Objectives. To analyse the financial basis for downsizing of a provincial health department and suggest implications for fiscal policy. Design. Analysis of relevant departmental, provincial and national financing and expenditure trends from 1995/96 to 2002/03. Setting. Western Cape (WC) Department of Health (DOH).
Mbaisi, Everline Muhonja; Ng'ang'a, Zipporah; Wanzala, Peter; Omolo, Jared
Introduction Accidental occupational exposure of healthcare workers to blood and body fluids after skin injury or mucous membrane contact constitutes a risk for transmission of blood-borne pathogens. Such pathogens include Human Immunodeficiency Virus (HIV), Hepatitis B virus (HBV) and Hepatitis C virus (HCV). We conducted a study to determine the prevalence and associated factors for percutaneous injuries and splash exposures among health-care workers in Rift Valley provincial hospital. Methods A cross-sectional study was carried out from October to November 2010. Self reported incidents, circumstances surrounding occupational exposure and post-exposure management were sought by use of interviewer administered questionnaire. Descriptive, bivariate and multiple logistic regression (forward stepwise procedure) analyses were performed. The level of significance was set at 0.05. Results Twenty five percent of health-care workers interviewed (N = 305) reported having been exposed to blood and body fluids in the preceding 12 months. Percutaneous injuries were reported by 19% (n = 305) and splash to mucous membrane by 7.2%. Higher rates of percutaneous injuries were observed among nurses (50%), during stitching (30%), and in obstetric and gynecologic department (22%). Health workers aged below 40 years were more likely to experience percutaneous injuries (OR= 3.7; 95% CI = 1.08-9.13) while previous training in infection prevention was protective (OR= 0.52; 95% CI = 0.03-0.90). Forty eight percent (n = 83) reported the incidents with 20% (n = 83) taking PEP against HIV. Conclusion Percutaneous injuries and splashes are common in Rift Valley Provincial hospital. Preventive measures remain inadequate. Health institutions should have policies, institute surveillance for occupational risks and enhance training of health care workers. PMID:23504245
Full Text Available The huge regional disparity in government health expenditures (GHE is a major policy concern in China. This paper addresses whether provincial GHE converges in China from 1997 to 2009 using the economic convergence framework based on neoclassical economic growth theory. Our empirical investigation provides compelling evidence of long-term convergence in provincial GHE within China, but not in short-term. Policy implications of these empirical results are discussed.
Pan, Jay; Wang, Peng; Qin, Xuezheng; Zhang, Shufang
The huge regional disparity in government health expenditures (GHE) is a major policy concern in China. This paper addresses whether provincial GHE converges in China from 1997 to 2009 using the economic convergence framework based on neoclassical economic growth theory. Our empirical investigation provides compelling evidence of long-term convergence in provincial GHE within China, but not in short-term. Policy implications of these empirical results are discussed. PMID:23977049
Pan, Jay; Liu, Gordon G
There is great divergence in provincial government health expenditures in China. Real per capita provincial government health expenditures (GHE) over the period 2002-2006 are examined using panel regression analysis. Key determinants of real per capita provincial GHE are real provincial per capita general budget revenue, real provincial per capita transfers from the central government, the proportion of provincial population under age 15, urban employee basic health insurance coverage, and proportion of urban population. Roughly equal and relatively low elasticities of budget revenue and transfers imply that the GHE is a necessity rather than a luxury good, and transfers have yet to become efficient instruments for the fair allocation of health resources by policy makers. Moreover, severe acute respiratory syndrome outbreak has increased the GHE, but we find no statistical evidence that provincial GHE have fluctuated according to the public health status. Copyright © 2011 John Wiley & Sons, Ltd.
Lorenz, Christian; Khalid, Muhammad
Since May 2009 the first National Health Accounts (NHA) for Pakistan have been finalised and published by Federal Bureau of Statistics (FBS) in cooperation with German Technical Cooperation (GTZ). This paper goes one step ahead of the report and analyses in more detail the regional differences in health expenditure structures in Pakistan. The further analyses can be divided into four parts: health expenditures in provinces (Provincial Health Accounts, PHA), Punjab provincial and district governments health expenditures and its comparison with ADB figures, all districts of Pakistan and comparison between total district government and provincial government expenditure for each province; the latter calculation is applied as indication for the degree of fiscal autonomy of the districts in each province. Consequently, first the provincial health expenditures by Financial Agents is analysed and compared between the provinces which leads to very heterogeneous results (section 2); the per capita health expenditures differ from 16 to 23 USD. Secondly, NHA results on Punjab district government are compared with available ADB results and differences in methods as possible reasons for different results are presented (section 3). Third, district data of all district governments in all four Pakistani provinces are analysed on the level of detailed function codes in section 4; the aim is to discover regional differences between districts of the same as well as of different provinces. Fourth, in section 5 the degree of fiscal autonomy on health of the districts in each province is analysed; therefore the ordinance description is reviewed and total district government with total provincial government expenditures are compared per province. Finally recommendations for future rounds of NHA in Pakistan are given regarding formats and necessities of detailed health expenditure data collection to ensure evidence based decision making not only on federal, but also on provincial and
Full Text Available Abstract Access to timely and quality maternal health care remains to be a major development challenge in many developing economies particularly in Kenya. The countrys system of providing maternal health care also continue to be anchored on conventional methods of physical presence of the patient and the doctor in a hospital setup. The countrys ICT and health policies also place very little emphasis on the use of these platforms. This study therefore sought to establish the factors affecting the adoption of mHealth by focusing on maternal health in Nakuru Provincial General Hospital. Objectives of the study were to determine the extent to knowledge and awareness affects the adoption of mHealth in maternal health care at Nakuru PGH to identify the government policies affecting the adoption of mHealth in maternal health care at Nakuru PGH to assess how access to technology affects the adoption of mHealth in maternal healthcare to establish the effects of ICT infrastructure on the adoption of mHealth in maternal health care and to identify the cost aspects affecting the adoption of mHealth in maternal health care at Nakuru Provincial General Hospital. It is envisaged that the study could provide useful information on the adoption of mHealth in managing maternal health care in Nakuru Provincial General Hospital. Descriptive survey research design will be used where all the medical staff and patients of Nakuru Provincial General Hospital was surveyed. The study population therefore was made up of 24 medical staff and 3460 mothers visiting the antenatal clinic selected using clustered random sampling technique. The main instrument for primary data collection was the questionnaire. Data analysis was then done using both descriptive and inferential statistics. Descriptive statistics to be used include frequency counts percentages and measures of central tendency. Inferential statistics on the other hand include t-test analysis and spearman correlation
Full Text Available This paper analyzes the notion of provincial identity in the Pampean Association of Writers of Santa Rosa, province of La Pampa. Although the group was shaped around literature, discourses and actions overflow this purpose and present a particular ideological stance regarding Pampean identity. Analysis focuses on interviews to members and documents produced both by local writers and the Association.
To analyse the financial basis for downsizing of a provincial health department and suggest implications for fiscal policy. Analysis of relevant departmental, provincial and national financing and expenditure trends from 1995/96 to 2002/03. Western Cape (WC) Department of Health (DOH). Downsizing involving 9,282 health workers (27.9%) and closure of 3,601 hospital beds (24.4%) over 5 years. Total aggregate provincial transfers (all provinces) remained fairly constant in real terms. The WC's share decreased from 11.8% in 1996/97 to 9.8% in 2002/03. This was offset by the DOH's share of the WC budget increasing from 25.6% to 29.6%, mainly because of an increase in national health conditional grants. The net effect of financing changes was that the DOH's allocation in real terms was similar in 2002/03 and 1995/96, which suggests that financing changes are not the major cause of downsizing. Expenditure analysis revealed a 39.7% real rise in the average cost of health personnel. Substantial interprovincial inequities remain. The major cause of downsizing was wage growth, particularly following the 1996 wage agreement. Disjointed fiscal and wage policy has affected health services. Simultaneous application of policies of fiscal constraint, redistribution and substantial real wage growth has resulted in substantial downsizing with limited inroads into inequities. Inequities will continue to call for further redistribution, reduction in conditional grants and downsizing, much of which could have been avoided if fiscal and wage policy choices had been optimal.
Mohammad Hossein Mehrolhassani
Full Text Available Background Provincial Health Accounts (PHA as a subset of National Health Accounts (NHA present financial information for health sectors. It leads to a logical decision making for policy-makers in order to achieve health system goals, especially Fair Financial Contribution (FFC. This study aimed to examine Health Accounts in Kerman Province. Methods The present analytical study was carried out retrospectively between 2008 and 2011. The research population consisted of urban and rural households as well as providers and financial agents in health sectors of Kerman Province. The purposeful sampling included 16 provincial organizations. To complete data, the report on Kerman household expenditure was taken as a data source from the Governor-General’s office. In order to classify the data, the International Classification for Health Accounts (ICHA method was used, in which data set was adjusted for the province. Results During the study, the governmental and non-governmental fund shares of the health sector in Kerman were 27.22% and 72.78% respectively. The main portion of financial sources (59.41 was related to private household funds, of which the Out-of-Pocket (OOP payment mounted to 92.35%. Overall, 54.86% of all financial sources were covered by OOP. The greatest portion of expenditure of Total Healthcare Expenditures (THEs (65.19% was related to curative services. Conclusion The major portion of healthcare expenditures was related to the OOP payment which is compatible with the national average rate in Iran. However, health expenditure per capita, was two and a half times higher than the national average. By performing the Family Physician Program (FPP and emphasizing Social Determinant of Health (SDH approach in the Iranian health system, the portion of OOP payment and curative expenditure are expected to be controlled in the medium term. It is suggested that PHA should be examined annually in a more comprehensive manner to monitor
Full Text Available A multi-sectoral core epidemiology capacity assessment was conducted in provinces that implemented One Health services in order to assess the efficacy of a One Health approach in Thailand. In order to conduct the assessment, four provinces were randomly selected as a study group from a total of 19 Thai provinces that are currently using a One Health approach. As a control group, four additional provinces that never implemented a One Health approach were also sampled. The provincial officers were interviewed on the epidemiologic capacity of their respective provinces. The average score of epidemiologic capacity in the provinces implementing the One Health approach was 66.45%, while the provinces that did not implement this approach earned a score of 54.61%. The epidemiologic capacity of surveillance systems in provinces that utilized the One Health approach earned higher scores in comparison to provinces that did not implement the approach (75.00% vs. 53.13%, p-value 0.13. Although none of the capacity evaluations showed significant differences between the two groups, we found evidence that provinces implementing the One Health approach gained higher scores in both surveillance and outbreak investigation capacities. This may be explained by more efficient capacity when using a One Health approach, specifically in preventing, protecting, and responding to threats in local communities.
Alton, Gillian D; Pearl, David L; Bateman, Ken G; McNab, W Bruce; Berke, Olaf
Ontario provincial abattoirs have the potential to be important sources of syndromic surveillance data for emerging diseases of concern to animal health, public health and food safety. The objectives of this study were to: (1) describe provincially inspected abattoirs processing cattle in Ontario in terms of the number of abattoirs, the number of weeks abattoirs process cattle, geographical distribution, types of whole carcass condemnations reported, and the distance animals are shipped for slaughter; and (2) identify various seasonal, secular, disease and non-disease factors that might bias the results of quantitative methods, such as cluster detection methods, used for food animal syndromic surveillance. Data were collected from the Ontario Ministry of Agriculture, Food and Rural Affairs and the Ontario Cattlemen's Association regarding whole carcass condemnation rates for cattle animal classes, abattoir compliance ratings, and the monthly sales-yard price for various cattle classes from 2001-2007. To analyze the association between condemnation rates and potential explanatory variables including abattoir characteristics, season, year and commodity price, as well as animal class, negative binomial regression models were fit using generalized estimating equations (GEE) to account for autocorrelation among observations from the same abattoir. Results of the fitted model found animal class, year, season, price, and audit rating are associated with condemnation rates in Ontario abattoirs. In addition, a subset of data was used to estimate the average distance cattle are shipped to Ontario provincial abattoirs. The median distance from the farm to the abattoir was approximately 82 km, and 75% of cattle were shipped less than 100 km. The results suggest that secular and seasonal trends, as well as some non-disease factors will need to be corrected for when applying quantitative methods for syndromic surveillance involving these data. This study also demonstrated that
Alton Gillian D
Full Text Available Abstract Background Ontario provincial abattoirs have the potential to be important sources of syndromic surveillance data for emerging diseases of concern to animal health, public health and food safety. The objectives of this study were to: (1 describe provincially inspected abattoirs processing cattle in Ontario in terms of the number of abattoirs, the number of weeks abattoirs process cattle, geographical distribution, types of whole carcass condemnations reported, and the distance animals are shipped for slaughter; and (2 identify various seasonal, secular, disease and non-disease factors that might bias the results of quantitative methods, such as cluster detection methods, used for food animal syndromic surveillance. Results Data were collected from the Ontario Ministry of Agriculture, Food and Rural Affairs and the Ontario Cattlemen's Association regarding whole carcass condemnation rates for cattle animal classes, abattoir compliance ratings, and the monthly sales-yard price for various cattle classes from 2001-2007. To analyze the association between condemnation rates and potential explanatory variables including abattoir characteristics, season, year and commodity price, as well as animal class, negative binomial regression models were fit using generalized estimating equations (GEE to account for autocorrelation among observations from the same abattoir. Results of the fitted model found animal class, year, season, price, and audit rating are associated with condemnation rates in Ontario abattoirs. In addition, a subset of data was used to estimate the average distance cattle are shipped to Ontario provincial abattoirs. The median distance from the farm to the abattoir was approximately 82 km, and 75% of cattle were shipped less than 100 km. Conclusions The results suggest that secular and seasonal trends, as well as some non-disease factors will need to be corrected for when applying quantitative methods for syndromic surveillance
Full Text Available Background: Fertility in the current situation is the most important determinant of a country's population increase rate. Iran's fertility rate has declined since the mid 1981’s, and has reached a relative stability below the replacement level in recent years. However, the fertility levels are different among provinces in the country. Methods: The present study investigated the reproductive behavior of women at both individual and provincial levels, so the two-level model was used. Data were adapted from the census in 2011 and Demographic and Health Surveys in 2010. The statistical population of the study was the 15-49 year-old married women in Iran and the study sample included 299,539 woman of the statistical population. Results: The results showed significant differences among the provinces in terms of the variance of the number of children born alive. Residence, employment status and educational status had significant effects on the number of children born. Moreover, the two-level variables (The mean age of women in the first marriage, contraception prevalence and development level by province had a significant effect on the slope of education and employment status. Conclusion: A convergence of fertility behavior has been initiated in the Iranian women, and the difference between some provinces is influenced by the development level of the given provinces. Other variables (such as education and employment status that affect women’s reproductive behavior are influenced by the development level of the province.
Schneider, Helen; Nxumalo, Nonhlanhla
National community health worker (CHW) programmes are returning to favour as an integral part of primary health care systems, often on the back of pre-existing community based initiatives. There are significant challenges to the integration and support of such programmes, and they require coordination and stewardship at all levels of the health system. This paper explores the leadership and governance tasks of large-scale CHW programmes at sub-national level, through the case of national reforms to South Africa's community based sector, referred to as the Ward Based Outreach Team (WBOT) strategy. A cross case analysis of leadership and governance roles, drawing on three case studies of adoption and implementation of the WBOTs strategy at provincial level (Western Cape, North West and Gauteng) was conducted. The primary case studies mapped system components and assessed implementation processes and contexts. They involved teams of researchers and over 200 interviews with stakeholders from senior to frontline, document reviews and analyses of routine data. The secondary, cross case analysis specifically focused on the issues and challenges facing, and strategies adopted by provincial and district policy makers and managers, as they engaged with the new national mandate. From this key sub-national leadership and governance roles were formulated. Four key roles are identified and discussed: 1. Negotiating a fit between national mandates and provincial and district histories and strategies of community based services 2. Defining new organisational and accountability relationships between CHWs, local health services, communities and NGOs 3. Revising and developing new aligned and integrated planning, human resource, financing and information systems 4. Leading change by building new collective visions, mobilising political, including budgetary, support and designing implementation strategies. This analysis, from real-life systems, adds to understanding of the processes
Andi Leny Susyanty
(GAIN UCI 2010–2014 stated that the general problems of decline in immunization coverage and quality of service were caused by several things, one of which is the lack of quantity, quality and distribution of human resources. Methods: A cross-sectional mix-method study to investigate human resources in vaccine management had been conducted in two provinces in 2012. Primary data were collected by interviewing stakeholders thoroughly, secondary data collection and observation were also carried out. Analysis was done by scoring for data concerning education, length of employment, training experience and knowledge. Result:The number of Vaccine management officers are still lacking. While the immunization guidelines required minimal two officers for each health centers. Officers’ knowledge in primary health centers is still inadequate, especially in terms of the vaccine and Coldchain (Ice Lined Refrigerators. Officers at Provincial Health Office had been trained in vaccine management, but not all officers at District Health Office and Primary Health Centers had received training yet. Suggestion: This study suggests the addition of the quantity and quality of human resources in vaccine management, because the officers can affect the quality of the vaccines, because vaccines need a special handling to maintain the quality to provide immunity and prevent the occurrence of diseases that can be prevented by immunization (PD3I.Key words: vaccine, human resources, training, knowledge
Xie, Yang; Dai, Hancheng; Dong, Huijuan; Hanaoka, Tatsuya; Masui, Toshihiko
This study evaluates the PM2.5 pollution-related health impacts on the national and provincial economy of China using a computable general equilibrium (CGE) model and the latest nonlinear exposure-response functions. Results show that the health and economic impacts may be substantial in provinces with a high PM2.5 concentration. In the WoPol scenario without PM2.5 pollution control policy, we estimate that China experiences a 2.00% GDP loss and 25.2 billion USD in health expenditure from PM2.5 pollution in 2030. In contrast, with control policy in the WPol scenario, a control investment of 101.8 billion USD (0.79% of GDP) and a gain of 1.17% of China's GDP from improving PM2.5 pollution are projected. At the provincial level, GDP loss in 2030 in the WoPol scenario is high in Tianjin (3.08%), Shanghai (2.98%), Henan (2.32%), Beijing (2.75%), and Hebei (2.60%) and the top five provinces with the highest additional health expenditure are Henan, Sichuan, Shandong, Hebei, and Jiangsu. Controlling PM2.5 pollution could bring positive benefits in two-thirds of provinces. Tianjin, Shanghai, Beijing, Henan, Jiangsu, and Hebei experience most benefits from PM2.5 pollution control as a result of a higher PM2.5 pollution and dense population distribution. Conversely, the control investment is higher than GDP gain in some underdeveloped provinces, such as Ningxia, Guizhou, Shanxi, Gansu, and Yunnan.
Blain, Natalie P; Helgason, Bobbi L; Germida, James J
The Bitumount Provincial Historic site is the location of 2 of the world's first oil-extracting and -refining operations. Despite hydrocarbon levels ranging from 330 to 24 700 mg·(kg soil)-1, plants have been able to recolonize the site through means of natural revegetation. This study was designed to achieve a better understanding of the plant-root-associated bacterial partnerships occurring within naturally revegetated hydrocarbon-contaminated soils. Root endophytic bacterial communities were characterized from representative plant species throughout the site by both high-throughput sequencing and culturing techniques. Population abundance of rhizosphere and root endosphere bacteria was significantly influenced (p bacteria was influenced by both plant species and sampling location. Quantitative real-time polymerase chain reaction was used to determine the potential functional diversity of the root endophytic bacteria. The gene copy numbers of 16S rRNA and 2 hydrocarbon-degrading genes (CYP153 and alkB) were significantly affected (p < 0.05) by the interaction of plant species and sampling location. Our findings suggest that some of the bacterial communities detected are known to exhibit plant growth promotion characteristics.
