani, Feriel; Devaux, Yvan; Coutance, Guillaume; Schlossarek, Saskia; Polidano, Evelyne; Fazal, Loubina; Merval, Regine; Carrier, Lucie; Solal, Alain Cohen; Chatziantoniou, Christos; Launay, Jean-Marie; Samuel, Jane-Lise; Delcayre, Claude

    2012-01-01

    Background Arterial hypertension (AH) induces cardiac hypertrophy and reactivation of “fetal” gene expression. In rodent heart, alpha-Myosin Heavy Chain (MyHC) and its micro-RNA miR-208a regulate the expression of beta-MyHC and of its intronic miR-208b. However, the role of aldosterone in these processes remains unclear. Methodology/Principal Findings RT-PCR and western-blot were used to investigate the genes modulated by arterial hypertension and cardiac hyperaldosteronism. We developed a model of double-transgenic mice (AS-Ren) with cardiac hyperaldosteronism (AS mice) and systemic hypertension (Ren). AS-Ren mice had increased (x2) angiotensin II in plasma and increased (x2) aldosterone in heart. Ren and AS-Ren mice had a robust and similar hypertension (+70%) versus their controls. Anatomical data and echocardiography showed a worsening of cardiac hypertrophy (+41%) in AS-Ren mice (P<0.05 vs Ren). The increase of ANP (x 2.5; P<0.01) mRNA observed in Ren mice was blunted in AS-Ren mice. This non-induction of antitrophic natriuretic peptides may be involved in the higher trophic cardiac response in AS-Ren mice, as indicated by the markedly reduced cardiac hypertrophy in ANP-infused AS-Ren mice for one month. Besides, the AH-induced increase of ßMyHC and its intronic miRNA-208b was prevented in AS-Ren. The inhibition of miR 208a (−75%, p<0.001) in AS-Ren mice compared to AS was associated with increased Sox 6 mRNA (x 1.34; p<0.05), an inhibitor of ßMyHC transcription. Eplerenone prevented all aldosterone-dependent effects. Conclusions/Significance Our results indicate that increased aldosterone in heart inhibits the induction of atrial natriuretic peptide expression, via the mineralocorticoid receptor. This worsens cardiac hypertrophy without changing blood pressure. Moreover, this work reveals an original aldosterone-dependent inhibition of miR-208a in hypertension, resulting in the inhibition of β-myosin heavy chain expression through the induction of

  4. Aldosterone inhibits the fetal program and increases hypertrophy in the heart of hypertensive mice.

    Directory of Open Access Journals (Sweden)

    Feriel Azibani

    Full Text Available BACKGROUND: Arterial hypertension (AH induces cardiac hypertrophy and reactivation of "fetal" gene expression. In rodent heart, alpha-Myosin Heavy Chain (MyHC and its micro-RNA miR-208a regulate the expression of beta-MyHC and of its intronic miR-208b. However, the role of aldosterone in these processes remains unclear. METHODOLOGY/PRINCIPAL FINDINGS: RT-PCR and western-blot were used to investigate the genes modulated by arterial hypertension and cardiac hyperaldosteronism. We developed a model of double-transgenic mice (AS-Ren with cardiac hyperaldosteronism (AS mice and systemic hypertension (Ren. AS-Ren mice had increased (x2 angiotensin II in plasma and increased (x2 aldosterone in heart. Ren and AS-Ren mice had a robust and similar hypertension (+70% versus their controls. Anatomical data and echocardiography showed a worsening of cardiac hypertrophy (+41% in AS-Ren mice (P<0.05 vs Ren. The increase of ANP (x 2.5; P<0.01 mRNA observed in Ren mice was blunted in AS-Ren mice. This non-induction of antitrophic natriuretic peptides may be involved in the higher trophic cardiac response in AS-Ren mice, as indicated by the markedly reduced cardiac hypertrophy in ANP-infused AS-Ren mice for one month. Besides, the AH-induced increase of ßMyHC and its intronic miRNA-208b was prevented in AS-Ren. The inhibition of miR 208a (-75%, p<0.001 in AS-Ren mice compared to AS was associated with increased Sox 6 mRNA (x 1.34; p<0.05, an inhibitor of ßMyHC transcription. Eplerenone prevented all aldosterone-dependent effects. CONCLUSIONS/SIGNIFICANCE: Our results indicate that increased aldosterone in heart inhibits the induction of atrial natriuretic peptide expression, via the mineralocorticoid receptor. This worsens cardiac hypertrophy without changing blood pressure. Moreover, this work reveals an original aldosterone-dependent inhibition of miR-208a in hypertension, resulting in the inhibition of β-myosin heavy chain expression through the induction

  5. Application of Transformational Leadership Principles in the Development and Integration of Palliative Care Within an Advanced Heart Failure Program.

    Science.gov (United States)

    George, Susan; Leasure, A Renee

    2016-01-01

    Heart failure (HF) is a major health problem in United States, and it has reached epidemic proportions. Heart failure is associated with significant morbidity, mortality, and cost. Although the prognosis of HF is worse than many forms of cancer, many patients, families, and clinicians are unaware of the dire prognosis. As the disease progress to advanced HF, patients are faced with many challenges, such as poor quality of life due to worsening symptoms and frequent hospitalizations. Heart failure management adds significant financial burden to the health care system. Palliative care can be integrated into HF care to improve quality of life and symptom management and to address physical, spiritual, and psychosocial needs of patients and families. Palliative care can be used concurrently with or independent of curative or life-prolonging HF therapies. Transformational leadership principles were used to guide the development of a plan to enhance integration of palliative care within traditional advanced HF care.

  6. Give your heart a workout

    Science.gov (United States)

    ... to your health care provider before starting an exercise program. The Benefits of Exercise Exercise helps your heart in several ways. Burns ... A.M. Editorial team. Related MedlinePlus Health Topics Benefits of Exercise Exercise and Physical Fitness How to Lower Cholesterol ...

  7. The direct health-care burden of valvular heart disease: evidence from US national survey data

    Directory of Open Access Journals (Sweden)

    Moore M

    2016-10-01

    Full Text Available Matt Moore,1 Jie Chen,2 Peter J Mallow,3 John A Rizzo4 1Global Health Economic Strategy, Edwards Lifesciences Inc, Irvine, CA, 2Department of Health Services and Administration, University of Maryland, College Park, MD, 3Health Economics and Outcomes Research, CTI Clinical Trial & Consulting Services Inc, Cincinnati, OH, 4Department of Preventive Medicine and Economics, Stony Brook University, Stony Brook, NY, USA Purpose: This study quantified the overall effects of aortic valve disease (AVD and mitral valve disease (MVD by disease severity on direct health-care costs to insurers and patients.Materials and methods: Based on 1996–2011 data from the Medical Expenditure Panel Survey (MEPS, a large, nationally representative US database, multivariate analyses were performed to assess the relationship between AVD and MVD and direct annual health-care costs to insurers and patients, at individual and US-aggregate levels. Adults aged 18 years and over with diagnosis codes for AVD or MVD based on International Classification of Diseases (ninth revision diagnosis codes were identified. Subjects were further classified as symptomatic AVD, asymptomatic AVD, symptomatic MVD, and asymptomatic MVD. These classifications were determined with clinical assistance and based in part on data availability in the MEPS.Results: The MEPS database included 148 patients with AVD: 53 patients with symptomatic AVD, 95 patients with asymptomatic AVD, and 1,051 with MVD, including 315 patients with symptomatic MVD and 736 patients with asymptomatic MVD. Symptomatic AVD had the largest incremental effect on annual per patient health-care expenditure: $12,789 for symptomatic AVD, $10,816 for asymptomatic AVD, $5,163 for symptomatic MVD, and $1,755 for asymptomatic MVD. When aggregated to the US population, heart-valve disease accounted for an incremental annual cost of $23.4 billion. The largest aggregate annual costs were incurred by patients with symptomatic MVD ($7

  8. Factors associated with health-related quality of life in stable ambulatory congestive heart failure patients: Systematic review.

    Science.gov (United States)

    Baert, Anneleen; De Smedt, Delphine; De Sutter, Johan; De Bacquer, Dirk; Puddu, Paolo Emilio; Clays, Els; Pardaens, Sofie

    2018-03-01

    Background Since improved treatment of congestive heart failure has resulted in decreased mortality and hospitalisation rates, increasing self-perceived health-related quality of life (HRQoL) has become a major goal of congestive heart failure treatment. However, an overview on predictieve factors of HRQoL is currently lacking in literature. Purpose The aim of this study was to identify key factors associated with HRQoL in stable ambulatory patients with congestive heart failure. Methods A systematic review was performed. MEDLINE, Web of Science and Embase were searched for the following combination of terms: heart failure, quality of life, health perception or functional status between the period 2000 and February 2017. Literature screening was done by two independent reviewers. Results Thirty-five studies out of 8374 titles were included for quality appraisal, of which 29 were selected for further data extraction. Four distinct categories grouping different types of variables were identified: socio-demographic characteristics, clinical characteristics, health and health behaviour, and care provider characteristics. Within the above-mentioned categories the presence of depressive symptoms was most consistently related to a worse HRQoL, followed by a higher New York Heart Association functional class, younger age and female gender. Conclusion Through a systematic literature search, factors associated with HRQoL among congestive heart failure patients were investigated. Age, gender, New York Heart Association functional class and depressive symptoms are the most consistent variables explaining the variance in HRQoL in patients with congestive heart failure. These findings are partly in line with previous research on predictors for hard endpoints in patients with congestive heart failure.

  9. Effect of an office worksite-based yoga program on heart rate variability: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Chang Dennis

    2011-07-01

    Full Text Available Abstract Background Chronic work-related stress is a significant and independent risk factor for cardiovascular and metabolic diseases and associated mortality, particularly when compounded by a sedentary work environment. Heart rate variability (HRV provides an estimate of parasympathetic and sympathetic autonomic control, and can serve as a marker of physiological stress. Hatha yoga is a physically demanding practice that can help to reduce stress; however, time constraints incurred by work and family life may limit participation. The purpose of the present study is to determine if a 10-week, worksite-based yoga program delivered during lunch hour can improve resting HRV and related physical and psychological parameters in sedentary office workers. Methods and design This is a parallel-arm RCT that will compare the outcomes of participants assigned to the experimental treatment group (yoga to those assigned to a no-treatment control group. Participants randomized to the experimental condition will engage in a 10-week yoga program delivered at their place of work. The yoga sessions will be group-based, prescribed three times per week during lunch hour, and will be led by an experienced yoga instructor. The program will involve teaching beginner students safely and progressively over 10 weeks a yoga sequence that incorporates asanas (poses and postures, vinyasa (exercises, pranayama (breathing control and meditation. The primary outcome of this study is the high frequency (HF spectral power component of HRV (measured in absolute units; i.e. ms2, a measure of parasympathetic autonomic control. Secondary outcomes include additional frequency and time domains of HRV, and measures of physical functioning and psychological health status. Measures will be collected prior to and following the intervention period, and at 6 months follow-up to determine the effect of intervention withdrawal. Discussion This study will determine the effect of worksite

  10. Disclosing Genetic Risk for Coronary Heart Disease: Attitudes Toward Personal Information in Health Records.

    Science.gov (United States)

    Brown, Sherry-Ann; Jouni, Hayan; Marroush, Tariq S; Kullo, Iftikhar J

    2017-04-01

    Incorporating genetic risk information in electronic health records (EHRs) will facilitate implementation of genomic medicine in clinical practice. However, little is known about patients' attitudes toward incorporation of genetic risk information as a component of personal health information in EHRs. This study investigated whether disclosure of a genetic risk score (GRS) for coronary heart disease influences attitudes toward incorporation of personal health information including genetic risk in EHRs. Participants aged 45-65 years with intermediate 10-year coronary heart disease risk were randomized to receive a conventional risk score (CRS) alone or with a GRS from a genetic counselor, followed by shared decision making with a physician using the same standard presentation and information templates for all study participants. The CRS and GRS were then incorporated into the EHR and made accessible to both patients and physicians. Baseline and post-disclosure surveys were completed to assess whether attitudes differed by GRS disclosure. Data were collected from 2013 to 2015 and analyzed in 2015-2016. GRS and CRS participants reported similar positive attitudes toward incorporation of genetic risk information in the EHR. Compared with CRS participants, participants with high GRS were more concerned about the confidentiality of genetic risk information (OR=3.67, 95% CI=1.29, 12.32, p=0.01). Post-disclosure, frequency of patient portal access was associated with positive attitudes. Participants in this study of coronary heart disease risk disclosure overall had positive attitudes toward incorporation of genetic risk information in EHRs, although those who received genetic risk information had concerns about confidentiality. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  11. Knowledge of parents about oral health in children with heart diseases

    Directory of Open Access Journals (Sweden)

    Homa Noorollahian

    2010-09-01

    Full Text Available Background: Transient bacteremia in dentistry is discussed as an important causative factor in bacterial endocarditis. The aim of this study was evaluate the knowledge of importance of dental caries prevention in parents whose children had heart disease. Materials and Method: In this descriptive cross sectional study a simple consecutive sampling was used and 320 parents (125 fathers, 195 mothers referred to the heart clinics of Zahedan were evaluated by a questionnaire. Questions were about the demographic information and their knowledge about oral health and it's relation to heart diseases. Data were analyzed using Mann-Whitney U and Kruskal-Wallis tests.Results: The results showed that the mean of their knowledge was 21.3±10.1 of 100. The father's knowledge (24.4±8.7 was higher compared to the mothers (19.23±10.3. The knowledge rural families were more than the urban families (22.5±9.8 and 14.51±9.1 respectively. Conclusion: Our findings showed limited knowledge of the parents about the interactions between oral hygiene and the risk bacterial endocarditis

  12. Profitability of our lung retrieval program from non heart beating donors.

    Science.gov (United States)

    Fernández, Elena; Calatayud, Joaquín; Jarabo, José Ramón; Hernando, Florentino; Rodríguez, Olga; Gómez, Ana María; Soria, Ana; Del Río, Francisco

    2009-02-01

    In 2002 the first lung transplant from non heart beating (NHB) donors took place in Madrid. The objective of this study was to analyse our Maastricht type I NHB lung donors retrieval program and to check out its profitability. Based on the NHB lung donors retrieval program carried out at Hospital Clínico San Carlos (Madrid) in association with Hospital Puerta de Hierro (Madrid), all lung donors from the beginning of the program from June 2002 to December 2006 have been analysed. When faced with a case of sudden death, advanced life support manoeuvres are initiated before 15 min. If the patient meets a given set of criteria, code 0/9 is activated. Arrival time to the hospital cannot exceed 90 min. Femoral artery and vein are cannulated, extracorporeal circulation is started and lungs are preserved. After the relatives' and judicial authorisation lungs are retrieved. Out of a total of 322 occurrences of code 0/9, 43 lung retrievals and 25 implants were reported. A total of 95% of donors were male, with an average age of 41 years and 91% with blood group A or O. 2004 saw the highest number of retrievals (14). January, May and December showed the highest number of retrievals. Incidence of sudden deaths was higher from 7 to 10 a.m. and from 7 to 10 p.m. Twenty-three implants at Hospital Puerta de Hierro and three more at Hospital Marqués de Valdecilla (Santander) were reported. A considerable amount of preserved lungs, valid for transplant, were not retrieved because of a lack of an appropriate recipient at the time. A total of 58.1% of preserved lungs were implanted. The ratio of obtained lungs was 11.4% of actual donors and 7.7% of total occurrences. However, this percentage could have been higher if we take into account the number of valid lungs that were not transplanted because of the lack of recipients.

  13. What can a pilot congestive heart failure disease management program tell us about likely return on investment?: A case study from a program offered to federal employees.

    Science.gov (United States)

    vanVonno, Catherine J; Ozminkowski, Ronald J; Smith, Mark W; Thomas, Eileen G; Kelley, Doniece; Goetzel, Ron; Berg, Gregory D; Jain, Susheel K; Walker, David R

    2005-12-01

    In 1999, the Blue Cross and Blue Shield Federal Employee Program (FEP) implemented a pilot disease management program to manage congestive heart failure (CHF) among members. The purpose of this project was to estimate the financial return on investment in the pilot CHF program, prior to a full program rollout. A cohort of 457 participants from the state of Maryland was matched to a cohort of 803 nonparticipants from a neighboring state where the CHF program was not offered. Each cohort was followed for 12 months before the program began and 12 months afterward. The outcome measures of primary interest were the differences over time in medical care expenditures paid by FEP and by all payers. Independent variables included indicators of program participation, type of heart disease, comorbidity measures, and demographics. From the perspective of the funding organization (FEP), the estimated return on investment for the pilot CHF disease management program was a savings of $1.08 in medical expenditure for every dollar spent on the program. Adding savings to other payers as well, the return on investment was a savings of $1.15 in medical expenditures per dollar spent on the program. The amount of savings depended upon CHF risk levels. The value of a pilot initiative and evaluation is that lessons for larger-scale efforts can be learned prior to full-scale rollout.

  14. Long-Term Body Weight Maintenance among StrongWomen–Healthy Hearts Program Participants

    Directory of Open Access Journals (Sweden)

    Rebecca A. Seguin

    2017-01-01

    Full Text Available Background. The repeated loss and regain of body weight, referred to as weight cycling, may be associated with negative health complications. Given today’s obesity epidemic and related interventions to address obesity, it is increasingly important to understand contexts and factors associated with weight loss maintenance. This study examined BMI among individuals who had previously participated in a 12-week, evidence-based, nationally disseminated nutrition and physical activity program designed for overweight and obese middle-aged and older women. Methods. Data were collected using follow-up surveys. Complete height and weight data were available for baseline, 12-week program completion (post-program and follow-up (approximately 3 years later for 154 women (response rate = 27.5%; BMI characteristics did not differ between responders and nonresponders. Results. Mean BMI decreased significantly from baseline to post-program (−0.5, P<0.001 and post-program to follow-up (−0.7, P<0.001. Seventy-five percent of survey respondents maintained or decreased BMI post-program to follow-up. Self-efficacy and social support for healthy eating behaviors (but not physical activity were associated with BMI maintenance or additional weight loss. Conclusions. These findings support the durability of weight loss following participation in a relatively short-term intervention.

  15. OSHA Training Programs. Module SH-48. Safety and Health.

    Science.gov (United States)

    Center for Occupational Research and Development, Inc., Waco, TX.

    This student module on OSHA (Occupational Safety and Health Act) training programs is one of 50 modules concerned with job safety and health. This module provides a list of OSHA training requirements and describes OSHA training programs and other safety organizations' programs. Following the introduction, 11 objectives (each keyed to a page in the…

  16. Programed Instruction in Health Education and Physical Education.

    Science.gov (United States)

    Mayshark, Cyrus; Evaul, Thomas W.

    This book contains eight chapters by several different authors, most of them professors of health or physical education. Focus is on applications and implications of programed instruction for professionals in the health and physical education fields. "Overview of Programed Instruction" defines programing, its development and implications for…

  17. Health-related fitness profiles in adolescents with complex congenital heart disease

    DEFF Research Database (Denmark)

    Klausen, Susanne Hwiid; Wetterslev, Jørn; Søndergaard, Lars

    2015-01-01

    PURPOSE: This study investigates whether subgroups of different health-related fitness (HrF) profiles exist among girls and boys with complex congenital heart disease (ConHD) and how these are associated with lifestyle behaviors. METHODS: We measured the cardiorespiratory fitness, muscle strength...... in the Robust clusters reported leading a physically active lifestyle and participants in the Less robust cluster reported leading a sedentary lifestyle. Diagnoses were evenly distributed between clusters. CONCLUSIONS: The cluster analysis attributed some of the variability in cardiorespiratory fitness among...

  18. Assessing responsiveness of generic and specific health related quality of life measures in heart failure

    Directory of Open Access Journals (Sweden)

    Johnson Jeffrey A

    2006-11-01

    Full Text Available Abstract Background Responsiveness, or sensitivity to clinical change, is an important consideration in selection of a health-related quality of life (HRQL measure for trials or clinical applications. Many approaches can be used to assess responsiveness, which may affect the interpretation of study results. We compared the relative responsiveness of generic and heart failure specific HRQL instruments, as measured both by common psychometric indices and by external clinical criteria. Methods We analyzed data collected at baseline and 6-weeks in 298 subjects with heart failure on the following HRQL measures: EQ-5D (US, UK, and VAS Scoring, Kansas City Cardiomyopathy Questionnaire (KCCQ (Clinical and Overall Summary Score, and RAND12 (Physical and Mental Component Summaries. Three external indicators of clinical change were used to classify subjects as improved, deteriorated, or unchanged: 6-minute walk test, New York Heart Association (NYHA class, and physician global rating of change. Four responsiveness statistics (T-test, effect size, Guyatt's responsiveness statistic, and standardized response mean were used to evaluate the responsiveness of the select measures. The median rank of each HRQL measure across responsiveness indices and clinical criteria was then determined. Results Average age of subjects was 60 years, 75 percent were male, and had moderate to severe heart failure symptoms. Overall, the KCCQ Summary Scores had the highest relative ranking, irrespective of the responsiveness index or external criterion used. Importantly, we observed that the relative ranking of responsiveness of the generic measures (i.e. EQ-5D, RAND12 was influenced by both the responsive indices and external criterion used. Conclusion The disease specific KCCQ was the most responsive HRQL measure assessing change over a 6-week period, although generic measures provide information for which the KCCQ is not suitable. The responsiveness of generic HRQL measures may

  19. On models of health assistance and the program of family health of the Brazilian Health Department

    Directory of Open Access Journals (Sweden)

    Claudia Hausman Silveira

    2008-08-01

    Full Text Available The article makes reference to the three models that have inspired the construction of the Program of Family Health in Brazil (Cuban, English and Canadian, observing their differences and similarities and comparing them with the Brazilian case. Therefore, an associative line is also constructed between the Only System of Health (SUS and the necessity of a practice which allows the functioning of its lines of direction and organization principles. Thus, we reach the conclusion that the Program of Family Health in Brazil, for its multi professional work proposal in interdisciplinary teams, in accordance with the SUS, can help keep the law of health in the Country. Key-words: SUS; Program of Family Health; Interdisciplinary; Medical care model; Sanitary practice

  20. Facilitators of and Barriers to mHealth Adoption in Older Adults With Heart Failure.

    Science.gov (United States)

    Cajita, Maan Isabella; Hodgson, Nancy A; Lam, Katherine Wai; Yoo, Sera; Han, Hae-Ra

    2018-05-04

    The purpose of this descriptive, exploratory study was to assess the perceptions of older adults with heart failure regarding the use of mobile technology and to identify potential facilitators of and barriers to mHealth adoption. Semistructured interviews were used to collect data. Transcripts were analyzed using qualitative content analysis. The findings indicated that older adults do not base their intention to use mHealth solely on perceived ease of use and perceived usefulness, as outlined in the Technology Acceptance Model. The following themes emerged from the content analysis: facilitators included previous experience with mobile technology, willingness to learn mHealth, ease of use, presence of useful features, adequate training, free equipment, and doctor's recommendation; barriers included lack of knowledge regarding how to use mHealth, decreased sensory perception, lack of need for technology, poorly designed interface, cost of technology, and limited/fixed income. Overall, the findings suggest that older adults are willing to use mobile health technology, albeit with reservations. Future researchers who seek to implement mHealth-based interventions should address person-related, technology-related, and contextual barriers, and simultaneously capitalize on the influence of potential facilitators, such as a physician's recommendation, to promote mHealth adoption.

  1. 78 FR 6275 - Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in...

    Science.gov (United States)

    2013-01-30

    ... Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative...'s Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 430...

  2. Wellness Programs: Preventive Medicine to Reduce Health Care Costs.

    Science.gov (United States)

    Martini, Gilbert R., Jr.

    1991-01-01

    A wellness program is a formalized approach to preventive health care that can positively affect employee lifestyle and reduce future health-care costs. Describes programs for health education, smoking cessation, early detection, employee assistance, and fitness, citing industry success figures. (eight references) (MLF)

  3. Case management to reduce cardiovascular disease risk in American Indians and Alaska Natives with diabetes: results from the Special Diabetes Program for Indians Healthy Heart Demonstration Project.

    Science.gov (United States)

    Moore, Kelly; Jiang, Luohua; Manson, Spero M; Beals, Janette; Henderson, William; Pratte, Katherine; Acton, Kelly J; Roubideaux, Yvette

    2014-11-01

    We evaluated cardiovascular disease (CVD) risk factors in American Indians/Alaska Natives (AI/ANs) with diabetes in the Special Diabetes Program for Indians Healthy Heart (SDPI-HH) Demonstration Project. Multidisciplinary teams implemented an intensive case management intervention among 30 health care programs serving 138 tribes. The project recruited 3373 participants, with and without current CVD, between 2006 and 2009. We examined data collected at baseline and 1 year later to determine whether improvements occurred in CVD risk factors and in Framingham coronary heart disease (CHD) risk scores, aspirin use, and smoking status. A1c levels decreased an average of 0.2% (P risk scores also decreased significantly. Aspirin therapy increased significantly, and smoking decreased. Participants with more case management visits had significantly greater reductions in LDL cholesterol and A1c values. SDPI-HH successfully translated an intensive case management intervention. Creative retention strategies and an improved understanding of organizational challenges are needed for future Indian health translational efforts.

  4. Heart Disease and Stroke Statistics

    Science.gov (United States)

    ... Media for Heart.org Heart and Stroke Association Statistics Each year, the American Heart Association, in conjunction ... health and disease in the population. Heart & Stroke Statistics FAQs What is Prevalence? Prevalence is an estimate ...