Jan 1, 2008 ... Objectives: To determine the usage of family planning services and safer sex practices among HIV infected ... general population, family planning usage is still contraception and high quality reproductive health very low. The Kenya ... Data management and analysis: Data from the structured questionnaires ...
Intaranongpai, Siranee; Hughes, David; Leethongdee, Songkramchai
This paper examines the implementation of Thailand's universal coverage healthcare reforms in a rural province, using data from field studies undertaken in 2003-2005 and 2008-2011. We focus on the strand of policy that aimed to develop primary care by allocating funds to contracting units for primary care (CUPs) responsible for managing local service networks. The two studies document a striking change in the balance of power in the local healthcare system over the 8-year period. Initially, the newly formed CUPs gained influence as 'power followed the money', and the provincial health offices (PHOs), which had commanded the service units, were left with a weaker co-ordination role. However, the situation changed as a new insurance purchaser, the National Health Security Office, took financial control and established regional outposts. National Health Security Office outposts worked with PHOs to develop rationalised management tools-strategic plans, targets, KPIs and benchmarking-that installed the PHOs as performance managers of local healthcare systems. New lines of accountability and changed budgetary systems reduced the power of the CUPs to control resource allocation and patterns of services within CUP networks. Whereas some CUPs fought to retain limited autonomy, the PHO has been able to regain much of its former control. We suggest that implementation theory needs to take a long view to capture the complexity of a major reform initiative and argue for an analysis that recognises the key role of policy networks and advocacy coalitions that span national and local levels and realign over time. Copyright © 2012 John Wiley & Sons, Ltd.
Rengifo-Reina, Herney A; Córdoba-Espinal, Alexandra; Serrano-Rodriguez, Mayerlin
Identifying the sexual and reproductive health knowledge and practice of adolescents living in the town of Miranda in the Cauca department of Colombia. Across-sectional, descriptive, observational study was made. The sample involved 406 adolescents. Sociodemographic, knowledge-related and practice-based variables were explored. The adolescents had high and very high levels of knowledge; 90.5 % of the adolescents had received information about sex and pregnancy; the main source of information came from their parents (67.5 %). Safe sex for 26.7 % of the adolescents meant just using a condom. Regarding their sexuality (practice), 42 % stated that they had had sexual relationships, beginning on average when around 13-years-old. Condom use was the most used protection mechanism. 12.5 % stated that they had used psychoactive substances or alcohol to intensify sexual experience; 87.7 % stated that they would seek counselling or treatment in a hospital or health centre without telling their parents if they contracted a sexually- transmitted infection (STI). The adolescents involved in this study had high levels of knowledge; however, such knowledge is not enough to stop them beginning their sexual life early and/or increasing the probability of using a condom or contraceptive when beginning their sexual relationships.
Norris, Jill M; White, Deborah E; Nowell, Lorelli; Mrklas, Kelly; Stelfox, Henry T
Engaging stakeholders from varied organizational levels is essential to successful healthcare quality improvement. However, engagement has been hard to achieve and to measure across diverse stakeholders. Further, current implementation science models provide little clarity about what engagement means, despite its importance. The aim of this study was to understand how stakeholders of healthcare improvement initiatives defined engagement. Participants (n = 86) in this qualitative thematic study were purposively sampled for individual interviews. Participants included leaders, core members, frontline clinicians, support personnel, and other stakeholders of Strategic Clinical Networks in Alberta Health Services, a Canadian provincial health system with over 108,000 employees. We used an iterative thematic approach to analyze participants' responses to the question, "How do you define engagement?" Regardless of their organizational role, participants defined engagement through three interrelated themes. First, engagement was active participation from willing and committed stakeholders, with levels that ranged from information sharing to full decision-making. Second, engagement centered on a shared decision-making process about meaningful change for everyone "around the table," those who are most impacted. Third, engagement was two-way interactions that began early in the change process, where exchanges were respectful and all stakeholders felt heard and understood. This study highlights the commonalities of how stakeholders in a large healthcare system defined engagement-a shared understanding and terminology-to guide and improve stakeholder engagement. Overall, engagement was an active and committed decision-making about a meaningful problem through respectful interactions and dialog where everyone's voice is considered. Our results may be used in conjunction with current implementation models to provide clarity about what engagement means and how to engage various
Yi, Yingying; Liang, Ying
This article sought to explore the impacts of socioeconomic status and social inclusion on intra-provincial and interprovincial migrants' mental health by constructing the Bayesian structural equation model. A total of 14,584 migrants aged 15-59 years living in eight cities of China were selected. It was found that the impacts of socioeconomic status and social inclusion on mental health were converse for these two groups. And the manifest variables coefficients of socioeconomic status and social inclusion were also converse. Therefore, governments should make some policies to further improve the mental health of migrants, including strengthening the community cohesion, social atmosphere, and governmental support.
Honore, Russel L; Boslego, David V
The Provincial Reconstruction Team (PRT) training mission completed by First U.S. Army in April 2006 was a joint Service effort to meet a requirement from the combatant commander to support goals in Afghanistan...
This article argues that provincial culture in the 19th century, even while presenting itself as patriotic and nationalist, may sometimes contain elements in which a certain aspiration to overcome provincialism and introduce a cosmopolitan quality to local culture is detectable. The themes...... of nationalist political propaganda, in effect – is analysed, and it is suggested that while it is certainly suffused with patriotic rhetoric (such as the occasion demanded), Rung nevertheless at the same time took the opportunity to incorporate a number of significant international musical influences, notably...
Sofie M van Dorp
Full Text Available It has been suggested that the high incidence of ribotype 078 Clostridium difficile infections (CDI in the Netherlands is related to pig farming.We used data of hospitalised CDI patients (>2yrs of age diagnosed between May 2009 and May 2015 in 26 hospitals participating in a national sentinel surveillance. We compared clinical and geographical characteristics of 078 CDI to other CDI. We investigated the association between 078 CDI incidence and four indicators of pig farming (piglet, pig, piglet farm and pig farm density by mixed-effects Poisson regression. We used a space-time permutation model to search for community-onset 078 CDI clusters (using SaTScan.A total of 4,691 CDI were identified. Ribotype 078 was isolated in 493 of 3,756 patients (13.1% including a typing result. These patients had slightly higher community-onset disease and a 35% increase of 30-day mortality compared to non-078 CDI patients. The pooled overall and 078 incidence rates were 2.82 (95% CI, 2.42-3.29 and 0.26 (95% CI, 0.21-0.31 CDI per 10,000 patients-days respectively. Hospital 078 CDI incidence was not associated with provincial pig (IRR, 0.98; 95% CI, 0.89-1.08, piglet (IRR, 0.95; 95% CI, 0.75-1.19, pig farm (IRR, 1.08; 95% CI, 0.84-1.39, or piglet farm density (IRR, 1.00; 95% CI, 0.56-1.79. No clusters of community-onset ribotype 078 CDI were found.Our results do not indicate that the ribotype 078 CDI incidence in hospitals is related to pig (farm or piglet (farm density. However, transmission beyond provincial borders or in non-hospitalised patients cannot be excluded.
Full Text Available Health workforce misdistribution is a major challenge faced by almost all countries. A more profound understanding of the dynamics of the health labor market provides evidence for policy makers to balance health workforce distribution with solid evidence. However, one major deficit of existing theoretical and empirical studies is that they often ignore the intra-regional spillovers of the health labor market. This study builds a theoretical “supply–demand–spillover” model that considers both intra-regional supply and demand-side factors, and inter-regional spillovers, hence providing a theoretical reference point for further in-depth studies. Using spatial econometric panel models, the effect of all determinants and spillovers were empirically measured based on a Chinese panel data set, shedding light on health workforce policies in China.
Passmore, Steven R.; Toth, Audrey; Kanovsky, Joel; Olin, Gerald
Background: The burden of fees for chiropractic services rendered often falls on the patient and must be provided out-of-pocket regardless of their socioeconomic status and clinical need. Universal healthcare coverage reduces the financial barrier to healthcare utilization, thereby increasing the opportunity for the financially disadvantaged to have access to care. In 2011 the Canadian Province of Manitoba initiated a pilot program providing access to chiropractic care within the Mount Carmel Clinic (MCC), a non-secular, non-profit, inner city community health centre. Objective: To describe the initial integration of chiropractic services into a publically funded healthcare facility including patient demographics, referral patterns, treatment practices and clinical outcomes. Method: A retrospective database review of chiropractic consultations in 2011 (N=177) was performed. Results: The typical patient referred for chiropractic care was a non-working (86%), 47.3(SD=16.8) year old, who self-identified as Caucasian (52.2%), or Aboriginal (35.8%) and female (68.3%) with a body mass index considered obese at 30.4(SD=7.0). New patient consultations were primarily referrals from other health providers internal to the MCC (71.2%), frequently primary care physicians (76%). Baseline to discharge comparisons of numeric rating scale scores for the cervical, thoracic, lumbar, sacroiliac and extremity regions all exceeded the minimally clinically important difference for reduction in musculoskeletal pain. Improvements occurred over an average of 12.7 (SD=14.3) treatments, and pain reductions were also statistically significant at pChiropractic services are being utilized by patients, and referring providers. Clinical outcomes indicate that services rendered decrease musculoskeletal pain in an inner city population. PMID:26816049
... a robust series of courses leading to a brand new certification – the College Health and Wellness Professional ( ... future college health and wellness professionals, and strengthen awareness of the profession and association. Each month we' ...
Murnaghan, D. A.; Leatherdale, S. T.; Sihvonen, M.; Kekki, P.
This paper examined how smoking policies and programs are associated with smoking behavior among Grade 10 students (n = 4709) between 1999 and 2001. Data from the Tobacco Module from the School Health Action Planning and Evaluation System were examined using multilevel logistic regression analyses. We identified that (i) attending a school with…
Chatterley, Trish; Storie, Dale; Chambers, Thane; Buckingham, Jeanette; Shiri, Ali; Dorgan, Marlene
Healthcare practitioners in Alberta and across Canada have varying levels of access to information resources depending on their institutional and professional affiliations, yet access to current health information is critical for all. To determine what information resources and services are provided by Albertan and Canadian professional health associations to their members. Representatives of professional colleges and associations were interviewed regarding information resources and services offered to members and perceptions of their members' information needs. National-level associations are more likely to provide resources than provincial ones. There is a clear distinction between colleges and associations in terms of information offered: colleges provide regulatory information, while associations are responsible for provision of clinical information resources. Only half of the associations interviewed provide members with access to licensed databases, with cost being a major barrier. There is considerable variation in the number of electronic resources and the levels of information support provided by professional health associations in Alberta and Canada. Access and usage vary among the health professions. National licensing of resources or creation of a portal linking to freely available alternatives are potential options for increasing access and awareness. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.
Prah Ruger, Jennifer
The summer 2014 Ebola virus outbreak in Western Africa illustrates global health's striking inequalities. Globalisation has also increased pandemics, and disparate health system conditions mean that where one falls ill or is injured in the world can mean the difference between quality care, substandard care or no care at all, between full recovery, permanent ill effects and death. Yet attention to the normative underpinnings of global health justice and distribution remains, despite some important exceptions, inadequate in medical ethics, bioethics and political philosophy. We need a theoretical foundation on which to build a more just world. Provincial globalism (PG), grounded in capability theory, offers a foundation; it provides the components of a global health justice framework that can guide implementation. Under PG, all persons possess certain health entitlements. Global health justice requires progressively securing this health capabilities threshold for every person. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
... individual mandate and eliminate billions in public health spending. This would be a disaster … Each year in ... Awareness Program (ADAP) increased #depression literacy among participants, & students approache… Poor sleep among blacks linked to health ...
, scant attention has been paid to the psychological processes that underpin mental toughness. Objectives: To explore the relationship between mindfulness and mental toughness among provincial adolescent female hockey players.
... Program SNF Requirements of Participation SNF Value-Based Purchasing (SNF VBP) Survey and Regulatory Therapy Services Workforce ... out, stay informed and spread. Looking for more information reguarding Prefered Provider Program Quality Care Book Store ... Nursing Home Administrator | Benedictine Health System US - MO - St. Louis, Qualifications Required: Bachelor’s degree ...
Warfa, Osman; Njai, Daniel; Ahmed, Laving; Admani, Bashir; Were, Fred; Wamalwa, Dalton; Osano, Boniface; Mburugu, Patrick; Mohamed, Musa
Introduction Half of Kenya's high infant and under five mortality rates is due to malnutrition. Proper implementation of World Health Organization's (WHO) Evidence Based Guidelines (EBG) in management of severe acute malnutrition can reduce mortality rates to less than 5%. The objectives were to establish the level of adherence to WHO guideline and the proportion of children appropriately managed for severe acute malnutrition (steps 1-8) as per the WHO protocol in the management of severe acute malnutrition. This was a short longitudinal study of 96 children, aged 6-59 months admitted to the pediatric ward with diagnosis of severe acute malnutrition. Methods Data was extracted from patients’ medical files and recorded into an audit tool to compare care provided in this hospital with WHO guidelines. Results Non-edematous malnutrition was the commonest presentation (93.8%). A higher proportion (63.5%) of patients was male. Most (85.4%) of patients were younger than 2 years. Patients with non-edematous malnutrition were younger (mean age for non-edematous malnutrition was 16 (± 10.6) months versus 25 (± 13.7) months in edematous malnutrition). The commonest co- morbid condition was diarrhea (52.1%). Overall, 13 children died giving an inpatient case fatality rate of 13.5%. Appropriate management was documented in only 14.6% for hypoglycemia (step1), 5.2% for hypothermia (step 2) and 31.3% for dehydration (step 3). Conclusion The level of adherence to MOH guidelines was documented in 5 out of the 8 steps. Appropriate management of children with severe acute malnutrition was inadequate at Garissa hospital. PMID:25237411
Sun, Xiaoqi; An, Haizhong; Liu, Xiaojia
Global economic system is a huge network formed by national subnetworks that contains the provincial networks. As the second largest world economy, China has "too big to fail" impact on the interconnected global economy. Detecting the critical sectors and vital linkages inside Chinese economic network is meaningful for understanding the origin of this Chinese impact. Different from tradition network research at national level, this paper focuses on the provincial networks and inter-provincial network. Using Chinese inter-regional input-output table to construct 30 provincial input-output networks and one inter-provincial input-output network, we identify central sectors and vital linkages, as well as analyze economic structure similarity. Results show that (1) Communication Devices sector in Guangdong and that in Jiangsu, Transportation and Storage sector in Shanghai play critical roles in Chinese economy. (2) Advanced manufactures and services industry occupy the central positions in eastern provincial economies, while Construction sector, Heavy industry, and Wholesale and Retail Trades sector are influential in middle and western provinces. (3) The critical monetary flow paths in Chinese economy are Communication Devices sector to Communication Devices sector in Guangdong, Metals Mining sector to Iron and Steel Smelting sector in Henan, Communication Devices sector to Communication Devices sector in Jiangsu, as well as Petroleum Mining sector in Heilongjiang to Petroleum Processing sector in Liaoning. (4) Collective influence results suggest that Finance sector, Transportation and Storage sector, Production of Electricity and Heat sector, and Rubber and Plastics sector in Hainan are strategic influencers, despite being weakly connected. These sectors and input-output relations are worthy of close attention for monitoring Chinese economy.
Full Text Available This paper investigates the effect of provincial corruption on the performance of local development bank, specifically to the profitability and credit quality. We use the data of 26 local development banks in 2012 and 2013. For the provincial corruption measurement we use “Public Institution Openness Index”. Results of this study are first, corruption significantly has a negative effect on the profitability of local development bank. Second, corruption doesn’t affect the credit quality of local development bank. These results are expected to enrich the within country corruption effect to the economic studies, particularly to the local development bank which is infrequently investigated.
Andrea Mubi Brighenti
Full Text Available To be provincial is to be territorialized. Not simply because the province is a territory, but because it makes a territory, it territorializes people and affects. Territory and belonging should not be taken as primordial features of the province, but rather as the effects of a territorializing act or a series of such acts.
In the period 1969 to 1971 a research project on the ecology of angling species in the Vaal River was undertaken by the Nature Conservation Division of the Transvaal Provincial Administra- tion. A paper on aspects on the ecology of the yellowfish species appears in this same number. (Mulder 1973) and the present paper ...
Obesity is defined clinically as a state of increased body weight, more specifically of increased fat tissue mass. It is associated with increased fat cell size and number, and is usually followed by serious health consequences if not controlled. Body weight and the storage of energy as triglyceride in adipose tissue are ...
Ferland, Adam; Chu, Yen Li; Gleddie, Doug; Storey, Kate; Veugelers, Paul
Life skills development is a core area for action in the Ottawa Charter for Health Promotion. The role of life skills in influencing health behaviours among children has received little attention in research. The purpose of this cross-sectional study was to investigate the relationship between self-leadership, as a model of life skills, and diet quality, physical activity, sleep duration and body weight. A provincially representative sample of 2328 grade 5 students (aged 10-11 years) was surveyed in Alberta, Canada. Self-leadership skills were assessed based on student responses indicating frequency of performing various leadership traits. Diet quality was based on responses to the Harvard Youth/Adolescent Food Frequency Questionnaire and physical activity on responses to the Physical Activity Questionnaire for Children. Sleep duration was assessed based on parent survey responses, and body mass index determined based on measured height and weight. Random effects regression models with children nested within schools were used to determine the associations. Higher self-leadership was associated with better diet quality (P leadership was suggestive of healthier body weight status (OR = 0.91, 95% CI = 0.66, 1.27). No association of self-leadership with sleep duration was found. The incorporation of leadership skill development may enhance the effectiveness of school-based health promotion programs. This study reinforces the importance of leadership skill promotion in the promotion of healthy eating and active living, which may help curb the obesity epidemic in the short term, and prevention of chronic diseases and mounting healthcare costs in the long term. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
Csiernik Rick; Schofield Ruth; Joplin Libbey; Forchuk Cheryl; Gorlick Carolyne; Turner Katherine
Abstract There exists a disconnection between evolving policies in the policy arenas of mental health, housing, and income support in Canada. One of the complexities associated with analysing the intersection of these policies is that federal, provincial, and municipal level policies are involved. Canada is one of the few developed countries without a national mental health policy and because of the federal policy reforms of the 1970s, the provincial governments now oversee the process of dei...
Manuel Lucena Salmoral
Full Text Available El acontecimiento más sobresaliente del patriarcado de don Fernando Arias de Ugarte, en el que hubo muchos notables, fue el Primer Concilio Provincial del Nuevo Reino de Granada, celebrado en el año 1623. Cumplió así una vieja aspiración de los arzobispos santafereños y la obligación impuesta en el Concilio de Trento, por lo que resulta incomprensible lo historiado por don José Antonio Plaza quien, al referirse a este hecho, dice lo siguiente...