  5. Family support programs and adolescent mental health: review of evidence

    Directory of Open Access Journals (Sweden)

    Kuhn ES

    2014-07-01

    Full Text Available Emily S Kuhn, Robert D Laird Department of Psychology, University of New Orleans, New Orleans, LA, USA Abstract: Family support programs aim to improve parent wellbeing and parenting as well as adolescent mental and behavioral health by addressing the needs of parents of adolescents experiencing or at risk for mental health problems. Family support programs can be part of the treatment for adolescents diagnosed with mental or behavioral health problems, or family support programs can be delivered as prevention programs designed to prevent the onset or escalation of mental or behavioral health problems. This review discusses the rationale for family support programs and describes the range of services provided by family support programs. The primary focus of the review is on evaluating the effectiveness of family support programs as treatments or prevention efforts delivered by clinicians or peers. Two main themes emerged from the review. First, family support programs that included more forms of support evidenced higher levels of effectiveness than family support programs that provided fewer forms of support. Discussion of this theme focuses on individual differences in client needs and program adaptions that may facilitate meeting diverse needs. Second, family support prevention programs appear to be most effective when serving individuals more in need of mental and behavioral health services. Discussion of this theme focuses on the intensity versus breadth of the services provided in prevention programs. More rigorous evaluations of family support programs are needed, especially for peer-delivered family support treatments. Keywords: intervention, parent, mental and behavioral health

  6. Prescribing and up-titration in recently hospitalized heart failure patients attending a disease management program.

    Science.gov (United States)

    Carroll, Robert; Mudge, Alison; Suna, Jessica; Denaro, Charles; Atherton, John

    2016-08-01

    Heart failure (HF) medications improve clinical outcomes, with optimal doses defined in clinical trials. Patient, provider and system barriers may limit achievement of optimal doses in real life settings, although disease management programs (HF-DMPs) can facilitate up-titration. Secondary analysis of a prospective cohort of 216 participants recently hospitalized with systolic HF, attending 5 HF-DMPs in Queensland, Australia. Medication history at baseline (6weeks after discharge) and 6months provided data to describe prescription rates, dosage and optimal titration of HF medications, and associations with patient and system factors were explored. At baseline, 94% were on an angiotensin converting enzyme inhibitor/angiotensin II receptor blocker (ACEI/ARB), 94% on a beta-blocker (BB) and 42% on a mineralocorticoid receptor antagonist (MRA). The proportion of participants on optimal doses of ACEI/ARB increased from 38% (baseline) to 52% (6months, p=0.001) and on optimal BB dose from 23% to 49% (ptitration were body mass index (BMI)titration were BMItitration in HF DMPs is influenced by patient, disease and service factors. Better understanding of barriers to effective up-titration in women, normal weight, and established HF patients may help provide targeted strategies for improving outcomes in these groups. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. A trial-based economic evaluation of 2 nurse-led disease management programs in heart failure.

    Science.gov (United States)

    Postmus, Douwe; Pari, Anees A Abdul; Jaarsma, Tiny; Luttik, Marie Louise; van Veldhuisen, Dirk J; Hillege, Hans L; Buskens, Erik

    2011-12-01

    Although previously conducted meta-analyses suggest that nurse-led disease management programs in heart failure (HF) can improve patient outcomes, uncertainty regarding the cost-effectiveness of such programs remains. To compare the relative merits of 2 variants of a nurse-led disease management program (basic or intensive support by a nurse specialized in the management of patients with HF) against care as usual (routine follow-up by a cardiologist), a trial-based economic evaluation was conducted alongside the COACH study. In terms of costs per life-year, basic support was found to dominate care as usual, whereas the incremental cost-effectiveness ratio between intensive support and basic support was found to be equal to €532,762 per life-year; in terms of costs per quality-adjusted life-year (QALY), basic support was found to dominate both care as usual and intensive support. An assessment of the uncertainty surrounding these findings showed that, at a threshold value of €20,000 per life-year/€20,000 per QALY, basic support was found to have a probability of 69/62% of being optimal against 17/30% and 14/8% for care as usual and intensive support, respectively. The results of our subgroup analysis suggest that a stratified approach based on offering basic support to patients with mild to moderate HF and intensive support to patients with severe HF would be optimal if the willingness-to-pay threshold exceeds €45,345 per life-year/€59,289 per QALY. Although the differences in costs and effects among the 3 study groups were not statistically significant, from a decision-making perspective, basic support still had a relatively large probability of generating the highest health outcomes at the lowest costs. Our results also substantiated that a stratified approach based on offering basic support to patients with mild to moderate HF and intensive support to patients with severe HF could further improve health outcomes at slightly higher costs. Copyright

  8. Effects of self-management intervention on health outcomes of patients with heart failure: a systematic review of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Holroyd-Leduc Jayna M

    2006-11-01

    Full Text Available Abstract Background Heart failure is the most common cause of hospitalization among adults over 65. Over 60% of patients die within 10 years of first onset of symptoms. The objective of this study is to determine the effectiveness of self-management interventions on hospital readmission rates, mortality, and health-related quality of life in patients diagnosed with heart failure. Methods The study is a systematic review of randomized controlled trials. The following data sources were used: MEDLINE (1966-11/2005, EMBASE (1980-11/2005, CINAHL (1982-11/2005, the ACP Journal Club database (to 11/2005, the Cochrane Central Trial Registry and the Cochrane Database of Systematic Reviews (to 11/2005; article reference lists; and experts in the field. We included randomized controlled trials of self-management interventions that enrolled patients 18 years of age or older who were diagnosed with heart failure. The primary outcomes of interest were all-cause hospital readmissions, hospital readmissions due to heart failure, and mortality. Secondary outcomes were compliance with treatment and quality of life scores. Three reviewers independently assessed the quality of each study and abstracted the results. For each included study, we computed the pooled odds ratios (OR for all-cause hospital readmission, hospital readmission due to heart failure, and death. We used a fixed effects model to quantitatively synthesize results. We were not able to pool effects on health-related quality of life and measures of compliance with treatment, but we summarized the findings from the relevant studies. We also summarized the reported cost savings. Results From 671 citations that were identified, 6 randomized trials with 857 patients were included in the review. Self-management decreased all-cause hospital readmissions (OR 0.59; 95% confidence interval (CI 0.44 to 0.80, P = 0.001 and heart failure readmissions (OR 0.44; 95% CI 0.27 to 0.71, P = 0.001. The effect on

  9. Family support programs and adolescent mental health: review of evidence

    OpenAIRE

    Laird, Robert; Kuhn,Emily

    2014-01-01

    Emily S Kuhn, Robert D Laird Department of Psychology, University of New Orleans, New Orleans, LA, USA Abstract: Family support programs aim to improve parent wellbeing and parenting as well as adolescent mental and behavioral health by addressing the needs of parents of adolescents experiencing or at risk for mental health problems. Family support programs can be part of the treatment for adolescents diagnosed with mental or behavioral health problems, or family support programs can be deli...

  10. Cardiometabolic risks, lifestyle health behaviors and heart disease in Filipino Americans.

    Science.gov (United States)

    Bayog, Maria Lg; Waters, Catherine M

    2017-08-01

    Cardiovascular disease is the leading cause of death among all racial and ethnic populations in the USA. Cardiovascular risks and cardioprotective factors have been disparately estimated among Asian American subpopulations. The study's purpose was to describe the cardiometabolic risks and lifestyle health behaviors associated with cardiovascular disease, considering age and gender, in Filipinos, the second largest Asian American population. Secondary analysis was conducted of behavioral (smoking, walking, body mass index and soda, fast food and fruit/vegetable consumption), cardiometabolic (hypertension and diabetes) and heart disease variables in the 2011-2012 California Health Interview Survey. The metropolitan sample of Filipino American adults included 57.3% women and had a mean age of 47.9 ± 18.3 years ( n = 555). Among the sample, 7.4% had heart disease, 38.9% had hypertension, 16.6% had diabetes, 12.4% smoked cigarettes, 83.2% were insufficiently active, 54.2% were overweight/obese, 21.8% routinely ate fast food, 13.2% routinely drank soda and 90.3% did not meet the fruit/vegetable consumption recommendation. Age (unadjusted odds ratio [OR] = 1.0, p Filipino American population. A multidisciplinary, chronic care model that is population-specific, emphasizes integrated, comprehensive care and provides linkages between primary healthcare and community resources is recommended for practice.

  11. Somatic versus cognitive symptoms of depression as predictors of all-cause mortality and health status in chronic heart failure

    DEFF Research Database (Denmark)

    Schiffer, Angélique A; Pelle, Aline J; Smith, Otto R F

    2009-01-01

    Depression is a predictor of adverse health outcomes in chronic heart failure (CHF), but it is not known whether specific symptoms drive this relationship. We examined the impact of somatic/affective, cognitive/affective, and total depressive symptoms on all-cause mortality and health status in CHF....

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

    DEFF Research Database (Denmark)

    Schiffer, Angélique A; Pedersen, Susanne S.; Widdershoven, Jos W

    2005-01-01

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

  13. Application of a marketing concept to patient-centered care: co-producing health with heart failure patients.

    Science.gov (United States)

    Leone, Robert P; Walker, Charles A; Curry, Linda Cox; Agee, Elizabeth J

    2012-04-03

    Increasing numbers of patients are being treated for heart failure each year. One out of four of the heart failure patients who receives care in a hospital is readmitted to the hospital within 30 days of discharge. Effective discharge instruction is critical to prevent these patient readmissions. Co-production is a marketing concept whereby the customer is a partner in the delivery of a good or service. For example, a patient and nurse may partner to co-produce a patient-centered health regimen to improve patient outcomes. In this article we review the cost of treating heart failure patients and current strategies to decrease hospital readmissions for these patients along with the role of the nurse and the concept of co-producing health as related to heart failure patients. Next we describe our study assessing the degree to which discharge processes were co-produced on two hospital units having a preponderance of heart failure patients, and present our findings indicating minimal evidence of co-production. A discussion of our findings, along with clinical implications of these findings, recommendations for change, and suggestions for future research are offered. We conclude that standardized discharge plans lead to a mindset of 'one size fits all,' a mindset inconsistent with the recent call for patient-centered care. We offer co-production as a patient-centered strategy for customizing discharge teaching and improving health outcomes for heart failure patients.

  14. [Medical and surgical health care for congenital heart disease: a panoramic vision of the reality in Mexico. Inquiry 2009].

    Science.gov (United States)

    Calderón-Colmenero, Juan; De-la-Llata, Manuel; Vizcaíno, Alfredo; Ramírez, Samuel; Bolio, Alejandro

    2011-01-01

    The only way to characterize the Mexican problem related to congenital heart disease care is promoting the creation of a national database for registering the organization, resources, and related activities. The Health Secretary of Mexico adopted a Spanish registration model to design a survey for obtaining a national Mexican reference in congenital heart disease. This survey was distributed to all directors of medical and/or surgical health care centers for congenital heart disease in Mexico. This communication presents the results obtained in relation to organization, resources and activities performed during the last year 2009. From the 22 health care centers which answered the survey 10 were reference centers (45%) and 12 were assistant centers (55%). All of them are provided with cardiologic auxiliary diagnostic methods. Except one, all centers have at least one bidimentional echocardiography apparatus. There is a general deficit between material and human resources detected in our study. Therapeutic actions for congenital heart disease (70% surgical and 30% therapeutical interventionism) show a clear centralization tendency for this kind of health care in Mexico City, Monterrey and finally Guadalajara. Due to the participation of almost all cardiac health centers in Mexico, our study provides an important information related to organization, resources, and medical and/or surgical activities for congenital heart disease. The data presented not only show Mexican reality, but allows us to identify better the national problematic for establishing priorities and propose solution alternatives.

  15. The perceptions of caregivers toward physical activity and health in youth with congenital heart disease.

    Science.gov (United States)

    Moola, Fiona; Fusco, Caroline; Kirsh, Joel A

    2011-02-01

    Medical advances have reduced mortality in youth with congenital heart disease (CHD). Although physical activity is associated with enhanced quality of life, most patients are inactive. By addressing medical and psychological barriers, previous literature has reproduced discourses of individualism which position cardiac youth as personally responsible for physical inactivity. Few sociological investigations have sought to address the influence of social barriers to physical activity, and the insights of caregivers are absent from the literature. In this study, caregiver perceptions toward physical activity for youth with CHD were investigated at a Canadian hospital. Media representations, school liability, and parental overprotection construct cardiac youth as "at risk" during physical activity, and position their health precariously. Indeed, from the perspective of hospital staff, the findings indicate the centrality of sociological factors to the physical activity experiences of youth with CHD, and the importance of attending to the contextual barriers that constrain their health and physical activity.

  16. The partial mediation effect of satisfaction with social support and coping effectiveness on health-related quality of life and perceived stress long-term after heart transplantation

    Directory of Open Access Journals (Sweden)

    White-Williams C

    2014-12-01

    Full Text Available Connie White-Williams,1 Kathleen L Grady,2 Pariya Fazeli,1 Susan Myers,1 Linda Moneyham,3 Karen Meneses,3 Bruce Rybarczyk4 1University of Alabama Medical Center, Birmingham, AL, USA; 2Division of Cardiac Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; 3School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA; 4Department of Psychology, Clinical Psychology Program, Virginia Commonwealth University, Richmond, VA, USA Abstract: The purpose of this research was to examine whether satisfaction with social support and coping effectiveness mediate the relationship between stress and health-related quality of life (HRQOL 5 years after heart transplantation. Data were collected from 212 heart transplant patients (80% male, 92% white, mean age 59.9 years at four United States sites using the Heart Transplant Stressor Scale, Social Support Index, Jalowiec Coping Scale, and Quality of Life Index. Using Baron and Kenny's approach, a series of regression equations for mediation revealed that both satisfaction with social support and coping partially mediated the relationship between perceived stress and HRQOL. Understanding the relationships of social support, stress, and coping on patients' HRQOL is important for the development of interventions to provide optimal patient care. Keywords: heart transplantation, social support, coping, stress, mediation

  17. Health plans' disease management programs: extending across the medical and behavioral health spectrum?

    Science.gov (United States)

    Merrick, Elizabeth Levy; Horgan, Constance M; Garnick, Deborah W; Hodgkin, Dominic; Morley, Melissa

    2008-01-01

    Although the disease management industry has expanded rapidly, there is little nationally representative data regarding medical and behavioral health disease management programs at the health plan level. National estimates from a survey of private health plans indicate that 90% of health plan products offered disease management for general medical conditions such as diabetes but only 37% had depression programs. The frequency of specific depression disease management activities varied widely. Program adoption was significantly related to product type and behavioral health contracting. In health plans, disease management has penetrated more slowly into behavioral health and depression program characteristics are highly variable.

  18. Disease management 360 degrees: a scorecard approach to evaluating TRICARE's programs for asthma, congestive heart failure, and diabetes.

    Science.gov (United States)

    Yang, Wenya; Dall, Timothy M; Zhang, Yiduo; Hogan, Paul F; Arday, David R; Gantt, Cynthia J

    2010-08-01

    To assess the effect of TRICARE's asthma, congestive heart failure, and diabetes disease management programs using a scorecard approach. EVALUATION MEASURES: Patient healthcare utilization, financial, clinical, and humanistic outcomes. Absolute measures were translated into effect size and incorporated into a scorecard. Actual outcomes for program participants were compared with outcomes predicted in the absence of disease management. The predictive equations were established from regression models based on historical control groups (n = 39,217). Z scores were calculated for the humanistic measures obtained through a mailed survey. Administrative records containing medical claims, patient demographics and characteristics, and program participation status were linked using an encrypted patient identifier (n = 57,489). The study time frame is 1 year prior to program inception through 2 years afterward (October 2005-September 2008). A historical control group was identified with the baseline year starting October 2003 and a 1-year follow-up period starting October 2004. A survey was administered to a subset of participants 6 months after baseline assessment (39% response rate). Within the observation window--24 months for asthma and congestive heart failure, and 15 months for the diabetes program--we observed modest reductions in hospital days and healthcare cost for all 3 programs and reductions in emergency visits for 2 programs. Most clinical outcomes moved in the direction anticipated. The scorecard provided a useful tool to track performance of 3 regional contractors for each of 3 diseases and over time.

  19. Factors influencing perceived sustainability of Dutch community health programs

    NARCIS (Netherlands)

    Vermeer, A. J. M.; van Assema, P.; Hesdahl, B.; Harting, J.; de Vries, N. K.

    2015-01-01

    We assessed the perceived sustainability of community health programs organized by local intersectoral coalitions, as well as the factors that collaborating partners think might influence sustainability. Semi-structured interviews were conducted among 31 collaborating partners of 5 community health

  20. Program Spotlight: National Outreach Network's Community Health Educators

    Science.gov (United States)

    National Outreach Network of Community Health Educators located at Community Network Program Centers, Partnerships to Advance Cancer Health Equity, and NCI-designated cancer centers help patients and their families receive survivorship support.

  1. CADIOVASCULAR HEALTH AND INCIDENT HYPERTENSION IN AFRICAN AMERICANS: THE JACKSON HEART STUDY

    Science.gov (United States)

    Booth, John N.; Abdalla, Marwah; Tanner, Rikki M.; Diaz, Keith M.; Bromfield, Samantha G.; Tajeu, Gabriel S.; Correa, Adolfo; Sims, Mario; Ogedegbe, Gbenga; Bress, Adam P.; Spruill, Tanya M.; Shimbo, Daichi; Muntner, Paul

    2018-01-01

    Several modifiable health behaviors and health factors that comprise the Life’s Simple 7, a cardiovascular health metric, have been associated with hypertension risk. We determined the association between cardiovascular health and incident hypertension in the Jackson Heart Study, a cohort of African-Americans. We analyzed participants without hypertension or cardiovascular disease at baseline (2000–2004) who attended ≥1 follow-up visit in 2005–2008 or 2009–2012 (n=1878). Body mass index, physical activity, diet, cigarette smoking, blood pressure, total cholesterol and fasting glucose were assessed at baseline and categorized as ideal, intermediate or poor using the American Heart Association’s Life’s Simple 7 definitions. Incident hypertension was defined at the first visit wherein a participant had systolic blood pressure≥140 mmHg, diastolic blood pressure≥90 mmHg or self-reported taking antihypertensive medication. There percentage of participants with ≤1, 2, 3, 4, 5 and 6 ideal Life’s Simple 7 components was 6.5%, 22.4%, 34.4%, 25.2%, 10.0% and 1.4%, respectively. No participants had 7 ideal components. During follow-up (median: 8.0 years), 944 (50.3%) participants developed hypertension, including 81.3% with ≤1 and 11.1% with 6 ideal components. The multivariable-adjusted hazard ratios (95% confidence interval) for incident hypertension comparing participants with 2, 3, 4, 5 and 6 versus ≤1 ideal component were 0.80 (0.61–1.03), 0.58 (0.45–0.74), 0.30 (0.23–0.40), 0.26 (0.18–0.37) and 0.10 (0.03–0.31), respectively (p-trendhypertension risk. PMID:28652461

  2. Heart Failure: Self-care to Success: Development and evaluation of a program toolkit.

    Science.gov (United States)

    Bryant, Rebecca

    2017-08-17

    The Heart Failure: Self-care to Success toolkit was developed to assist NPs in empowering patients with heart failure (HF) to improve individual self-care behaviors. This article details the evolution of this toolkit for NPs, its effectiveness with patients with HF, and recommendations for future research and dissemination strategies.

  3. Patient Education Leads to Better Care for Heart Patients.

    Science.gov (United States)

    Rosenberg, Stanley G.

    The staff of a heart and circulatory disease program of a State department of health conducted a special project at a city hospital which showed that a well-organized treatment and education program for patients with congestive heart failure increased the patient's knowledge of his disease, medication, and diet as well as his adherence to a…

  4. Consumer health information technology in an adult public health primary care clinic: a heart health education feasibility study.

    Science.gov (United States)

    Gleason-Comstock, Julie A; Streater, Alicia; Jen, Kai-Lin Catherine; Artinian, Nancy T; Timmins, Jessica; Baker, Suzanne; Joshua, Bosede; Paranjpe, Aniruddha

    2013-12-01

    To explore the feasibility and short term outcomes of using an interactive kiosk integrated into office flow to deliver health information in a primary care clinic. Fifty-one adults with BMI ≥25 were randomly assigned to use a kiosk with attached devices to receive a six-week healthy eating/weight monitoring (intervention) or general health/BP monitoring (attention-control) program. Outcomes were measured at baseline, 8 weeks (post) and three month follow-up. Participants completed an average of 2.73 weekly sessions, with transportation and time given as limiting factors. They found the kiosk easy to use (97%), liked the touchscreen (94%), and would use the kiosk again (81%). Although there were no differences between groups, the 27 completing all assessments showed reduced weight (p=.02), and decreased systolic (p=.01) and diastolic BP (pinformation and self-monitoring. Multi-session educational content can provide beneficial short-term outcomes in overweight adults. A kiosk with attached peripherals in a clinic setting is a viable adjunct to provider education, particularly in medically underserved areas. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  5. 78 FR 42788 - School-Based Health Center Program

    Science.gov (United States)

    2013-07-17

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration School-Based... Gadsden County. SUMMARY: HRSA will be transferring a School-Based Health Center Capital (SBHCC) Program... support the expansion of services at school-based health centers will continue. SUPPLEMENTARY INFORMATION...

  6. Healthe Kids: An Assessment of Program Performance and Participation

    Science.gov (United States)

    Dean, Bonnie B.; Kindermann, Sylvia L.; Carson, Tabetha; Gavin, Jan; Frerking, Melissa; Bergren, Martha Dewey

    2014-01-01

    Many states in the United States have mandated school health screenings for early identification and referral to professional services for a set of health conditions. Healthe Kids, a community-based program, began offering school-based health screenings to Missouri elementary schools in March 2007. The purpose of the article is to provide a…

  7. Transitions: A Mental Health Literacy Program for Postsecondary Students

    Science.gov (United States)

    Potvin-Boucher, Jacqueline; Szumilas, Magdalena; Sheikh, Tabinda; Kutcher, Stan

    2010-01-01

    Enhancement of mental health literacy is a mental health promotion strategy that may be effective at destigmatizing mental illness and increasing self-seeking behavior. Transitions is a mental health literacy program intended to heighten students' awareness and discussion of mental health problems and promote help-seeking behaviors. Transitions…

  8. The Association Between Health Program Participation and Employee Retention.

    Science.gov (United States)

    Mitchell, Rebecca J; Ozminkowski, Ronald J; Hartley, Stephen K

    2016-09-01

    Using health plan membership as a proxy for employee retention, the objective of this study was to examine whether use of health promotion programs was associated with employee retention. Propensity score weighted generalized linear regression models were used to estimate the association between telephonic programs or health risk surveys and retention. Analyses were conducted with six study samples based on type of program participation. Retention rates were highest for employees with either telephonic program activity or health risk surveys and lowest for employees who did not participate in any interventions. Participants ranged from 71% more likely to 5% less likely to remain with their employers compared with nonparticipants, depending on the sample used in analyses. Using health promotion programs in combination with health risk surveys may lead to improvements in employee retention.

  9. Financial burdens and mental health needs in families of children with congenital heart disease.

    Science.gov (United States)

    McClung, Nancy; Glidewell, Jill; Farr, Sherry L

    2018-04-06

    To examine the financial burdens and mental health needs of families of children with special healthcare needs (CSHCN) with congenital heart disease (CHD). Data from the 2009-2010 National Survey of Children with Special Health Care Needs (NS-CSHCN) were used to examine parent-reported financial burdens (out-of-pocket expenses, financial problems, employment impact, caregiving hours) and family members' need for mental health services in families of CSHCN with CHD. Multivariable logistic regression was used to compare financial burdens and family members' need for mental health services among CSHCN with and without CHD. Among CSHCN with CHD, multivariable logistic regression, stratified by age (0-5 and 6-17 years), was used to assess characteristics associated with the outcomes. Overall, families of 89.1% of CSHCN with CHD experienced at least one financial burden and 14.9% needed mental health services due to the child's condition. Compared with CSHCN without CHD, those with CHD had families with a higher prevalence of all financial burdens (adjusted prevalence ratio [aPR] range: 1.4-1.8) and similar family member need for mental health services (aPR = 1.3, 95% CI [1.0, 1.6]). Across both age groups, insurance type, activity limitations, and comorbidities were significantly associated with financial burdens and/or family members' need for mental health services. CSHCN with CHD, compared with those without CHD, lived in families with more financial burdens. Interventions that reduce financial burdens and improve mental health of family members are needed, especially among CSHCN with CHD who are uninsured and have comorbidities or activity limitations. © 2018 Wiley Periodicals, Inc.

  10. 78 FR 42159 - Medicaid and Children's Health Insurance Programs: Essential Health Benefits in Alternative...

    Science.gov (United States)

    2013-07-15

    ... and 156 Medicaid and Children's Health Insurance Programs: Essential Health Benefits in Alternative... Secretary 45 CFR Parts 155 and 156 [CMS-2334-F] RIN 0938-AR04 Medicaid and Children's Health Insurance... Medicaid and the Children's Health Insurance Program (CHIP) eligibility notices, delegation of appeals, and...

  11. Exploratory study into awareness of heart disease and health care seeking behavior among Emirati women (UAE) - Cross sectional descriptive study.

    Science.gov (United States)

    Khan, Sarah; Ali, Syed Adnan

    2017-09-26

    Cardiovascular disease was the leading cause of death among women in the United Arab Emirates (UAE) in 2010. Heart attacks usually happen in older women thus symptoms of heart disease may be masked by symptoms of chronic diseases, which could explain the delay in seeking health care and higher mortality following an ischaemic episode among women. This study seeks to a) highlight the awareness of heart diseases among Emirati women and b) to understand Emirati women's health care seeking behaviour in UAE. A cross sectional, descriptive study was conducted using a survey instrument adapted from the American Heart Association National survey. A convenience sample of 676 Emirati women between the ages of 18-55 years completed the questionnaire. The study showed low levels of awareness of heart disease and associated risk factors in Emirati women; only 19.4% participants were found to be aware of heart diseases. Awareness levels were highest in Dubai (OR 2.18, p < 0.05) among all the other emirates and in the 18-45 years age group (OR 2.74, p < 0.05). Despite low awareness levels, women paradoxically perceived themselves to be self-efficacious in seeking health care. Interestingly, just 49.1% Emirati women believed that good quality and affordable health care was available in the UAE. Only 28.8% of the participants believed there were sufficient female doctors to respond to health needs of women in UAE. Furthermore, only 36.7% Emirati women chose to be treated in the UAE over treatment in other countries. Emirati women clearly lack the knowledge on severity and vulnerability to heart disease in the region that is essential to improve cardiovascular related health outcomes. This study has identified the need for wider outreach that focuses on gender and age specific awareness on heart disease risks and symptoms. The study has also highlighted potential modifiable barriers in seeking health care that should be overcome to reduce morbidity and mortality due to heart

  12. Community health events for enrolling uninsured into public health insurance programs: implications for health reform.

    Science.gov (United States)

    Cheng, Scott; Tsai, Kai-ya; Nascimento, Lori M; Cousineau, Michael R

    2014-01-01

    To determine whether enrollment events may serve as a venue to identify eligible individuals, enroll them into health insurance programs, and educate them about the changes the Patient Protection and Affordable Care Act will bring about. More than 2900 surveys were administered to attendees of 7 public health insurance enrollment events in California. Surveys were used to identify whether participants had any change in understanding of health reform after participating in the event. More than half of attendees at nearly all events had no knowledge about health reform before attending the event. On average, more than 80% of attendees knew more about health reform following the event and more than 80% believed that the law would benefit their families. Enrollment events can serve as an effective method to educate the public on health reform. Further research is recommended to explore in greater detail the impact community enrollment events can have on expanding public understanding of health reform.

  13. PLAN Bicol, Philippines: health manpower development program in action.

    Science.gov (United States)

    Lind, K

    1994-06-01

    PLAN Bicol in the Philippines is a community based Health Manpower Development Program (HMDP) geared toward training and mobilization of indigenous health practitioners, providing infrastructural and logistical support to individual families, and educating the community about health, nutrition, and the environment. The field officer recommends at the initiation of a project that program staff have roles that are well defined. New programs should be introduced to the community first and should involve the community in the planning stages. The HMDP program is directed to 38 villages located around national parks that have suffered from deforestation. Community health issues are malnutrition, low immunization, and lack of access to health services. HMDP established a training program for auxiliary health workers (AHWs), who make a commitment to return to their villages after training. Midwives are being trained at local schools. Village houses are being built and repaired; water systems and sanitary toilet facilities are being installed. Village health stations have been constructed and equipped with basic medicines, supplies, and equipment, and are open 5 days a week. Health education classes inform the community about nutrition and health. The problems at inception were the unwillingness of field staff to participate in the program and a high drop out rate among AHWs. Problems were worked out as the program progressed. Facilitative factors are the close coordination with the provincial health office, community acceptance, and the availability of qualified people.

  14. Multimedia Exercise Training Program Improves Distance Walked, Heart Rate Recovery, and Self-efficacy in Cardiac Surgery Patients.

    Science.gov (United States)

    Wang, Li-Wei; Ou, Shu-Hua; Tsai, Chien-Sung; Chang, Yue-Cune; Kao, Chi-Wen

    2016-01-01

    Patient education has been shown to be more effective when delivered using multimedia than written materials. However, the effects of using multimedia to assist patients in cardiac rehabilitation have not been investigated. The purpose of this study is to examine the effect of an inpatient multimedia exercise training program on distance walked in the 6-minute walking test (6MWT), heart rate recovery, and walking self-efficacy of patients who had undergone heart surgery. For this longitudinal quasi-experimental study, 60 consecutive patients were assigned to an experimental (n = 20; inpatient multimedia exercise training program) or control (n = 40; routine care) group. Data were collected at 3 times (before surgery, 1 to 2 days before hospital discharge, and 1 month after hospital discharge) and analyzed with the generalized estimating equation approach. Most subjects were men (66.7%), had a mean age of 61.32 ± 13.4 years and left ventricular ejection fraction of 56.96% ± 13.28%, and underwent coronary artery bypass graft surgery (n = 34, 56.7%). Subjects receiving the exercise training program showed significantly greater improvement than those in the control group in the 6MWT walking distance (P self-efficacy (P = .002) at hospital discharge. Furthermore, the intervention effects on 6MWT distance (P self-efficacy (P exercise training program safely improved distance walked in the 6MWT, heart rate recovery, and self-efficacy at hospital discharge in patients after heart surgery and maintained their improvement in 6MWT and self-efficacy 1 month later.

  15. Coping Styles Mediate the Relationship Between Self-esteem, Health Locus of Control, and Health-Promoting Behavior in Chinese Patients With Coronary Heart Disease.

    Science.gov (United States)

    Zou, Huijing; Tian, Qian; Chen, Yuxia; Cheng, Cheng; Fan, Xiuzhen

    Health-promoting behavior plays an important role in reducing the burden of coronary heart disease. Self-esteem and health locus of control may contribute to health-promoting behavior, and coping styles may mediate these associations. The aims of our study were to examine whether self-esteem and health locus of control are associated with health-promoting behavior and examine the possible mediating effect of coping styles in patients with coronary heart disease. Health-promoting behavior, self-esteem, health locus of control, and coping styles were assessed in 272 hospitalized patients (60 ± 12 years, 61% male) with coronary heart disease. Hierarchical regression analysis was conducted to analyze the relationships between health-promoting behavior and other variables. Mediation effect was examined according to the methods of Baron and Kenny. The mean score for health-promoting behavior was 2.57 ± 0.51; 38.2% of patients (n = 104) scored lower than 2.5. Self-esteem (β = .139, P locus of control and health-promoting behavior. Confrontation plays a mediating role in the association among self-esteem, internal health locus of control, and health-promoting behavior. Strategies should be undertaken to encourage the use of confrontation coping style, which will facilitate health-promoting behavior.

  16. Monitoring and Follow-up of Chronic Heart Failure: a Literature Review of eHealth Applications and Systems.

    Science.gov (United States)

    de la Torre Díez, Isabel; Garcia-Zapirain, Begoña; Méndez-Zorrilla, Amaia; López-Coronado, Miguel

    2016-07-01

    In developed countries heart failure is one of the most important causes of death, followed closely by strokes and other cerebrovascular diseases. It is one of the major healthcare issues in terms of increasing number of patients, rate of hospitalizations and costs. The main aim of this paper is to present telemedicine applications for monitoring and follow-up of heart failure and to show how these systems can help reduce costs of administering heart failure. The search for e-health applications and systems in the field of telemonitoring of heart failure was pursued in IEEE Xplore, Science Direct, PubMed and Scopus systems between 2005 and the present time. This search was conducted between May and June 2015, and the articles deemed to be of most interest about treatment, prevention, self-empowerment and stabilization of patients were selected. Over 100 articles about telemonitoring of heart failure have been found in the literature reviewed since 2005, although the most interesting ones have been selected from the scientific standpoint. Many of them show that telemonitoring of patients with a high risk of heart failure is a measure that might help to reduce the risk of suffering from the disease. Following the review conducted, in can be stated that via the research articles analysed that telemonitoring systems can help to reduce the costs of administering heart failure and result in less re-hospitalization of patients.

  17. Heart Rate Variability: New Perspectives on Physiological Mechanisms, Assessment of Self-regulatory Capacity, and Health risk.

    Science.gov (United States)

    McCraty, Rollin; Shaffer, Fred

    2015-01-01

    Heart rate variability, the change in the time intervals between adjacent heartbeats, is an emergent property of interdependent regulatory systems that operates on different time scales to adapt to environmental and psychological challenges. This article briefly reviews neural regulation of the heart and offers some new perspectives on mechanisms underlying the very low frequency rhythm of heart rate variability. Interpretation of heart rate variability rhythms in the context of health risk and physiological and psychological self-regulatory capacity assessment is discussed. The cardiovascular regulatory centers in the spinal cord and medulla integrate inputs from higher brain centers with afferent cardiovascular system inputs to adjust heart rate and blood pressure via sympathetic and parasympathetic efferent pathways. We also discuss the intrinsic cardiac nervous system and the heart-brain connection pathways, through which afferent information can influence activity in the subcortical, frontocortical, and motor cortex areas. In addition, the use of real-time HRV feedback to increase self-regulatory capacity is reviewed. We conclude that the heart's rhythms are characterized by both complexity and stability over longer time scales that reflect both physiological and psychological functional status of these internal self-regulatory systems.

  18. Vitamin C and Heart Health: A Review Based on Findings from Epidemiologic Studies

    Directory of Open Access Journals (Sweden)

    Melissa A. Moser

    2016-08-01

    Full Text Available Vitamin C is a powerful dietary antioxidant that has received considerable attention in the literature related to its possible role in heart health. Although classical vitamin C deficiency, marked by scurvy, is rare in most parts of the world, some research has shown variable heart disease risks depending on plasma vitamin C concentration, even within the normal range. Furthermore, other studies have suggested possible heart-related benefits to vitamin C taken in doses beyond the minimal amounts required to prevent classically defined deficiency. The objective of this review is to systematically review the findings of existing epidemiologic research on vitamin C and its potential role in cardiovascular disease (CVD. It is well established that vitamin C inhibits oxidation of LDL-protein, thereby reducing atherosclerosis, but the cardiovascular outcomes related to this action and other actions of vitamin C are not fully understood. Randomized controlled trials as well as observational cohort studies have investigated this topic with varying results. Vitamin C has been linked in some work to improvements in lipid profiles, arterial stiffness, and endothelial function. However, other studies have failed to confirm these results, and observational cohort studies are varied in their findings on the vitamin’s effect on CVD risk and mortality. Overall, current research suggests that vitamin C deficiency is associated with a higher risk of mortality from CVD and that vitamin C may slightly improve endothelial function and lipid profiles in some groups, especially those with low plasma vitamin C levels. However, the current literature provides little support for the widespread use of vitamin C supplementation to reduce CVD risk or mortality.

  19. [Quality of service provided to heart surgery patients of the Unified Health System-SUS].

    Science.gov (United States)

    Borges, Juliana Bassalobre Carvalho; Carvalho, Sebastião Marcos Ribeiro de; Silva, Marcos Augusto de Moraes

    2010-01-01

    To evaluate the service quality provided to heart surgery patients during their hospital stay, identifying the patient's expectations and perceptions. To associate service quality with: gender, age and the use of extracorporeal circulation. We studied 82 elective heart surgery patients (52.4% females and 47.6% males), operated by midsternal thoracotomy, age: 31 to 83 years (60.4 +/- 13.2 years); period: March to September 2006. Service quality was evaluated in two instances: the expectations at pre-operative and the perceptions of the service received on the 6th post-operative; through the application of the modified SERVQUAL scale (SERVQUAL-Card). The result was obtained by the difference of the sum of the scores on perception minus those of the expectations, and through statistical analysis. The SERVQUAL-Card scale was statistically validated, showing adequate level of internal consistency. We found a higher frequency of myocardial revascularization 55 (67.0%); first heart surgery 72 (87.8%) and the use of ECC 69 (84.1%). We noticed high mean values for expectations and perceptions with significant results (Pquality of service with: gender, in empathy (P= 0.04) and age, in reliability (P = 0.02). There was no significant association between ECC and quality of service. Service quality was satisfactory. The patient demonstrated a high expectation to hospital medical service. Women present a higher perception of quality in empathy and younger people in reliability. The use of ECC is not related to service quality in this sample. The data obtained in this study suggest that the quality of this health service can be monitored through the periodical application of the SERVQUAL scale.

  20. A Guide for Understanding Health Education and Promotion Programs.

    Science.gov (United States)

    Kim, Richard W; Nahar, Vinayak K

    2018-03-01

    Planning, Implementing & Evaluating Health Promotion Programs: A Primer is a versatile and comprehensive resource on the theoretical and practical underpinnings of successful health promotion programs. The requirements for effective health promotion program development are presented with frequent use of practical planning examples, pedagogical devices, and expert rationale. Ideal for undergraduate and graduate students in health education, promotion, and planning courses, this 15-chapter textbook is organized in a manner that specifically addresses the responsibilities and competencies required of health education specialists as published in the Health Education Specialist Practice Analysis of 2015. The authors of this textbook are leaders in the field and provide readers with the skills necessary to carry out the full process of health promotion program execution, while also offering direct preparation for CHES and MCHES licensing exams.

  1. NHLBI's program for VAD therapy for moderately advanced heart failure: the REVIVE-IT pilot trial.

    Science.gov (United States)

    Baldwin, J Timothy; Mann, Douglas L

    2010-11-01

    Ventricular assist devices (VADs) are used to bridge heart failure patients to transplantation, to allow their own hearts to recover, or as permanent ("destination") therapy. To date, the use of VADs has been limited to late-stage heart failure patients because of the associated device risks. In 2008, a National Heart, Lung, and Blood Institute (NHLBI) working group met to evaluate the treatment of heart failure using VADs and to advise the institute on how therapy for heart failure may be best advanced by clinical trials involving the devices. Recognizing the improvements in VAD technology and in patient care and selection over the past decade, the working group recommended that a trial be performed to assess the use of chronic VAD therapy in patients who are less ill than those currently eligible for destination therapy. The hypothesis proposed for the trial is that VAD therapy may improve both survival and quality of life in moderately advanced heart failure patients who are neither inotrope-dependent nor exercise-intolerant and have not yet developed serious consequences such as malnourishment, end-organ damage, and immobility. Based on the group's recommendations, NHLBI issued an RFP in 2009 for the REVIVE-IT Pilot Trail, which will serve to test the hypothesis and inform the pivotal trial. Published by Elsevier Inc.

  2. A Perspective on Promoting Diversity in the Biomedical Research Workforce: The National Heart, Lung, and Blood Institute’s PRIDE Program

    Science.gov (United States)

    Boyington, Josephine E.A.; Maihle, Nita J.; Rice, Treva K.; Gonzalez, Juan E.; Hess, Caryl A.; Makala, Levi H.; Jeffe, Donna B.; Ogedegbe, Gbenga; Rao, Dabeeru C.; Dávila-Román, Victor G.; Pace, Betty S.; Jean-Louis, Girardin; Boutjdir, Mohamed

    2016-01-01

    Aspiring junior investigators from groups underrepresented in the biomedical sciences face various challenges as they pursue research independence. However, the biomedical research enterprise needs their participation to effectively address critical research issues such as health disparities and health inequities. In this article, we share a research education and mentoring initiative that seeks to address this challenge: Programs to Increase Diversity among Individuals Engaged in Health Related Research (PRIDE), funded by the National Heart, Lung, and Blood Institute (NHLBI). This longitudinal research-education and mentoring program occurs through summer institute programs located at US-based academic institutions. Recruited participants are exposed to didactic and lab-based research-skill enhancement experiences, with year-round mentoring over the course of two years. Mentor-mentee matching is based on shared research interests to promote congruence and to enhance skill acquisition. Program descriptions and sample narratives of participants’ perceptions of PRIDE’s impact on their career progress are showcased. Additionally, we highlight the overall program design and structure of four of seven funded summer institutes that focus on cardiovascular disease, related conditions, and health disparities. Mentees’ testimonials about the value of the PRIDE mentoring approach in facilitating career development are also noted. Meeting the clinical and research needs of an increasingly diverse US population is an issue of national concern. The PRIDE initiative, which focuses on increasing research preparedness and professional development of groups underrepresented in the biomedical research workforce, with an emphasis on mentoring as the critical approach, provides a robust model that is impacting the careers of future investigators. PMID:27440978

  3. Sexual Health Education in Massage Therapy Programs: A Survey of Program Directors

    Science.gov (United States)

    Zamboni, Brian D.; Healey, Dale K.

    2016-01-01

    Massage therapy program directors completed an online survey to explore sexual education in massage therapy programs. The overall data suggest that program directors are supportive of sexual health education in the training of massage therapists and that such education is integrated into several aspects of their training programs. To enhance…

  4. [Common competencies and contents in public health in graduate programs].

    Science.gov (United States)

    Davó, M A Carmen; Vives-Cases, Carmen; Benavides, Fernando García; Alvarez-Dardet, Carlos; Segura-Benedicto, Andreu; Icart, Teresa; Astasio, Paloma; Gil, Angel; Ortiz, M Del Rocío; García, Angel; Ronda, Elena; Bosch, Félix

    2011-01-01

    To identify fundamental public health competencies and contents in nursing, pharmacy, teaching, medicine, human nutrition and dietetics, optics and optometry, labor relations and human resources, and social work in graduate programs and to formulate proposals for their improvement. The workshop on Public health contents in graduate programs in the XXI Menorca Public Health School was organized as follows: eight groups were set up, coordinated by 37 Spanish university teachers participating in the workshop and selected through key informants and snowball techniques. Two studies on public health professional competencies and the participants' own graduate programs were used to discuss public health professional competencies and contents and establish recommendations to improve public health programs. Each group worked on a particular degree course and the results were shared in plenary. Professional competencies for the three essential public health functions were indentified in all the degrees, except teaching, optics and optometry, and social work. Some of the competencies included in degrees in nursing, teaching, human nutrition and dietetics, and social work were rewritten to highlight the role of each type of professional in public health functions. The groups agreed on the introductory topics (basic concepts and health determinants) and intervention strategies. Common competencies and contents were identified in graduate programs. Updating public health contents in graduate programs would help to define and promote the profile of public health professionals. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

  5. Changes in health indicators related to health promotion and microcredit programs in the Dominican Republic.

    Science.gov (United States)

    Dohn, Anita L; Chávez, Andrea; Dohn, Michael N; Saturria, Luis; Pimentel, Carlos

    2004-03-01

    To assess the impact of health promotion programs and microcredit programs on three communities in the Dominican Republic. One community had only the health promotion program, one community had only the microcredit program, and one community had both a health promotion program and a microcredit program. This pilot project examined the hypothesis that the largest changes in 11 health indicators that were studied would be in the community with both a health promotion program and a microcredit program, that there would be intermediate changes in the community with only a health promotion program, and that the smallest changes would be in the community with only a microcredit program. The health promotion programs used community volunteers to address two major concerns: (1) the prevalent causes of mortality among children under 5 years of age and (2) women's health (specifically breast and cervical cancer screening). The microcredit program made small loans to individuals to start or expand small businesses. Outcome measures were based on comparisons for 11 health indicators from baseline community surveys (27 households surveyed in each of the three communities, done in December 2000 and January 2001) and from follow-up surveys (also 27 households surveyed in each of the three communities, in June and July 2002, after the health promotion program had been operating for about 13 months). Households were randomly chosen during both the baseline and follow-up surveys, without regard to their involvement in the microcredit or health promotion programs. The health indicators improved in all three communities. However, the degree of change was different among the communities (P microcredit and health promotion programs had the largest changes for 10 of the 11 health indicators. Multisector development is known to be important on a macroeconomic scale. The results of this pilot project support the view that multisector development is also important on a microeconomic level

  6. Impact of a standardized training program on midwives’ ability to assess fetal heart anatomy by ultrasound

    International Nuclear Information System (INIS)

    Hildebrand, Eric; Abrandt Dahlgren, Madeleine; Sved, Catarina; Gottvall, Tomas; Blomberg, Marie; Janerot-Sjoberg, Birgitta

    2014-01-01

    Studies of prenatal detection of congenital heart disease (CHD) in the UK, Italy, and Norway indicate that it should be possible to improve the prenatal detection rate of CHD in Sweden. These studies have shown that training programs, visualization of the outflow tracts and color-Doppler all can help to speed up and improve the detection rate and accuracy. We aimed to introduce a more accurate standardized fetal cardiac ultrasound screening protocol in Sweden. A novel pedagogical model for training midwives in standardized cardiac imaging was developed, a model using a think-aloud analysis during a pre- and post-course test and a subsequent group reflection. The self-estimated difficulties and knowledge gaps of two experienced and two beginner midwives were identified. A two-day course with mixed lectures, demonstrations and hands-on sessions was followed by a feedback session three months later consisting of an interview and check-up. The long-term effects were tested two years later. At the post-course test the self-assessed uncertainty was lower than at the pre-course test. The qualitative evaluation showed that the color Doppler images were difficult to interpret, but the training seems to have improved their ability to use the new technique. The ability to perform the method remained at the new level at follow-up both three months and two years later. Our results indicate that by implementing new imaging modalities and providing hands-on training, uncertainty can be reduced and examination time decreased, but they also show that continuous on-site training with clinical and technical back-up is important

  7. Relationship between legumes consumption and metabolic syndrome: Findings of the Isfahan Healthy Heart Program

    Directory of Open Access Journals (Sweden)

    Firouzeh Sajjadi

    2014-01-01

    Full Text Available BACKGROUND: Epidemiologic studies have shown an inverse association between dietary fiber and metabolic syndrome (MetS. Therefore, the purpose of this study was to investigate the association between MetS and consumption of legumes in adults in Isfahan, Iran. METHODS: This cross-sectional study was carried out on 2027 individuals who were a subsample of the 3rd phase of the Isfahan Healthy Heart Program (IHHP. Basic characteristics information such as age, sex, smoking status, and physical activity were collected using a questionnaire. A validated 48-item food frequency questionnaire was used to assess dietary behaviors. Blood pressure, waist circumference (WC, glucose, triacylglycerols, and high-density lipoprotein cholesterol were measured, and MetS was defined based on Adult Treatment Panel III guidelines. Multiple logistic regression models examined associations of frequency consumption of legumes with MetS occurrence and its components. RESULTS: All MetS components were less prevalent among subjects with regular legume intake (P < 0.01. Legume intake was inversely associated with the risk of MetS, after adjustment for confounding factors in women. Life style adjusted odds ratio of Mets between highest and lowest tertile and no consumption (as reference category of legume intake were 0.31 (0.13, 0.70, 0.38 (0.17, 0.87, respectively, in women (P = 0.01. CONCLUSION: This study showed that age has a crucial role in MetS incidence; therefore, after further age adjustment to lifestyle adjusted model there was no significant difference in lower and higher tertile of legume intake and MetS.   Keywords: Legumes, Metabolic Syndrome, Iran 

  8. Perceived discrimination is associated with health behaviours among African-Americans in the Jackson Heart Study.

    Science.gov (United States)

    Sims, Mario; Diez-Roux, Ana V; Gebreab, Samson Y; Brenner, Allison; Dubbert, Patricia; Wyatt, Sharon; Bruce, Marino; Hickson, DeMarc; Payne, Tom; Taylor, Herman

    2016-02-01

    Using Jackson Heart Study data, we examined associations of multiple measures of perceived discrimination with health behaviours among African-Americans (AA). The cross-sectional associations of everyday, lifetime and burden of discrimination with odds of smoking and mean differences in physical activity, dietary fat and sleep were examined among 4925 participants aged 35-84 years after adjustment for age and socioeconomic status (SES). Men reported slightly higher levels of everyday and lifetime discrimination than women and similar levels of burden of discrimination as women. After adjustment for age and SES, everyday discrimination was associated with more smoking and a greater percentage of dietary fat in men and women (OR for smoking: 1.13, 95% CI 1.00 to 1.28 and 1.19, 95% CI 1.05 to 1.34; mean difference in dietary fat: 0.37, pwomen, respectively). Everyday and lifetime discrimination were associated with fewer hours of sleep in men and women (mean difference for everyday discrimination: -0.08, pdiscrimination: -0.08, pdiscrimination was associated with more smoking and fewer hours of sleep in women only. Higher levels of perceived discrimination were associated with select health behaviours among men and women. Health behaviours offer a potential mechanism through which perceived discrimination affects health in AA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. INTRODUCTION OF UNIVERSAL HEALTH PROGRAM IN GEORGIA: PROBLEMS AND PERSPECTIVES.

    Science.gov (United States)

    Verulava, T; Jorbenadze, R; Barkalaia, T

    2017-01-01

    Since 2013, Georgia enacted Universal Healthcare (UHC) program. Inclusion of uninsured population in the UHC program will have a positive impact on their financial accessibility to the health services. The study aims to analyze the referral rate of the beneficiaries to the health service providers before introduction and after application of the UHC program, particularly, how much it increased the recently uninsured population referral to primary health care units, and also to study the level of satisfaction with the UHC program. Research was conducted by qualitative and quantitative methods. The target groups' (program beneficiaries, physicians, personnel of the Social Service Agency) opinions were identified by means of face-to-face interviews. Enactment of the UHC programs significantly raised the population refferal to the family physicians, and the specialists. Insignificantly, but also increased the frequency of laboratory and diagnostic services. Despite the serious positive changes caused by UHC program implementation there still remain the problems in the primary healthcare system. Also, it is desirable to raise the financial availability of those medical services, which may cause catastrophic costs. In this respect, such medical services must be involved in the universal healthcare program and been expanded their scale. For the purpose of effective usage of the limited funds allocated for health care services provision, the private health insurance companies should be involved in UHC programs. This, together with the reduction of health care costs will increase a competition in the medical market, and enhance the quality of health service.

  10. Factors Affecting Health Related Quality of Life in Hospitalized Patients with Heart Failure

    Directory of Open Access Journals (Sweden)

    Georgia Audi

    2017-01-01

    Full Text Available This study identified factors affecting health related quality of life (HRQOL in 300 hospitalized patients with heart failure (HF. Data were collected by the completion of a questionnaire which included patients’ characteristics and the Minnesota Living with Heart Failure Questionnaire (MLHFQ. Analysis of data showed that the median of the total score of MLHFQ was 46 and the median of the physical and mental state was 22 and 6, respectively. Also, participants who were householders or had “other” professions had lower score of 17 points and therefore better quality of life compared to patients who were civil/private employees (p<0.001 and p<0.001, resp.. Patients not receiving anxiolytics and antidepressants had lower quality of life scores of 6 and 15.5 points, respectively, compared to patients who received (p=0.003 and p<0.001, resp.. Patients with no prior hospitalization had lower score of 7 points compared to those with prior hospitalization (p=0.002, whereas patients not retired due to the disease had higher score of 7 points (p=0.034. Similar results were observed for the physical and mental state. Improvement of HF patients’ quality of life should come to the forefront of clinical practice.