In the early nineteenth century, geology was a new but rapidly growing science, in the provinces and among the gentlemen scientists of London, Oxford and Cambridge. Industry, particularly mining, often motivated local practical geologists, and the construction of canals and railways exposed the strata for all to see. The most notable of the early practical men of geology was the mineral surveyor William Smith; his geological map of England and Wales, published in 1815, was the first of its kind. He was not alone. The contributions of professional men, and the provincial societies with which they were connected, are sometimes underestimated in the history of geology.
Kort, Rodney; Stuart, Allison J; Bontovics, Erika
The SARS crisis revealed critical gaps in Ontario's health emergency response capacity, and identified, in the starkest terms possible, the need for improved emergency response planning. This article reviews the development of the Ontario Health Plan for an Influenza Pandemic (OHPIP), released in June 2005. Some key points arising from the provincial planning process include the necessity to: ensure a broad and inclusive development process; ensure the pandemic plan identifies: 1) clear roles and responsibilities of federal, provincial/territorial and municipal levels of government, 2) the approach to occupational health and safety issues and ethical decision-making, 3) a communications strategy linking all affected sectors and levels of government and health sector; 4) any commitments to antiviral stockpiling, vaccine and antiviral allocation and use, and an approach for drug delivery from provincial stockpiles to local public health units; 5) health human resource management and supplementation; and 6) key programs/services to be scaled back to maximize surge capacity; address best practices (e.g., involve all sectors of the health care system at the outset, acquire strategic expertise, coordinate/advocate with broader emergency response system, etc); and, outline future stages that include strengthening the delivery of clinical care to influenza cases; clarifying the role of primary care practitioners during a pandemic; leveraging Ontario's significant e-Health investments.
Ding, Jingmei; Hu, Xuejun; Zhang, Xianzhi; Shang, Lei; Yu, Min; Chen, Huoliang
The astonishing economic achievements of China in the past few decades have remarkably increased not only the quantity and quality of medical services but also the inequalities in health resources allocation across regions and inefficiency of the medical service delivery. A descriptive analysis was used to compare the inequities in inputs and outputs of the provincial medical service systems, a non-radial super-efficiency data envelopment analysis model was then used to estimate the efficiency, and a regression analysis of the panel data was used to explore the determinants. The inputs and outputs of most provincial medical service systems increased gradually from 2009 to 2014. Overall, the eastern region allocated more human and capital resources than the other two regions, and produced more than 50% of the total outpatient and emergency room visits, whereas the western region produced more inpatient services (about 30% of the total volume of inpatient services) according to the distribution of the population. The average efficiency scores of the provincial medical systems in China's mainland were 0.895, 0.927, 0.929, 0.963, 0.977 and 0.968 from 2009 to 2014, with a slight average improvement of 1.60%. The efficiency score of each provincial medical service system varied greatly from one another: Tibet (1.475 ± 0.057) performed extremely well, whereas several others including Heilongjiang (0.579 ± 0.001) performed poorly. Furthermore, the proportion of high-class medical facilities was negatively associated with efficiency, whereas the proportion of the vulnerable population, the per capita Gross Domestic Product, the proportion of the illiterate population and the improvement of primary health care had positive effects on efficiency. Inequity in health resources allocation and service provision existed across the regions, but not all the gaps have begun to narrow since 2009. The difference of efficiency was great among provincial medical service systems
Mitchell, W. [British Columbia Ministry of Finance, Victoria, BC (Canada). Land Use Coordination Office
The efforts being made to include Aboriginal communities in land use planning in British Columbia are discussed. British Columbia is in the midst of historic changes with respect to land and resource allocation, use and management. Historic trends in land use allocation and management are contrasted with land use planning and resource management of today. The impact of provincial government moves to double park space within the province, and the Protected Areas Strategy initiative will have on the natural gas and petroleum industry is discussed. New efforts being made to include First Nations directly in land use planning discussions in ways that do not prejudice treaty negotiations, are reviewed. Creation of a new Oil and Gas Commission in the Fort St. John area, is cited as the most recent example of the interconnections between First Nations communities and other public and industry stakeholders in land use planning in the province.
Liao, Hua; Liu, Yanan; Gao, Yixuan; Hao, Yu; Ma, Xiao-Wei; Wang, Kan
In China, more than 80% electricity comes from coal which dominates the CO2 emissions. Residential electricity demand forecasting plays a significant role in electricity infrastructure planning and energy policy designing, but it is challenging to make an accurate forecast for developing countries. This paper forecasts the provincial residential electricity consumption of China in the 13th Five-Year-Plan (2016-2020) period using panel data. To overcome the limitations of widely used predication models with unreliably prior knowledge on function forms, a robust piecewise linear model in reduced form is utilized to capture the non-deterministic relationship between income and residential electricity consumption. The forecast results suggest that the growth rates of developed provinces will slow down, while the less developed will be still in fast growing. The national residential electricity demand will increase at 6.6% annually during 2016-2020, and populous provinces such as Guangdong will be the main contributors to the increments.
Full Text Available This essay discusses the writing and personalities surrounding the 1981 establishment of the Australian art magazine, Art & Text, and traces its progression under Paul Taylor’s editorship up to his relocation to New York. During this period, Art & Text published Taylor’s own essays and, more importantly, those of other writers and artists — Meaghan Morris, Paul Foss, Philip Brophy, Imants Tillers, Rex Butler, Edward Colless — all articulating a consistent and complex postmodern position. The magazine’s founder and editor, Paul Taylor, personified the shattering impact of postmodernism upon the Australian art world as well as postmodernism’s limitations. Taylor facilitated a new theoretical framework for the discussion of Australian art, one that continues to dominate the internationalist aspirations of Australian art writers. He produced temporarily convincing solutions to problems that earlier critics had wrestled with unsuccessfully, in particular the twin problems of provincialism, and the relationship of Australian to international art.
Natalia Alejandra Alaniz
Full Text Available En el marco del proyecto “Dispositivos pedagógicos en las dinámicas de lavida escolar en contexto de pobreza urbana” lo que se propuso investigar es la forma de implementación del Programa de Lectura de la provincia de Chubut. El mismo fue creado por Resolución Ministerial N° 1044/ 08, a partir de diversos trabajos que comenzaron en el año 2003 a través de la Ley de Educación 26. 026, y que posteriormente se incorporaron a nivel provincial mediante la Resolución N ° 174/12 para revalorizar las trayectorias escolares de cada niño/a. El programa consiste en poner el énfasis en el vínculo pedagógico mediante la adecuación de los espacios curriculares, de tal modo que se pueda lograr una articulación entre los diferentes niveles educativos, desde el nivel inicial al secundario. Articulando para ello recursos materiales y humanos que posibiliten el acompañamiento del proceso de enseñanza y aprendizaje de lectura.A partir de esto, el objetivo de este trabajo fue indagar cómo perciben los docentes de una escuela pública la implementación del Programa Provincial de Lectura, lo que implico utilizar metodologías y técnicas de investigación apropiadas para obtener las experiencias actuales en el territorio y en la cotidianidad de los propios actores escolares. Teniendo en consideración que el dispositivo pedagógico es una construcción histórica, que produce subjetividades, y por consiguiente formas de ver y entender el mundo.
...: Notice of Administrative Meetings for the Northwest Forest Plan Provincial Advisory Committees. SUMMARY... up under the Northwest Forest Plan. The PIECs facilitate the successful implementation of the Record... administrative meetings will be to inform the current Provincial Advisory Committee membership of the following...
This study explores the experiences of youth in the provincial town of Pontianak, West Kalimantan, done in Pontianak, the provincial capital of West Kalimantan during the years 2008-2009. It tries to understand the various patterns of relations between growing up and being young, how social
Review of Paediatric Admissions In Mongomo Provincial Hospital, Wele Nzas, Equatorial Guinea. Nnamdi B Onyire. Abstract. Background: The author was part of the Technical Aid Corps team of the Nigerian Government to Mongomo Provincial Hospital, Wele Nzas province of Equatorial Guinea, between May 1997 and ...
Full Text Available Islamic symbols have flourished in the public spaces of Indonesian provincial towns after Suharto. This phenomenon has occurred in parallel with the significant shifts in the social, economic and political fields, which is tied to the mounting impact of Islamization, social mobility, economic growth, and democratization occurring among town people. It is as if we see a parallel move between Islamization, modernization, globalization and democratization. Key concepts associated with these trends are appropriated with those rooted in tradition and local culture to inform the whole dynamics of Indonesian provincial towns today. The key player in this process is the new middle class, who look to Islam for inspiration both to claim distinction and social status and to legitimize their consumptive lifestyle. They are newly pious who act as active negotiators between the global and the local as well as the cosmopolitan centre and the hinterland. They also play a pivotal role as an agency that liberalizes religion from its traditionally subservient, passive and docile posture by turning it into a source of moral legitimacy and distinction to represent a modern form of life. Given its intimate relationship with locality, tradition, modernity as well as globalization, Islam has increasingly assumed a greater importance for local politics. Political elites have used Islamic symbols for the instrumental purpose of extending their political legitimacy and mobilizing constituency support, in a political environment of open competition and increased public participation in decision making. In this process religious symbols have irrefutably been distanced from their religious moorings and narrow, Islamist understandings, in favor of pragmatic political purposes. Keywords: Islamic symbols, middle class, globalization, lifestyle, local politics
Astri Syse; Marijke Veenstra; Trude Furunes; Per Erik Solem; Reidar Mykletun
Objectives: While poor health contributes to early work exits, it is less clear how early work exits affect health. This study therefore examines changes in health associated with retirement. Method: Survey data from gainfully employed individuals aged 57 to 66 in 2002 were used to assess changes in
Agarwal, Shanu; Abell, Virginia; File, Thomas M
Nosocomial Legionnaire's disease is most frequently associated with presence of the organism in hospital water systems. Patients are often susceptible as a result of age, underlying comorbidities, or immunosuppression. Prevention focuses on reducing the reservoir within water systems and includes super heating, ultraviolent light, chlorination, silver-copper ionization, and distal filtration. This article reviews the epidemiology of health care-associated Legionnaire's disease, reviews characteristics of several health care-associated outbreaks, and discusses strategies to prevent health care-associated infection. Copyright © 2016 Elsevier Inc. All rights reserved.
... and international bodies as well as the military. Provincial Reconstruction Teams (PRTs), as employed in Afghanistan, are used as a vehicle to examine the wide range of activities necessary for Nation Building...
Five years after the 2008 recession, provincial unemployment rates in Canada remain higher than pre-recession levels. In some provinces, initial declines in unemployment have plateaued. When structural changes occur, a higher unemployment rate can persist even after a full economic recovery. This study undertakes an empirical analysis of provincial panel data to uncover potential causes of persistent unemployment across Canada. The results indicate that, after the recession, the structural co...
Ekholm, Ola; Juel, Knud; Bonde, Lars Ole
/day. RESULTS: Both musically active men and women were more likely to report good self-rated health than individuals that were not active musically. However, the results also indicated that musically active women were less likely to report poor physical and mental health than women who were not active...... musically, while this pattern was not found among men. CONCLUSIONS GENDER SEEMS TO PLAY AN IMPORTANT ROLE IN THE ASSOCIATION BETWEEN MUSICKING AND HEALTH, BUT MORE RESEARCH IS NEEDED TO UNDERSTAND THESE DIFFERENCES AND THE UNDERLYING MECHANISMS IN ADDITION, LONGITUDINAL STUDIES ARE WARRANTED TO EXAMINE......AIMS: To examine the associations between singing/playing musical instruments daily and various outcomes such as health-related quality of life and health behaviour. METHODS: Data originates from the Danish Health and Morbidity Survey 2013. The survey was based on a random sample of 25,000 adult...
Although there have been several negative media reports on the plight of irregular migrants from Ghana, research on issues related to their health has been rather scanty. The study assesses health implications associated with irregular migration from Ghana using both the Techiman and Nkoranza Municipalities as a case ...
Chan, Ellen; Barnes, Morgan E; Sharif, Omar
Public Health Ontario (PHO) publishes various infectious disease surveillance reports, but none have yet been formally evaluated. PHO evaluated its monthly and annual infectious disease surveillance reports to assess public health stakeholders' current perception of the products and to develop recommendations for improving future products. An evaluation consisting of an online survey and a review of public Web sites of other jurisdictions with similar annual reports. For the online survey, stakeholder organizations targeted were the 36 local public health units and the Health health ministry in Ontario, Canada. Survey participants included epidemiologists, managers, directors, and other public health practitioners from participating organizations. Online survey respondents' awareness and access to the reports, their rated usefulness of reports and subsections, and suggestions for improving usefulness; timeliness of select annual reports from other jurisdictions based on the period from data described to report publication. Among 57 survey respondents, between 74% and 97% rated each report as useful; the most common use was for situational awareness. Respondents ranked timeliness as the most important attribute of surveillance reports, followed by data completeness. Among 6 annual reports reviewed, the median time to publication was 11.5 months compared with 23.2 months for PHO. Recommendations based on this evaluation have already been applied to the monthly report (eg, focusing on the most useful sections) and have become key considerations when developing future annual reports and other surveillance reporting tools (eg, need to provide more timely reports). Other public health organizations may also use this evaluation to inform aspects of their surveillance report development and evaluation. The evaluation results have provided PHO with direction on how to improve its provincial infectious disease surveillance reporting moving forward, and formed a basis for
Shang, Mei; Fu, Yujie; Zhang, Liping
In the 13th Five-Year plan, promoting Low-carbon cycle development is proposed. Low-carbon economy has become the key direction. As the pillar industry of national economy, the construction industry contributes obviously to the economic development. And the consumption of energy and the pollution of the environment can not be ignored. Accurately grasping the carbon emission level of the provincial construction industry is critical to making the future development strategy. In the paper, carbon emissions, energy consumption and economic growth of the provincial construction industry are analyzed firstly., then low carbon evaluation index is built to measure low-carbon level of provincial construction industry, at last relevant policy suggestions are put forward accordingly.
Schmidt, Simone; Duangdala, Phouvieng; Saysanasongkham, Bounnack; Sabir, Hemmen; Brenner, Sebastian; Schmid, Manuel; Kuehn, Thomas; Hoehn, Thomas
The aim of this study was to identify the causes and incidences of neonatal diseases and deaths in five provincial hospitals in People's Democratic Republic of Laos retrospectively for the years 2010-12. Data of neonatal patients were collected before a 3-year-training program for medical and nursing staff involved in the care of newborn infants in the provincial and associated district hospitals. In the years 2010-12, a total of 1673 neonatal patients were treated in the provincial hospitals. The reasons of treatment were as follows: 48% infections, 17% complications of prematurity, 14% intrapartum-related complications and 9% other, not categorized diseases. The average mortality rate in all hospitals was 6.5%. The main causes of death were complications because of prematurity, infectious diseases and asphyxia. These data could be the basis for any teaching program aimed at reducing neonatal mortality. Furthermore, they enable an evaluation of the ongoing teaching program. © The Author . Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Ren, Jie; Grundy, Scott M; Liu, Jing; Wang, Wei; Wang, Miao; Sun, Jiayi; Liu, Jun; Li, Yan; Wu, Zhaosu; Zhao, Dong
Few studies have examined very-low-density lipoprotein (VLDL) cholesterol as an independent risk factor of coronary heart disease (CHD) or its combined effects with coexisting cardiac risk factors. The current study examined the association between VLDL cholesterol and the risk of future CHD events. This study reports the association of VLDL cholesterol level and long-term CHD risk, as well as the combined effects of VLDL cholesterol and LDL cholesterol with other cardiovascular disease (CVD) risk factors. The cohort comprises 30,378 participants aged 35-64 years from 11 Chinese provinces. All participants were followed up annually until 2007. We found 20% of the sample population had elevated VLDL cholesterol>or=30 mg/dL. Elevated VLDL cholesterol levels were found to increase CHD risk by 2.19-3.36-fold in people with LDL cholesterol within the normal range and presenting no other major risk factors. This effect was exacerbated in those with elevated LDL cholesterol levels, and further increased CHD risk in those displaying three or more risk factors. The population-attributable risk proportion (PAR%) of CHD associated with VLDL cholesterol was calculated to be 17.3%, higher than that associated with LDL cholesterol alone. In a large Chinese cohort, elevated VLDL cholesterol was found to be significantly associated with elevated CHD risk, similar to that observed with LDL cholesterol. CHD risk was further amplified when elevated VLDL cholesterol was combined with elevated LDL cholesterol and/or the presence of major CVD risk factors. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.
Khan, Wasiq Mehmood; Smith, Helen; Qadeer, Ejaz; Hassounah, Sondus
To understand how national and provincial tuberculosis programme managers in Pakistan perceive and engage with the Stop TB strategy, its strengths, weaknesses and their experience in its implementation. National and provincial tuberculosis programme managers play an important role in effective implementation of the Stop TB strategy. A qualitative interview study was conducted with 10 national and provincial tuberculosis programme managers to understand how they perceive and engage with the Stop TB strategy, its strengths, weaknesses and their experience in its implementation. Managers were selected purposively; 10 managers were interviewed (six national staff and four from provincial level). National and provincial tuberculosis programme managers in Pakistan. Managers were selected purposively; 10 managers were interviewed (six national staff and four from provincial level). National and provincial tuberculosis programmes in Pakistan. 1. Knowledge and perceptions of national and provincial tuberculosis programme managers about the Stop TB strategy 2. Progress in implementing the strategy in Pakistan 3. Significant success factors 4. Significant implementation challenges 5. Lessons learnt to scale up successful implementation. The managers reported that most progress had been made in extending DOTS, health systems strengthening, public -private mixed interventions, MDR-TB care and TB/HIV care. The four factors that contributed significantly to progress were the availability of DOTS services, the public-private partnership approach, comprehensive guidance for TB control and government and donor commitment to TB control. This study identified three main challenges as perceived by national and provincial tuberculosis programme managers in terms of implementing the Stop TB strategy: 1. Inadequate political commitment, 2. Issue pertaining to prioritisation of certain components in the TB strategy over others due to external influences and 3. Limitations in the overall
El-Zaatari, Ziad M; Chami, Hassan A; Zaatari, Ghazi S
It is widely held that waterpipe smoking (WPS) is not associated with health hazards. However, several studies have documented the uptake of several toxicants and carcinogens during WPS that is strongly associated with harmful health effects. This paper reviews the literature on the health effects of WPS. Three databases-PubMed, MEDLINE and EMBASE-were searched until August 2014 for the acute and long-term health effects of WPS using the terms 'waterpipe' and its synonyms (hookah, shisha, goza, narghileh, arghileh and hubble-bubble) in various spellings. We included original clinical studies, case reports and systematic reviews and focused on clinical human studies. ∼10% of the identified studies met the selection criteria. Data were abstracted by all three authors and summarised into tables. Abstracted data included study type, results and methodological limitations and were analysed jointly by all three authors. WPS acutely leads to increased heart rate, blood pressure, impaired pulmonary function and carbon monoxide intoxication. Chronic bronchitis, emphysema and coronary artery disease are serious complications of long-term use. Lung, gastric and oesophageal cancer are associated with WPS as well as periodontal disease, obstetrical complications, osteoporosis and mental health problems. Contrary to the widely held misconception, WPS is associated with a variety of adverse short-term and long-term health effects that should reinforce the need for stronger regulation. In addition, this review highlights the limitations of the published work, which is mostly cross-sectional or retrospective. Prospective studies should be undertaken to assess the full spectrum of health effects of WPS, particularly in view of its growing popularity and attractiveness to youth. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
A study of the health hazards that traditional cloth weavers encounter at the workplace was carried out over a three-week period in Ilorin, Nigeria. All the registered members of the Association whose workplace could be identified were included in the study. The questionnaires were administered as interview schedule by ...