  11. Big heart data: advancing health informatics through data sharing in cardiovascular imaging.

    Science.gov (United States)

    Suinesiaputra, Avan; Medrano-Gracia, Pau; Cowan, Brett R; Young, Alistair A

    2015-07-01

    The burden of heart disease is rapidly worsening due to the increasing prevalence of obesity and diabetes. Data sharing and open database resources for heart health informatics are important for advancing our understanding of cardiovascular function, disease progression and therapeutics. Data sharing enables valuable information, often obtained at considerable expense and effort, to be reused beyond the specific objectives of the original study. Many government funding agencies and journal publishers are requiring data reuse, and are providing mechanisms for data curation and archival. Tools and infrastructure are available to archive anonymous data from a wide range of studies, from descriptive epidemiological data to gigabytes of imaging data. Meta-analyses can be performed to combine raw data from disparate studies to obtain unique comparisons or to enhance statistical power. Open benchmark datasets are invaluable for validating data analysis algorithms and objectively comparing results. This review provides a rationale for increased data sharing and surveys recent progress in the cardiovascular domain. We also highlight the potential of recent large cardiovascular epidemiological studies enabling collaborative efforts to facilitate data sharing, algorithms benchmarking, disease modeling and statistical atlases.

  12. Cardiac rehabilitation increases physical capacity but not mental health after heart valve surgery

    DEFF Research Database (Denmark)

    Sibilitz, Kirstine L.; Berg, Selina K.; Rasmussen, Trine B.

    2016-01-01

    Objective: The evidence for cardiac rehabilitation after valve surgery remains sparse. Current recommendations are therefore based on patients with ischaemic heart disease. The aim of this randomised clinical trial was to assess the effects of cardiac rehabilitation versus usual care after heart......-educational consultations (intervention) versus usual care without structured physical exercise or psycho-educational consultations (control). Primary outcome was physical capacity measured by VO2 peak and secondary outcome was self-reported mental health measured by Short Form-36. Results: 76% were men, mean age 62 years......, with aortic (62%), mitral (36%) or tricuspid/pulmonary valve surgery (2%). Cardiac rehabilitation compared with control had a beneficial effect on VO2 peak at 4 months (24.8 mL/kg/min vs 22.5 mL/kg/min, p=0.045) but did not affect Short Form-36 Mental Component Scale at 6 months (53.7 vs 55.2 points, p=0...

  13. Chocolate consumption and risk of heart failure in the Physicians' Health Study.

    Science.gov (United States)

    Petrone, Andrew B; Gaziano, J Michael; Djoussé, Luc

    2014-12-01

    To test the hypothesis that chocolate consumption is associated with a lower risk of heart failure (HF). We prospectively studied 20 278 men from the Physicians' Health Study. Chocolate consumption was assessed between 1999 and 2002 via a self-administered food frequency questionnaire and HF was ascertained through annual follow-up questionnaires with validation in a subsample. We used Cox regression to estimate multivariable adjusted relative risk of HF. During a mean follow-up of 9.3 years there were 876 new cases of HF. The mean age at baseline was 66.4 ± 9.2 years. Hazard ratios [95% confidence intervals (CI)] for HF were 1.0 (ref), 0.86 (0.72-1.03), 0.80 (0.66-0.98), 0.92 (0.74-1.13), and 0.82 (0.63-1.07), for chocolate consumption of less than 1/month, 1-3/week, 2-4/week, and 5+/week, respectively, after adjusting for age, body mass index (BMI), smoking, alcohol, exercise, energy intake, and history of atrial fibrillation (P for quadratic trend = 0.62). In a secondary analysis, chocolate consumption was inversely associated with risk of HF in men whose BMI was chocolate might be associated with a lower risk of HF in male physicians. © 2014 The Authors. European Journal of Heart Failure © 2014 European Society of Cardiology.

  14. Stakeholder Knowledge Levels of Coordinated School Health Programs

    Science.gov (United States)

    Minor, Lisa Crouch

    2012-01-01

    Acute and chronic health conditions may be important factors impacting absenteeism and student achievement in schools. Coordinated school health programs can support students who have these conditions. Although such programs have had documented success, implementation can be costly and time consuming. The local problem addressed in this project…

  15. Directory of Academic Programs in Occupational Safety and Health.

    Science.gov (United States)

    Weis, William J., III; And Others

    This booklet describes academic program offerings in American colleges and universities in the area of occupational safety and health. Programs are divided into five major categories, corresponding to each of the core disciplines: (1) occupational safety and health/industrial hygiene, (2) occupational safety, (3) industrial hygiene, (4)…

  16. Occupational Safety and Health Programs in Career Education.

    Science.gov (United States)

    DiCarlo, Robert D.; And Others

    This resource guide was developed in response to the Occupational Safety and Health Act of 1970 and is intended to assist teachers in implementing courses in occupational safety and health as part of a career education program. The material is a synthesis of films, programed instruction, slides and narration, case studies, safety pamphlets,…

  17. Sexual health education in U.S. physician assistant programs.

    Science.gov (United States)

    Seaborne, Lori A; Prince, Ronald J; Kushner, David M

    2015-05-01

    Since the 1950s, sexual health education in medical schools has been evaluated and reported upon, but there has never been an assessment published about sexual health curricula in U.S. physician assistant (PA) programs. The aim of this study was to gain better understanding of how PA programs cover sexual health topics. Between January and March 2014, 181 accredited PA programs received a mailed survey inquiring about their sexual health curriculum. The survey assessed general sexual health topics; lesbian, gay, bisexual, transgender (LGBT) topics; teaching methods; and the amount of time spent on sexual health education. A total of 106 programs responded (59%). Ten programs offered a required, discrete course on human sexuality. The majority incorporated training into other coursework, which is consistent with most medical schools. LGBT topics were covered less thoroughly than the general sexual health topics. Total amount of time spent on sexual health topics varied widely among programs, from a minimum of 2-4 hours to a maximum of 60 hours, with a median of 12 hours. PA programs in the United States appear to compare favorably with the training offered to medical students in regard to time spent on sexual health education. Transgender issues were least well-covered of all the topics queried. © 2015 International Society for Sexual Medicine.

  18. Tensions of Health: Narratives of Employee Wellness Program Participants.

    Science.gov (United States)

    Tang, Lu; Baker, Jane S; Meadows, Cui Zhang

    2016-09-01

    This article examines dialectical tensions in the health narratives of participants of the Employee Wellness Program (EWP) of a large public university in the southeastern United States. Semi-structured interviews (n = 12) with team leaders in the program indicated that health is a multifaceted concept characterized by three pairs of dialectical tensions: autonomy versus connection, private versus public, and control versus lack of control. These findings suggest that to better promote health and wellness in the workplace, EWP staff should consider employees' unique experiences and beliefs about health when designing organization-wide programs and campaigns. © 2016 The Author(s).

  19. Defence Health Service Mentoring Program Evaluation 2001

    National Research Council Canada - National Science Library

    Highfield, Jane

    2002-01-01

    The Defense Health Services (DHS) Steering Committee has considered the concept of Mentoring as part of an effort to assist in the development of future health leaders in the Australian Defense Force (ADF...

  20. Designing health promotion programs by watching the market.

    Science.gov (United States)

    Gelb, B D; Bryant, J M

    1992-03-01

    More health care providers and payors are beginning to see health promotion programs as a significant tool for attracting patients, reducing costs, or both. To help design programs that take into account the values and lifestyles of the target group, naturalistic observation can be useful. The authors illustrate the approach in a study of pipeline workers that provided input for the design of nutrition and smoking cessation programs.

  1. A cost-effectiveness analysis of a program to control rheumatic fever and rheumatic heart disease in Pinar del Rio, Cuba.

    Directory of Open Access Journals (Sweden)

    David A Watkins

    Full Text Available Acute rheumatic fever (ARF and rheumatic heart disease (RHD persist in many low- and middle-income countries. To date, the cost-effectiveness of population-based, combined primary and secondary prevention strategies has not been assessed. In the Pinar del Rio province of Cuba, a comprehensive ARF/RHD control program was undertaken over 1986-1996. The present study analyzes the cost-effectiveness of this Cuban program.We developed a decision tree model based on the natural history of ARF/RHD, comparing the costs and effectiveness of the 10-year Cuban program to a "do nothing" approach. Our population of interest was the cohort of children aged 5-24 years resident in Pinar del Rio in 1986. We assessed costs and health outcomes over a lifetime horizon, and we took the healthcare system perspective on costs but did not apply a discount rate. We used epidemiologic, clinical, and direct medical cost inputs that were previously collected for publications on the Cuban program. We estimated health gains as disability-adjusted life years (DALYs averted using standard approaches developed for the Global Burden of Disease studies. Cost-effectiveness acceptability thresholds were defined by one and three times per capita gross domestic product per DALY averted. We also conducted an uncertainty analysis using Monte Carlo simulations and several scenario analyses exploring the impact of alternative assumptions about the program's effects and costs. We found that, compared to doing nothing, the Cuban program averted 5051 DALYs (1844 per 100,000 school-aged children and saved $7,848,590 (2010 USD despite a total program cost of $202,890 over 10 years. In the scenario analyses, the program remained cost saving when a lower level of effectiveness and a reduction in averted years of life lost were assumed. In a worst-case scenario including 20-fold higher costs, the program still had a 100% of being cost-effective and an 85% chance of being cost saving.A 10-year

  2. A cost-effectiveness analysis of a program to control rheumatic fever and rheumatic heart disease in Pinar del Rio, Cuba.

    Science.gov (United States)

    Watkins, David A; Mvundura, Mercy; Nordet, Porfirio; Mayosi, Bongani M

    2015-01-01

    Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) persist in many low- and middle-income countries. To date, the cost-effectiveness of population-based, combined primary and secondary prevention strategies has not been assessed. In the Pinar del Rio province of Cuba, a comprehensive ARF/RHD control program was undertaken over 1986-1996. The present study analyzes the cost-effectiveness of this Cuban program. We developed a decision tree model based on the natural history of ARF/RHD, comparing the costs and effectiveness of the 10-year Cuban program to a "do nothing" approach. Our population of interest was the cohort of children aged 5-24 years resident in Pinar del Rio in 1986. We assessed costs and health outcomes over a lifetime horizon, and we took the healthcare system perspective on costs but did not apply a discount rate. We used epidemiologic, clinical, and direct medical cost inputs that were previously collected for publications on the Cuban program. We estimated health gains as disability-adjusted life years (DALYs) averted using standard approaches developed for the Global Burden of Disease studies. Cost-effectiveness acceptability thresholds were defined by one and three times per capita gross domestic product per DALY averted. We also conducted an uncertainty analysis using Monte Carlo simulations and several scenario analyses exploring the impact of alternative assumptions about the program's effects and costs. We found that, compared to doing nothing, the Cuban program averted 5051 DALYs (1844 per 100,000 school-aged children) and saved $7,848,590 (2010 USD) despite a total program cost of $202,890 over 10 years. In the scenario analyses, the program remained cost saving when a lower level of effectiveness and a reduction in averted years of life lost were assumed. In a worst-case scenario including 20-fold higher costs, the program still had a 100% of being cost-effective and an 85% chance of being cost saving. A 10-year program to

  3. Public dental health care program for persons with disability

    DEFF Research Database (Denmark)

    Christensen, Lisa Bøge; Hede, Børge; Petersen, Poul Erik

    2005-01-01

    The objectives of the study were (1) to describe the organization and content of the Danish public oral health care program for persons with disability, and (2) to analyse possible variations in relation to the goals and requirements set by the health authorities. Data were collected by means......) payment of service, (4) providers of oral health care, (5) special training of staff, 6) dental services delivered, (7) ethical issues, and (8) patient rights. Less than one-third of persons estimated by the health authorities were enrolled in the program. On average, 0.4% of the municipal population...... of knowledge of oral health and oral health care for persons with disability were barriers to equal access to the program. Preventive dental services were the most frequent services delivered, although relatively few oral hygienists were involved in the program. Special training was most frequent in large...

  4. Impact of a chronic disease management program on hospital admissions and readmissions in an Australian population with heart disease or diabetes.

    Science.gov (United States)

    Hamar, G Brent; Rula, Elizabeth Y; Wells, Aaron; Coberley, Carter; Pope, James E; Larkin, Shaun

    2013-04-01

    Chronic disease management programs (CDMPs) were introduced in Australia to reduce unnecessary health care utilization by the growing population with chronic conditions; however, evidence of effectiveness is needed. This study evaluated the impact of a comprehensive CDMP, My Health Guardian (MHG), on rate of hospital admissions, readmissions, and average length of hospital stay (ALOS) for insured individuals with heart disease or diabetes. Primary outcomes were assessed through retrospective comparison of members in MHG (treatment; n=5053) to similar nonparticipating members (comparison; n=23,077) using a difference-in-differences approach with the year before program commencement serving as baseline and the subsequent 12 or 18 months serving as the program periods. All outcomes were evaluated for the total study population and for disease-matched subgroups (heart disease and diabetes). Statistical tests were performed using multivariate regression controlling for age, sex, number of chronic diseases, and past hospitalization status. After both 12 and 18 months, treatment members displayed decreases in admissions (both, P≤0.001) and readmissions (both, P≤0.01), and ALOS after 18 months (P≤0.01) versus the comparison group; magnitude of impact increased over time for these 3 measures. All outcomes for both disease-matched subgroups directionally mirrored the total study group, but the diabetes subgroup did not achieve significance for readmissions or ALOS. Within the treatment group, admissions decreased with increasing care calls to members (12 and 18 months, Phospital admissions and presents a promising approach to reduce the burden associated with hospitalizations in populations with chronic disease.

  5. Correlation between changes in diastolic dysfunction and health-related quality of life after cardiac rehabilitation program in dilated cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Sherin H.M. Mehani

    2013-03-01

    Full Text Available Chronic heart failure (CHF is a complex syndrome characterized by progressive decline in left ventricular function, low exercise tolerance and raised mortality and morbidity. Left ventricular diastolic dysfunction plays a major role in CHF and progression of most cardiac diseases. The current recommended goals can theoretically be accomplished via exercise and pharmacological therapy so the aim of the present study was to evaluate the impact of cardiac rehabilitation program on diastolic dysfunction and health related quality of life and to determine the correlation between changes in left ventricular diastolic dysfunction and domains of health-related quality of life (HRQoL. Forty patients with chronic heart failure were diagnosed as having dilated cardiomyopathy (DCM with systolic and diastolic dysfunction. The patients were equally and randomly divided into training and control groups. Only 30 of them completed the study duration. The training group participated in rehabilitation program in the form of circuit-interval aerobic training adjusted according to 55–80% of heart rate reserve for a period of 7 months. Circuit training improved both diastolic and systolic dysfunction in the training group. On the other hand, only a significant correlation was found between improvement in diastolic dysfunction and health related quality of life measured by Kansas City Cardiomyopathy Questionnaire. It was concluded that improvement in diastolic dysfunction as a result of rehabilitation program is one of the important underlying mechanisms responsible for improvement in health-related quality of life in DCM patients.

  6. Sense of coherence does not moderate the relationship between the perceived impact of stress on health and self-rated health in adults with congenital heart disease.

    Science.gov (United States)

    Apers, Silke; Sevenants, Lien; Budts, Werner; Luyckx, Koen; Moons, Philip

    2016-12-01

    Adults with congenital heart disease seem to be more distressed than their healthy counterparts, which might render them even more susceptible to developing detrimental health outcomes. Previous research has confirmed the relationship between the perceived impact of stress on health and self-rated health. However, it remains unknown whether sense of coherence, a person's capacity to cope with stressors, moderates this relationship. This cross-sectional study aims to explore: the relationship between demographic and clinical characteristics, sense of coherence, and the perceived impact of stress on health; the relationship between the perceived impact of stress on health and self-rated health; and the moderating effect of sense of coherence in a sample of adults with congenital heart disease. Patients were recruited from the database of congenital and structural cardiology of a university hospital. The analytic sample included 255 patients (median age 35 years; 50% men). Data were obtained using self-report questionnaires and through medical record view. Univariate analyses and multiple regression analysis were conducted. The perceived impact of stress on health was negatively associated with sense of coherence (Pstress on health and self-rated health were negatively associated (Prelationship. Our findings support the need for further research on the perceived impact of stress on health. Such insights can be valuable for developing interventions aimed at reducing the negative health consequences of stress in patients with congenital heart disease. © The European Society of Cardiology 2015.

  7. Health Literacy and Global Cognitive Function Predict E-Mail but Not Internet Use in Heart Failure Patients

    Directory of Open Access Journals (Sweden)

    Jared P. Schprechman

    2013-01-01

    Full Text Available Background. The internet offers a potential for improving patient knowledge, and e-mail may be used in patient communication with providers. However, barriers to internet and e-mail use, such as low health literacy and cognitive impairment, may prevent patients from using technological resources. Purpose. We investigated whether health literacy, heart failure knowledge, and cognitive function were related to internet and e-mail use in older adults with heart failure (HF. Methods. Older adults (N=119 with heart failure (69.84±9.09 years completed measures of health literacy, heart failure knowledge, cognitive functioning, and internet use in a cross-sectional study. Results. Internet and e-mail use were reported in 78.2% and 71.4% of this sample of patients with HF, respectively. Controlling for age and education, logistic regression analyses indicated that higher health literacy predicted e-mail (P<.05 but not internet use. Global cognitive function predicted e-mail (P<.05 but not internet use. Only 45% used the Internet to obtain information on HF and internet use was not associated with greater HF knowledge. Conclusions. The majority of HF patients use the internet and e-mail, but poor health literacy and cognitive impairment may prevent some patients from accessing these resources. Future studies that examine specific internet and email interventions to increase HF knowledge are needed.

  8. Directory of personnel responsible for radiological health programs

    International Nuclear Information System (INIS)

    1977-01-01

    This is a directory of professional personnel who administer the radiological health program activities in state and local governmental agencies. Included in the directory is a listing of each state health officer or the head of the agency responsible for the radiological health program. The name, address, and telephone number of the radiological health personnel are listed, followed by the alternate contact who, in many instances, may be chief of a larger administrative unit of which the radiological health program is a subunit. The address for the program is also included if it differs from the official health department or agency. Generally, the titles of the personnel listed will indicate the administrative status of the radiological health program. The directory also includes a list of key professional personnel in the Bureau of Radiological Health, Radiation Operations Staff, Regional Radiological Health Representatives, Winchester Engineering and Analytical Center, Food and Drug Administration; Office of Radiation Programs, Regional Radiation Representatives, National Environmental Research Center, and Eastern Environmental Radiation Laboratory, Environmental Protection Agency; selected personnel in the U.S. Nuclear Regulatory Commission; and selected personnel in the National Bureau of Standards

  9. 42 CFR 457.618 - Ten percent limit on certain Children's Health Insurance Program expenditures.

    Science.gov (United States)

    2010-10-01

    ... Insurance Program expenditures. 457.618 Section 457.618 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS... Children's Health Insurance Program expenditures. (a) Expenditures. (1) Primary expenditures are...

  10. Professional competence in a health promotion program in the Netherlands

    NARCIS (Netherlands)

    Rijkers-de Boer, Caroline J. M.; Heijsman, Anke; van Nes, Fenna; Abma, Tineke A.

    Health promotion for senior citizens ('seniors') is an increasingly important factor in health and welfare policy, having important implications for occupational therapy. The health promotion program 'Healthy and Active Aging' originated in the US, has been modified and adapted to the Dutch context

  11. Federal Program Encourages Health Service Innovations on Developmental Disabilities

    Science.gov (United States)

    Nix, Mary P.

    2009-01-01

    There is always room for improvement in the delivery of health services. This article discusses the U.S. Agency for Healthcare Research and Quality's (AHRQ) Health Care Innovations Exchange (www.innovations.ahrq.gov), a comprehensive program that aims to increase awareness of innovative strategies to meet health service delivery challenges and…

  12. Workplace Setting of Mental Health Nursing Program Graduates in ...

    African Journals Online (AJOL)

    Rwanda Journal Series F: Medicine and Health Sciences Vol. 2 No. 2, 2015. Workplace Setting of Mental Health Nursing Program Graduates in Rwanda. Marie Claire Gasanganwa. 1. , Benoite Umubyeyi1, Darius Gishoma1. 1. University of Rwanda, College of Medicine and Health Sciences, Rwanda. Background.

  13. Leading by Example: Health Promotion Programs for School Staff

    Science.gov (United States)

    Herbert, Patrick C.; Lohrmann, David K.

    2011-01-01

    Health promotion programs for school staff are an overlooked and underused resource that can reduce overweight and obesity among teachers and other staff members. They can also reduce staff absenteeism, increase productivity, reduce costs associated with health care and disability, and foster a climate that promotes good health schoolwide. An…

  14. Evaluation of the Health Rocks! Program: The Association of Youth Engagement with Program Outcomes

    Directory of Open Access Journals (Sweden)

    Yan Xia

    2017-01-01

    Full Text Available This evaluation research examined the relationship between program process and program outcome, specifically, youth engagement in the national 4-H Council Health Rocks! program and their program outcomes.  Based on program evaluation surveys completed after the program by participants, youths’ engagement in the program was associated with their gains in knowledge and skills about substance use, and personal assets related to avoiding risks.  When youth participants find a program interesting, are actively engaged in the program, and find the program staff friendly, they benefit more from the program.  Findings underscore the importance of engaging curriculum and friendly staff to the success of extension or afterschool youth programs. The evaluation method may offer an example of balancing rigor of evaluation design and feasibility of implementing an evaluation.

  15. A pilot study of expenditures on, and utilization of resources in, health care in adults with congenital heart disease.

    Science.gov (United States)

    Moons, P; Siebens, K; De Geest, S; Abraham, I; Budts, W; Gewillig, M

    2001-05-01

    Congenital cardiac disease may be a chronic condition, necessitating life-long follow-up for a substantial proportion of the patients. Such patients, therefore, are often presumed to be high users of resources for health care. Information on utilization of resources in adults with congenital heart disease, however, is scarce. This retrospective pilot study, performed in Belgium, investigated 192 adults with congenital heart disease to measure the annual expenditures and utilization of health care and compared the findings with data from the general population. We also sought to explore demographic and clinical parameters as predictors for the expenditures. Hospitalization was documented in 20.3% of the patients, with a median length of stay of 5 days. The overall payment by health insurance associations in 1997 was 1794.5 ECU per patient, while patients paid on average 189.5 ECU out-of-pocket. For medication, the average reimbursement and out-of-pocket expenses were estimated at 78 ECU and 20 ECU, respectively. Expenditures for patients with congenital heart disease were considerably higher than the age and gender-corrected expenditures for the general population (411.7 ECU), though this difference was accounted for by only one-eighth of the cohort of those with congenital heart disease. In general, higher expenditures were associated with abnormal left ventricular end-diastolic diameter, female gender, functional impairment and higher age, although the explained variance was limited. Our study has provided pilot data on the economic outcomes for patients with congenital heart diseases. We have identified parameters that could predict expenditure, but which will have to be examined in future research. This is needed to develop guidelines for health insurance for those with congenital heart diseases.

  16. AAHD's Health Promotion and Wellness, Part 2: Health Promotion Programs

    Science.gov (United States)

    Exceptional Parent, 2011

    2011-01-01

    This article is part 2 of a 4-part series on "Health Promotion and Wellness" from the American Association on Health and Disability (AAHD). According to the U.S. Census Bureau, more than 54 million people--one in five Americans--have a disability, and these Americans are more likely to report: (1) Being in poorer overall health; (2) Having less…

  17. Infusing Adult Education Principles Into a Health Insurance Literacy Program.

    Science.gov (United States)

    Brown, Virginia

    2018-03-01

    Health insurance literacy is an emerging concept in the health education and health promotion field. The passage of the Affordable Care Act highlighted the link between health insurance and health outcomes. However, the law does not specifically address how the public should be educated on choosing an appropriate health insurance plan. Research shows adults, regardless of previous health insurance status, are likely confused and uncertain about their selection. The University of Maryland Extension developed and created health insurance Smart Choice Health Insurance™ to reduce confusion and increase confidence and capability to make this decision. Andragogy, an adult learning theory, was used to guide the development of the program and help ensure best practices are used to achieve desired outcomes. Using the six principles of andragogy, the team incorporated reality-based case studies, allowed adults time to practice, and emphasized choice making and many other elements to create an atmosphere conducive to adult learning. Results from Smart Choice indicate the program is successful in reducing confusion and increasing confidence. Furthermore, feedback from participants and trained educators indicates that adults were engaged in the program and found the materials useful. Based on program success, creation of new health insurance literacy programs grounded in adult education principles is under way.

  18. Signs for early diagnosis of heart failure in primary health care

    Directory of Open Access Journals (Sweden)

    Devroey D

    2011-09-01

    Full Text Available Dirk Devroey1,2, Viviane Van Casteren11Scientific Institute of Public Health, Unit of Epidemiology, Brussels, Belgium; 2Vrije Universiteit Brussel (VUB, Department of Family Medicine, Brussels, BelgiumObjective: The current guidelines for the diagnosis of heart failure (HF are based on studies of hospital-based patients. The aim of this study is to describe the symptoms, clinical signs, and diagnostic procedures confirming the diagnosis of HF in primary health care.Materials/subjects and methods: Data were prospectively collected during a 2-year period by a nationwide network of sentinel practices. All adult patients without known HF, for which the diagnosis of HF was clinically suspected for the first time, were registered. When diagnosed, HF was confirmed after 1 month.Results: 754 patients with a suspicion of HF were recorded. The diagnosis of HF was confirmed for 74% of the patients. The average age of the patients with confirmed HF was 77.7 years, and for those without HF 75.6 years (P = 0.018. From a logistic regression, breathlessness on exercise (P < 0.001, limitations of physical activity (P = 0.003, and orthopnea (P = 0.040 were the symptoms most associated with HF. The clinical signs most associated with HF, were pulmonary rales (P < 0.001, peripheral edema (P < 0.001, and raised jugular venous pressure (P = 0.039. An electrocardiogram was performed in 75% of the cases, blood analyses in 68%, echocardiogram in 63%, chest X-ray in 61%, and determination of natriuretic peptides in 11% of the cases.Conclusion: Many clinical signs may occur in patients with HF. However, the occurrence of peripheral edema, breathlessness on exercise, or pulmonary rales, are highly suggestive for HF when diagnosed in primary health care, as is the case in hospital-admitted patients. The diagnosis of HF was often left unconfirmed by an echocardiogram and/or an electrocardiogram.Keywords: heart failure, primary health care, diagnostic clinical signs

  19. Women's knowledge about heart disease: Differences among ethnic and cultural groups in the Israeli Women's Health in Midlife Study.

    Science.gov (United States)

    Blumstein, Tzvia; Benyamini, Yael; Boyko, Valentina; Lerner-Geva, Liat

    2016-01-01

    The current investigation aimed to assess levels of knowledge about risk factors for heart disease among midlife Israeli women, and to evaluate the relationship of knowledge to personal risk factors and vulnerability to heart disease. Face-to-face interviews with women aged 45-64 years were conducted during 2004-2006 within three population groups: long-term Jewish residents (LTR), immigrants from the former Soviet Union, and Arab women. The survey instrument included six knowledge statements relating to: the risk after menopause, family history, elevated cholesterol level, diabetes, obesity, and warning signs of a heart attack. The findings showed wide disparities in knowledge by educational level and between immigrants and LTR, after taking into account personal risk factors and education. Personal risk factors were not significantly related to the knowledge items, except for personal history of cardiovascular disease, which was associated with knowledge about "warning signs of a heart attack" and "family history." Women who perceived themselves as more vulnerable to heart disease were more likely to identify several risk factors correctly. These findings stress the need to increase knowledge about heart disease, especially among less educated and minority women, and to emphasize the risk of patients' personal status by health providers.

  20. Development and validation of a smartphone heart rate acquisition application for health promotion and wellness telehealth applications.

    Science.gov (United States)

    Gregoski, Mathew J; Mueller, Martina; Vertegel, Alexey; Shaporev, Aleksey; Jackson, Brenda B; Frenzel, Ronja M; Sprehn, Sara M; Treiber, Frank A

    2012-01-01

    Objective. Current generation smartphones' video camera technologies enable photoplethysmographic (PPG) acquisition and heart rate (HR) measurement. The study objective was to develop an Android application and compare HRs derived from a Motorola Droid to electrocardiograph (ECG) and Nonin 9560BT pulse oximeter readings during various movement-free tasks. Materials and Methods. HRs were collected simultaneously from 14 subjects, ages 20 to 58, healthy or with clinical conditions, using the 3 devices during 5-minute periods while at rest, reading aloud under observation, and playing a video game. Correlation between the 3 devices was determined, and Bland-Altman plots for all possible pairs of devices across all conditions assessed agreement. Results. Across conditions, all device pairs showed high correlations. Bland-Altman plots further revealed the Droid as a valid measure for HR acquisition. Across all conditions, the Droid compared to ECG, 95% of the data points (differences between devices) fell within the limits of agreement. Conclusion. The Android application provides valid HRs at varying levels of movement free mental/perceptual motor exertion. Lack of electrode patches or wireless sensor telemetric straps make it advantageous for use in mobile-cell-phone-delivered health promotion and wellness programs. Further validation is needed to determine its applicability while engaging in physical movement-related activities.

  1. Development and Validation of a Smartphone Heart Rate Acquisition Application for Health Promotion and Wellness Telehealth Applications

    Directory of Open Access Journals (Sweden)

    Mathew J. Gregoski

    2012-01-01

    Full Text Available Objective. Current generation smartphones' video camera technologies enable photoplethysmographic (PPG acquisition and heart rate (HR measurement. The study objective was to develop an Android application and compare HRs derived from a Motorola Droid to electrocardiograph (ECG and Nonin 9560BT pulse oximeter readings during various movement-free tasks. Materials and Methods. HRs were collected simultaneously from 14 subjects, ages 20 to 58, healthy or with clinical conditions, using the 3 devices during 5-minute periods while at rest, reading aloud under observation, and playing a video game. Correlation between the 3 devices was determined, and Bland-Altman plots for all possible pairs of devices across all conditions assessed agreement. Results. Across conditions, all device pairs showed high correlations. Bland-Altman plots further revealed the Droid as a valid measure for HR acquisition. Across all conditions, the Droid compared to ECG, 95% of the data points (differences between devices fell within the limits of agreement. Conclusion. The Android application provides valid HRs at varying levels of movement free mental/perceptual motor exertion. Lack of electrode patches or wireless sensor telemetric straps make it advantageous for use in mobile-cell-phone-delivered health promotion and wellness programs. Further validation is needed to determine its applicability while engaging in physical movement-related activities.

  2. STRESS LEVEL AND SMOKING STATUS IN CENTRAL IRAN: ISFAHAN HEALTHY HEART PROGRAM

    Directory of Open Access Journals (Sweden)

    Hamidreza Roohafza

    2011-04-01

    Full Text Available BACKGROUND: Individuals are faced with numerous stressful life events which can negatively influence mental health. Many individuals use smoking as a means of confronting stress. Given the relatively high prevalence of smoking in central Iran, the present study was conducted to compare stress levels in smokers, non-smokers and those who had quit smoking.    METHODS: This study was conducted as part of Isfahan Cardiovascular Research Program on 9752 individuals in the cities of Isfahan, Arak, and Najafabad in 2008. Sampling was performed using multi-stage cluster randomization method. Data on age, sex, demographic characteristics, and smoking status was collected through interviews. Stress level detected by General Health questionnaire.Logistic regression and chi- squere test was used for data analyzing.    RESULTS: In the present study, 30% of non-smokers, 32.1% ex- smoker and 36.9% of smokers had GHQ of 4 and higher (P = 0.01. In regression analysis, the final model which was controlled for age, sex, socioeconomic statues (including place of residence, marital status and education level showed that the odds ratio of stress in smokers and ex- smoker was significantly higher than in non-smokers (OR = 1.66 and OR = 1.12, respectively.    CONCLUSION: Since in conducted studies, mental problems and stresses have had an important role in people’s smoking, it seems suitable to use the results of this study to present intervention for correct methods of coping with stress towards reducing the prevalence of smoking in the community.Keywords: Cigarette, Stress, Community-based Program.

  3. 21 CFR 101.83 - Health claims: plant sterol/stanol esters and risk of coronary heart disease (CHD).

    Science.gov (United States)

    2010-04-01

    ... factors for CHD is a major public health goal that can assist in reducing risk of CHD. High blood total... LDL cholesterol levels. (c) Requirements—(1) General. All requirements set forth in § 101.14 shall be... benefits of exercise and management of body weight to help lower the risk of heart disease. (2) The claim...

  4. An electronic health records cohort study on heart failure following myocardial infarction in England : Incidence and predictors

    NARCIS (Netherlands)

    Gho, Johannes M.I.H.; Schmidt, Amand F.; Pasea, Laura; Koudstaal, Stefan; Pujades-Rodriguez, Mar; Denaxas, Spiros; Shah, Anoop D.; Patel, Riyaz S.; Gale, Chris P.; Hoes, Arno W.; Cleland, John G.; Hemingway, Harry; Asselbergs, Folkert W.

    2018-01-01

    Objectives: To investigate the incidence and determinants of heart failure (HF) following a myocardial infarction (MI) in a contemporary cohort of patients with MI using routinely collected primary and hospital care electronic health records (EHRs). Methods: Data were used from the CALIBER

  5. Flavonoids and heart health: Proceedings of the ILSI North America Flavonoids Workshop may 31-june 1, 2005, Washington DC

    NARCIS (Netherlands)

    Erdman, J.W.; Balentine, D.; Arab, L.; Beecher, G.; Dwyer, J.T.; Folts, J.; Harnly, J.; Hollman, P.C.H.; Keen, C.L.; Mazza, G.; Messina, M.; Scalbert, A.; Vita, J.; Williamson, G.; Burrows, J.

    2007-01-01

    This article provides an overview of current research on flavonoids as presented during a workshop entitled, "Flavonoids and Heart Health," held by the ILSI North America Project Committee on Flavonoids in Washington, DC, May 31 and June 1, 2005. Because a thorough knowledge and understanding about

  6. Design Thinking for mHealth Application Co-Design to Support Heart Failure Self-Management.

    Science.gov (United States)

    Woods, Leanna; Cummings, Elizabeth; Duff, Jed; Walker, Kim

    2017-01-01

    Heart failure is a prevalent, progressive chronic disease costing in excess of $1billion per year in Australia alone. Disease self-management has positive implications for the patient and decreases healthcare usage. However, adherence to recommended guidelines is challenging and existing literature reports sub-optimal adherence. mHealth applications in chronic disease education have the potential to facilitate patient enablement for disease self-management. To the best of our knowledge no heart failure self-management application is available for safe use by our patients. In this paper, we present the process established to co-design a mHealth application in support of heart-failure self-management. For this development, an interdisciplinary team systematically proceeds through the phases of Stanford University's Design Thinking process; empathise, define, ideate, prototype and test with a user-centred philosophy. Using this clinician-led heart failure app research as a case study, we describe a sequence of procedures to engage with local patients, carers, software developers, eHealth experts and clinical colleagues to foster rigorously developed and locally relevant patient-facing mHealth solutions. Importantly, patients are engaged in each stage with ethnographic interviews, a series of workshops and multiple re-design iterations.

  7. Effect of an office worksite-based yoga program on heart rate variability: outcomes of a randomized controlled trial

    Science.gov (United States)

    2013-01-01

    Background Chronic work-related stress is an independent risk factor for cardiometabolic diseases and associated mortality, particularly when compounded by a sedentary work environment. The purpose of this study was to determine if an office worksite-based hatha yoga program could improve physiological stress, evaluated via heart rate variability (HRV), and associated health-related outcomes in a cohort of office workers. Methods Thirty-seven adults employed in university-based office positions were randomized upon the completion of baseline testing to an experimental or control group. The experimental group completed a 10-week yoga program prescribed three sessions per week during lunch hour (50 min per session). An experienced instructor led the sessions, which emphasized asanas (postures) and vinyasa (exercises). The primary outcome was the high frequency (HF) power component of HRV. Secondary outcomes included additional HRV parameters, musculoskeletal fitness (i.e. push-up, side-bridge, and sit & reach tests) and psychological indices (i.e. state and trait anxiety, quality of life and job satisfaction). Results All measures of HRV failed to change in the experimental group versus the control group, except that the experimental group significantly increased LF:HF (p = 0.04) and reduced pNN50 (p = 0.04) versus control, contrary to our hypotheses. Flexibility, evaluated via sit & reach test increased in the experimental group versus the control group (p yoga sessions (n = 11) to control (n = 19) yielded the same findings, except that the high adherers also reduced state anxiety (p = 0.02) and RMSSD (p = 0.05), and tended to improve the push-up test (p = 0.07) versus control. Conclusions A 10-week hatha yoga intervention delivered at the office worksite during lunch hour did not improve HF power or other HRV parameters. However, improvements in flexibility, state anxiety and musculoskeletal fitness were noted with high adherence

  8. Heart Disease and Occupational Risk Factors in the Canadian Population: An Exploratory Study Using the Canadian Community Health Survey

    Directory of Open Access Journals (Sweden)

    Behdin Nowrouzi-Kia

    2018-06-01

    Full Text Available Background: The objective of this study is to find temporal trends in the associations between cardiovascular disease and occupational risk factors in the context of the Canadian population. Methods: Population data were analyzed from the Canadian Community Health Survey (CCHS collected between 2001 and 2014 for trends over time between heart disease and various occupational risk factors: hours worked, physical exertion at work, and occupation type (management/arts/education, business/finance, sales/services, trades/transportations, and primary industry/processing. Results: We found no significant difference in the average number of hours worked/wk between individuals who report having heart disease in all years of data except in 2011 (F1,96 = 7.02, p = 0.009 and 2012 (F1,96 = 8.86, p = 0.004. We also found a significant difference in the degree of physical exertion at work in 2001 (F1,79 = 7.45, p = 0.008. There were statistically significant results of occupation type on self-reported heart disease from 2003 to 2014. Conclusion: Canadian data from the CCHS do not exhibit a trend toward an association between heart disease and the number of hours worked/wk. There is an association between heart disease and physical exertion at work, but the trend is inconsistent. The data indicate a trend toward an association between heart disease and occupation type, but further analysis is required to determine which occupation type may be associated with heart disease. Keywords: occupational health, occupation type, physical exertion, self-reported cardiovascular disease

  9. Referral to a Commercial Weight Management Program in Patients With Coronary Heart Disease: A PILOT STUDY IN THE NETHERLANDS.

    Science.gov (United States)

    Minneboo, Madelon; Peters, Ron J G; Miller-Kovach, Karen; Lemmens, Jeanine; Bucx, Jeroen J J

    2015-01-01

    To quantify the impact of a commercial weight management program on weight change in obese patients with coronary heart disease. An observational, single-center pilot study in the Netherlands. Forty-five patients diagnosed with a recent acute coronary syndrome and a body mass index of >30 kg/m2 were recruited. The commercial weight management intervention (Weight Watchers) promotes a hypoenergetic and balanced diet, increased physical activity, and group support. The program included weekly 30-minute in-hospital meetings with an experienced coach. The program was offered in parallel with a cardiac rehabilitation program. Thirty-five patients completed the program. Of these patients, 32 patients (91%) decreased body weight. Mean weight change was -5.8 kg (range: +0.6 kg to -15.4 kg), and 20 patients (57%) achieved the target of 5% weight loss of their initial weight. Twenty-seven patients continued the commercial weight loss program after 14 weeks, the mean followup of these patients was 34 weeks and their mean weight change was -9.1 kg (range: 0.0-23.0 kg). Obese patients, discharged after an acute coronary syndrome, who were referred to a commercial weight management program, achieved significant weight loss. Although this is a nonrandomized pilot study with patients who were selected by motivation and by the ability to participate in the program, the proportion of weight loss is significant and promising.

  10. Defence Health Service Mentoring Program Evaluation 2001

    National Research Council Canada - National Science Library

    Highfield, Jane

    2002-01-01

    ...). DHS commissioned the Directorate of Strategic Personnel Planning and Research (DSPPR) to evaluate a recent Mentoring Program trial in order to assess the effectiveness and organizational value of Mentoring within DHS...

  11. [Evaluation of a workplace health promotion program].

    Science.gov (United States)

    Forette, Françoise; Brieu, Marie-Anne; Lemasson, Hervé; Salord, Jean-Claude; Le Pen, Claude

    2014-01-01

    Some studies suggest that a workplace prevention programme could reduce health inequalities related to education level and improve the health status of the employees. The objective of the study was to demonstrate the advantages for a company to implement a health prevention programme in the workplace in order to: 1-improve health literacy 2 - change health-related behaviours 3-improve the company image. A "before - after" methodology was used in a population of 2153 employees of three companies. Three areas of prevention were considered: nutrition, physical activity and prevention of back pain. The successive steps of the EBS programme included general communication, group workshops and individual coaching. Data collection was carried out using anonymous questionnaires sent by e-mail. A global assessment was performed based on the companies' pooled data, with separate analysis according to the steps of the programme. The programme mobilized employees with participation rates ranging from 25% to 45.5%. After completion of the full programme, 77.5% of respondents reported an improvement of their health knowledge versus 50.3% of those who only received general communication. Behavioural modification was observed, especially in the fields of nutrition and back pain.. EBS can be considered to be a vector of the company image for almost 7 out of 10 employees. A health prevention education programme provided by the company in the workplace mobilizes employees and contributes to improvement of health knowledge and behaviour change. All approaches tested were important and applicable to various types of companies or workers.

  12. 78 FR 54256 - Health Careers Opportunity Program

    Science.gov (United States)

    2013-09-03

    ..., such as a graduate degree in Clinical or Counseling Psychology, Clinical Social Work, and/or Marriage.... D18HP23014 Research NY 111,764 Foundation of the State University of New York. D18HP23023 Howard DC 111,764..., dentistry, pharmacy, and allied health. With the growing need for mental health and substance abuse services...

  13. The Association of Fasting Glucose, Insulin, and C-Peptide, with 19-Year Incidence of Coronary Heart Disease in Older Japanese-American Men; the Honolulu Heart Program

    Directory of Open Access Journals (Sweden)

    Nazneem Wahab

    2018-04-01

    Full Text Available The role of fasting glucose, insulin levels, and C-peptide in coronary heart disease (CHD in non-diabetic individuals remains uncertain. We examined the association between fasting glucose, insulin and C-peptide with the long-term incidence of CHD in Japanese-American men. In 1980–1982, from a random sample of the Honolulu Heart Program men (n = 1378, aged 61–81 years, data on several CHD and metabolic risk factors were obtained to examine the relation of fasting glucose, insulin and C-peptide to 19-year CHD incidence. Age-adjusted incidence of CHD increased with increasing quintiles of glucose, insulin and C-peptide. Age-adjusted CHD rates in the glucose quintiles were 11.9, 11.6, 14.4, 18.1 and 24.1 per 1000 person-years (trend p < 0.001. In individual Cox models (lowest quintiles of glucose, insulin and C-peptide as reference the relative risks (95% confidence interval of CHD incidence for the glucose quintiles adjusting for age, smoking, hypertension, cholesterol, physical activity, and body mass index, were 0.9 (0.6–1.4, 1.2 (0.8–1.8, 1.4 (0.9–2.2, and 1.7 (1.1–2.6, respectively (trend p = 0.004. Insulin and C-peptide were not significantly associated with CHD on multivariate analysis. Fasting glucose remained the only significant predictor of increased CHD risk (p = 0.003 in a model combining all 3 metabolic variables. In this cohort, only fasting glucose independently predicts long-term incidence of CHD. Age-adjusted insulin and C-peptide levels were associated with CHD incidence, but after adjustment for other risk factors, do not independently predict CHD.

  14. Coordinated school health program and dietetics professionals: partners in promoting healthful eating.

    Science.gov (United States)

    Gross, Sandra M; Cinelli, Bethann

    2004-05-01

    Although research indicates that school meal programs contribute to improved academic performance and healthier eating behaviors for students who participate, fewer than 60% of students choose the National School Lunch Program or School Breakfast Program. School meal programs have a difficult time competing with foods that are marketed to young people through sophisticated advertising campaigns. Youth's preferences for fast foods, soft drinks, and salty snacks; mixed messages sent by school personnel; school food preparation and serving space limitations; inadequate meal periods; and lack of education standards for school foodservice directors challenge school meal programs as well. A coordinated school health program offers a framework for meeting these challenges and provides children and adolescents with the knowledge and skills necessary for healthful eating. This article identifies challenges facing school foodservice directors in delivering healthful meals and acquaints dietetics professionals with the coordinated school health program to be used as a tool for addressing unhealthful weight gain and promoting healthful eating.

  15. Evaluation of a self-management patient education program for patients with chronic heart failure undergoing inpatient cardiac rehabilitation: study protocol of a cluster randomized controlled trial.

    Science.gov (United States)

    Meng, Karin; Musekamp, Gunda; Seekatz, Bettina; Glatz, Johannes; Karger, Gabriele; Kiwus, Ulrich; Knoglinger, Ernst; Schubmann, Rainer; Westphal, Ronja; Faller, Hermann

    2013-08-23

    Chronic heart failure requires a complex treatment regimen on a life-long basis. Therefore, self-care/self-management is an essential part of successful treatment and comprehensive patient education is warranted. However, specific information on program features and educational strategies enhancing treatment success is lacking. This trial aims to evaluate a patient-oriented and theory-based self-management educational group program as compared to usual care education during inpatient cardiac rehabilitation in Germany. The study is a multicenter cluster randomized controlled trial in four cardiac rehabilitation clinics. Clusters are patient education groups that comprise HF patients recruited within 2 weeks after commencement of inpatient cardiac rehabilitation. Cluster randomization was chosen for pragmatic reasons, i.e. to ensure a sufficient number of eligible patients to build large-enough educational groups and to prevent contamination by interaction of patients from different treatment allocations during rehabilitation. Rehabilitants with chronic systolic heart failure (n = 540) will be consecutively recruited for the study at the beginning of inpatient rehabilitation. Data will be assessed at admission, at discharge and after 6 and 12 months using patient questionnaires. In the intervention condition, patients receive the new patient-oriented self-management educational program, whereas in the control condition, patients receive a short lecture-based educational program (usual care). The primary outcome is patients' self-reported self-management competence. Secondary outcomes include behavioral determinants and self-management health behavior (symptom monitoring, physical activity, medication adherence), health-related quality of life, and treatment satisfaction. Treatment effects will be evaluated separately for each follow-up time point using multilevel regression analysis, and adjusting for baseline values. This study evaluates the effectiveness of a

  16. Healthy lifestyle and decreasing risk of heart failure in women: the Women's Health Initiative observational study.

    Science.gov (United States)

    Agha, Golareh; Loucks, Eric B; Tinker, Lesley F; Waring, Molly E; Michaud, Dominique S; Foraker, Randi E; Li, Wenjun; Martin, Lisa W; Greenland, Philip; Manson, JoAnn E; Eaton, Charles B

    2014-10-28

    The impact of a healthy lifestyle on risk of heart failure (HF) is not well known. The objectives of this study were to evaluate the effect of a combination of lifestyle factors on incident HF and to further investigate whether weighting each lifestyle factor has additional impact. Participants were 84,537 post-menopausal women from the WHI (Women's Health Initiative) observational study, free of self-reported HF at baseline. A healthy lifestyle score (HL score) was created wherein women received 1 point for each healthy criterion met: high-scoring Alternative Healthy Eating Index, physically active, healthy body mass index, and currently not smoking. A weighted score (wHL score) was also created in which each lifestyle factor was weighted according to its independent magnitude of effect on HF. The incidence of hospitalized HF was determined by trained adjudicators using standardized methodology. There were 1,826 HF cases over a mean follow-up of 11 years. HL score was strongly associated with risk of HF (multivariable-adjusted hazard ratio [HR] [95% confidence interval (CI)] 0.49 [95% CI: 0.38 to 0.62], 0.36 [95% CI: 0.28 to 0.46], 0.24 [95% CI: 0.19 to 0.31], and 0.23 [95% CI: 0.17 to 0.30] for HL score of 1, 2, 3, and 4 vs. 0, respectively). The HL score and wHL score were similarly associated with HF risk (HR: 0.46 [95% CI: 0.41 to 0.52] for HL score; HR: 0.48 [95% CI: 0.42 to 0.55] for wHL score, comparing the highest tertile to the lowest). The HL score was also strongly associated with HF risk among women without antecedent coronary heart disease, diabetes, or hypertension. An increasingly healthy lifestyle was associated with decreasing HF risk among post-menopausal women, even in the absence of antecedent coronary heart disease, hypertension, and diabetes. Weighting the lifestyle factors had minimal impact. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  17. Epidemiology, health systems and stakeholders in rheumatic heart disease in Africa: a systematic review protocol.

    Science.gov (United States)

    Moloi, Annesinah Hlengiwe; Watkins, David; Engel, Mark E; Mall, Sumaya; Zühlke, Liesl

    2016-05-20

    Rheumatic heart disease (RHD) is a chronic disease affecting the heart valves, secondary to group A streptococcal infection (GAS) and subsequent acute rheumatic fever (ARF). However, RHD cure and preventative measures are inextricably linked with socioeconomic development, as the disease mainly affects children and young adults living in poverty. In order to address RHD, public health officials and health policymakers require up-to-date knowledge on the epidemiology of GAS, ARF and RHD, as well as the existing enablers and gaps in delivery of evidence-based care for these conditions. We propose to conduct a systematic review to assess the literature comprehensively, synthesising all existing quantitative and qualitative data relating to RHD in Africa. We plan to conduct a comprehensive literature search using a number of databases and reference lists of relevant articles published from January 1995 to December 2015. Two evaluators will independently review and extract data from each article. Additionally, we will assess overall study quality and risk of bias, using the Newcastle-Ottawa Scale and the Critical Appraisal Skills Programme criteria for quantitative and qualitative studies, respectively. We will meta-analyse estimates of prevalence, incidence, case fatality and mortality for each of the conditions separately for each country. Qualitative meta-analysis will be conducted for facilitators and barriers in RHD health access. Lastly, we will create a list of key stakeholders. This protocol is registered in the PROSPERO International Prospective Register of systematic reviews, registration number CRD42016032852. The information provided by this review will inform and assist relevant stakeholders in identifying key areas of intervention, and designing and implementing evidence-based programmes and policies at the local and regional level. With slight modifications (ie, to the country terms in the search strategy), this protocol can be used as part of a needs

  18. Health characteristics of heart transplant recipients surviving into their 80s.

    Science.gov (United States)

    Tabachnick, Deborah R; Bowen, Megan E; Stehlik, Josef; Kfoury, Abdallah G; Caine, William T; Selzman, Craig H; McKellar, Stephen H

    2017-08-01

    Heart transplantation (HTx) is the preferred treatment for patients with end-stage heart failure and has been successful for >30 y. The clinical course of recipients at the extreme of age is unknown. We reviewed our experience to determine the overall health and prevalence of Tx-related medical problems for recipients in their ninth decade. We reviewed the UCTP experience from 1985 to present to identify patients who survived into their 80s and matched (1:1) with other recipients for gender and age at HTx, but did not survive to ≥80 y. The end point was the prevalence of medical problems. Since 1985, 1129 adult HTx have been performed and 14 patients (1.2%) survived to ≥80 y old. The mean age at HTx was 63 ± 4 y. Of octogenarians, the majority were males with ischemic cardiomyopathy. The average survival after transplant was 19 ± 5 y in the octogenarians and 5 ± 5 y in the controls (P  55%) for all octogenarians at age 80 y. Despite improvements in posttransplant care, survival of HTx patients into the ninth decade is rare (1%). For those surviving into their 80s, cardiac function is preserved but dyslipidemia, renal insufficiency, and skin cancers are common. As the age of Htx patients continues to increase, posttransplant care should be tailored to minimize post-HTx complications and further extend survival. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. The mediation effect of health literacy between subjective social status and depressive symptoms in patients with heart failure.