Jia, Yingnan; Gao, Junling; Dai, Junming; Zheng, Pinpin; Fu, Hua
To examine the associations between demographic characteristics, health behaviors, workplace health culture, and health-related outcomes in Chinese workplaces. A total of 1508 employees from 10 administrative offices and 6 enterprises were recruited for a cross-sectional survey. Self-administered questionnaires mainly addressed demographic characteristics, health behaviors, workplace health culture, and health-related outcomes including self-rated health, mental health, and happiness. The proportion of participants who reported good health-related outcomes was significantly higher in those working in administrative offices than those working in enterprises. The result of the potential factors related to self-rated health (SRH), mental health, and happiness by logistic regression analyses showed that age and income were associated with SRH; type of workplace, age, smoking, and health culture at the workplace level were associated with mental health; and beneficial health effects of direct leadership was positively associated with happiness. Moreover, there were some similar results among 3 multivariate regression models. Firstly, good SRH (Odds Ratio (OR) = 1.744), mental health (OR = 1.891), and happiness (OR = 1.736) were more common among highly physically active participants compared with those physical inactive. Furthermore, passive smoking was negatively correlated with SRH (OR = 0.686), mental health (OR = 0.678), and happiness (OR = 0.616), while health culture at the individual level was positively correlated with SRH (OR = 1.478), mental health (OR = 1.654), and happiness (OR = 2.916). The present study indicated that workplace health culture, health behaviors, and demographic characteristics were associated with health-related outcomes. Furthermore, individual health culture, physical activity, and passive smoking might play a critical role in workplace health promotion.
Aim To determine the etiology and outcome of pediatric burns (0-12 years). Design A retrospective study of burn victims hospitalized at the Rift Valley Provincial General Hospital, Nakuru, Kenya from April 2004 to March 2007. Method Charts of all children hospitalized for burn injury were reviewed for patient demographics, ...
surgical/female burn ward were eligible. On average the ward admits 680 patients a year out of which 170 pa- tients (25.7 %) are due to pediatric burns. The Hospital attracts patients mostly from low socioeconomic status. Pediatric Burns at The Rift Valley. Provincial General Hospital, Nakuru,. Kenya. Author: Oduor P.R. ...
Psychological skills of provincial netball players in different playing positions. ... South African Journal for Research in Sport, Physical Education and Recreation ... Differences regarding the psychological skill levels of soccer, basketball, rugby union and American football players in different playing positions have been ...
The context of the study is the concern over declining provincial road conditions due to insufficient government funding for road maintenance. The roads are used by a ... There is a 20% reduction in the road condition during wet periods, which would indicate poor drainage and/or use of poor quality road building materials.
A major deflection from the exponential growth patterns seen hitherto can be anticipated only once all or most of the highly populated provinces have traversed their respective points of inflection. The exponential model significantly explains the HIV epidemics in the provinces. The combination of these provincial epidemics ...
At link level it was possible to synchronise the upgraded network with the financial asset registry in order to gauge the current state of the provincial roads within Gauteng, and to identify those that are in need of attention and/or rehabilitation to optimise efficiency and safety. This approach can be standardised throughout the ...
Background: Injuries related to motorcycles contribute significantly to the number of road traffic injuries This study was aimed at determining the pattern of injuries caused by motorcycle crash among patients seen at Kakamega provincial hospital in Kenya... Methods: This was a cross sectional study which was conducted in ...
Results compare favourably with those from a principal component and cluster analysis, which has previously been used to demarcate the South African space economy into a hierarchy of development regions. Keywords: Journey-to-work flows, provincial boundaries, intramax method, principal component analysis, ...
..., intends to re-establish the Provincial Advisory Committees (PACs) for the provinces in California, Oregon, and Washington. This re-establishment is in response to the continued need for the PACs to provide... Northern Spotted Owl. The PACs also provide advice and recommendations to promote integration and...
van Klinken, G.; Berenschot, W.
The post-1998 surge in local politics has moved the provincial town back to centre stage. This book examines the Indonesian middle class (now 43%!) up close in the place where its members are most at home: the town. Middle Indonesia generates national political forces, yet it is neither particularly
Lu, L N; He, X G; Zhu, J F; Xu, X; Zhang, R; Hu, X; Zou, H D
Objective: To establish an assessment system, including indexes and scoring methods, that can be used for performance evaluation of the provincial blindness prevention technical guidance group properly and effectively . Methods: The indexes and scoring methods were set based on the core content of The " National Plan of Prevention and Treatment of Blindness (2012-2015)" , the specific requirement and target of the World Health Organization (WHO) "For the General Eye Health: Global plan of Action (2014-2019)" , and the current situation of the China's provinces and autonomous regions. These indexes should be of effectiveness, feasibility, comparability, guidance and advancing. Formed by a literature review of candidate indicators, the framework of the system is built by qualitative assessment. With the Delphi method, the system was further revised and improved. Empirical pilot study was then used to prove the feasibility, followed by the final qualitative analysis that establish the " Chinese provincial Blindness prevention technical guidance group performance evaluation system" . Results: Through the literature review and qualitative assessment, a six dimensional system framework was built, including 6 first-level indicators, 16 second-level indicators, and 29 third-level indicators through Delphi method evaluation. With the variation coefficient method, the coeffiences of the first-level index weight were calculated as: Organization and management 0.15, Development and implementation of blindness prevention plans 0.15, Implementation of blindness prevention projects 0.14, Training 0.17, Health education 0.18, and Cooperation and exchanges 0.21. The specific scoring method for this system is confirmed as: data and files check, field interview, and record interview, sampling investigation. Empirical pilot study was conducted in the Jilin, Guizhou and Gansu provinces, and the self-assessment results from local experts were consistent with the scores from the systems
Serrano Morales, Riansares
En este artículo se analiza el papel que representan las Asociaciones culturales en la difusión de las actividades de los archivos. A través de una experiencia concreta, la Asociación de Amigos del Archivo Histórico Provincial de Guadalajara (España), se muestra la colaboración de la sociedad civil en la gestión cultural. This article describes the role played by cultural associations in order to disseminate the activities of the archives. Through a concrete experience as the Association ...
Roberge, Pasquale; Fournier, Louise; Brouillet, Hélène; Delorme, André; Beaucage, Clément; Côté, Rodrigue; Demers, Pierre; Gervais, Michel; Laflamme, France; Latulippe, Louise; Marchand, André; Patry, Simon; Pelchat, Suzanne; Provencher, Martin D; Provost, Jean-Rémy; Robitaille, David; Cloutier, Anne-Marie
Mental health services for patients with a major depressive disorder are commonly delivered by primary care. To support the uptake of clinical practice guidelines in primary care, we developed and disseminated a practice protocol for depression tailored for a multidisciplinary audience of primary mental health care providers with the ADAPTE methodology. The research questions addressed in this study aimed at examining the experience of the development process of a mental health practice protocol in terms of adaptation, facilitation and implementation. We present a descriptive case study of the development and implementation of a practice protocol for major depressive disorder for primary mental health care in the organizational and cultural context of the province of Québec (Canada), following the steps of the ADAPTE methodology. An expert committee composed of general practitioners, mental health specialists, health care administrators and decision makers at regional and provincial levels participated in the protocol development process. The practice protocol was based on two clinical practice guidelines: the NICE guideline on the treatment and management of depression in adults (2009, 2010) and the Canadian Network for Mood and Anxiety Treatments clinical guidelines for the management of major depressive disorder in adults (2009). A stepped care model was embedded in the protocol to facilitate the implementation of clinical recommendations in primary mental health care. A multifaceted dissemination strategy was used to support the uptake of the protocol recommendations in clinical practice. The ADAPTE methodology provided structure, rigour and efficiency to the trans-contextual adaptation of guideline recommendations. We will share the challenges associated with the adaptation of clinical recommendations and organizational strategies for a mental health guideline, and the dissemination of the practice protocol in primary care. © 2015 John Wiley & Sons, Ltd.
Xu, Xiaofei; Wang, Zhujun; Zhang, Xuewu
Human body harbors diverse microbes, the main components include bacteria, eukaryotes and viruses. Emerging evidences show that the human microbiota is intrinsically linked with overall health. The development of next-generation sequencing provides an unprecedented opportunity to investigate the complex microbial communities that are associated with the human body. Many factors like host genetics and environmental factors have a major impact on the composition and dynamic changes of human microbiota. The purpose of this paper is to present an overview of the relationship between human health and human microbiota (skin, nasal, throat, oral, vaginal and gut microbiota), then to focus on the factors modulating the composition of the microbiota and the future challenges to manipulate the microbiota for personalized health.
Bolton, Declan J; Robertson, Lucy J
Human infections with foodborne pathogenic organisms are relatively well described in terms of their overt physical symptoms, such as diarrhea, abdominal cramps, vomiting, fever, and associated sequelae. Indeed, some of these are key for diagnosis and treatment, although it should be noted that, for some foodborne pathogens, the physical symptoms might be more diffuse, particularly those associated with some of the foodborne parasites. In contrast, the impact of these pathogens on mental health is less well described, and symptoms such as depression, anxiety, and general malaise are usually ignored when foodborne infections are recorded. Despite this, it is generally accepted that there are several psychiatric disorders of unknown etiology that may be associated with microbial pathogens. Depression, autism, hypochondriasis and anxiety, schizophrenia, and Tourette syndrome probably have multiple contributing causes, among which foodborne pathogens may play a decisive or contributory role, possibly sharing pathophysiological pathways with other environmental triggers. This review focuses on foodborne parasites and bacterial pathogens. Some foodborne parasites, such as metacestodes of Taenia solium and tissue cysts (bradyzoites) of Toxoplasma gondii , may affect mental health by directly infecting the brain. In contrast, bacterial infections and other parasitic infections may contribute to mental illness via the immune system and/or by influencing neurotransmission pathways. Thus, cytokines, for example, have been associated with depression and schizophrenia. However, infectious disease models for psychiatry require a more complete understanding of the relationship between psychiatric disorders and microbial triggers. This article reviews the current state of knowledge on the role of foodborne parasitic and bacterial pathogens in mental illness and identifies some of the gaps that should be addressed to improve diagnosis and treatment of mental health issues that are
Du, Wen-Bo; Liang, Bo-Yuan; Hong, Chen; Lordan, Oriol
The air transportation system is of a great impact on the economy and globalization of a country. In this paper, we analyze the Chinese air transportation network (ATN) from a provincial perspective via the complex network framework, where all airports located in one province are abstracted as a single node and flights between two provinces are denoted by a link. The results show that the network exhibits small-world property, homogeneous structure and disassortative mixing. The variation of the flight flow within 24 h is investigated and an obvious tide phenomenon is found in the dynamics of Chinese provincial ATN for high output level of tertiary industry. Our work will offer a novel approach for understanding the characteristic of the Chinese air transportation network.
Zhang, Yongjie; Zhang, Yuzhao; Shen, Dehua; Zhang, Wei
In this paper, we advocate the provincial TV audience rating as the novel proxy for the provincial investor sentiment (PIS) and investigate its relation with stock returns. The empirical results firstly show that the PIS is positively related to stock returns. Secondly, we provide direct evidence on the existence of home bias in China by observing that the provincial correlation coefficient is significantly larger than the cross-provincial correlation coefficient. Finally, the PIS can explain a large proportion of provincial comovement. To sum up, all these findings support the role of the non-traditional information sources in understanding the "anomalies" in stock market.
Sim, S Meaghan; Kirk, Sara F L
Healthy Eating Nova Scotia represents the first provincial comprehensive healthy eating strategy in Canada and a strategy that is framed within a population-health model. Five years after strategy launch, our objective was to evaluate Healthy Eating Nova Scotia to determine perceptions of strategy implementation and strategy outputs. The focus of the current paper is on the findings of this evaluation. We conducted an evaluation of the strategy through three activities that included a document review, survey of key stakeholders and in-depth interviews with key strategy informants. The findings from each of the activities were integrated to determine what has worked well with strategy implementation, what could be improved and what outputs have resulted. The evaluation was conducted in the Canadian province of Nova Scotia. Participants for this evaluation included survey respondents (n 120) and key informants (n 16). A total of 156 documents were also reviewed. Significant investments have been made towards inter-sectoral partnerships and resourcing that has provided the necessary leadership and momentum for the strategy. Policy development has been leveraged through the strategy primarily in the health and education sectors and is perceived as a visible success. Clarity of human resource roles and funding within the context of a provincial strategy may be beneficial for continued strategy implementation, as is expansion of policy development. Known to be the first evaluation of its kind, these findings and related considerations will be of interest to policy makers developing and implementing similar strategies in their own jurisdictions.
Cette étude prospective a été menée pour évaluer l'utilisation des services de soins prénatals à l'Hôpital Spécialisé Provincial à Mongomo en Guinée Equatoriale, en mettant l'accent sur les facteurs déconcertant qui affectent les prestations des soins prénatals (SP) efficaces. Nous avons recueilli des renseignements à ...
Khemiss, Mehdi; Rouatbi, Sonia; Berrezouga, Latifa; Ben Saad, Helmi
Background - As dentists are certain to encounter narghile-smokers amongst their patients, it is important to inform them of the possible detrimental impacts of narghile-use on oral-health. Objective - To review the literature on the oral-health effects of narghile-use. Methods - Data Sources - We made a search on pubmed until June 30th, 2015 for the chronic oral-health effects of narghile-use using the terms "oral-lesions" or "oral-cancer" or "dry-socket" or "periodontium" and 'narghile' or its different synonyms. Study selection - Only original studies and case reports or series focusing on clinical human studies were included. Sixteen studies met the selection criteria and 14 were retained. Data extraction - Data were abstracted by two authors and summarized into tables. Abstracted data, including study type and results, were analyzed jointly by four authors. Results - Data synthesis. Narghile-use has harmful effects on oral-cavity including periodontal diseases, dry-sockets and oral-mucosa lesions. Conclusion - Narghile-use is associated with a variety of adverse long-term oral-health effects that should reinforce the need for stronger regulation. Key-words - Tobacco - Oral lesions - Oral cancer - Periodontium - Dry-socket.
During space travel, astronauts are exposed to energetic particles of a complex composition and energy distribution. For the same amount of absorbed dose, these particles can be much more effective than X- or gamma rays in the induction of biological effects, including cell inactivation, genetic mutations, cataracts, and cancer induction. Several of the biological consequences of space radiation exposure have already been observed in astronauts. This presentation will introduce the space radiation environment and discuss its associated health risks. Accurate assessment of the radiation risks and development of respective countermeasures are essential for the success of future exploration missions to the Moon and Mars.
Hyshka, Elaine; Anderson-Baron, Jalene; Karekezi, Kamagaju; Belle-Isle, Lynne; Elliott, Richard; Pauly, Bernie; Strike, Carol; Asbridge, Mark; Dell, Colleen; McBride, Keely; Hathaway, Andrew; Wild, T Cameron
In Canada, funding, administration, and delivery of health services-including those targeting people who use drugs-are primarily the responsibility of the provinces and territories. Access to harm reduction services varies across jurisdictions, possibly reflecting differences in provincial and territorial policy commitments. We examined the quality of current provincial and territorial harm reduction policies in Canada, relative to how well official documents reflect internationally recognized principles and attributes of a harm reduction approach. We employed an iterative search and screening process to generate a corpus of 54 provincial and territorial harm reduction policy documents that were current to the end of 2015. Documents were content-analyzed using a deductive coding framework comprised of 17 indicators that assessed the quality of policies relative to how well they described key population and program aspects of a harm reduction approach. Only two jurisdictions had current provincial-level, stand-alone harm reduction policies; all other documents were focused on either substance use, addiction and/or mental health, or sexually transmitted and/or blood-borne infections. Policies rarely named specific harm reduction interventions and more frequently referred to generic harm reduction programs or services. Only one document met all 17 indicators. Very few documents acknowledged that stigma and discrimination are issues faced by people who use drugs, that not all substance use is problematic, or that people who use drugs are legitimate participants in policymaking. A minority of documents recognized that abstaining from substance use is not required to receive services. Just over a quarter addressed the risk of drug overdose, and even fewer acknowledged the need to apply harm reduction approaches to an array of drugs and modes of use. Current provincial and territorial policies offer few robust characterizations of harm reduction or go beyond rhetorical or
Conclusions: We found large provincial disparities in determinants of women's health in Iran. Determinants such as lifestyle, health behavior, health knowledge, and health-care services availability should be considered by health policymakers in addressing the inequality in women's health at a provincial level.
Park, Aesoon; Eckert, Tanya L.; Zaso, Michelle J.; Scott-Sheldon, Lori A. J.; Vanable, Peter A.; Carey, Kate B.; Ewart, Craig K.; Carey, Michael P.
Background: Health literacy is crucial to develop health-related knowledge, adopt healthy lifestyles, and benefit from health care services. However, research on the association between health literacy and adolescent health outcomes, particularly on their prospective associations, is rare. We assessed health literacy using 3 validated measures,…
Factores de riesgo del bajo peso al nacer, Hospital Gineco-Obstétrico Provincial de Sancti Spíritus, Cuba Risk factors for low birthweight, Provincial Obstetric-Gynecologic Hospital of Sancti Spíritus, Cuba
Marcos Aurelio Grau Espinosa
Full Text Available El objetivo de este trabajo fue identificar algunos factores de riesgo que pudiera presentar la madre durante el embarazo, asociados con la incidencia de bajo peso al nacer (menos de 2500 g. Se diseñó un estudio con 378 casos y 649 controles del Hospital Gineco-Obstétrico Provincial de Sancti Spíritus, Cuba, durante el año 1994. Los datos se obtuvieron de la historia clínica, el registro de partos y una entrevista personal con la madre. Se realizó un análisis bivariado y se controlaron los posibles factores de confusión utilizando la regresión logística dicotómica, mediante los programas Epi Info 5 y SPSS. Por medio del modelo multivariado final se identificaron como factores de riesgo significativos de bajo peso al nacer la hipertensión arterial durante el embarazo, la consulta extemporánea de evaluación del embarazo, los abortos anteriores, último intervalo intergenésico menor de 2 años y el aumento de peso materno menor de 8 kg. Se debe dar prioridad a estas tres últimas variables para mantener buenos indicadores en el programa maternoinfantil de la Provincia de Sancti Spíritus, Cuba.The objective of this work was to identify some risk factors that women could present during pregnancy and that are associated with low birthweight (less than 2500 g. A study was performed during 1994 with 378 cases and 649 controls at the Provincial Obstetric-Gynecologic Hospital of Sancti Spíritus, Cuba. The data were obtained from clinical histories, the registry of births, and personal interviews with mothers. A bivariate analysis was carried out and possible confounding factors were controlled utilizing dichotomous logistic regression, using the Epi Info 5 and SPSS software programs. With the final multivariate model, the following risk factors for low birthweight were identified as significant: hypertension during pregnancy, infrequent checkups during pregnancy, previous abortions, a period of less than 2 years since the last birth, and
July 10, 2001, an administrative agreement on National Development of Wind Energy (BLOW, abbreviated in Dutch), was signed by the Dutch government, all the Dutch provinces and the Association of Dutch Municipalities (VNG). The aim of BLOW is to realize 1500 MW wind energy in the Netherlands in 2010. Each province has the task to realize a share of the 1500 MW. The province of Friesland will realize 200 MW. In this report the wind energy policy plan for the Province Friesland is presented. [Dutch] Op 10 juli 2001 is de Bestuursovereenkomst Landelijke Ontwikkeling Windenergie (BLOW) ondertekend door het Rijk, alle provincies en de VNG. Doel van de BLOW is te komen tot de realisering van in totaal 1500 MW opgesteld windenergievermogen in Nederland in 2010. Elke provincie heeft in verband daarmee een taakstelling op zich genomen. Voor de provincie Friesland bedraagt deze taakstelling 200 MW. In de BLOW is vastgelegd dat de provincies in een Plan van Aanpak (PvA) moeten aangeven op welke wijze zij hun taakstelling denken te realiseren. Een PvA moet inzicht geven in de concrete activiteiten ter ontwikkeling van locaties voor windturbines en de wijze van samenwerking met gemeenten en marktpartijen. Tevens moet het PvA inzicht geven in de tijdsplanning van deze activiteiten en de meerkosten die de uitvoering daarvan voor de provincie met zich meebrengt.