    Science.gov (United States)

    Zou, Huijing; Chen, Yuxia; Fang, Wenjie; Zhang, Yanting; Fan, Xiuzhen

    2016-12-01

    Depressive symptoms are prevalent and cause adverse outcomes in heart failure. Previous studies have linked depressive symptoms with socioeconomic status. However, little is known about the mechanisms underlying this relationship. This study aimed to evaluate the association between socioeconomic status and depressive symptoms, and to examine whether access to healthcare, health literacy and social support mediated this relationship in patients with heart failure. Cross-sectional design was used to study 321 patients with heart failure recruited from a general hospital. Demographics, clinical data, depressive symptoms, socioeconomic status (i.e., education, employment, income, and subjective social status), access to healthcare, health literacy, and social support were collected by patient interview, medical record review or questionnaires. A series of logistic regressions and linear regressions were conducted to examine mediation. The mean age of patients with heart failure was 63.6±10.6years. Fifty-eight patients (18%) had depressive symptoms. Lower subjective social status (OR=1.321, p=0.012) and lower health literacy (OR=1.065, psubjective social status and health literacy were entered simultaneously, the relationship between subjective social status and depressive symptoms became non-significant (OR=1.208, p=0.113), demonstrating mediation. Additionally, lower social support was associated with depressive symptoms (OR=1.062, p=0.007). In patients with heart failure, health literacy mediated the relationship between subjective social status and depressive symptoms. Lower social support was associated with depressive symptoms. Interventions should take these factors into account. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Adolescents with congenital heart disease: the importance of perceived parenting for psychosocial and health outcomes.

    Science.gov (United States)

    Luyckx, Koen; Goossens, Eva; Missotten, Lies; Moons, Philip

    2011-11-01

    : Little is known about how parenting relates to psychosocial functioning and health behavior in adolescents with congenital heart disease (CHD). Different parenting styles were identified through relying on adolescent perceptions of multiple dimensions (regulation, responsiveness, and psychological control). The degree to which parents were perceived as consistent in their rearing style was assessed. : Adolescents with CHD were selected from the database of pediatric and congenital cardiology of the University Hospitals Leuven; control individuals were recruited at secondary schools. A total of 429 adolescents (14-18 years) with CHD participated; 403 were matched on gender and age with control individuals. Adolescents completed questionnaires on maternal and paternal regulation, psychological control, and responsiveness. Main outcome measures were depressive symptoms, loneliness, quality of life, health status, alcohol, cigarette, and drug use. : No significant differences emerged between adolescents with CHD and controls in perceived parenting styles. Democratic parenting was accompanied by the most optimal pattern of outcomes in adolescents with CHD, whereas psychologically controlling parenting by the least optimal pattern. Overprotective parenting was related to high patient substance use. Perceiving both parents as democratic turned out most favorably for psychosocial functioning and quality of life, whereas parental consistency was unrelated to substance use in adolescents with CHD. : By building bridges between the fields of adolescent medicine and family studies, the present study generated important information on the role of parents in psychosocial and behavioral functioning of adolescents with CHD. Future longitudinal studies could inform family-based interventions for this population.

  1. Geographical variation in cardiovascular incidence: results from the British Women's Heart and Health Study

    Directory of Open Access Journals (Sweden)

    Ebrahim Shah

    2010-11-01

    Full Text Available Abstract Background Prevalence of cardiovascular disease (CVD in women shows regional variations not explained by common risk factors. Analysis of CVD incidence will provide insight into whether there is further divergence between regions with increasing age. Methods Seven-year follow-up data on 2685 women aged 59-80 (mean 69 at baseline from 23 towns in the UK were available from the British Women's Heart and Health Study. Time to fatal or non-fatal CVD was analyzed using Cox regression with adjustment for risk factors, using multiple imputation for missing values. Results Compared to South England, CVD incidence is similar in North England (HR 1.05 (95% CI 0.84, 1.31 and Scotland (0.93 (0.68, 1.27, but lower in Midlands/Wales (0.85 (0.64, 1.12. Event severity influenced regional variation, with South England showing lower fatal incident CVD than other regions, but higher non-fatal incident CVD. Kaplan-Meier plots suggested that regional divergence in CVD occurred before baseline (before mean baseline age of 69. Conclusions In women, regional differences in CVD early in adult life do not further diverge in later life. This may be due to regional differences in early detection, survivorship of women entering the study, or event severity. Targeting health care resources for CVD by geographic variation may not be appropriate for older age-groups.

  2. Mental Health Problems in Parents of Children with Congenital Heart Disease.

    Science.gov (United States)

    Kolaitis, Gerasimos A; Meentken, Maya G; Utens, Elisabeth M W J

    2017-01-01

    This review will provide a concise description of mental health problems in parents of children with a (non-syndromic) congenital heart disease (CHD) during different stressful periods. Predictors of these problems and also implications for clinical practice will be mentioned. Having a child with CHD can be very stressful for parents, who have to face overwhelming emotions and also extra physical, financial, and other practical challenges. Parental distress has been reported in 30-80% of parents and appears not to be related to severity of CHD. Parental mental health, parenting, the parent-child relationship, and parental quality of life can all be affected. Parents, and especially mothers, are at risk of psychological distress, anxiety, depression, somatization, hopelessness, and posttraumatic stress symptoms, which in turn may influence mother's responsiveness. In the long term, the majority of parents adapt successfully to living with a child with CHD, but approximately 40% report a need for psychosocial care. These families may be helped by early psychosocial interventions to alleviate stress and reduce children's emotional and behavioral problems. A holistic approach to early psychosocial interventions should aim at improving coping and enhance parenting. During routine medical checkups, medical professionals should ask about parental stress, family functioning, and psychosocial functioning of the child and, when needed, adequate psychosocial care should be provided.

  3. Study protocol for the FITR Heart Study: Feasibility, safety, adherence, and efficacy of high intensity interval training in a hospital-initiated rehabilitation program for coronary heart disease.

    Science.gov (United States)

    Taylor, Jenna; Keating, Shelley E; Leveritt, Michael D; Holland, David J; Gomersall, Sjaan R; Coombes, Jeff S

    2017-12-01

    For decades, moderate intensity continuous training (MICT) has been the cornerstone of exercise prescription for cardiac rehabilitation (CR). High intensity interval training (HIIT) is now recognized in CR exercise guidelines as an appropriate and efficient modality for improving cardiorespiratory fitness, a strong predictor of mortality. However, the clinical application of HIIT in a real world CR setting, in terms of feasibility, safety, and long-term adherence, needs further investigation to address ongoing reservations. Furthermore, studies using objective measures of exercise intensity (such as heart rate; HR) have produced variable outcomes. Therefore we propose investigating the use of subjective measures (such as rating of perceived exertion (RPE)) for prescribing exercise intensity. One hundred adults with coronary artery disease (CAD) attending a hospital-initiated CR program will be randomized to 1) HIIT: 4 × 4 min high intensity intervals at 15-18 RPE interspersed with 3-min active recovery periods or 2) MICT: usual care exercise including 40 min continuous exercise at a moderate intensity corresponding to 11-13 RPE. Primary outcome is change in exercise capacity (peak VO 2 ) following 4 weeks of exercise training. Secondary outcome measures are: feasibility, safety, exercise adherence, body composition, vascular function, inflammatory markers, intrahepatic lipid, energy intake, and dietary behavior over 12-months; and visceral adipose tissue (VAT) following 12 weeks of exercise training. This study aims to address the ongoing concerns regarding the practicality and safety of HIIT in CR programs. We anticipate study findings will lead to the development of a standardized protocol to facilitate CR programs to incorporate HIIT as a standard exercise option for appropriate patients.

  4. Oral health status of children with congenital heart disease and the awareness, attitude and knowledge of their parents.

    Science.gov (United States)

    Rai, Kavita; Supriya, S; Hegde, Amitha M

    2009-01-01

    The oral health status of children with congenital heart diseases and the parental awareness on maintaining good oral health and attitude towards preventive dental health measures were evaluated. A total of 170 children between the age group of 1-16 yrs belonging to both genders, with the history of congenital heart disease from Sree Chitra Tirunal Institute of Medical Science and Technology, Thiruvananthapuram and Narayana Hrudayalaya Institute of Medical Sciences, Bangalore were examined. Oral lesions and caries experience were recorded using modified WHO oral health assessment form. Oral hygiene of the children with congenital heart disease was found to be poor with tongue coating (50.6%), plaque (41.8%), calculus (35.3%), and caries (42.4%). Parental awareness on the importance of maintaining good oral hygiene, preventive dentistry, medicinal decay and its systemic effects has been found to be very poor. Dentistry should give priority to patients whose general health may be put at risk by poor dental health. Closer cooperation between Pediatrician, Pediatric Cardiologists and Pediatric Dentists could help improve dental care for these children.

  5. Health policy programs realised in Poland in 2016-2017

    Science.gov (United States)

    Kurowska, Patrycja; Królak, Anna; Giermaziak, Wojciech

    2018-01-01

    Health Policy Program (Program Polityki Zdrowotnej – PPZ) is a state policy tool for engaging local government units into the mechanism of granting provision of health services. Authors show areas in which self-governments most often took preventive health care actions and describe legislative changes in the Act on provision of health services. The aim of the article is to quantitative and qualitative statement of PPZ prepared in Poland in 2016 and 2017, as well as presenting changing legal situation in the scope of evaluation of these projects. Authors use descriptive method, presenting changes of legal status. The article includes data available in the Bulletin of Public Information by The Agency for Health Technology Assessment. 590 programs were analyzed (239 from 2016 and 351 from 2017). In 2016 – 67% of submitted programs were given a positive opinion and in 2017 – 71%. The most of positively evaluated PPZ submitted by local government units (53% in 2016; 47% in 2017) referred to prevention of infectious diseases by vaccines. On the basis of analyses conducted, significant differences were observed in the implementation of the PPZ in various regions of Poland. In the recent years a big improvement in the quality of planned self-government health programs is observed. It is suggested that due to the regulation defining the model of the health policy program and the model of the final report, this trend will continue.

  6. Effectiveness of a Walking Group Intervention to Promote Physical Activity and Cardiovascular Health in Predominantly Non-Hispanic Black and Hispanic Urban Neighborhoods: Findings from the Walk Your Heart to Health Intervention

    Science.gov (United States)

    Schulz, Amy J.; Israel, Barbara A.; Mentz, Graciela B.; Bernal, Cristina; Caver, Deanna; DeMajo, Ricardo; Diaz, Gregoria; Gamboa, Cindy; Gaines, Causandra; Hoston, Bernadine; Opperman, Alisha; Reyes, Angela G.; Rowe, Zachary; Sand, Sharon L.; Woods, Sachiko

    2015-01-01

    Objectives: The purpose of this study was to evaluate the effectiveness of the "Walk Your Heart to Health" ("WYHH") intervention, one component of the multilevel Community Approaches to Cardiovascular Health: Pathways to Heart Health (CATCH:PATH) intervention designed to promote physical activity and reduce cardiovascular risk…

  7. Results of the Medicare Health Support disease-management pilot program.

    Science.gov (United States)

    McCall, Nancy; Cromwell, Jerry

    2011-11-03

    In the Medicare Modernization Act of 2003, Congress required the Centers for Medicare and Medicaid Services to test the commercial disease-management model in the Medicare fee-for-service program. The Medicare Health Support Pilot Program was a large, randomized study of eight commercial programs for disease management that used nurse-based call centers. We randomly assigned patients with heart failure, diabetes, or both to the intervention or to usual care (control) and compared them with the use of a difference-in-differences method to evaluate the effects of the commercial programs on the quality of clinical care, acute care utilization, and Medicare expenditures for Medicare fee-for-service beneficiaries. The study included 242,417 patients (163,107 in the intervention group and 79,310 in the control group). The eight commercial disease-management programs did not reduce hospital admissions or emergency room visits, as compared with usual care. We observed only 14 significant improvements in process-of-care measures out of 40 comparisons. These modest improvements came at substantial cost to the Medicare program in fees paid to the disease-management companies ($400 million), with no demonstrable savings in Medicare expenditures. In this large study, commercial disease-management programs using nurse-based call centers achieved only modest improvements in quality-of-care measures, with no demonstrable reduction in the utilization of acute care or the costs of care.

  8. Selecting, adapting, and sustaining programs in health care systems

    Directory of Open Access Journals (Sweden)

    Zullig LL

    2015-04-01

    Full Text Available Leah L Zullig,1,2 Hayden B Bosworth1–4 1Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA; 2Department of Medicine, Duke University Medical Center, Durham, NC, USA; 3School of Nursing, 4Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA Abstract: Practitioners and researchers often design behavioral programs that are effective for a specific population or problem. Despite their success in a controlled setting, relatively few programs are scaled up and implemented in health care systems. Planning for scale-up is a critical, yet often overlooked, element in the process of program design. Equally as important is understanding how to select a program that has already been developed, and adapt and implement the program to meet specific organizational goals. This adaptation and implementation requires attention to organizational goals, available resources, and program cost. We assert that translational behavioral medicine necessitates expanding successful programs beyond a stand-alone research study. This paper describes key factors to consider when selecting, adapting, and sustaining programs for scale-up in large health care systems and applies the Knowledge to Action (KTA Framework to a case study, illustrating knowledge creation and an action cycle of implementation and evaluation activities. Keywords: program sustainability, diffusion of innovation, information dissemination, health services research, intervention studies 

  9. Epigenomic programing: a future way to health?

    OpenAIRE

    Shenderov, Boris A.; Midtvedt, Tore

    2014-01-01

    It is now generally accepted that the ‘central genome dogma’ (i.e. a causal chain going from DNA to RNA to proteins and downstream to biological functions) should be replaced by the ‘fluid genome dogma’, that is, complex feed-forward and feed-back cycles that interconnect organism and environment by epigenomic programing – and reprograming – throughout life and at all levels, sometimes also down the generations. The epigenomic programing is the net sum of interactions derived from own metabol...

  10. Evaluation of medical and health economic effectiveness of non-pharmacological secondary prevention of coronary heart disease

    Directory of Open Access Journals (Sweden)

    Greiner, Wolfgang

    2009-12-01

    Full Text Available Background: Coronary heart disease (CHD is a common and potentially fatal malady with a life time prevalence of over 20%. For Germany, the mortality attributable to chronic ischemic heart disease or acute myocardial infarction is estimated at 140,000 deaths per year. An association between prognosis of CHD and lifestyle risk factors has been consistently shown. To positively influence lifestyle risk factors in patients with CHD, non-pharmaceutical secondary prevention strategies are frequently recommended and implemented. Objectives: The aim of this HTA (HTA = Health Technology Assessment is to summarise the current literature on strategies for non-pharmaceutical secondary prevention in patients with CHD and to evaluate their medical effectiveness/efficacy and cost-effectiveness as well as the ethical, social and legal implications. In addition, this report aims to compare the effectiveness and efficacy of different intervention components and to evaluate the generalisability with regard to the German context. Methods: Relevant publications were identified by means of a structured search of databases accessed through the German Institute of Medical Documentation and Information (DIMDI. In addition, a manual search of identified reference lists was conducted. The present report includes German and English literature published between January 2003 and September 2008 targeting adults with CHD. The methodological quality of included studies was assessed according to pre-defined quality criteria, based on the criteria of evidence based medicine. Results: Among 9,074 publications 43 medical publications met the inclusion criteria. Overall study quality is satisfactory, but only half the studies report overall mortality or cardiac mortality as an outcome, while the remaining studies report less reliable outcome parameters. The follow-up duration varies between twelve and 120 months. Although overall effectiveness of non-pharmaceutical secondary

  11. The duty health physicist program at Byron Nuclear Power Station

    International Nuclear Information System (INIS)

    Goldsmith, D.G.; Carey, T.R.

    1987-01-01

    The Duty Health Physicist Program at Byron Station was established to deal with routine health physics tasks and provide an interface between frontline and upper radiation-chemistry management. The program consists of a weekly rotation of selected members of the health physics staff into the duty health physicist position to handle the assigned duty tasks. The tasks include, but are not limited to, daily isotopic and air sample review, effluent release package review, maximum permissible concentration calculations, dose approvals, as-low-as-reasonably-achievable action review of pending jobs, and general availability to answer questions and address problems in health-physics-related areas of plant operation. The daily attendance of the duty health physicist at the radiation-chemistry and station plan-of-the-day meetings has increased the overall presence and visibility of the health physics program to upper station management and other station departments. Since its inception in July of 1985, the Duty Health Physics Program has been a major contributor to the observed 50% reduction in reportable personnel errors in the radiation-chemistry department (based on personnel-error-related deviation reports and license event reports generated on the radiation-chemistry department at Byron Station). Although difficulty to quantify, other important benefits of this program are also discussed in this paper

  12. Hospital Value-Based Purchasing (HVBP) – Heart Failure Scores

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospitals participating in the Hospital VBP Program and their performance rates and scores for the Clinical Process of Care Heart Failure measures.

  13. The Need and Curricula for Health Professions Education Graduate Programs

    Science.gov (United States)

    Cervero, Ronald M.; Daley, Barbara J.

    2018-01-01

    This chapter provides an overview of the emerging social and organizational contexts for health professions education and the rationale for foundational adult and continuing education concepts to be included in the curricula of HPE graduate programs.

  14. Federal Employees Health Benefits Program (FEHBP) Plan Information

    Data.gov (United States)

    Office of Personnel Management — A list of all Federal Employees Health Benefits Program (FEHBP) plans available in each state, as well as links to the plan brochures, changes for each plan from the...

  15. Continuous-Time Semi-Markov Models in Health Economic Decision Making: An Illustrative Example in Heart Failure Disease Management.

    Science.gov (United States)

    Cao, Qi; Buskens, Erik; Feenstra, Talitha; Jaarsma, Tiny; Hillege, Hans; Postmus, Douwe

    2016-01-01

    Continuous-time state transition models may end up having large unwieldy structures when trying to represent all relevant stages of clinical disease processes by means of a standard Markov model. In such situations, a more parsimonious, and therefore easier-to-grasp, model of a patient's disease progression can often be obtained by assuming that the future state transitions do not depend only on the present state (Markov assumption) but also on the past through time since entry in the present state. Despite that these so-called semi-Markov models are still relatively straightforward to specify and implement, they are not yet routinely applied in health economic evaluation to assess the cost-effectiveness of alternative interventions. To facilitate a better understanding of this type of model among applied health economic analysts, the first part of this article provides a detailed discussion of what the semi-Markov model entails and how such models can be specified in an intuitive way by adopting an approach called vertical modeling. In the second part of the article, we use this approach to construct a semi-Markov model for assessing the long-term cost-effectiveness of 3 disease management programs for heart failure. Compared with a standard Markov model with the same disease states, our proposed semi-Markov model fitted the observed data much better. When subsequently extrapolating beyond the clinical trial period, these relatively large differences in goodness-of-fit translated into almost a doubling in mean total cost and a 60-d decrease in mean survival time when using the Markov model instead of the semi-Markov model. For the disease process considered in our case study, the semi-Markov model thus provided a sensible balance between model parsimoniousness and computational complexity. © The Author(s) 2015.

  16. Satisfaction with a distance continuing education program for health professionals.

    Science.gov (United States)

    Bynum, Ann B; Irwin, Cathy A; Cohen, Betty

    2010-09-01

    This study assessed differences in program satisfaction among health professionals participating in a distance continuing education program by gender, ethnicity, discipline, and community size. A one-group posttest design was used with a sample of 45,996 participants in the University of Arkansas for Medical Sciences, Rural Hospital, Distance Continuing Medical Education Program during 1995-2007. This program provided 2,219 continuing education programs for physicians (n = 7,047), nurses (n = 21,264), allied health (n = 3,230) and dental (n = 305) professionals, pharmacists (n = 4,088), administrators (n = 1,211), and marketing/finance/human resources professionals (n = 343). These programs were provided in Arkansas hospitals, clinics, and area health education centers. Interactive video technology and the Internet were used to deliver these programs. The program satisfaction instrument demonstrated adequate internal consistency reliability (Cronbach's alpha = 0.91) and construct validity. Participants had high levels of satisfaction regarding knowledge and skills, use of information to enhance patient care, program quality, and convenience of the technology (mean total satisfaction score = 4.44, range: 1-5). Results from the t-test for independent samples and one-way analysis of variance indicated that men (p = 0.01), African-Americans and Hispanics (p affect satisfaction with distance continuing education programs.

  17. Short-term outcomes following implementation of a dedicated young adult congenital heart disease transition program.

    Science.gov (United States)

    Vaikunth, Sumeet S; Williams, Roberta G; Uzunyan, Merujan Y; Tun, Han; Barton, Cheryl; Chang, Philip M

    2018-01-01

    Transition from pediatric to adult care is a critical time for patients with congenital heart disease. Lapses in care can lead to poor outcomes, including increased mortality. Formal transition clinics have been implemented to improve success of transferring care from pediatric to adult providers; however, data regarding outcomes remain limited. We sought to evaluate outcomes of transfer within a dedicated transition clinic for young adult patients with congenital heart disease. We performed a retrospective analysis of all 73 patients seen in a dedicated young adult congenital heart disease transition clinic from January 2012 to December 2015 within a single academic institution that delivered pediatric and adult care at separate children's and adult hospitals, respectively. Demographic characteristics including congenital heart disease severity, gender, age, presence of comorbidities, presence of cardiac implantable electronic devices, and type of insurance were correlated to success of transfer. Rate of successful transfer was evaluated, and multivariate analysis was performed to determine which demographic variables were favorably associated with transfer. Thirty-nine percent of patients successfully transferred from pediatric to adult services during the study period. Severe congenital heart disease (OR 4.44, 95% CI 1.25-15.79, P = .02) and presence of a cardiac implantable electronic device (OR 4.93, 95% CI 1.18-20.58, P = .03) correlated with transfer. Trends favoring successful transfer with presence of comorbidities and private insurance were also noted. Despite a dedicated transition clinic, successful transfer rates remained relatively low though comparable to previously published rates. Severity of disease and presence of implantable devices correlated with successful transfer. Other obstacles to transfer remain and require combined efforts from pediatric and adult care systems, insurance carriers, and policy makers to improve transfer outcomes.

  18. Defining Optimal Brain Health in Adults: A Presidential Advisory From the American Heart Association/American Stroke Association.

    Science.gov (United States)

    Gorelick, Philip B; Furie, Karen L; Iadecola, Costantino; Smith, Eric E; Waddy, Salina P; Lloyd-Jones, Donald M; Bae, Hee-Joon; Bauman, Mary Ann; Dichgans, Martin; Duncan, Pamela W; Girgus, Meighan; Howard, Virginia J; Lazar, Ronald M; Seshadri, Sudha; Testai, Fernando D; van Gaal, Stephen; Yaffe, Kristine; Wasiak, Hank; Zerna, Charlotte

    2017-10-01

    Cognitive function is an important component of aging and predicts quality of life, functional independence, and risk of institutionalization. Advances in our understanding of the role of cardiovascular risks have shown them to be closely associated with cognitive impairment and dementia. Because many cardiovascular risks are modifiable, it may be possible to maintain brain health and to prevent dementia in later life. The purpose of this American Heart Association (AHA)/American Stroke Association presidential advisory is to provide an initial definition of optimal brain health in adults and guidance on how to maintain brain health. We identify metrics to define optimal brain health in adults based on inclusion of factors that could be measured, monitored, and modified. From these practical considerations, we identified 7 metrics to define optimal brain health in adults that originated from AHA's Life's Simple 7: 4 ideal health behaviors (nonsmoking, physical activity at goal levels, healthy diet consistent with current guideline levels, and body mass index brain health but recognize that the truly ideal circumstance may be uncommon because there is a continuum of brain health as demonstrated by AHA's Life's Simple 7. Therefore, there is opportunity to improve brain health through primordial prevention and other interventions. Furthermore, although cardiovascular risks align well with brain health, we acknowledge that other factors differing from those related to cardiovascular health may drive cognitive health. Defining optimal brain health in adults and its maintenance is consistent with the AHA's Strategic Impact Goal to improve cardiovascular health of all Americans by 20% and to reduce deaths resulting from cardiovascular disease and stroke by 20% by the year 2020. This work in defining optimal brain health in adults serves to provide the AHA/American Stroke Association with a foundation for a new strategic direction going forward in cardiovascular health

  19. 77 FR 37415 - Office of Urban Indian Health Programs; Title V HIV/AIDS Program

    Science.gov (United States)

    2012-06-21

    ... Indian health program HIV/AIDS activities is necessary to reduce the incidence of HIV/AIDS in the urban Indian communities by increasing access to HIV related services, reducing stigma, and making testing..., Substance Abuse and Mental Health Services Administration, Health Resource and Services Administration, and...

  20. The US Public Health Service's radioactive materials program

    International Nuclear Information System (INIS)

    Villforth, J.C.