Schmidt, S; Bounnack, S; Hoehn, T
Aim of this study was to analyze neonatal mortality and morbidity in the post-implementation period of a neonatal teaching program to examine a possible impact on neonatal outcomes. This study is a retrospective data analysis of all neonatal patients treated in five provincial hospitals in Laos after implementation of a neonatal teaching program. A simulation-based teaching program aims to have positive impact on the theoretical and practical skill of hospital staff in the field of newborn care. A comparison between pre-implementation and post-implementation data of newborns admitted to provincial hospitals in Laos was used to quantify the effect of repetitive teaching on neonatal outcomes. Neonatal mortality and morbidity as well as case fatality rates of infections and asphyxia decreased in the post-implementation period. In contrast, neonatal mortality rate as well as case fatality rate of prematurity increased. The total neonatal mortality rate increased in the post-implementation period. The pre-implementation and post-implementation data enable longitudinal comparisons between hospitals and highlight the differences between hospitals concerning neonatal mortality and morbidity in provincial hospitals in Laos. These data can serve as a basis for an individual adaption of the teaching program to the unique requirements of each single hospital. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Brega, A. G.; Thomas, J. F.; Henderson, W. G.; Batliner, T. S.; Quissell, D. O.; Braun, P. A.; Wilson, A.; Bryant, L. L.; Nadeau, K. J.; Albino, J.
Health literacy is "the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions". Although numerous studies show a link between health literacy and clinical outcomes, little research has examined the association of health literacy with oral health. No large-scale…
This paper reports a provincial-level analysis of the way in which various socio-economic and socio-demographic determinants influence the decision to discriminate against daughters in China. While most existing studies use the infant or child sex ratio as the only variable to be explained, this study analyses separately the two main discriminatory practices: sex-selective abortion (with sex ratio at birth as a proxy) and neglect of girls' health care (with excess infant mortality among females as a proxy). The analysis helps to illuminate the circumstances that encourage sex-selective behaviours, which appear to be dictated mainly by extreme poverty, family support to the elderly, and father's education, together with the social pressure on couples to adhere to traditional values and roles and the constraints on family size. While sex-selective abortion appears to result from long-term strategies to optimize family composition, lethal neglect is the immediate result of economic constraints.
Franklin, Monica D; Schlundt, David G; McClellan, Linda H; Kinebrew, Tunu; Sheats, Jylana; Belue, Rhonda; Brown, Anne; Smikes, Dorlisa; Patel, Kushal; Hargreaves, Margaret
To examine the association between religious fatalism and health care utilization, health behaviors, and chronic illness. As part of Nashville's REACH 2010 project, residents (n=1273) participated in a random telephone survey that included health variables and the helpless inevitability subscale of the Religious Health Fatalism Questionnaire. Religious health fatalism was higher among African Americans and older participants. Some hypotheses about the association between fatalism and health outcomes were confirmed. Religious fatalism is only partially predictive of health behaviors and outcomes and may be a response to chronic illness rather than a contributor to unhealthy behaviors.
Martín del Castillo, Juan Francisco
Full Text Available The «Instituto Provincial de Higiene de las Canarias Orientales» is an example of Estatuto Provincial of José Calvo Sotelo (1925. Involved in administrative affaires and economical distributions between the Townhall of Las Palmas de Gran Canaria and Insular Council, its beginning is labour of Doctor Antonio Ortiz de Landázuri, in that moment Health Inspector. In this paper, be described the structure and functions of Hygiene Institute, so the change of technical members of laboratories and stations of previous town health services.
El Instituto Provincial de Higiene de las Canarias Orientales es un ejemplo de la puesta en marcha del Estatuto Provincial de José Calvo Sotelo (1925. Envuelto en medidas administrativas y repartos financieros entre el Ayuntamiento de Las Palmas de Gran Canaria y el Cabildo Insular, su inicio es obra directa del doctor Antonio Ortiz de Landázuri, en aquellos momentos al cargo de la Inspección de Sanidad. En el presente, quedan descritos la estructura y funciones del Instituto de Higiene, además del pase de los miembros facultativos de los laboratorios y estaciones de anteriores servicios municipales del ramo.
Full Text Available This paper presents the CSIR’s contribution to technical advances in the approach to provincial spatial planning in South Africa. It demonstrates the CSIR’s involvement in conducting the national Provincial Growth and Development Strategy Assessment...
The aim of the study is to determine the attitudes of employees of Provincial Directorates of National Education and school administrators towards strategic planning. The research was designed as a survey model study. The population of the research consisted of employees of Provincial Directorate of National Education of Kutahya and school…
Thorpe, Kenneth E; Joski, Peter
Recent studies on state-level spending on social services have shown that states with higher ratios of social to health care spending were associated with better health outcomes. This study extends this work by examining the association of specific elements of social service spending and other determinants of health, such as health behaviors, education, and environmental factors at the metropolitan/city level, on several measures of health outcomes between 2005 and 2014. This study found that several potential determinants of health including exercise, air pollution, smoking, per pupil educational spending, and several types of social service spending were associated with improvements in health outcomes. These health outcomes included age-adjusted mortality, chronic disease prevalence, days of poor health, and obesity rates. The results suggest that a broader strategy beyond health care that includes investments in social services, improved environmental quality, and health behaviors could improve the health of communities.
role, self-image and marital satisfaction on psychological health status, perception of menopause and sexual satisfaction in climacteric women in Ibadan, Nigeria. Subjects and methods: 45 female participants were randomly selected from Ibadan ...
Feron, VJ; Arts, JHE; Kuper, CF; Slootweg, PJ; Woutersen, RA
Health risks of inhaled nasal toxicants were reviewed with emphasis on chemically induced nasal lesions in humans, sensory irritation, olfactory and trigeminal nerve toxicity, nasal immunopathology and carcinogenesis, nasal responses to chemical mixtures, in vitro models, and nasal dosimetry- and
Boekeloo, Bradley O; Todaro Brooks, Alyssa; Qi Wang, Min
We examined modifiable facilitation strategies (exposures) during high school that are associated with motiva- tion for minority youth pursuit of health science. A sample (N = 116) of minority (73% African-American/Black, 21% Hispanic/Latino) 12th graders from 6 high schools in a lower socioeconomic area bordering Washington, DC completed a self-administered survey. Path modeling was used to examine whether: (1) exposures: high school science courses, extra-curricular science activities, personal health experiences, and adult encouragement predict Theory of Planned Behavior (TPB) constructs including attitude, subjective norm, and perceived behavioral control, and (2) TPB constructs predict the outcome of intent to pursue college health science. The path model indicated that adult encouragement was associated with attitude (p health experiences were associated with attitude (p health experiences to value health scientists and to perceive that others support their pursuit of health science may be pathways for facilitating their intention to pursue college health science.
Zhao, Yu; Zhou, Yaduan; Qiu, Liping; Zhang, Jie
A comprehensive uncertainty analysis was conducted on emission inventories for industrial sources at national (China), provincial (Jiangsu), and city (Nanjing) scales for 2012. Based on various methods and data sources, Monte-Carlo simulation was applied at sector level for national inventory, and at plant level (whenever possible) for provincial and city inventories. The uncertainties of national inventory were estimated at -17-37% (expressed as 95% confidence intervals, CIs), -21-35%, -19-34%, -29-40%, -22-47%, -21-54%, -33-84%, and -32-92% for SO2, NOX, CO, TSP (total suspended particles), PM10, PM2.5, black carbon (BC), and organic carbon (OC) emissions respectively for the whole country. At provincial and city levels, the uncertainties of corresponding pollutant emissions were estimated at -15-18%, -18-33%, -16-37%, -20-30%, -23-45%, -26-50%, -33-79%, and -33-71% for Jiangsu, and -17-22%, -10-33%, -23-75%, -19-36%, -23-41%, -28-48%, -45-82%, and -34-96% for Nanjing, respectively. Emission factors (or associated parameters) were identified as the biggest contributors to the uncertainties of emissions for most source categories except iron & steel production in the national inventory. Compared to national one, uncertainties of total emissions in the provincial and city-scale inventories were not significantly reduced for most species with an exception of SO2. For power and other industrial boilers, the uncertainties were reduced, and the plant-specific parameters played more important roles to the uncertainties. Much larger PM10 and PM2.5 emissions for Jiangsu were estimated in this provincial inventory than other studies, implying the big discrepancies on data sources of emission factors and activity data between local and national inventories. Although the uncertainty analysis of bottom-up emission inventories at national and local scales partly supported the ;top-down; estimates using observation and/or chemistry transport models, detailed investigations and
Jamieson Lisa M; Parker Eleanor J
Abstract Objectives To determine oral health literacy (REALD-30) and oral health literacy-related outcome associations, and to calculate if oral health literacy-related outcomes are risk indicators for poor self-reported oral health among rural-dwelling Indigenous Australians. Methods 468 participants (aged 17-72 years, 63% female) completed a self-report questionnaire. REALD-30 and oral health literacy-related outcome associations were determined through bivariate analysis. Multivariate mode...
Cavalli, Enrico; Mattasoglio, Andrea; Pinciroli, Francesco; Spaggiari, Piergiorgio
In recent years, major and widely accepted information security understandings and achievements confirm that the problem is complex. They clarify that technologies are fundamental tools, but management processes have even bigger relevance, as also prestigious international magazines dossier clearly explained recently. Such a magazine attention outlines the wide impact that the subject has on watchful decision makers. ISO17799 is an emerging standard in information security. In principle there are no reasons for considering it not applicable to the health care sector. In practice, because of both the just conceptual level of the standard and the peculiarities of the health care data and institutions, a lot of analysis and design work need to be invested any time a health care institution decides to deal with the subject. CEN/ENV 12924 is another emerging standard certainly more on the spot of the health care. Nevertheless, it also asks for evident further investigation. The practical case of information security design, implementation, management, and auditing inside a multi-specialty provincial Italian hospital will be described.
Jan H Havenga; Leila L Goedhals-Gerber; Anneke de Bod; Zane Simpson
Background: Logistics costs are most commonly measured on a national level. An understanding of the provincial logistics landscape can add significant value both to provincial and national policy interventions...
Full Text Available The paper analyzes findings yielded by the empirical study performed in the framework of an RGNF grant entitled “Image of a region as a communicative strategy for the authorities and mass media”. The methods of study included expert survey and formal survey (N=1000, July-September 2013, studying the opinion of respondents who were either internal experts residing in the Volgograd region (N=20; May-September 2013 or external experts who reside outside the region but maintain stable ties with the representatives of state and municipal authorities, regional mass media and business. The findings indicate that the Volgograd region has fallen behind other modernized Russian regions, that young people tend to leave it, that a negative image of the region as a declining territory persists. Answers to the open question “What is unacceptable for you in the existing image of the Volgograd region?” revealed major problems determining the local context of a declining region, and those were issues associated with inefficient regional/municipal administration: “the condition of the roads”, “constant replacement of people in the administration”, “politics as a whole”, “a destitute region without a good manager”, “unemployment”, “countryside is dying off”, “indifference of the authorities”, “roads, housing and public utilities and the administration”, “the authorities are not responsible for the people”, “the authorities do not solve the problems of the city or its people”, “thieving”, “dishonest authorities”, “the region goes to rack and ruin, no kindergartens or jobs”, “one cannot even walk in the streets”, “corruption”, “a stagnant region with low pay”, “no perspectives in the future”, “the region is stagnating due to corruption among officials”. According to the local Census Bureau, the Volgograd region can be classified as a declining territory where the population decline
Full Text Available It is a fact that mind and body share an intimate relationship. There are many ways in which mental and physical health impact each other. Psychosocial factors play a part in the pathogenesis of physical health, and oral health is no exception. Chronic and painful oral symptoms lead to psychosocial disorder and at the same time, some patients with psychosocial disorders experience painful oral and facial symptoms. Several investigators have concluded that psychosocial factors play an important role in the pathogenesis of an array of oral problems, ranging from poor oral hygiene to chronic pain disorders, such as temporomandibular joint disorders, burning mouth syndrome, and atypical pain. This review aims at the in-depth analysis of the correlation between psychosocial disorders and various oral symptoms.
Cowman, Peter F; Parravicini, Valeriano; Kulbicki, Michel; Floeter, Sergio R
The largest marine biodiversity hotspot straddles the Indian and Pacific Oceans, driven by taxa associated with tropical coral reefs. Centred on the Indo-Australian Archipelago (IAA), this biodiversity hotspot forms the 'bullseye' of a steep gradient in species richness from this centre to the periphery of the vast Indo-Pacific region. Complex patterns of endemism, wide-ranging species and assemblage differences have obscured our understanding of the genesis of this biodiversity pattern and its maintenance across two-thirds of the world's oceans. But time-calibrated molecular phylogenies coupled with ancestral biogeographic estimates have provided a valuable framework in which to examine the origins of coral reef fish biodiversity across the tropics. Herein, we examine phylogenetic and biogeographic data for coral reef fishes to highlight temporal patterns of marine endemism and tropical provinciality. The ages and distribution of endemic lineages have often been used to identify areas of species creation and demise in the marine tropics and discriminate among multiple hypotheses regarding the origins of biodiversity in the IAA. Despite a general under-sampling of endemic fishes in phylogenetic studies, the majority of locations today contain a mixture of potential paleo- and neo-endemic fishes, pointing to multiple historical processes involved in the origin and maintenance of the IAA biodiversity hotspot. Increased precision and sampling of geographic ranges for reef fishes has permitted the division of discrete realms, regions and provinces across the tropics. Yet, such metrics are only beginning to integrate phylogenetic relatedness and ancestral biogeography. Here, we integrate phylogenetic diversity with ancestral biogeographic estimation of lineages to show how assemblage structure and tropical provinciality has changed through time. © 2017 Cambridge Philosophical Society.
Callen, Bonnie L; Lindley, Lisa C; Niederhauser, Victoria P
An emerging concern in the workplace is the productivity of employees who come to work instead of staying home when they are ill, also referred to as presenteeism. This study examined the health risks associated with presenteeism. Using a cross-sectional correlational design, we used data from a 2010 self-reported wellness surveys. A negative binomial regression model was used to explore the association between employee health risks and presenteeism. The findings revealed that workplace stress (β = 0.76; P presenteeism. Other health risks were not associated with presenteeism. We found that only stress was related to presenteeism, and other health risks were unrelated to presenteeism.
Abstract: Phytochemicals are a naturally occurring group of chemicals in plants and plant-derived foods. Presence of phytochemical components such as phytohemagglutinins, tannins, phytic acid, saponins, protease inhibitors, oligosaccharides and phytoestrogens in food legumes has both health benefits and adverse ...
Richmond, Virginia L.
Discussion is presented concerning fluoridation of water supplies. Correlation between fluoride in drinking water and improved dental health is reviewed. Relationship is expressed between fluoridation and reduced tooth decay. Use of fluoride in treating skeletal disorders is discussed. Author advocates fluoridating water supplies. (SA)
Russ, Shirley A; Larson, Kandyce; Franke, Todd Michael; Halfon, Neal
Television viewing has been associated with poorer health attributes, but relationships between computer use and health are less clear. The aim of this study was to determine associations between TV and computer use, both separately and combined, and health attributes in US children. We performed bivariate and multivariate logistic regression analyses of cross-sectional data on 54 863 children ages 6 to 17 years who participated in the National Survey of Children's Health. Key independent variables were TV, computer, and combined media use; outcome variables were 6 measures of health. In models controlling for a wide range of sociodemographic variables, each additional hour of television viewing was associated with greater odds of overweight/obesity (odds ratio [OR] 1.05, 95% confidence interval (95% CI) 1.02-1.08), poorer oral health (OR 1.05, 95% CI 1.02-1.09), social-emotional problems (OR 1.08, 95% CI 1.05-1.11), concern about self-esteem, and lower social competence. Greater computer use was associated only with overweight/obesity (OR 1.04, 95% CI 1.01-1.07). Combined media use showed similar, but weaker, health associations to television viewing alone. Interaction analyses showed that TV viewing was associated with overweight/obesity only for white, not black or Hispanic, children. TV/video use is associated with a broader range of negative physical and social-emotional health attributes than computer use. Associations between media use and health are modest, but persistent at the population level. TV/video use reduction strategies may lead to improved physical and social-emotional population health. However, reductions in TV viewing may have little effect on overweight/obesity in black or Hispanic children. Mechanisms underlying observed health associations need further study.
Healthy eating plays a fundamental role in the promotion and maintenance of good health throughout the entire course of life. Healthy eating has been said to be related to a number of common chronic diseases, including cardiovascular disease, certain cancers, hypertension, diabetes, overweight and obesity, as well as a number of other diseases. In recent years, the prevalence of such dietary-related diseases has increased. Therefore, measures to encourage consumers to eat more healthily are c...
... Chapter 2 - Safety & Security Chapter 2 - Environmental Hazards Animal-Associated Hazards Heather Bair-Brake, Ryan M. Wallace, G. Gale Galland, Nina Marano HUMAN INTERACTION WITH ANIMALS: A RISK FACTOR FOR INJURY AND ILLNESS Animals, ...
BACKGROUND: Advocates for environmental justice, local, state, and national public health officials, exposure scientists, need broad-based heath indices to identify vulnerable communities. Longitudinal studies show that perception of current health status predicts subsequent mortality, suggesting that self-reported health (SRH) may be useful in screening-level community assessments. This paper evaluates whether SRH is an appropriate surrogate indicator of health status by evaluating relationships between SRH and sociodemographic, lifestyle, and health care factors as well as serological indicators of nutrition, health risk, and environmental exposures.METHODS: Data were combined from the 2003-2006 National Health and Nutrition Examination Surveys for 1372 nonsmoking 20-50 year olds. Ordinal and binary logistic regression was used to estimate odds ratios and 95 % confidence intervals of reporting poorer health based on measures of nutrition, health condition, environmental contaminants, and sociodemographic, health care, and lifestyle factors.RESULTS: Poorer SRH was associated with several serological measures of nutrition, health condition, and biomarkers of toluene, cadmium, lead, and mercury exposure. Race/ethnicity, income, education, access to health care, food security, exercise, poor mental and physical health, prescription drug use, and multiple health outcome measures (e.g., diabetes, thyroid problems, asthma) were also associated with poorer SRH.CONCLUS
Coulombe, Simon; Meunier, Sophie; Cloutier, Lyne; Auger, Nathalie; Roy, Bernard; Tremblay, Gilles; de Montigny, Francine; Gaboury, Isabelle; Bernard, François-Olivier; Lavoie, Brigitte; Dion, Harold; Houle, Janie
Despite the importance of healthy settings for health promotion, little is known about how neighborhood characteristics affect men's health. The present study aims to explore the associations between perceptions of home and workplace neighborhoods with diverse health outcomes, and to examine mediating mechanisms. A sample of 669 men members of labor unions in Quebec, Canada, completed a questionnaire assessing social and physical aspects of their work and home neighborhoods (the Health-Promoting Neighborhood Questionnaire) as well as subjective and objective health outcomes (perceived health, positive mental health, body mass index) and potential mediators (health behaviors, self-efficacy). Structural equation modeling (path analysis) revealed that the Health-Promoting Neighborhood Questionnaire was associated with all three health outcomes, either directly or indirectly through health behaviors and self-efficacy. Both home and workplace neighborhoods were associated with men's health, home neighborhood being more strongly associated. The findings suggest that physical and social aspects of neighborhood might contribute to men's health. The study highlights positive environmental levers for urban planners, policy makers, and health professionals to promote men's health.
Coulombe, Simon; Meunier, Sophie; Cloutier, Lyne; Auger, Nathalie; Roy, Bernard; Tremblay, Gilles; de Montigny, Francine; Gaboury, Isabelle; Bernard, François-Olivier; Lavoie, Brigitte; Dion, Harold; Houle, Janie
Despite the importance of healthy settings for health promotion, little is known about how neighborhood characteristics affect men’s health. The present study aims to explore the associations between perceptions of home and workplace neighborhoods with diverse health outcomes, and to examine mediating mechanisms. A sample of 669 men members of labor unions in Quebec, Canada, completed a questionnaire assessing social and physical aspects of their work and home neighborhoods (the Health-Promoting Neighborhood Questionnaire) as well as subjective and objective health outcomes (perceived health, positive mental health, body mass index) and potential mediators (health behaviors, self-efficacy). Structural equation modeling (path analysis) revealed that the Health-Promoting Neighborhood Questionnaire was associated with all three health outcomes, either directly or indirectly through health behaviors and self-efficacy. Both home and workplace neighborhoods were associated with men’s health, home neighborhood being more strongly associated. The findings suggest that physical and social aspects of neighborhood might contribute to men’s health. The study highlights positive environmental levers for urban planners, policy makers, and health professionals to promote men’s health. PMID:29073845
Marco Cobus Pretorius
Full Text Available Problems experienced with website usability can prevent users from accessing and adopting technology, such as e-Government. At present, a number of guidelines exist for e-Government website user experience (UX design; however, the effectiveness of the implementation of these guidelines depends on the expertise of the website development team and on an organisation’s understanding of UX. Despite the highlighted importance of UX, guidelines are rarely applied in South African e-Government website designs. UX guidelines cannot be implemented if there is a lack of executive support, trained staff, budget and user-centred design processes. The goal of this research is to propose and evaluate a methodology (called the “Institutionalise UX in Government (IUXG methodology” to institutionalise UX in South African Provincial Governments (SAPGs. The Western Cape Government in South Africa was used as a case study to evaluate the proposed IUXG methodology. The results show that the IUXG methodology can assist SAPGs to establish UX as standard practice and improve the UX maturity levels.
Garcia, Cesar H.; Espinoza, Sara E.; Lichtenstein, Michael; Hazuda, Helen P.
Knowing health literacy levels of older patients and their caregivers is important because caregivers assist patients in the administration of medications, manage daily health care tasks, and help make health services utilization decisions. The authors examined the association of health literacy levels between older Hispanic patients and their caregivers among 174 patient-caregiver dyads enrolled from 3 community clinics and 28 senior centers in San Antonio, Texas. Health literacy was measured using English and Spanish versions of the Short-Test of Functional Health Literacy Assessment and categorized as “low” or “adequate.” The largest dyad category (41%) consisted of a caregiver with adequate health literacy and patient with low health literacy. Among the dyads with the same health literacy levels, 28% had adequate health literacy and 24% had low health literacy. It is notable that 7% of dyads consisted of a caregiver with low health literacy and a patient with adequate health literacy. Low health literacy is a concern not only for older Hispanic patients but also for their caregivers. To provide optimal care, clinicians must ensure that information is given to both patients and their caregivers in clear effective ways as it may significantly affect patient health outcomes. PMID:24093360
Poutiainen, Hannele; Hakulinen-Viitanen, Tuovi; Laatikainen, Tiina
The family and the way it functions have a key role for the health and well-being of children and adolescents. Approximately 10-30% of children grow up in families where their health and well-being may be endangered or weakened. There is very little research data on public health nurses' concerns in connection with children's health examinations related to family characteristics. The aim of this study was to investigate the associations of children's gender, age, family structure, mother's employment status and parents' perception on the sufficiency of income with public health nurses' concerns on physical and psychosocial health at children's health examinations. In 2007-2009, information about children's health and well-being and their background factors was collected from the health examinations of altogether 6506 children in Finland using a cross-sectional design. Associations between family characteristics and nurses concern related to physical and psychosocial health and development of children were assessed using logistic regression analysis. Physical health and psychosocial issues of school-age children raised most concern in public health nurses. Especially, public health nurses felt concern for the psychosocial development of boys both under and of school age. Family structure and the family's financial situation were associated with public health nurses' concern for children's physical health, psychosocial development and the presence of at least one concern. The fact that public health nurses found cause for concern during health examinations was associated with the child's gender, development stage and family characteristic. The research findings may be utilised in planning and targeting health counselling and services in child and school health care. Understanding the role of family characteristics in health and well-being challenges in children is useful in promoting multidisciplinary work in health care. © 2013 Nordic College of Caring Science.
Yang, Jun; Xiao, Yang-Yu
The phytochemicals present in fruits and vegetables may play an important role in deceasing chronic disease risk. Grapes, one of the most popular and widely cultivated and consumed fruits in the world, are rich in phytochemicals. Epidemiological evidence has linked the consumption of grapes with reduced risk of chronic diseases, including certain types of cancer and cardiovascular disease. In vitro and in vivo studies have shown that grapes have strong antioxidant activity, inhibiting cancer cell proliferation and suppressing platelet aggregation, while also lowering cholesterol. Grapes contain a variety of phytochemicals, like phenolic acids, stilbenes, anthocyanins, and proanthocyanidins, all of which are strong antioxidants. The phytochemical composition of grapes, however, varies greatly among different varieties. While extensive research exists, a literature review of the health benefits of grapes and their phytochemicals has not been compiled to summarize this work. The aim of this paper is to critically review the most recent literature regarding the concentrations, biological activities, and mechanisms of grape phytochemicals.
Full Text Available Smoking tobacco is a habit of individuals. Determinants of smoking behavior are multiple factors both within the individual and in the social environment around the individual. Staff smoking has been an undesirable phenomenon at Dr. Zainoel Abidin Provincial General Hospital in Banda Aceh. Health promotion efforts are a strategy that has resulted in behavioral changes with reductions in smoking by staff. This action research was designed to analyze changes in smoking behavior of hospital staff. The sample for this research was all 152 male staff who were smokers. The results of this research showed that Health Promotion Interventions (HPI consisting of personal empowerment plus social support and advocacy to improve employee knowledge and attitudes influenced staff to stop or to significantly. HPI employed included counseling programs, distribution of antismoking leaflets, putting up antismoking posters, and installation of no smoking signs. These HPI proved effective to increase knowledge and create a positive attitude to nonsmoking that resulted in major reductions in smoking by staff when offsite and complete cessation of smoking whilst in the hospital. Continuous evaluation, monitoring, and strengthening of policies banning smoking should be maintained in all hospitals.
Mitchell, Rebecca J; Ozminkowski, Ronald J; Hartley, Stephen K
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.
National Aeronautics and Space Administration — This data set contains the national and provincial boundaries of Ecuador as well as the boundaries of two national parks: the Cuyabeno Wildlife Reserve and the...
Provincial mortality in South Africa, 2000- priority-setting for now and a benchmark for the future. Debbie Bradshaw, Nadine Nannan, Pam Groenewald, Jane Joubert, Ria Laubscher, Beatrice Nojilana, Rosana Norman, Desiree Pieterse, Michelle Schneider ...
Shah, Gulzar H; Leider, Jonathon P; Castrucci, Brian C; Williams, Karmen S; Luo, Huabin
Assessing local health departments' (LHDs') informatics capacities is important, especially within the context of broader, systems-level health reform. We assessed a nationally representative sample of LHDs' adoption of information systems and the factors associated with adoption and implementation by examining electronic health records, health information exchange, immunization registry, electronic disease reporting system, and electronic laboratory reporting. We used data from the National Association of County and City Health Officials' 2013 National Profile of LHDs. We performed descriptive statistics and multinomial logistic regression for the five implementation-oriented outcome variables of interest, with three levels of implementation (implemented, plan to implement, and no activity). Independent variables included infrastructural and financial capacity and other characteristics associated with informatics capacity. Of 505 LHDs that responded to the survey, 69 (13.5%) had implemented health information exchanges, 122 (22.2%) had implemented electronic health records, 245 (47.5%) had implemented electronic laboratory reporting, 368 (73.0%) had implemented an electronic disease reporting system, and 416 (83.8%) had implemented an immunization registry. LHD characteristics associated with health informatics adoption included provision of greater number of clinical services, greater per capita public health expenditures, health information systems specialists on staff, larger population size, decentralized governance system, one or more local boards of health, metropolitan jurisdiction, and top executive with more years in the job. Many LHDs lack health informatics capacity, particularly in smaller, rural jurisdictions. Cross-jurisdictional sharing, investment in public health informatics infrastructure, and additional training may help address these shortfalls.
Reports of toxic cyanobacteria blooms are increasing worldwide. Warming and eutrophic surface water systems support the development of blooms. We examine the evidence for adverse human health effects associated with exposure to toxic blooms in drinking water, recreational water a...
Kovaleva, Julia; Degener, John E.; van der Mei, Henny C.
Methylobacterium species are a cause of health care-associated infection, including infections in immunocompromised hosts. The ability of Methylobacterium species to form biofilms and to develop resistance to high temperatures, drying, and disinfecting agents may explain the colonization of
Full Text Available The aim of our study was to examine whether risk factors for chronic non-communicable diseases (tobacco use, heavy alcohol consumption, inadequate physical activity and unhealthy eating habits are associated with satisfaction with life and if they are able to predict it. 225 respondents, aged between 18 and 65 years, participated. Results show that all risk factors together explain 3 % of variance in satisfaction with life after controlling for both demographic and personality variables. Unhealthy eating habit is the only risk factor that can predict lower satisfaction with life. We also examined if objective and subjective evaluations of health associate with satisfaction with life and (unhealthy lifestyle. Results show that lower health is mostly associated with inadequate physical activity and that subjective evaluation of health is more associated with satisfaction with life than are objective indicators of health. Those findings can give us an important starting point for preventive actions against chronic non-communicable diseases in Slovenia.
This dissertation is about health-related sense of humor measurement and associations between a sense of humor and health. Two sense of humor measures were developed, the QOHC and the HCL. The QOHC measures four humorous coping styles, aimed at acquiring positive affective states: antecedent-focused
Zwaanswijk, Marieke; Ende, J. van der; Verhaak, P.F.M.; Bensing, J.; Verhulst, F.C.
Objective: To determine the association of parent, family, and adolescent variables with adolescent mental health service need and utilization. Method: Correlates of adolescent mental health service utilization, self-perceived need and unmet need were investigated in a general population sample of
Background: Although mobile telecommunications deliver enormous benefit to society, there are concerns whether its electric and magnetic field emissions are linked with cancer or other health hazards. Objectives: 1) determining some of the mobile phone(Mph) associated health problems. 2) identifying some of the risk ...
Background: HIV infection impacts heavily on the infected individual's overall health status. Aim: To determine significant health, lifestyle (smoking and alcohol use) and independent clinical manifestations associated with HIV status in rural and urban communities. Methods: Adults aged between 25 and 64 years completed ...
Andi Amin Akhiruddin
Full Text Available Abstract This study aims to describe the identification of regional Organization Structuring South Sulawesi Provincial Government under Government Regulation No. 38 of 2007 and Government Regulation No. 41 of 2007 knowing Planning Implications regional organization based on Government Regulation No. 38 of 2007 and Government Regulation No. 41 of 2007 on Performance government of South Sulawesi and analyze models of regional Organization Structuring South Sulawesi Provincial Government ideal based on Government Regulation No. 38 of 2007 and Government Regulation No. 41 of 2007. The method used is descriptive to assess the condition of the South Sulawesi provincial government organizations as a result of the implementation of Government Regulation No. 38 of 2007 and Government Regulation No. 41 Year 2007 on Organizational Structure Model of the Region of South Sulawesi Provincial Government and the resulting impact on South Sulawesi Provincial Government Performance. Data collection techniques used were interviews questionnaires and study documents analyzed by descriptive qualitative and quantitative in percentage. The results showed that the arrangement of the South Sulawesi Provincial Government Organizations related mass organizations using maximal patterns based on Government Regulation No. 41 of 2007 has not kept pace even found no addition of several fields and sub-sub-fields in the affairs handled by the regional work units of South Sulawesi Province. But seen from the Organization Structuring implications arising on the performance of the Government of South Sulawesi showed quite good results this is in line with some of the responses of respondents who said it was very appropriate views of some of the indicators used by the author in a variable rate Accountability Responsibility and Innovation as a parameter in describing South Sulawesi provincial government performance. Structuring the ideal model of the regional organization of South
Full Text Available The article presents the results of sociological study carried out to obtain a general model of ideas, expectations and preferences of provincial students in their attitude to higher education. The received results are presented in the form of diagrams. Provides a general interpretation of the data and on their basis are proposed recommendations for development marketing strategy and campaign to attract university entrants to the provincial university.
Jerant, Anthony; Fiscella, Kevin; Franks, Peter
Millions of Americans lack or lose health insurance annually, yet how health characteristics predict insurance acquisition and loss remains unclear. To examine associations of health characteristics with acquisition and loss of private and public health insurance. Prospective observational analysis of 2000 to 2007 Medical Expenditure Panel Survey data for persons aged 18 to 63 on entry, enrolled for 2 years. We modeled year 2 private and public insurance gain and loss. year 2 insurance status [none (reference), any private insurance, or public insurance] among those uninsured in year 1 (N=13,022), and retaining or losing coverage in year 2 among those privately or publicly insured in year 1 (N=47,239). age, sex, race/ethnicity, education, income, region, urbanity, health status, health conditions, year 1 health expenditures, year 1 and 2 employment status, and (in secondary analyses) skepticism toward medical care and insurance. In adjusted analyses, lower income and education were associated with not gaining and with losing private insurance. Poorer health status was associated with public insurance gain. Smoking and being overweight were associated with not gaining private insurance, and smoking with losing private coverage. Secondary analyses adjusting for medical skepticism yielded similar findings. Social disadvantage and poorer health status are associated with gaining public insurance, whereas social advantage, not smoking, and not being overweight are associated with gaining private insurance, even when adjusting for attitudes toward medical care. Private insurers seem to benefit from relatively low health risk selection.
van Scheppingen, Arjella R; de Vroome, Ernest M M; ten Have, Kristin C J M; Zwetsloot, Gerard I J M; Bos, Ellen H; van Mechelen, Willem
Investigate employees' underlying motivational regulatory styles toward healthy living and their associations with lifestyle, work style, health, vitality, and productivity. Regression analyses on cross-sectional data from Dutch employees (n = 629), obtained as baseline measurement before a workplace health promotion project. Controlled regulation was not associated with smoking and alcohol use, and negatively associated with physical activity, healthy dietary habits, relaxation, and a balanced work style. Autonomous regulation was positively associated with physical activity, healthy dietary habits, and relaxation, and negatively associated with smoking and alcohol use. Healthy lifestyle and work style were associated with perceived health and vitality, which in turn were associated with employees' productivity (absenteeism and presenteeism). Internalization of the value of health is important to promote a healthy lifestyle and work style among employees, and has meaningful business implications.
Full Text Available Changes are rapidly occur in this world, especially developments in the field of information and communication technology. Man must be able to adjust quickly to keep up. Developments in information and communication technology has made it easier for people in work. Utilization of information and communication technology are expected to make work performed by humans is more effective and efficient. National Library of Indonesia mandated by Law No. 43 of 2007 as an adviser to all types of libraries throughout Indonesia. In carrying out the task, the National Library should coordinate with local government including the provincial government, represented by the provincial library which can be said to represent the provincial government in the affairs of the library. National Library of Indonesia in coordination with the provincial library has been facilitated by information and communication technology such as telephone, fax and internet. In addition, coordination can also be done through conventional correspondency or direct face to face. This study tried to define which communication system that is commonly used by the National Library of Indonesia when coordinating with the provincial library and the reasons that lie behind them. The method used in this research is descriptive with a participatory approach, the researchers and respondents are equal and shared a mutual cooperation. This research indicates that face-to-face coordination is more preferred, because face-to-face coordination offers a social and economical benefit. Keywords: library, national library, provincial library, utilization technology
Full Text Available For the Benefit of the Common Good? A Historical View on the Flemish Provinces as an Intermediary at the Level of AdministrationThe nation state of Belgium saw its provinces chiefly as intermediary administrative entities from which political dispute had to be excluded. Nevertheless, they disposed of elected provincial councils and enjoyed fiscal autonomy. Although the provincial governments underwent a slow process of politicisation, the effects of the broad socio-political developments over the course of the last two centuries on this level remained far less tangible, due above all to the slow democratisation of the provincial suffrage. The provinces only had a modicum of public visibility and a very limited scope for policymaking. To argue their relevance, the provincial governments referred occasionally to the shared history of their respective inhabitants or to their cultural coherence(s. But this discourse was not powerful enough to shape a common provincial cultural identity. Moreover, it clashed on the artificial borders of the provinces and with the much stronger feelings of local and regional coherence. By clustering these expressions of (subregionalism, the provincial governments may have provided building stones for the creation of identity-structures on a higher level. However, this role too remained very modest and can hardly be used to substantiate the institutional tenacity of this level of government.
Gidding, Samuel S.; And Others
This article presents recommendations developed at the 1994 American Heart Association's Children's Heart Health Conference to promote cardiovascular health in children, particularly regarding public health, lifestyle, and behavior. The recommendations cover the areas of physical activity, nutrition, and tobacco, providing suggestions for schools,…
Kraft, David P.
In 1910, the first college mental health service sought to help college students with personality development and building a healthy mind. In 1920, the meeting that founded the American College Health Association (ACHA) identified "mental hygiene" as important, although a separate Mental Health Section was not established in ACHA until 1957.…
Ansari, Walid El; Suominen, Sakari; Berg-Beckhoff, Gabriele
associated with a higher consumption of sweets, cookies and snacks and a lower adherence to dietary guidelines. More healthy nutrition behaviour was consistently associated with better self-reported health and less health complaints. Of the four nutrition behaviour indicators we employed, the dietary...