    1996-01-01

    This review concentrates primarily on the U.S. Public Health Service's radiological health programs that are related to the use of radium in medicine. The history of program development is given, with a focus on legal and regulatory aspects. Federal and state cooperative actions are outlined, including congressional radium hearings, National Advisory Committee on Radiation, and Federal Radiation Council rulings. Problems associated with the medical use of radium, such as contamination and disposal, are also described. 30 refs

  1. The effect of the cardiac rehabilitation program on obese and non-obese females with coronary heart disease

    Directory of Open Access Journals (Sweden)

    Fatemeh Esteki Ghashghaei

    2012-01-01

    Full Text Available Introduction: Obesity is strongly associated with coronary heart disease and it is known as an independent risk factor. So, the aim of this study was to investigate the effects of phase II comprehensive cardiac rehabilitation program on obesity indexes, functional capacity, lipid profiles, and fasting blood sugar in obese and non-obese female patients with coronary heart disease and to compare changes in these groups. Materials and Methods: Two hundred and five women with coronary heart disease participated in our study. At the beginning of study, body mass index, functional capacity, and lipid profiles and fasting blood sugar were evaluated; then, these patients were divided into two groups, patients who had BMI≥30 were known as obese and who had BMI<30 were known as non-obese patients. All of them completed the period of cardiac rehabilitation program, and 2 months later, all risk factors were examined for the second time in each group. Data were analyzed with SPSS software version 15. For comparing the mean of outcomes, independent t-tests and paired t-tests were used. Results: Data revealed that unless in weight (P=0.00 and functional capacity (P=0.001, there were no significant differences in obese and non-obese female patients, at baseline. As a result of the cardiac rehabilitation program, both groups had significant improvement in functional capacity (P=0.00, weight reduction (P=0.00, triglyceride (P=0.01 and P=0.02, respectively, low-density lipoprotein cholesterol (P=0.01, and low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio (P=0.00 and P=0.003, respectively. As well, significant improvement was observed in high-density lipoprotein (P=0.01 only in obese female, and non-obese female had significant differences in total cholesterol (P=0.003. However, there were not significant changes in total cholesterol (P=0.05 and fasting blood sugar (P=0.09 in obese female. Also, non-obese females didn′t have

  2. Sing Your Heart Out: community singing as part of mental health recovery.

    Science.gov (United States)

    Shakespeare, Tom; Whieldon, Alice

    2017-11-25

    This paper reports on a qualitative evaluation of a Norfolk-based network of community singing workshops aimed at people with mental health conditions and the general public. The aims of the study were (a) to evaluate the effectiveness of the Sing Your Heart Out (SYHO) project and (b) to identify the key features which made the project distinctive. The study draws on 20 interviews with participants, two focus groups with organisers and workshop leaders, and participative observation over a 6-month period. Interviewees all reported improvement in or maintenance of their mental health and well-being as a direct result of engagement in the singing workshops. For most it was a key component, and for some the only and sufficient component in their recovery and ongoing psychological stability. SYHO was regarded as different from choirs and from most other social groups and also different from therapy groups, music or otherwise. The combination of singing with an inclusive social aspect was regarded as essential in effecting recovery. The lack of pressure to discuss their condition and the absence of explicit therapy was also mentioned by most participants as an important and welcome element in why SYHO worked for them. The combination of singing and social engagement produced an ongoing feeling of belonging and well-being. Attendance provided them with structure, support and contact that improved functioning and mood. We conclude that the SYHO model offers a low-commitment, low-cost tool for mental health recovery within the community. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. The women's heart health programme: a pilot trial of sex-specific cardiovascular management.

    Science.gov (United States)

    Low, Ting Ting; Chan, Siew Pang; Wai, Shin Hnin; Ang, Zhou; Kyu, Kyu; Lee, Kim Yee; Ching, Anne; Comer, Sarah; Tan, Naomi Qiu Pin; Thong, Elizabeth Grace Hui En; Nang, Tracy; Dutta, Mohan; Lam, Carolyn S P

    2018-04-16

    There is increasing knowledge of sex-specific differences in cardiovascular disease and recognition of sex disparities in management. In our study, we investigated whether a cardiovascular programme tailored to the specific needs of women could lead to improved outcomes. We randomised 100 female patients to receive cardiology follow-up with the conventional sex-neutral cardiac programme (control), or the sex-tailored Women's Heart Health Programme (intervention). The intervention group was managed by an all-women multidisciplinary team and received culture-centred health intervention workshops, designed through in-depth interviews with the participants. The primary outcome was cardiovascular risk factor improvement at 1 year. Secondary outcomes include cardiovascular event rates, quality of life scores, and self-reported improvement in knowledge, attitudes, intentions and practices. Generalised structural equation model analysis was used to determine if the intervention group had better outcomes at alpha level 0.1. The mean age was 67.3 ± 12.7 years, with an ethnic distribution of 70% Chinese, 18% Malays, and 12% Indians. The majority of these patients had no formal or primary level of education (63%), and were mostly unemployed (78%). Patients in intervention group had better control of diabetes mellitus (lower HbA1c of 0.63% [CI 0.21-1.04], p = 0.015) and lower body-mass-index (0.74 kg/m 2 [CI 0.02-1.46], p = 0.092) at 1 year, but there was no significant difference in blood pressure or lipid control. Overall, there was a trend towards better risk factor control, 31.6% of intervention group versus 26.5% of control group achieved improvement in at least 1 CV risk factor control to target range. There was no significant difference in incidence of cardiovascular events, quality of life, or domains in knowledge, attitudes, intention and practices. This pilot study is the first of its kind evaluating a new model of care for women with heart disease

  4. Integrated Worker Health Protection and Promotion Programs: Overview and Perspectives on Health and Economic Outcomes

    Science.gov (United States)

    Pronk, Nicolaas P.

    2014-01-01

    Objective To describe integrated worker health protection and promotion (IWHPP) program characteristics, to discuss the rationale for integration of OSH and WHP programs, and to summarize what is known about the impact of these programs on health and economic outcomes. Methods A descriptive assessment of the current state of the IWHPP field and a review of studies on the effectiveness of IWHPP programs on health and economic outcomes. Results Sufficient evidence of effectiveness was found for IWHPP programs when health outcomes are considered. Impact on productivity-related outcomes is considered promising, but inconclusive, whereas insufficient evidence was found for health care expenditures. Conclusions Existing evidence supports an integrated approach in terms of health outcomes but will benefit significantly from research designed to support the business case for employers of various company sizes and industry types. PMID:24284747

  5. Sri Lanka's Health Unit Program: A Model of "Selective" Primary Health Care

    Directory of Open Access Journals (Sweden)

    Soma Hewa

    2011-12-01

    Full Text Available This paper argues that the health unit program developed in Sri Lanka in the early twentieth century was an earlier model of selective primary health care promoted by the Rockefeller Foundation in the 1980s in opposition to comprehensive primary health care advocated by the Alma-Ata Declaration of the World Health Organization. A key strategy of the health unit program was to identify the most common and serious infectious diseases in each health unit area and control them through improved sanitation, health education, immunization and treatment with the help of local communities. The health unit program was later introduced to other countries in South and Southeast Asia as part of the Rockefeller Foundation's global campaign to promote public health.

  6. Home Economics/Health Grades 6-12. Program Evaluation.

    Science.gov (United States)

    Des Moines Public Schools, IA. Teaching and Learning Div.

    Home economics programs are offered to students in grades 6-12 in the Des Moines INdependent Community School District (Iowa). Programs at the middle school level are exploratory, leading to occupational training in family and consumer science, child care, food service, and textile and fashion arts at the high school level. Health education…

  7. Ethics in Worksite Health Programming: Who Is Served?

    Science.gov (United States)

    Roman, Paul M.; Blum, Terry C.

    1987-01-01

    Based on extensive research experience with employee assistance programs, ethical issues concerning employee assistance and wellness/health promotion programs are considered at three levels: (1) the individual level, (2) the organizational level, and (3) the interorganizational level. (Author/CH)

  8. 77 FR 10455 - National Institutes of Health Loan Repayment Programs

    Science.gov (United States)

    2012-02-22

    ... science or clinical research parameters and is not targeted toward a specific area (e.g., AIDS) or type of..., whether the time is spent on research, teaching, patient care, or other activities. Living Expenses: Means...) Primary Care Loan (PCL) Program, and (10) Public Health Service Scholarship (PHS) Program; (d) For...

  9. 78 FR 20466 - National Institutes of Health Loan Repayment Programs

    Science.gov (United States)

    2013-04-05

    ... science or clinical research parameters and is not targeted toward a specific area (e.g., AIDS) or type of..., whether the time is spent on research, teaching, patient care, or other activities. Living expenses means... Shortage Area Scholarship Program, (9) Primary Care Loan (PCL) Program, and (10) Public Health Service...

  10. Outcomes Assessment in Accredited Health Information Management Programs

    Science.gov (United States)

    Bennett, Dorine

    2010-01-01

    The purpose of this study was to determine the use and perceived usefulness of outcomes assessment methods in health information management programs. Additional characteristics of the outcomes assessment practices were recognized. The findings were evaluated for significant differences in results based on age of the program, type of institution,…

  11. Preventing Heart Disease - At Any Age

    Science.gov (United States)

    ... Check Recipe Certification Program Nutrition Requirements Heart-Check Professional Resources Contact the Heart-Check Certification Program Simple Cooking and Recipes Dining Out Choosing a Restaurant Deciphering ...

  12. Understanding Heart Valve Problems and Causes

    Science.gov (United States)

    ... Check Recipe Certification Program Nutrition Requirements Heart-Check Professional Resources Contact the Heart-Check Certification Program Simple Cooking and Recipes Dining Out Choosing a Restaurant Deciphering ...

  13. Assessment of Student Outcomes in Undergraduate Health Information Administration Programs

    OpenAIRE

    Smith, Jody

    2006-01-01

    The purpose of this research was to a) determine what assessment methods are being used in undergraduate health information administration programs to assess student learning and the usefulness of those methods, b) determine to what extent programs have incorporated good student learning assessment practices. Programs use a variety of assessment tools to measure student learning; the most useful include assessments by the professional practice supervisor, course tests, assignments, presentati...

  14. Integrating Million Hearts into nursing and interprofessional educational curricula and community settings: a key strategy for improving population health across the United States.

    Science.gov (United States)

    Sustersic Gawlik, Kate; Mazurek Melnyk, Bernadette

    2015-01-01

    Million Hearts is a national initiative to prevent 1 million heart attacks and strokes by 2017 by screening and educating the public on the "ABCS" of cardiovascular health. Million Hearts is an innovative platform for educating nursing and health sciences students on the importance of population health and interprofessional teamwork. The National Interprofessional Education and Practice Consortium to Advance Million Hearts was created, and a free on-line educational module was developed to help health care professionals and health sciences faculty and students learn about the Million Hearts initiative, conduct community screenings, and refer people who screen positive to appropriate resources. After completion of the module, individuals receive certification as a Million Hearts Fellow. More than 2,500 individuals from 80 colleges across the United States have accessed the module. More than 20,000 people have been screened. The module and screenings have been incorporated into health sciences curricula and community activities. Academic institutions and health science professions partnering together as part of the National Interprofessional Education and Practice Consortium to Advance Million Hearts provide a unique opportunity to demonstrate the impact that a unified approach can have on improving population health through the use of screening, education, and prevention. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Peer mentoring is associated with positive change in physical activity and aerobic fitness of grades 4, 5, and 6 students in the heart healthy kids program.

    Science.gov (United States)

    Spencer, Rebecca A; Bower, Jenna; Kirk, Sara F L; Hancock Friesen, Camille

    2014-11-01

    Only 7% of Canadian children achieve activity recommendations, contributing to obesity and preventable disease. The Heart Healthy Kids (H2K) program was designed to test the relationship between peer mentoring, physical activity, and cardiovascular fitness. Participants from 10 schools (5 control, 5 intervention) were enrolled in the program. In control schools, H2K included a physical activity challenge and education sessions. Intervention schools included the addition of a peer-mentoring component. Physical activity was measured through daily pedometer recording. Cardiovascular fitness was evaluated using the PACER (Progressive Aerobic Cardiovascular Endurance Run) protocol to calculate maximal oxygen uptake (VO2 max). Participants included 808 children (average age 9.9 ± 1.0 years). Although control and intervention schools did not differ at baseline, participants with peer mentoring logged significantly more steps per school day, on average, than those in control schools (6,785 ± 3,011 vs. 5,630 ± 2,586; p peer mentoring shows promise for application in health promotion interventions. © 2014 Society for Public Health Education.

  16. Planning and Implementing a Public Health Professional Distance Learning Program

    Science.gov (United States)

    Escoffery, Cam; Leppke, Allison M.; Robinson, Kara B.; Mettler, Erik P.; Miner, Kathleen R.; Smith, Iris

    2005-01-01

    Training of public health professionals through web-based technology is rapidly increasing. This article describes one school of public health's effort to establish an online Master's program that serves students nationally and internationally. It examines the critical components in the design and implementation of distance education, including…

  17. Evaluation of a Reproductive Health Program to Support Married ...

    African Journals Online (AJOL)

    ... self-esteem, reproductive health and gender through girls' groups. The husbands' program focused on non-violence, support to families, and reproductive health. Population-based surveys were undertaken among married girls, at midterm and end line. Outcomes of interest were husbands' assistance with domestic work, ...

  18. The Rural Alabama Pregnancy and Infant Health (RAPIH) Program.

    Science.gov (United States)

    Leeper, J. D.; And Others

    The impact of the Rural Alabama Pregnancy and Infant Health (RAPIH) Program was evaluated in relation to prenatal care, birth outcome measures, and several child health and home environment outcomes. Begun in 1983, RAPIH targets poor rural blacks in three of west-central Alabama's poorest counties, where economic conditions and infant mortality…

  19. Integrating health education and physical activity programming for cardiovascular health promotion among female inmates: A proof of concept study.

    Science.gov (United States)

    Nair, Uma S; Jordan, Jeremy S; Funk, Daniel; Gavin, Kristin; Tibbetts, Erica; Collins, Bradley N

    2016-05-01

    Female inmate populations in the United States tend to be overweight, physically inactive, experience high stress, and have a history of nicotine and other drug dependence. Thus, they bear an elevated risk of cardiovascular (CV) disease than the general population. However, few evidence-based health interventions exist for this population. This study will test proof of concept, feasibility, and potential efficacy of a multiple health behavior change intervention that integrates CV-health promotion education delivered during a physical activity (PA) program (indoor cycling) tailored to this population. This study uses a quasi-experimental 2-group design with two measurement time-points: baseline and 8-week end of treatment. N=120 incarcerated women (18-59years of age) who are medically cleared for participation in PA will be enrolled. Indoor cycling instructors will be trained to deliver five health education topics over an 8-week period during twice-weekly cycling classes. Topics match the American Heart Association recommendations for CV health: (a) nutrition, (b) PA promotion, (c) weight management, (d) stress management, and (e) smoking cessation and relapse prevention. Modes of intervention include instructor advice, written materials and audio/video clips reviewed during class. CV-related and mental health measures will be assessed at both time-points. Results will guide a full scale efficacy study. Future research in this area has potential to impact the health of female inmates, a high-risk population. Moreover, this multiple health behavior change intervention model represents a community approach to health promotion that could generalize to other underserved populations who may benefit most from similar intervention efforts. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. 78 FR 46339 - Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of Temporary Moratoria...

    Science.gov (United States)

    2013-07-31

    ...] Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of Temporary Moratoria on... combat fraud, waste, and abuse in Medicare, Medicaid, and the Children's Health Insurance Program (CHIP... Health Insurance Programs; Additional Screening Requirements, Application Fees, Temporary Enrollment...

  1. Operating plan for the Office of International Health Programs

    International Nuclear Information System (INIS)

    1996-01-01

    In this report unified ideas are presented about what the Office of International Health Programs does, what the individual contributions are, and how the organization connects to the Department of Energy. The planning efforts have focused on the office's three areas of responsibility: Europe, Japan, and the Marshall Islands. Common to each technical program area are issues related to the following: health of populations exposed to radiation incidents and the associated medical aspects of exposure; dose reconstruction; training; and public involvement. Each of the program areas, its customers, and primary customer interests are described

  2. Building an Educational Program together health community agents

    Directory of Open Access Journals (Sweden)

    Lúcia Rondelo Duarte

    2007-01-01

    Full Text Available Aiming at contributing inputs to the learning process of community health agents from Family Health Strategy, this study has sought to devise an Educational Program to qualify seven community agents from the Family Health Unit on Habiteto, a neighborhood in the Brazilian city of Sorocaba. Speeches on the perception these agents have of their work, their difficulties and proposals were captured and analyzed within the framework of the "Collective Subject Speech". Results showed the group's learning needs, and guided the devising and implementation of the Educational Program, which adopted the "Problem-Based Education" model. This knowledge was built by the agents through a problem-focused reality, debating, searching for solutions, and implementing intervention projects. They noticed that being a community health agent means, above all, to struggle and harness community forces for purposes of defending health & education public services and for improving social health determinants.

  3. Hormones, heart disease, and health: individualized medicine versus throwing the baby out with the bathwater.

    Science.gov (United States)

    Rubinow, David R; Girdler, Susan S

    2011-06-01

    It is increasingly axiomatic that depression has widespread adverse physiological effects and, conversely, that a variety of physiological systems impact the risk for developing depression. This convergence of depression and altered physiology is particularly dramatic during midlife--a time during which reproductive failure presages dramatic increases in prevalence of both heart disease and depression. The potentially meaningful and illuminating links between estrogen deficiency, cardiovascular disease (CVD), and depression have largely been obscured, first by assertions, subsequently repudiated, that the perimenopause was not a time of increased risk of depression, and more recently by the denegration of hormone replacement therapy by initial reports of the Women's Health Initiative. Increasingly, however, research has led to unavoidable conclusions that CVD and depression share common, mediating pathogenic processes and that these same processes are dramatically altered by the presence or absence of estrogen (E2). This review summarizes data supporting these contentions with the intent of placing depression and estrogen therapy in their proper physiologic context. © 2011 Wiley-Liss, Inc.

  4. Chocolate consumption and risk of heart failure in the Physicians’ Health Study

    Science.gov (United States)

    Petrone, Andrew B; Gaziano, J. Michael; Djoussé, Luc

    2015-01-01

    Aims To test the hypothesis that chocolate consumption is associated with a lower risk of heart failure (HF). Methods and Results We prospectively studied 20,278 men from the Physicians’ Health Study. Chocolate consumption was assessed between 1999 and 2002 via a self-administered food frequency questionnaire and HF was ascertained through annual follow-up questionnaires with validation in a subsample. We used Cox regression to estimate multivariable adjusted relative risk of HF. During a mean follow-up of 9.3 years, there were 876 new cases of HF. The mean age at baseline was 66.4 ± 9.2 years. Hazard ratios (95% CI) for HF were 1.0 (ref), 0.86 (0.72–1.03), 0.80 (0.66–0.98), 0.92 (0.74–1.13), and 0.82 (0.63–1.07), for chocolate consumption of less than 1/month, 1–3/week, 2–4/week, and 5+/week, respectively, after adjusting for age, body mass index (BMI), smoking, alcohol, exercise, energy intake, and history of atrial fibrillation (p for quadratic trend = 0.62). In a secondary analysis, chocolate consumption was inversely associated with risk of HF in men whose BMI was chocolate might be associated with a lower risk of HF in male physicians.. PMID:25311633

  5. Counseling Health Psychology: Assessing Health Psychology Training within Counseling Psychology Doctoral Programs

    Science.gov (United States)

    Raque-Bogdan, Trisha L.; Torrey, Carrie L.; Lewis, Brian L.; Borges, Nicole J.

    2013-01-01

    Training directors of American Psychological Association-approved counseling psychology doctoral programs completed a questionnaire assessing (a) student and faculty involvement in health-related research, practice, and teaching; (b) health-related research conducted by students and faculty; and (c) programs' expectations and ability to…

  6. Psychological well-being in obese in-patients with ischemic heart disease at entry and at discharge from a four-week cardiac rehabilitation program

    Directory of Open Access Journals (Sweden)

    Gian Mauro Manzoni

    2010-08-01

    Full Text Available The purposes of this observational pre-post study were twofold: 1- to evaluate psychological health in obese patients with ischemic heart disease (IHD at admission to cardiac rehabilitation (CR and 2 - to examine the effectiveness of a four-week CR residential program in improving obese patients’ psychological well-being at discharge from CR. A sample of 177 obese patients completed the Psychological General Well-Being Inventory (PGWBI at admission to the CR program and at discharge. The equivalence testing method with normative comparisons was used to determine the clinical significance of improvements after having established that baseline mean scores on the PGWBI scales were significantly lower than normal means. Results show that patients scored equally or better than norms on many PGWBI dimensions at admission to CR but scored significantly worse on Global Score, Vitality and Self-control. At discharge, mean scores that were impaired at baseline returned to normal levels at the more conservative equivalence interval. A four-week CR program was thus effective in improving obese patients’ psychological well-being. The equivalence testing method allowed to establish the clinical significance of such improvement.

  7. Program Development and Evaluation - Nutrition / Health

    OpenAIRE

    2004-01-01

    Martha Archuleta: Kitchen Creations - A Cooking School for People with Diabetes. Darlene Christensen: University of Wyoming Food & Nutrition Extension Website. Judith L. Corbus: Hawaii Five-A-Day A Taste of the Tropics with Fruits and Vegetables. Luanne J. Hughes: Reaching Key Audiences with Food Safety Messages. Darlene Liesch: Pregnancy Prevention for Latino Teens. Karen Richey: Food Irradiation - Insuring your Food’s Safety. Carole Rison: Farmers Markets – Impacting Health through Economic...

  8. Neighborhood blight, stress, and health: a walking trial of urban greening and ambulatory heart rate

    Science.gov (United States)

    Eugenia C. South; Michelle C. Kondo; Rose A. Cheney; Charles C. Branas

    2015-01-01

    We measured dynamic stress responses using ambulatory heart rate monitoring as participants in Philadelphia, Pennsylvania walked past vacant lots before and after a greening remediation treatment of randomly selected lots. Being in view of a greened vacant lot decreased heart rate significantly more than did being in view of a nongreened vacant lot or not in view of...

  9. Mental disorders among persons with heart disease : results from World Mental Health Surveys

    NARCIS (Netherlands)

    Ormel, Johan; Von Korff, Michael; Burger, Huibert; Scott, Kate; Demyttenaere, Koen; Huang, Yue-qin; Posada-Villa, J.; Lepine, Jean Pierre; Angermeyer, Matthias C.; Levinson, Daphna; de Girolamo, Giovanni; Kawakami, Norito; Karam, Elie; Medina-Mora, Maria Elena; Gureje, Oye; Williams, David; Haro, Josep Maria; Bromet, Evelyn J.; Alonso, Jordi; Kessler, Ron

    2007-01-01

    Objectives: While depression and heart disease often co-occur in Western countries, less is known about the association of anxiety and alcohol use disorders with heart disease and about the cross-cultural consistency of this association. Consistency across emotional disorders and cultures would

  10. Fetal health locus of control: Scale properties and applications in preconception health programs.

    Science.gov (United States)

    Soliday, Elizabeth; Strahm, Anna; Mammenga, Stefani

    2016-04-01

    Preconception health programs have resulted in improved health behaviors among participants and have shown promise in reducing adverse birth outcomes. However, the role of health beliefs in preconception health program outcomes has been overlooked but warrants attention due to reported positive associations between women's views of control over fetal health and health behavior in pregnancy. Towards an ultimate aim of improving preconception health program reach and effectiveness, we examined properties of a fetal health locus of control (FHLC; Labs & Wurtele, 1986) measure in nulliparous, childbearing aged university women and men. Students (n=1467) completed an online survey that included the FHLC subscales maternal, powerful others', and chance control over fetal health. Factor analyses and correlations with related scales supported the soundness of FHLC constructs in both women and men. All participants rated maternal control in fetal health nearly twice as highly as powerful others' and chance. We therefore recommend that FHLC be integrated into preconception health program evaluation as personal agency in fetal health likely has an important role in women's and men's preconception health behavior and health behavior change. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Organizational Leadership and Adaptive Reserve in Blood Pressure Control: The Heart Health NOW Study.

    Science.gov (United States)

    Henderson, Kamal H; DeWalt, Darren A; Halladay, Jacquie; Weiner, Bryan J; Kim, Jung I; Fine, Jason; Cykert, Samuel

    2018-04-01

    Our purpose was to assess whether a practice's adaptive reserve and high leadership capability in quality improvement are associated with population blood pressure control. We divided practices into quartiles of blood pressure control performance and considered the top quartile as the benchmark for comparison. Using abstracted clinical data from electronic health records, we performed a cross-sectional study to assess the association of top quartile hypertension control and (1) the baseline practice adaptive reserve (PAR) scores and (2) baseline practice leadership scores, using modified Poisson regression models adjusting for practice-level characteristics. Among 181 practices, 46 were in the top quartile, which averaged 68% or better blood pressure control. Practices with higher PAR scores compared with lower PAR scores were not more likely to reside in the top quartile of performance (prevalence ratio [PR] = 1.92 for highest quartile; 95% CI, 0.9-4.1). Similarly, high quality improvement leadership capability compared with lower capability did not predict better blood pressure control performance (PR = 0.94; 95% CI, 0.57-1.56). Practices with higher proportions of commercially insured patients were more likely than practices with lower proportions of commercially insured patients to have top quartile performance (37% vs 26%, P =.002), whereas lower proportions of the uninsured (8% vs 14%, P =.055) were associated with better performance. Our findings show that adaptive reserve and leadership capability in quality improvement implementation are not statistically associated with achieving top quartile practice-level hypertension control at baseline in the Heart Health NOW project. Our findings, however, may be limited by a lack of patient-related factors and small sample size to preclude strong conclusions. © 2018 Annals of Family Medicine, Inc.