Nunes, Claudete Ivani Panizzi; Abegg, Claídes
To investigate the self-perception of oral health in older people, aged 65-74, from the central region of southern Brazil. Cross-sectional population-based study using data from the Oral Health Conditions Survey of Southern Brazil, developed between the years 2002 and 2003, by the State Health Secretary (SHS) of Rio Grande do Sul (RS), Brazil. Socioeconomic and demographic variables, self-perception of oral health and clinical data, as well as dental pain were evaluated in 618 elderly people. Multinomial logistic regression was used to evaluate the effect of explanatory variables on the self-perception of oral health. Almost half of the elderly were edentate and rated their oral health as good or very good. With regard to dental pain, 28.8% of the people declared that they had experienced dental pain in the 6 months before the interview. There was a significant relationship between dental pain and classification of oral health, and chewing ability. Following adjustment, the need for dental prostheses remained associated with the influence of oral health on establishing relationships. Similarly, personal income remained associated with the elderly's perception of their ability to talk. Finally, the level of education remained related to the influence of oral health status in people's relationships. Dental pain and the need for dental prostheses were the main factors that affected the self-perception of oral health of elderly people from southern Brazil.
Park, Hyojung; Reber, Bryan H
This study explored health organizations' public relations efforts to frame health issues through their press releases. Content analysis of 316 press releases from three health organizations-the American Heart Association, the American Cancer Society, and the American Diabetes Association-revealed that they used the medical research frame most frequently and emphasized societal responsibility for health issues. There were differences, however, among the organizations regarding the main frames and health issues: the American Diabetes Association was more likely to focus on the issues related to social support and education, while the American Heart Association and the American Cancer Society were more likely to address medical research and scientific news. To demonstrate their initiatives for public health, all the organizations employed the social support/educational frame most frequently. Researchers and medical doctors frequently were quoted as trusted sources in the releases.
Smith, Samuel G.; Curtis, Laura M.; Wardle, Jane; von Wagner, Christian; Wolf, Michael S.
Objective There is ongoing debate on whether health literacy represents a skill-based construct for health self-management, or if it also more broadly captures personal ‘activation’ or motivation to manage health. This research examines 1) the association between patient activation and health literacy as they are most commonly measured and 2) the independent and combined associations of patient activation and health literacy skills with physical and mental health. Methods A secondary analysis of baseline cross-sectional data from the LitCog cohort of older adults was used. Participants (n = 697) were recruited from multiple US-based health centers. During structured face-to-face interviews, participants completed the Test of Functional Health Literacy in Adults (TOFHLA), the Patient Activation Measure (PAM), the SF-36 physical health summary subscale, and Patient Reported Outcomes Measurement Information Service (PROMIS) short form subscales for depression and anxiety. Results The relationship between health literacy and patient activation was weak, but significant (r = 0.11, pliteracy was associated with worse physical health (β = 0.13, pliteracy and patient activation are weakly correlated with each other, but also independently correlated with health outcomes. This suggests health literacy represents a distinct skill-based construct, supporting the Institute of Medicine’s definition. Deficits in either construct could be useful targets for behavioral intervention. PMID:24023942
Stone, Jacqueline D; Belcher, Harolyn M E; Attoh, Prince; D'Abundo, Michelle; Gong, Tao
Leadership is a process by which an individual influences a group or individual to achieve a common goal, in this case health promotion for individuals with disabilities. (1) To examine the association between the transformational leadership behaviors of the Association of University Centers on Disabilities (AUCD) network professionals and their practice beliefs about health promotion activities, specifically cardiovascular fitness and healthy weight, for people with disabilities. (2) To determine if discipline and/or years of practice moderate the association between transformational leadership behaviors and practice beliefs regarding health promotion. There is a positive association between transformational leadership behaviors and health professionals practice beliefs regarding health promotion activities for persons with disabilities. A quantitative cross-sectional web-based survey design was used to determine the association between leadership behaviors and practices beliefs regarding health promotion for people with disabilities. The Multifactor Leadership Questionnaire and an adapted version of the Role of Health Promotion in Physical Therapy Survey were used to measure leadership and practice beliefs, respectively. Multiple regression analysis was applied to determine the association of leadership behaviors with health promotion practice beliefs variables. Transformational leadership behaviors of the AUCD network professionals were positively associated with health promotion practice beliefs about cardiovascular fitness for people with disabilities. Years post licensure and discipline did not moderate the association between transformational leadership and practice beliefs regarding health promotion. Transformational leadership may facilitate health professionals' health promotion practices for people with disabilities. Further research and training in leadership is needed. Copyright © 2017 Elsevier Inc. All rights reserved.
Phillips, Christina Ann
This thesis focuses on explorations of science, technology, society and the environment (i.e., STS[E]) outcomes/expectations in tenth-grade level science curricula across three Canadian provinces (i.e., Alberta, Manitoba & Ontario) with distinctive provincial political environments at the time of curriculum construction and/or implementation. Document analysis, discourse analysis and a range of theoretical frameworks (i.e., Levinson, 2010; Pedretti & Nazir, 2011 & Krathwohl, 2002) were used to aid in explorations of STS[E] curriculum segments and discourses in each provincial region. More detailed analysis and thematic exploration is presented for each unit associated with climate change as some interesting patterns emerged following initial analysis. My findings are presented as three comparative case studies and represent a small and original contribution to the large body of scholarly research devoted to studies of STS[E] education, where each province represents a unique case that has been explored regarding some aspects the STS[E] curriculum outcomes/expectations and general political culture as well as some other theoretical factors. Findings from this study indicate that Alberta's STS[E] outcomes may be related to Levinson's (2010) 'deliberative' citizenship focus. The following currents from Pedretti and Nazir (2011) appear to be emphasized: logical reasoning, historical, application & design and socio-cultural aligned outcomes when STS[E] is considered as an entity separate from the Alberta curriculum combination of STS and Knowledge. Ontario's STS[E] expectations may align with Levinson's (2010) 'deliberative' or in some select cases a 'deliberative'/'praxis' framework category with some emphasis related to logical reasoning and socio-cultural awareness (Pedretti & Nazir, 2011) in their STS[E] curriculum. The Manitoba STS[E] outcomes may be aligned with a more 'deliberative' approach with some associations that could intersect with the framework
Chang, Yao-Tsung; Su, Chien-Tien; Chen, Ruey-Yu; Yeh, Ching-Ying; Huang, Pai-Tsang; Chen, Chiou-Jong; Chu, Ming
The aim of this study was to examine relationships of organizational culture and health behaviors with presenteeism. Data of a self-reported questionnaire were collected from 816 employees, who joined the study on a voluntary basis, in seven enterprises in northern Taiwan. Organizational culture and health behaviors were found to be significantly associated with presenteeism. After adjusting for confounding factors, the number of health complaints seemed to be more suitable than chronic diseases in predicting presenteeism. This study result implied that advantage could be taken of organizational culture and employees' health behaviors to reduce presenteeism in the workplace.
Mary Augustina Egbuta
Full Text Available Filamentous fungi occur widely in the environment, contaminating soil, air, food and other substrates. Due to their wide distribution, they have medical and economic implications. Regardless of their use as a source of antibiotics, vitamins and raw materials for various industrially important chemicals, most fungi and filamentous fungi produce metabolites associated with a range of health risks, both in humans and in animals. The association of filamentous fungi and their metabolites to different negative health conditions in humans and animals, has contributed to the importance of investigating different health risks induced by this family of heterotrophs. This review aims to discuss health risks associated with commonly occurring filamentous fungal species which belong to genera Aspergillus, Penicillium and Fusarium, as well as evaluating their pathogenicity and mycotoxic properties.
Egbuta, Mary Augustina; Mwanza, Mulunda
Filamentous fungi occur widely in the environment, contaminating soil, air, food and other substrates. Due to their wide distribution, they have medical and economic implications. Regardless of their use as a source of antibiotics, vitamins and raw materials for various industrially important chemicals, most fungi and filamentous fungi produce metabolites associated with a range of health risks, both in humans and in animals. The association of filamentous fungi and their metabolites to different negative health conditions in humans and animals, has contributed to the importance of investigating different health risks induced by this family of heterotrophs. This review aims to discuss health risks associated with commonly occurring filamentous fungal species which belong to genera Aspergillus, Penicillium and Fusarium, as well as evaluating their pathogenicity and mycotoxic properties. PMID:28677641
Nghia Ho Dang Trung
Full Text Available BACKGROUND: Infectious diseases of the central nervous system (CNS remain common and life-threatening, especially in developing countries. Knowledge of the aetiological agents responsible for these infections is essential to guide empiric therapy and develop a rational public health policy. To date most data has come from patients admitted to tertiary referral hospitals in Asia and there is limited aetiological data at the provincial hospital level where most patients are seen. METHODS: We conducted a prospective Provincial Hospital-based descriptive surveillance study in adults and children at thirteen hospitals in central and southern Viet Nam between August 2007-April 2010. The pathogens of CNS infection were confirmed in CSF and blood samples by using classical microbiology, molecular diagnostics and serology. RESULTS: We recruited 1241 patients with clinically suspected infection of the CNS. An aetiological agent was identified in 640/1241 (52% of the patients. The most common pathogens were Streptococcus suis serotype 2 in patients older than 14 years of age (147/617, 24% and Japanese encephalitis virus in patients less than 14 years old (142/624, 23%. Mycobacterium tuberculosis was confirmed in 34/617 (6% adult patients and 11/624 (2% paediatric patients. The acute case fatality rate (CFR during hospital admission was 73/617 (12% in adults and to 42/624 (7% in children. CONCLUSIONS: Zoonotic bacterial and viral pathogens are the most common causes of CNS infection in adults and children in Viet Nam.
Devries, Karen; Watts, Charlotte; Yoshihama, Mieko; Kiss, Ligia; Schraiber, Lilia Blima; Deyessa, Negussie; Heise, Lori; Durand, Julia; Mbwambo, Jessie; Jansen, Henrica; Berhane, Yemane; Ellsberg, Mary; Garcia-Moreno, Claudia
Suicidal behaviours are one of the most important contributors to the global burden of disease among women, but little is known about prevalence and modifiable risk factors in low and middle income countries. We use data from the WHO multi-country study on women's health and domestic violence against women to examine the prevalence of suicidal thoughts and attempts, and relationships between suicide attempts and mental health status, child sexual abuse, partner violence and other variables. Population representative cross-sectional household surveys were conducted from 2000-2003 in 13 provincial (more rural) and city (urban) sites in Brazil, Ethiopia, Japan, Namibia, Peru, Samoa, Serbia, Thailand and Tanzania. 20967 women aged 15-49 years participated. Prevalence of lifetime suicide attempts, lifetime suicidal thoughts, and suicidal thoughts in the past four weeks were calculated, and multivariate logistic regression models were fit to examine factors associated with suicide attempts in each site. Prevalence of lifetime suicide attempts ranged from 0.8% (Tanzania) to 12.0% (Peru city); lifetime thoughts of suicide from 7.2% (Tanzania province) to 29.0% (Peru province), and thoughts in the past four weeks from 1.9% (Serbia) to 13.6% (Peru province). 25-50% of women with suicidal thoughts in the past four weeks had also visited a health worker in that time. The most consistent risk factors for suicide attempts after adjusting for probable common mental health disorders were: intimate partner violence, non-partner physical violence, ever being divorced, separated or widowed, childhood sexual abuse and having a mother who had experienced intimate partner violence. Mental health policies and services must recognise the consistent relationship between violence and suicidality in women in low and middle income countries. Training health sector workers to recognize and respond to the consequences of violence may substantially reduce the health burden associated with
Smith? Robert J
Full Text Available Abstract Background Recently, provincial health programs in Canada and elsewhere have begun rolling out vaccination against human papillomavirus for girls aged 9–13. While vaccination is voluntary, the cost of vaccination is waived, to encourage parents to have their daughters vaccinated. Adult women who are eligible for the vaccine may still receive it, but at a cost of approximately CAN$400. Given the high efficacy and immunogenicity of the vaccine, the possibility of eradicating targeted types of the virus may be feasible, assuming the vaccination programs are undertaken strategically. Methods We develop a mathematical model to describe the epidemiology of vaccination against human papillomavirus, accounting for a widespread childhood vaccination program that may be supplemented by voluntary adult vaccination. A stability analysis is performed to determine the stability of the disease-free equilibrium. The critical vaccine efficacy and immunogenicity thresholds are derived, and the minimum level of adult vaccination required for eradication of targeted types is determined. Results We demonstrate that eradication of targeted types is indeed feasible, although the burden of coverage for a childhood-only vaccination program may be high. However, if a small, but non-negligible, proportion of eligible adults can be vaccinated, then the possibility of eradication of targeted types becomes much more favourable. We provide a threshold for eradication in general communities and illustrate the results with numerical simulations. We also investigate the effects of suboptimal efficacy and immunogenicity and show that there is a critical efficacy below which eradication of targeted types is not possible. If eradication is possible, then there is a critical immunogenicity such that even 100% childhood vaccination will not eradicate the targeted types of the virus and must be supplemented with voluntary adult vaccination. However, the level of adult
Srikanthan, A; Mai, H; Penner, N; Amir, E; Laupacis, A; Sabharwal, M; Chan, K K W
The pan-Canadian Oncology Drug Review (pcodr) was implemented in 2011 to address uneven drug coverage and lack of transparency with respect to the various provincial cancer drug review processes in Canada. We evaluated the impact of the pcodr on provincial decision concordance and time from Notice of Compliance (noc) to drug funding. In a retrospective review, Health Canada's Drug Product Database was used to identify new indications for cancer drugs between January 2003 and May 2014, and provincial formulary listings for drug-funding dates and decisions between 1 January 2003 and 31 December 2014 were retrieved. Multiple linear models and quantile regressions were used to evaluate changes in time to decision-making before and after the implementation of the pcodr. Agreement of decisions between provinces was evaluated using kappa statistics. Data were available from 9 provinces (all Canadian provinces except Quebec), identifying 88 indications that represented 51 unique cancer drugs. Two provinces lacked available data for all 88 indications at the time of data collection. Interprovincial concordance in drug funding decisions significantly increased after the pcodr's implementation (Brennan-Prediger coefficient: 0.54 pre-pcodr vs. 0.78 post-pcodr; p = 0.002). Nationwide, the median number of days from Health Canada's noc date to the date of funding significantly declined (to 393 days from 522 days, p drug funding decisions between provinces and decreased time to funding decisions were observed.
Chen, Lu; Hannon, Peggy A; Laing, Sharon S; Kohn, Marlana J; Clark, Kathleen; Pritchard, Scott; Harris, Jeffrey R
To examine the relationship between perceived workplace health support and employee productivity. A quantitative cross-sectional study. Washington State agencies. A total of 3528 employees from six state agencies were included in this analysis. Perceived workplace health support was assessed by two questions that queried respondents on how often they felt supported by the workplace for healthy living and physical activity. The Work Productivity and Activity Impairment Questionnaire was used to measure health-related absenteeism and presenteeism in the past 7 days. Multivariate linear regression was used to estimate the mean differences in productivity by levels of perceived health support. Most participants were between 45 and 64 years of age and were predominantly non-Hispanic white. Presenteeism varied significantly by the level of perceived workplace health support, with those who felt least supported having higher presenteeism than those who felt most supported. The difference in presenteeism by perceived workplace support remained significant in models adjusting for sociodemographic and health characteristics (mean difference: 7.1% for support for healthy living, 95% confidence interval: 3.7%, 10.4%; 4.3% for support for physical activity, 95% confidence interval: 1.7%, 6.8%). Absenteeism was not associated with perceived workplace health support. Higher perceived workplace health support is independently associated with higher work productivity. Employers may see productivity benefit from wellness programs through improved perceptions of workplace health support.
Friedman, Bruce; Veazie, Peter J; Chapman, Benjamin P; Manning, Willard G; Duberstein, Paul R
Context The patterns of health care utilization in the United States pose well-established challenges for public policy. Although economic and sociological research has resulted in considerable knowledge about what influences the use of health services, the psychological literature in this area is underdeveloped. Importantly, it is not known whether personality traits are associated with older adults’ use of acute and long-term care services. Methods Data were collected from 1,074 community-dwelling seniors participating in a Medicare demonstration. First they completed a self-report questionnaire measuring the “Big Five” personality traits: Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness. During the next two years, the participants maintained daily journals of their use of health care services. We used regression models based on the Andersen behavioral model of health care utilization to test for associations. Findings Our hypothesis that higher Neuroticism would be associated with greater health care use was confirmed for three services—probability of any emergency department (ED) use, likelihood of any custodial nursing home use, and more skilled nursing facility (SNF) days for SNF users—but was disconfirmed for hospital days for those hospitalized. Higher Openness to Experience was associated with a greater likelihood of custodial home care use, and higher Agreeableness and lower Conscientiousness with a higher probability of custodial nursing home use. For users, lower Openness was associated with more ED visits and SNF days, and lower Conscientiousness with more ED visits. For many traits with significant associations, the predicted use was 16 to 30 percent greater for people high (low) versus low (high) in specific traits. Conclusions Personality traits are associated with Medicare beneficiaries’ use of many expensive health care services, findings that have implications for health services research and
Poulin, Céline; Alary, Michel; Lambert, Gilles; Godin, Gaston; Landry, Suzanne; Gagnon, Hélène; Demers, Eric; Morarescu, Elena; Rochefort, Jean; Claessens, Christiane
To determine the prevalence of HIV and hepatitis C virus (HCV) infections and examine risk factors for these infections among inmates in Quebec provincial prisons. Anonymous cross-sectional data were collected from January to June 2003 for men (n = 1357) and women (n = 250) who agreed to participate in the study and who completed a self-administrated questionnaire and provided saliva samples. The prevalence of HIV infection was 2.3% among the male participants and 8.8% among the female participants. The corresponding prevalence of HCV infection was 16.6% and 29.2%, respectively. The most important risk factor was injection drug use. The prevalence of HIV infection was 7.2% among the male injection drug users and 0.5% among the male non-users. Among the women, the rate was 20.6% among the injection drug users, whereas none of the non-users was HIV positive. The prevalence of HCV infection was 53.3% among the male injection drug users and 2.6% among the male non-users; the corresponding values among the women were 63.6% and 3.5%. HIV and HCV infections constitute an important public health problem in prison, where the prevalence is affected mainly by a high percentage of injection drug use among inmates.
Keller, Abiola; Litzelman, Kristin; Wisk, Lauren E.; Maddox, Torsheika; Cheng, Erika Rose; Creswell, Paul D.; Witt, Whitney P.