  12. Relationship between Medication Use and Cardiovascular Disease Health Outcomes in the Jackson Heart Study

    Directory of Open Access Journals (Sweden)

    Monique S. White

    2011-06-01

    Full Text Available Even though some medications have the potential to slow the progress of atherosclerosis and development of CVD, there are many at-risk individuals who continue to resist the benefits that are available by not following the advice of medical professionals. Non-adherence to prescribed drug regimens is a pervasive medical problem that negatively affects treatment outcomes. Information from standardized interviews of 5301 African Americans participating in the Jackson Heart Study was examined to determine the association between demographic parameters, behavior including adherence to prescribed medical regimens, and health outcomes. Data were also collected at Annual Follow-Up and Surveillance visits. During the two weeks prior to the examination visit, almost 52% of the participants reported taking blood pressure medication, 14% took cholesterol medication, 16% took medication for diabetes, and 19% took blood thinning medication. Of those who did not take the prescribed medications, the reasons given were the following: 47% were in a hurry, too busy, or forgot to take medications; 23% were trying to do without medications; 18% had no money to purchase medications; 19% indicated that the medications made them feel bad; 17% felt that they could not carry out daily functions when taking medications. The African American population can benefit from heightened awareness of the risk factors that are associated with CVD and the benefits of following a prescribed treatment regimen. Unacceptable secondary effects of prescribed medication comprised an important cause of non-compliance. Encouragement of this population to communicate with their healthcare providers to ensure that medication regimens are better tolerated could increase compliance and improve health outcomes.

  13. Health physics educational program in the Tennessee Valley Authority

    International Nuclear Information System (INIS)

    Holley, Wesley L.

    1978-01-01

    In the spring of 1977, the Radiological Hygiene Branch of the Tennessee Valley Authority (TVA) instituted a training program for health physics technicians to ensure availability of qualified personnel for the agency, which is rapidly becoming the world's largest nuclear utility. From this, a health physics education program is developing to also include health physics orientation and retraining for unescorted entry into nuclear power plants, health physics training for employees at other (non-TVA) nuclear plants, specialized health physics training, and possibly theoretical health physics courses to qualify technician-level personnel for professional status. Videotaped presentations are being used extensively, with innovations such as giving examinations by videotape of real-life, in-plant experiences and acted out scenarios of health physics procedures; and teaching health physics personnel to observe, detect, and act on procedural, equipment, and personnel deficiencies promptly. Video-taped lectures are being used for review and to complement live lectures. Also, a 35-mm slide and videotape library is being developed on all aspects of the operational health physics program for nuclear plants using pressurized and boiling water reactors. (author)

  14. Program collaboration and service integration activities among HIV programs in 59 U.S. health departments.

    Science.gov (United States)

    Fitz Harris, Lauren F; Toledo, Lauren; Dunbar, Erica; Aquino, Gustavo A; Nesheim, Steven R

    2014-01-01

    We identified the level and type of program collaboration and service integration (PCSI) among HIV prevention programs in 59 CDC-funded health department jurisdictions. Annual progress reports (APRs) completed by all 59 health departments funded by CDC for HIV prevention activities were reviewed for collaborative and integrated activities reported by HIV programs for calendar year 2009. We identified associations between PCSI activities and funding, AIDS diagnosis rate, and organizational integration. HIV programs collaborated with other health department programs through data-related activities, provider training, and providing funding for sexually transmitted disease (STD) activities in 24 (41%), 31 (53%), and 16 (27%) jurisdictions, respectively. Of the 59 jurisdictions, 57 (97%) reported integrated HIV and STD testing at the same venue, 39 (66%) reported integrated HIV and tuberculosis testing, and 26 (44%) reported integrated HIV and viral hepatitis testing. Forty-five (76%) jurisdictions reported providing integrated education/outreach activities for HIV and at least one other disease. Twenty-six (44%) jurisdictions reported integrated partner services among HIV and STD programs. Overall, the level of PCSI activities was not associated with HIV funding, AIDS diagnoses, or organizational integration. HIV programs in health departments collaborate primarily with STD programs. Key PCSI activities include integrated testing, integrated education/outreach, and training. Future assessments are needed to evaluate PCSI activities and to identify the level of collaboration and integration among prevention programs.

  15. What is Broken Heart Syndrome

    Science.gov (United States)

    ... pumping action and blood flow, go to the Health Topics How the Heart Works article.) Researchers are trying to identify the precise way in which the stress hormones affect the heart. Broken heart syndrome may result from ...

  16. A Qualitative Study Exploring Facilitators for Improved Health Behaviors and Health Behavior Programs: Mental Health Service Users’ Perspectives

    Directory of Open Access Journals (Sweden)

    Candida Graham

    2014-01-01

    Full Text Available Objective. Mental health service users experience high rates of cardiometabolic disorders and have a 20–25% shorter life expectancy than the general population from such disorders. Clinician-led health behavior programs have shown moderate improvements, for mental health service users, in managing aspects of cardiometabolic disorders. This study sought to potentially enhance health initiatives by exploring (1 facilitators that help mental health service users engage in better health behaviors and (2 the types of health programs mental health service users want to develop. Methods. A qualitative study utilizing focus groups was conducted with 37 mental health service users attending a psychosocial rehabilitation center, in Northern British Columbia, Canada. Results. Four major facilitator themes were identified: (1 factors of empowerment, self-value, and personal growth; (2 the need for social support; (3 pragmatic aspects of motivation and planning; and (4 access. Participants believed that engaging with programs of physical activity, nutrition, creativity, and illness support would motivate them to live more healthily. Conclusions and Implications for Practice. Being able to contribute to health behavior programs, feeling valued and able to experience personal growth are vital factors to engage mental health service users in health programs. Clinicians and health care policy makers need to account for these considerations to improve success of health improvement initiatives for this population.

  17. Factors influencing perceived sustainability of Dutch community health programs.

    Science.gov (United States)

    Vermeer, A J M; Van Assema, P; Hesdahl, B; Harting, J; De Vries, N K

    2015-09-01

    We assessed the perceived sustainability of community health programs organized by local intersectoral coalitions, as well as the factors that collaborating partners think might influence sustainability. Semi-structured interviews were conducted among 31 collaborating partners of 5 community health programs in deprived neighborhoods in the southern part of the Netherlands. The interview guide was based on a conceptual framework that includes factors related to the context, the leading organization, leadership, the coalition, collaborating partners, interventions and outcomes. Interviews were recorded, transcribed and content analyzed using NVivo 8.0. Participants in each of the programs varied in their perceptions of the sustainability of the program, but those people collaborating in pre-existing neighborhood structures expressed relatively high faith in their continuation. The participating citizens in particular believed that these structures would continue to address the health of the community in the future. We found factors from all categories of the conceptual framework that were perceived to influence sustainability. The program leaders appeared to be crucial to the programs, as they were frequently mentioned in close interaction with other factors. Program leaders should use a motivating and supportive leadership style and should act as 'program champions'. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. Value drivers: an approach for estimating health and disease management program savings.

    Science.gov (United States)

    Phillips, V L; Becker, Edmund R; Howard, David H

    2013-12-01

    Health and disease management (HDM) programs have faced challenges in documenting savings related to their implementation. The objective of this eliminate study was to describe OptumHealth's (Optum) methods for estimating anticipated savings from HDM programs using Value Drivers. Optum's general methodology was reviewed, along with details of 5 high-use Value Drivers. The results showed that the Value Driver approach offers an innovative method for estimating savings associated with HDM programs. The authors demonstrated how real-time savings can be estimated for 5 Value Drivers commonly used in HDM programs: (1) use of beta-blockers in treatment of heart disease, (2) discharge planning for high-risk patients, (3) decision support related to chronic low back pain, (4) obesity management, and (5) securing transportation for primary care. The validity of savings estimates is dependent on the type of evidence used to gauge the intervention effect, generating changes in utilization and, ultimately, costs. The savings estimates derived from the Value Driver method are generally reasonable to conservative and provide a valuable framework for estimating financial impacts from evidence-based interventions.

  19. Review and analysis of the Mental Health Nurse Incentive Program.

    Science.gov (United States)

    Happell, Brenda; Platania-Phung, Chris

    2017-09-04

    Objective The aim of the present study was to review and synthesise research on the Mental Health Nurse Incentive Program (MHNIP) to ascertain the benefits and limitations of this initiative for people with mental illness, general practitioners, mental health nurses and the wider community. Methods An electronic and manual search was made of the research literature for MHNIP in May 2017. Features of studies, including cohorts and findings, were tabulated and cross-study patterns in program processes and outcomes were closely compared. Results Seventeen reports of primary research data have been released. Triangulation of data from different cohorts, regions and design show that the program has been successful on the primary objectives of increased access to primary mental health care, and has received positive feedback from all major stakeholders. Although the program has been broadly beneficial to consumer health, there are inequities in access for people with mental illness. Conclusions The MHNIP greatly benefits the health of people with mental illness. Larger and more representative sampling of consumers is needed, as well as intensive case studies to provide a more comprehensive and effective understanding of the benefits and limitations of the program as it evolves with the establishment of primary health networks. What is known about the topic? The MHNIP is designed to increase access to mental health care in primary care settings such as general practice clinics. Studies have reported favourable views about the program. However, research is limited and further investigation is required to demonstrate the strengths and limitations of the program. What does this paper add? All studies reviewed reported that the MHNIP had positive implications for people with severe and persistent mental illness. Qualitative research has been most prevalent for mental health nurse views and research on Health of the Nation Outcome Scale scores for recipients of the program

  20. Heart Attack Payment - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — Payment for heart attack patients measure – national data. This data set includes national-level data for payments associated with a 30-day episode of care for heart...

  1. Heart Attack Payment - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — Payment for heart attack patients measure – provider data. This data set includes provider data for payments associated with a 30-day episode of care for heart...

  2. Heart Attack Payment - State

    Data.gov (United States)

    U.S. Department of Health & Human Services — Payment for heart attack patients measure – state data. This data set includes state-level data for payments associated with a 30-day episode of care for heart...

  3. Heart disease - risk factors

    Science.gov (United States)

    Heart disease - prevention; CVD - risk factors; Cardiovascular disease - risk factors; Coronary artery disease - risk factors; CAD - risk ... a certain health condition. Some risk factors for heart disease you cannot change, but some you can. ...

  4. Merging Electronic Health Record Data and Genomics for Cardiovascular Research: A Science Advisory From the American Heart Association.

    Science.gov (United States)

    Hall, Jennifer L; Ryan, John J; Bray, Bruce E; Brown, Candice; Lanfear, David; Newby, L Kristin; Relling, Mary V; Risch, Neil J; Roden, Dan M; Shaw, Stanley Y; Tcheng, James E; Tenenbaum, Jessica; Wang, Thomas N; Weintraub, William S

    2016-04-01

    The process of scientific discovery is rapidly evolving. The funding climate has influenced a favorable shift in scientific discovery toward the use of existing resources such as the electronic health record. The electronic health record enables long-term outlooks on human health and disease, in conjunction with multidimensional phenotypes that include laboratory data, images, vital signs, and other clinical information. Initial work has confirmed the utility of the electronic health record for understanding mechanisms and patterns of variability in disease susceptibility, disease evolution, and drug responses. The addition of biobanks and genomic data to the information contained in the electronic health record has been demonstrated. The purpose of this statement is to discuss the current challenges in and the potential for merging electronic health record data and genomics for cardiovascular research. © 2016 American Heart Association, Inc.

  5. A closer look at the developmental interplay between parenting and perceived health in adolescents with congenital heart disease.

    Science.gov (United States)

    Rassart, Jessica; Luyckx, Koen; Goossens, Eva; Apers, Silke; Moons, Philip

    2014-12-01

    The present study examined associations between parenting and perceived health in adolescents with congenital heart disease (CHD) using a longitudinal trajectory approach. Adolescents with CHD were selected from the database of pediatric and congenital cardiology of the University Hospitals Leuven. A total of 429 adolescents (M age = 16 at T1) participated in the present study, comprising four measurement waves spanning approximately 3 years. Latent class growth analysis was used to identify trajectory classes of parenting and perceived health. Whereas adolescents from democratic households reported the most favorable health outcomes, adolescents from authoritarian, overprotective, and psychologically controlling families (all characterized by relatively high levels of psychological control) showed an increased risk for poor perceived health over time. Hence, the present study found substantial developmental associations between parenting and perceived health in adolescents with CHD. Future research should investigate whether working on the parent-adolescent relationship can foster patients' health.

  6. Impact of a health promotion program on employee health risks and work productivity.

    Science.gov (United States)

    Mills, Peter R; Kessler, Ronald C; Cooper, John; Sullivan, Sean

    2007-01-01

    Evaluate the impact of a multicomponent workplace health promotion program on employee health risks and work productivity. Quasi-experimental 12-month before-after intervention-control study. A multinational corporation headquartered in the United Kingdom. Of 618 employees offered the program, 266 (43%) completed questionnaires before and after the program. A total of 1242 of 2500 (49.7%) of a control population also completed questionnaires 12 months apart. A multicomponent health promotion program incorporating a health risk appraisal questionnaire, access to a tailored health improvement web portal, wellness literature, and seminars and workshops focused upon identified wellness issues. Outcomes were (1) cumulative count of health risk factors and the World Health Organization health and work performance questionnaire measures of (2) workplace absenteeism and (3) work performance. After adjusting for baseline differences, improvements in all three outcomes were significantly greater in the intervention group compared with the control group. Mean excess reductions of 0.45 health risk factors and 0.36 monthly absenteeism days and a mean increase of 0.79 on the work performance scale were observed in the intervention group compared with the control group. The intervention yielded a positive return on investment, even using conservative assumptions about effect size estimation. The results suggest that a well-implemented multicomponent workplace health promotion program can produce sizeable changes in health risks and productivity.

  7. Heart MRI

    Science.gov (United States)

    Magnetic resonance imaging - cardiac; Magnetic resonance imaging - heart; Nuclear magnetic resonance - cardiac; NMR - cardiac; MRI of the heart; Cardiomyopathy - MRI; Heart failure - MRI; Congenital heart disease - MRI

  8. Components of cultural competence in three mental health programs.

    Science.gov (United States)

    Siegel, Carole; Haugland, Gary; Reid-Rose, Lenora; Hopper, Kim

    2011-06-01

    The aim of this study was to identify components of cultural competence in mental health programs developed for cultural groups by community and mental health professionals from these groups. Three programs were studied: a prevention program primarily serving African-American and Afro-Caribbean youth, a Latino adult acute inpatient unit, and a Chinese day treatment program in a community-based agency. Nine study-trained field researchers used a semistructured instrument that captures program genealogy, structure, processes, and cultural infusion. Program cultural elements were identified from field notes and from individual and group interviews of consumers and staff (N=104). A research-group consensus process with feedback from program staff was used to group elements by shared characteristics into the program components of cultural competence. Components included communication competencies (with use of colloquialisms and accepted forms of address); staff in culturally acceptable roles; culturally framed trust building (such as pairing youths with mentors), stigma reduction, friendly milieus (such as serving culturally familiar foods and playing music popular with the culture), and services; and peer, family, and community involvement (including use of peer counselors and mentors, hosting parent weekends, and linking clients with senior center and community services). Incorporating these components into any program in which underserved cultural populations are seen is recommended for improving cultural competence.

  9. Workplace Violence Training Programs for Health Care Workers: An Analysis of Program Elements.

    Science.gov (United States)

    Arbury, Sheila; Hodgson, Michael; Zankowski, Donna; Lipscomb, Jane

    2017-06-01

    Commercial workplace violence (WPV) prevention training programs differ in their approach to violence prevention and the content they present. This study reviews 12 such programs using criteria developed from training topics in the Occupational Safety and Health Administration's (OSHA) Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers and a review of the WPV literature. None of the training programs addressed all the review criteria. The most significant gap in content was the lack of attention to facility-specific risk assessment and policies. To fill this gap, health care facilities should supplement purchased training programs with specific training in organizational policies and procedures, emergency action plans, communication, facility risk assessment, and employee post-incident debriefing and monitoring. Critical to success is a dedicated program manager who understands risk assessment, facility clinical operations, and program management and evaluation.

  10. Prevalence of health promotion programs in primary health care units in Brazil

    Science.gov (United States)

    Ramos, Luiz Roberto; Malta, Deborah Carvalho; Gomes, Grace Angélica de Oliveira; Bracco, Mário M; Florindo, Alex Antonio; Mielke, Gregore Iven; Parra, Diana C; Lobelo, Felipe; Simoes, Eduardo J; Hallal, Pedro Curi

    2014-01-01

    OBJECTIVE Assessment of prevalence of health promotion programs in primary health care units within Brazil’s health system. METHODS We conducted a cross-sectional descriptive study based on telephone interviews with managers of primary care units. Of a total 42,486 primary health care units listed in the Brazilian Unified Health System directory, 1,600 were randomly selected. Care units from all five Brazilian macroregions were selected proportionally to the number of units in each region. We examined whether any of the following five different types of health promotion programs was available: physical activity; smoking cessation; cessation of alcohol and illicit drug use; healthy eating; and healthy environment. Information was collected on the kinds of activities offered and the status of implementation of the Family Health Strategy at the units. RESULTS Most units (62.0%) reported having in place three health promotion programs or more and only 3.0% reported having none. Healthy environment (77.0%) and healthy eating (72.0%) programs were the most widely available; smoking and alcohol use cessation were reported in 54.0% and 42.0% of the units. Physical activity programs were offered in less than 40.0% of the units and their availability varied greatly nationwide, from 51.0% in the Southeast to as low as 21.0% in the North. The Family Health Strategy was implemented in most units (61.0%); however, they did not offer more health promotion programs than others did. CONCLUSIONS Our study showed that most primary care units have in place health promotion programs. Public policies are needed to strengthen primary care services and improve training of health providers to meet the goals of the agenda for health promotion in Brazil. PMID:25372175

  11. Formal intervention in employee health: comparisons of the nature and structure of employee assistance programs and health promotion programs.

    Science.gov (United States)

    Roman, P M; Blum, T C

    1988-01-01

    Health promotion programs (HPP) and employee assistance programs (EAP) are compared in terms of their structure and process. Two common themes are extracted: a belief that both are beneficial to both employers and employees, and a sense of 'mission'. The technology of HPP and EAP are examined and compared. EAPs' stimulation from Federal funding is contrasted with the more indigenous roots of HPPs. Examination of empirical data comparing organizations with EAPs which have and have not adopted HPPs indicate the former tend to be somewhat more 'caring' toward employees. An examination of program ingredients indicates much greater commonality of structural and processual ingredients within EAPs as compared to HPPs. The extent to which each program type has become more 'populist' in orientation and the implications of these changes for program technology are considered. Finally the paper describes differences in program evaluation stemming from target group definitions in the two types of programs.

  12. Measuring the diffusion of innovative health promotion programs.

    Science.gov (United States)

    Steckler, A; Goodman, R M; McLeroy, K R; Davis, S; Koch, G

    1992-01-01

    Once a health promotion program has proven to be effective in one or two initial settings, attempts may be made to transfer the program to new settings. One way to conceptualize the transference of health promotion programs from one locale to another is by considering the programs to be innovations that are being diffused. In this way, diffusion of innovation theory can be applied to guide the process of program transference. This article reports on the development of six questionnaires to measure the extent to which health promotion programs are successfully disseminated: Organizational Climate, Awareness-Concern, Rogers's Adoption Variables, Level of Use, Level of Success, and Level of Institutionalization. The instruments are being successfully used in a study of the diffusion of health promotion/tobacco prevention curricula to junior high schools in North Carolina. The instruments, which measure the four steps of the diffusion process, have construct validity since they were developed within existing theories and are derived from the work of previous researchers. No previous research has attempted to use instruments like these to measure sequentially the stages of the diffusion process.

  13. Depressive Symptoms, Health Behaviors, and Subsequent Inflammation in Patients With Coronary Heart Disease : Prospective Findings From the Heart and Soul Study

    NARCIS (Netherlands)

    Duivis, Hester E.; de Jonge, Peter; Penninx, Brenda W.; Na, Bee Ya; Cohen, Beth E.; Whooley, Mary A.

    Objective: Depression has been associated with inflammation in patients with coronary heart disease. However, it is uncertain whether depressive symptoms lead to inflammation or vice versa. Method: The authors evaluated 667 outpatients with established coronary heart disease from the Heart and Soul

  14. Health risk reduction programs in employer-sponsored health plans: Part II-law and ethics.

    Science.gov (United States)

    Rothstein, Mark A; Harrell, Heather L

    2009-08-01

    We sought to examine the legal and ethical implications of workplace health risk reduction programs (HRRPs) using health risk assessments, individually focused risk reduction, and financial incentives to promote compliance. We conducted a literature review, analyzed relevant statutes and regulations, and considered the effects of these programs on employee health privacy. A variety of laws regulate HRRPs, and there is little evidence that employer-sponsored HRRPs violate these provisions; infringement on individual health privacy is more difficult to assess. Although current laws permit a wide range of employer health promotion activities, HRRPs also may entail largely unquantifiable costs to employee privacy and related interests.

  15. Health Risk Reduction Programs in Employer-Sponsored Health Plans: Part II—Law and Ethics

    Science.gov (United States)

    Rothstein, Mark A.; Harrell, Heather L.

    2011-01-01

    Objective We sought to examine the legal and ethical implications of workplace health risk reduction programs (HRRPs) using health risk assessments, individually focused risk reduction, and financial incentives to promote compliance. Methods We conducted a literature review, analyzed relevant statutes and regulations, and considered the effects of these programs on employee health privacy. Results A variety of laws regulate HRRPs, and there is little evidence that employer-sponsored HRRPs violate these provisions; infringement on individual health privacy is more difficult to assess. Conclusion Although current laws permit a wide range of employer health promotion activities, HRRPs also may entail largely unquantifiable costs to employee privacy and related interests. PMID:19625971

  16. Know thy eHealth user: Development of biopsychosocial personas from a study of older adults with heart failure.

    Science.gov (United States)

    Holden, Richard J; Kulanthaivel, Anand; Purkayastha, Saptarshi; Goggins, Kathryn M; Kripalani, Sunil

    2017-12-01

    Personas are a canonical user-centered design method increasingly used in health informatics research. Personas-empirically-derived user archetypes-can be used by eHealth designers to gain a robust understanding of their target end users such as patients. To develop biopsychosocial personas of older patients with heart failure using quantitative analysis of survey data. Data were collected using standardized surveys and medical record abstraction from 32 older adults with heart failure recently hospitalized for acute heart failure exacerbation. Hierarchical cluster analysis was performed on a final dataset of n=30. Nonparametric analyses were used to identify differences between clusters on 30 clustering variables and seven outcome variables. Six clusters were produced, ranging in size from two to eight patients per cluster. Clusters differed significantly on these biopsychosocial domains and subdomains: demographics (age, sex); medical status (comorbid diabetes); functional status (exhaustion, household work ability, hygiene care ability, physical ability); psychological status (depression, health literacy, numeracy); technology (Internet availability); healthcare system (visit by home healthcare, trust in providers); social context (informal caregiver support, cohabitation, marital status); and economic context (employment status). Tabular and narrative persona descriptions provide an easy reference guide for informatics designers. Personas development using approaches such as clustering of structured survey data is an important tool for health informatics professionals. We describe insights from our study of patients with heart failure, then recommend a generic ten-step personas development process. Methods strengths and limitations of the study and of personas development generally are discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Chronic beryllium disease prevention program; worker safety and health program. Final rule.

    Science.gov (United States)

    2006-02-09

    The Department of Energy (DOE) is today publishing a final rule to implement the statutory mandate of section 3173 of the Bob Stump National Defense Authorization Act (NDAA) for Fiscal Year 2003 to establish worker safety and health regulations to govern contractor activities at DOE sites. This program codifies and enhances the worker protection program in operation when the NDAA was enacted.

  18. Honolulu Community College Program Health Indicators: 2000-2001 Program Reviews.

    Science.gov (United States)

    Hawaii Univ., Honolulu. Honolulu Community Coll.

    This report presents an overall health summation of 21 programs offered at Honolulu Community College (Hawaii) during 2000-2001. The programs profiled are: (1) Auto Body Repair and Painting; (2) Aeronautics Maintenance Technology; (3) Administration of Justice; (4) Automotive Mechanics Technology; (5) Boat Maintenance Repair; (6) Carpentry; (7)…

  19. 76 FR 40733 - National Institute for Occupational Safety and Health, (NIOSH), World Trade Center Health Program...

    Science.gov (United States)

    2011-07-11

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Institute for Occupational Safety and Health, (NIOSH), World Trade Center Health Program Science/Technical Advisory Committee (WTCHP-STAC) Correction: This notice was published in the Federal Register on June 23...

  20. An Overview of State Policies Supporting Worksite Health Promotion Programs.

    Science.gov (United States)

    VanderVeur, Jennifer; Gilchrist, Siobhan; Matson-Koffman, Dyann

    2017-05-01

    Worksite health promotion (WHP) programs can reduce the occurrence of cardiovascular disease risk factors. State law can encourage employers and employer-provided insurance companies to offer comprehensive WHP programs. This research examines state law authorizing WHP programs. Quantitative content analysis. Worksites or workplaces. United States (and the District of Columbia). State law in effect in 2013 authorizing WHP programs. Frequency and distribution of states with WHP laws. To determine the content of the laws for analysis and coding, we identified 18 policy elements, 12 from the Centers for Disease Control and Prevention's Worksite Health ScoreCard (HSC) and 6 additional supportive WHP strategies. We used these strategies as key words to search for laws authorizing WHP programs or select WHP elements. We calculated the number and type of WHP elements for each state with WHP laws and selected two case examples from states with comprehensive WHP laws. Twenty-four states authorized onsite WHP programs, 29 authorized WHP through employer-provided insurance plans, and 18 authorized both. Seven states had a comprehensive WHP strategy, addressing 8 or more of 12 HSC elements. The most common HSC elements were weight management, tobacco cessation, and physical activity. Most states had laws encouraging the adoption of WHP programs. Massachusetts and Maine are implementing comprehensive WHP laws but studies evaluating their health impact are needed.