Objective This study sought to examine the relationship among the amount of stress, the perception that stress affects health, and health and mortality outcomes in a nationally-representative sample of U.S. adults. Methods Data from the 1998 National Health Interview Survey were linked to prospective National Death Index mortality data through 2006. Separate logistic regression models were used to examine the factors associated with current health status and psychological distress. Cox proportional hazard models were used to determine the impact of perceiving that stress affects health on all-cause mortality. Each model specifically examined the interaction between the amount of stress and the perception that stress affects health, controlling for sociodemographic, health behavior, and access to healthcare factors. Results 33.7% of nearly 186 million (n=28,753) U.S. adults perceived that stress affected their health a lot or to some extent. Both higher levels of reported stress and the perception that stress affects health were independently associated with an increased likelihood of worse health and mental health outcomes. The amount of stress and the perception that stress affects health interacted such that those who reported a lot of stress and that stress impacted their health a lot had a 43% increased risk of premature death (HR = 1.43, 95% CI [1.20, 1.71]). Conclusions High amounts of stress and the perception that stress impacts health are each associated with poor health and mental health. Individuals who perceived that stress affects their health and reported a large amount of stress had an increased risk of premature death. PMID:22201278
The founders of the Association of Academic Health Sciences Libraries (AAHSL) envisioned the development of a professional organization that would provide a greater voice for academic health sciences libraries, facilitate cooperation and communication with the Association of American Medical Colleges, and create a forum for identifying problems and solutions that are common to academic health sciences libraries. This article focuses on the fulfillment of the "greater voice" vision by describing action and leadership by AAHSL and its members on issues that directly influenced the role of academic health sciences libraries. These include AAHSL's participation in the work that led to the publication of the landmark report, Academic Information in the Academic Health Sciences Center: Roles for the Library in Information Management; its contributions to the recommendations of the Physicians for the Twenty-first Century: The GPEP Report; and the joint publication with the Medical Library Association of Challenge to Action: Planning and Evaluation Guidelines for Academic Health Sciences Libraries.
Daniel T. C. Cox
Full Text Available Exposure to nature provides a wide range of health benefits. A significant proportion of these are delivered close to home, because this offers an immediate and easily accessible opportunity for people to experience nature. However, there is limited information to guide recommendations on its management and appropriate use. We apply a nature dose-response framework to quantify the simultaneous association between exposure to nearby nature and multiple health benefits. We surveyed ca. 1000 respondents in Southern England, UK, to determine relationships between (a nature dose type, that is the frequency and duration (time spent in private green space and intensity (quantity of neighbourhood vegetation cover of nature exposure and (b health outcomes, including mental, physical and social health, physical behaviour and nature orientation. We then modelled dose-response relationships between dose type and self-reported depression. We demonstrate positive relationships between nature dose and mental and social health, increased physical activity and nature orientation. Dose-response analysis showed that lower levels of depression were associated with minimum thresholds of weekly nature dose. Nearby nature is associated with quantifiable health benefits, with potential for lowering the human and financial costs of ill health. Dose-response analysis has the potential to guide minimum and optimum recommendations on the management and use of nearby nature for preventative healthcare.
Cox, Daniel T C; Shanahan, Danielle F; Hudson, Hannah L; Fuller, Richard A; Anderson, Karen; Hancock, Steven; Gaston, Kevin J
Exposure to nature provides a wide range of health benefits. A significant proportion of these are delivered close to home, because this offers an immediate and easily accessible opportunity for people to experience nature. However, there is limited information to guide recommendations on its management and appropriate use. We apply a nature dose-response framework to quantify the simultaneous association between exposure to nearby nature and multiple health benefits. We surveyed ca. 1000 respondents in Southern England, UK, to determine relationships between (a) nature dose type, that is the frequency and duration (time spent in private green space) and intensity (quantity of neighbourhood vegetation cover) of nature exposure and (b) health outcomes, including mental, physical and social health, physical behaviour and nature orientation. We then modelled dose-response relationships between dose type and self-reported depression. We demonstrate positive relationships between nature dose and mental and social health, increased physical activity and nature orientation. Dose-response analysis showed that lower levels of depression were associated with minimum thresholds of weekly nature dose. Nearby nature is associated with quantifiable health benefits, with potential for lowering the human and financial costs of ill health. Dose-response analysis has the potential to guide minimum and optimum recommendations on the management and use of nearby nature for preventative healthcare.
Bock, Jens-Oliver; Hajek, André; König, Hans-Helmut
Little attention has been given to psychological factors as correlates of health care use, which could be an important key to manage it. We analyzed the association of psychological factors with health care use. Primary data were obtained from three follow-ups (2002, 2008, and 2011) of a large population-based study with participants aged 40+. Using a longitudinal observational study, we analyzed the psychological factors of negative and positive affect (affective well-being), life satisfaction (cognitive well-being), self-efficacy, loneliness, self-esteem, optimism, and flexible goal adjustment using fixed-effects regressions. The participants provided data on health care use (visits to general practitioners [GPs] and specialists as well as hospitalization) and psychological factors via self-administered questionnaires and personal interviews (7,116 observations). The sample was drawn using national probability sampling. Controlling for self-rated health, chronic diseases and sociodemographics, increases in affective well-being, and optimism decreased health care use of GPs, specialists, and hospital treatment. Increases in cognitive well-being decreased health care use of GPs and specialists. Increases in self-efficacy decreased hospitalization. The study underlines the influence of psychological factors on health care use. Thus, whenever possible, future studies of health care use should include psychological factors, and efforts to reduce health care use might focus on such factors. © Health Research and Educational Trust.
Full Text Available The research’s purpose is to test empirically examine the effect of the regional financial accounting information system characteristics and behavior of managers towards cost consciouness in the use of financial information systems area. Manager behavior is proxied by the control decision-making and cost management consciousness as practiced by Abernethy and Emidia. The study will examine whether the phenomenon occurs in Indonesia, particularly in the South Kalimantan provincial government. Concretely influences the characteristics of accounting information systems in this area of financial information systems, it is seen from the behavior of Chief SKPD in the South Kalimantan provincial government in decision-. The Result shows that Characteristics of Financial Accounting Information Systems affect the use of the local financial system to control decision-making and management. There is a significant relationship between system characteristics financial information to the control area decisions. Financial regionally accounting information system characteristics were positively associated with decision controlling policy. The use of financial information systems area for menajament decisions affect cost consciousness. The effect of control decisions the cost consciousness is significant.
Segura-Jiménez, Víctor; Carbonell-Baeza, Ana; Keating, Xiaofen D; Ruiz, Jonatan R; Castro-Piñero, José
Psychological positive health and health complaints have long been ignored scientifically. Sleep plays a critical role in children and adolescents development. We aimed at studying the association of sleep duration and quality with psychological positive health and health complaints in children and adolescents from southern Spain. A randomly selected two-phase sample of 380 healthy Caucasian children (6-11.9 years) and 304 adolescents (12-17.9 years) participated in the study. Sleep duration (total sleep time), perceived sleep quality (morning tiredness and sleep latency), psychological positive health and health complaints were assessed using the Health Behaviour in School-aged Children questionnaire. The mean (standard deviation [SD]) reported sleep time for children and adolescents was 9.6 (0.6) and 8.8 (0.6) h/day, respectively. Sleep time ≥10 h was significantly associated with an increased likelihood of reporting no health complaints (OR 2.3; P = 0.005) in children, whereas sleep time ≥9 h was significantly associated with an increased likelihood of overall psychological positive health and no health complaints indicators (OR ~ 2; all P adolescents. Reporting better sleep quality was associated with an increased likelihood of reporting excellent psychological positive health (ORs between 1.5 and 2.6; all P adolescents with no difficulty falling asleep were more likely to report no health complaints (OR ~ 3.5; all P sleep duration and poor perceived quality of sleep might directly impact quality of life in children, decreasing general levels of psychological positive health and increasing the frequency of having health complaints.
Journal of American College Health, 2009
Objective: Assessing and understanding the health needs and capacities of college students is paramount to creating healthy campus communities. The American College Health Association-National College Health Assessment (ACHA-NCHA) is a survey that ACHA developed in 1998 to assist institutions of higher education in achieving this goal. The…
Bui, Thanh Cong; Markham, Christine M; Ross, Michael Wallis; Mullen, Patricia Dolan
Oral human papillomavirus (HPV) infection is the cause of 40% to 80% of oropharyngeal cancers; yet, no published study has examined the role of oral health in oral HPV infection, either independently or in conjunction with other risk factors. This study examined the relation between oral health and oral HPV infection and the interactive effects of oral health, smoking, and oral sex on oral HPV infection. Our analyses comprised 3,439 participants ages 30 to 69 years for whom data on oral HPV and oral health were available from the nationally representative 2009-2010 National Health and Nutrition Examination Survey. Results showed that higher unadjusted prevalence of oral HPV infection was associated with four measures of oral health, including self-rated oral health as poor-to-fair [prevalence ratio (PR) = 1.56; 95% confidence interval (CI), 1.25-1.95], indicated the possibility of gum disease (PR = 1.51; 95% CI, 1.13-2.01), reported use of mouthwash to treat dental problems in the past week (PR = 1.28; 95% CI, 1.07-1.52), and higher number of teeth lost (Ptrend = 0.035). In multivariable logistic regression models, oral HPV infection had a statistically significant association with self-rated overall oral health (OR = 1.55; 95% CI, 1.15-2.09), independent of smoking and oral sex. In conclusion, poor oral health was an independent risk factor of oral HPV infection, irrespective of smoking and oral sex practices. Public health interventions may aim to promote oral hygiene and oral health as an additional measure to prevent HPV-related oral cancers.
Yuan, Changwei; Liu, Hongchao
The transportation sector is a complex system. Collecting transportation activity and the associated emissions data is extremely expensive and time-consuming. Grey Relational Analysis provides a viable alternative to overcome data insufficiency and gives insights for decision makers into such a complex system. In this paper, we achieved three major goals: (i) we explored the inter-relationships among transportation development, energy consumption and CO2 emissions for 30 provincial units in China; (ii) we identified the transportation development mode for each individual province; and (iii) we revealed policy implications regarding the sustainable transportation development at the provincial level. We can classify the 30 provinces into eight development modes according to the calculated Grey Relational Grades. Results also indicated that energy consumption has the largest influence on CO2 emission changes. Lastly, sustainable transportation policies were discussed at the province level according to the level of economy, urbanization and transportation energy structure. PMID:29292779
Yamashita, Takashi; Brown, J Scott
Growing empirical evidence supports the generally positive relationship between education, health literacy and health outcomes. However, little is known about cohort in this relationship. This study examined the role of cohort defined by 10-year age period in the association between educational attainment, health literacy and self-rated health. The data were obtained from the 2003 National Assessment of Adult Literacy survey restricted file. Focusing on nationally representative community-dwelling adults age 25 years and older, self-rated health was modeled as a function of health literacy, educational attainment, cohorts (defined by 10-year age periods), other demographic characteristics and socio-economic status. While the youngest cohort was positively associated with self-rated health, middle-age cohorts were more likely to have lower self-rated health (compared with the age 65 years and older cohort). Interestingly, age was no longer statistically significant after adjusting for cohort and other covariates. Recognition of possible cohort effects in education, health literacy and health should be reflected in future health literacy research and intervention programs for addressing health disparities in the USA.
Full Text Available Since its foundation, China’s government auditing system has played a very important role in maintaining financial and economic order and improving government accountability and transparency. Though a great deal of research has discussed the role of government auditing in discovering and deterring corruption, there is little empirical evidence on whether government auditing actually helps to reduce corruption. Using China’s provincial panel data from 1999 to 2008, this paper empirically examines the role of government auditing in China’s corruption control initiatives. Our findings indicate that the number of irregularities detected in government auditing is positively related to the corruption level in that province, which means the more severe the corruption is in a province, the more irregularities in government accounts are found by local audit institutions. Also, post-audit rectification effort is negatively related to the corruption level in that province, indicating that greater rectification effort is associated with less corruption. This paper provides empirical evidence on how government auditing can contribute to curbing corruption, which is also helpful for understanding the role of China’s local audit institutions in government governance and can enrich the literature on both government auditing and corruption control.
Márcio Flávio Moura de Araújo; Roberto Wagner Júnior Freire de Freitas; Adman Câmara Soares Lima; Dayse Christina Rodrigues Pereira; Maria Lúcia Zanetti; Marta Maria Coelho Damasceno
Objective To associate the sleep quality of Brazilian undergraduate students with health indicators. Method A cross-sectional study was developed with a random sample of 662 undergraduate students from Fortaleza, Brazil. The demographic data, Pittsburgh Sleep Quality Index and health data indicators (smoking, alcoholism, sedentary lifestyle, nutritional condition and serum cholesterol) were collected through a self-administered questionnaire. Blood was collected at a clinical laboratory. In o...
Hilbrand, Sonja; Coall, David A; Meyer, Andrea H; Gerstorf, Denis; Hertwig, Ralph
How does helping behavior contribute to the health and the longevity of older helpers? From an evolutionary perspective, the ultimate cause may be rooted in ancestral parenting and grandparenting. These activities may have generalized to a neural and hormonal caregiving system that also enabled prosocial behavior beyond the family. From a psychological perspective, helping others may be associated with healthy aging, which, in turn, contributes to longevity as a proximate cause. Yet little is known about the extent to which mediating factors such as the health benefits of helping behaviors translate into enhanced longevity, particularly in regard to grandparenting. To fill this gap, we conducted mediation analyses (structural equation models) to examine whether grandparenting and supporting others in the social network contributed directly or indirectly (through better health 5-6 years later) to the longevity of older helpers. We drew on longitudinal data from the Berlin Aging Study (N = 516), in which older adults in Berlin, Germany, were interviewed at baseline (1990-1993, mean age at entry = 85 years) and continuously followed up until 2009. Results suggest that the associations of both grandparenting and supporting others with enhanced longevity are mediated by better prospective health (indirect effect). The effect of helping was not fully mediated, however-helping was also directly associated with increased longevity independently of the health indicators measured. The results were robust against effects of the helper's preexisting health status and sociodemographic characteristics of participants, their children, and grandchildren. We conclude that better prospective health contributes to the link between helping and longevity, but does not fully account for it. Other potential contributing mechanisms remain to be identified. As populations age across the globe, identifying mechanisms that foster health in old age can help to highlight potential targets
Kovaleva, Julia; Degener, John E; van der Mei, Henny C
Methylobacterium species are a cause of health care-associated infection, including infections in immunocompromised hosts. The ability of Methylobacterium species to form biofilms and to develop resistance to high temperatures, drying, and disinfecting agents may explain the colonization of Methylobacterium in the hospital environment in, e.g., endoscopes. Due to its slow growth, it can be easily missed during microbiological surveillance of endoscope reprocessing. The purpose of this minireview is to present an overview of documented infections and cross-contaminations with Methylobacterium related to endoscopic procedures and to illustrate the health care-associated relevance of this slow-growing bacterium.
Full Text Available Background and Objectives: Depression, as one of the common mental disorders, has a main contribution to the burden of diseases. Regarding the adverse effects of depression on different aspects of life, this study was conducted to study association between depression and spiritual health among students. Methods: This cross-sectional, descriptive, and analytical study was conducted on the students of faculties of health and Quranic Sciences in 2015-2016. A demographic questionnaire, Spiritual Health Scale, and Beck's Depression Inventory were used to collect data. Sampling was conducted by census. The data were analyzed by chi-square test, Pearson correlation coefficient, Mann-Whitney test, and Spearman's correlation coefficient in SPSS 16. For all analytical tests, the level of significance was considered 0.05. Results: Statistically, spiritual health and depression were significantly and inversely correlated among the students (p≤0.001, r=-0.619. Spiritual health was significantly different between the faculties. Conclusion: High level of spiritual health is associated with relieved depression. Therefore, spiritual health can be used to prevent and control depression.
Full Text Available The aim of this paper is twofold: firstly to examine how the concepts of accounting andaccountability are understood by indigenous Fijians; and secondly to examine the role ofaccounting in the accountability of provincial councils.Provincial councils are part of the Fijian Administration, which runs alongside the centralgovernment but applies only to indigenous Fijians. The Fijian Administration was introducedby the British colonial administration in the late 1800s as a mechanism for controllingindigenous Fijians. It has undergone several reviews resulting from criticisms that it has failedto fulfill the aspirations of indigenous Fijians.There is evidence of implied and actual accountability by indigenous Fijians in Namosi. Thisis supported by monitoring mechanisms established by provincial offices. On the other hand,neither the Fijian Affairs Board nor the Namosi Provincial Council appears to take seriousresponsibility for accounting to indigenous Fijians in the province. Sadly, there is littleevidence to demonstrate an explicit accountability to indigenous Fijians. Significant scopeexists for improving the standard of accounting and accountability by provincial councils.This study contributes to understanding the role of accounting among indigenous peoples, inthe context of inherited colonial structures. It also represents accounting research conductedby indigenous academics, primarily in the Fijian language. This enables an examination ofhow language frames understanding of accounting concepts.
van Scheppingen, A.R.; de Vroome, E.M.M.; ten Have, K.C.J.M.; Zwetsloot, G.I.J.M.; Bos, E.H.; van Mechelen, W.
OBJECTIVE:: Investigate employees' underlying motivational regulatory styles toward healthy living and their associations with lifestyle, work style, health, vitality, and productivity. METHODS:: Regression analyses on cross-sectional data from Dutch employees (n = 629), obtained as baseline
Scheppingen, A.R. van; Vroome, E.M.M. de; Have, K.C.J.M. ten; Zwetsloot, G.I.J.M.; Bos, E.H.; Mechelen, W. van
Objective: Investigate employees' underlying motivational regulatory styles toward healthy living and their associations with lifestyle, work style, health, vitality, and productivity. Methods: Regression analyses on cross-sectional data from Dutch employees (n = 629), obtained as baseline
Carter, K N; Blakely, T; Collings, S; Imlach Gunasekara, F; Richardson, K
Socioeconomic inequalities in mental health have been shown in a number of populations. This study aims to investigate the association between asset wealth and psychological distress in New Zealand and whether it is independent of other socioeconomic measures and baseline health status. Data for this study were from the first three waves of the Survey of Families, Income and Employment (SoFIE) conducted in New Zealand (2002-2004/05) (n = 15 340). The Kessler-10 was used as a measure of psychological distress. The association of quintiles of wealth with psychological distress was investigated using logistic regression, controlling for confounders, socioeconomic variables and prior health status. The odds ratio (OR) of reporting high psychological distress were greater in the lowest wealth quintile compared with the highest (OR 3.06, 95% CI 2.68 to 3.50). Adjusting for age and sex did not alter the relationship; however, adjusting for income and area deprivation attenuated the OR to 1.73 (95% CI 1.48 to 2.04). Further controlling for baseline health status reduced the OR to 1.45 (95% CI 1.23 to 1.71), although the confidence interval still excluded the null. Inequalities in wealth are strongly associated with psychological distress, over and above other confounding demographic variables and baseline health status. Much, but not all, of that association is confounded by adult socioeconomic position. This suggests that policy measures to improve asset wealth, through savings and home ownership, may have positive health implications and help to reduce health inequalities.
Jeanette M. Sebaeng
Full Text Available Background: Sexual assault poses a serious health problem to both the survivor and the health system. Experiencing sexual assault requires women to seek medical and psychological assistance as part of their journey towards recovery. This study examined the experiences of women who received post-sexual assault services from a specialised care centre within a provincial hospital.Methods: A qualitative, exploratory and contextual design was used to explore and describe experiences of women. Data were obtained through individual in-depth interviews from a total of 18 women aged between 18 and 55 years. Interviews were supplemented by the researcher’s field notes and audiotape recordings.Results: Findings yielded two main themes: Women expressed their lived experiences of sexual assault characterised by different forms of trauma. The second theme was an expression of a need for safety and support.Conclusion: Women who experience sexual assault are left with devastating effects such as physical and psychological harm and social victimisation. There is also a need for safety and support towards the recovery of these women. This study recommends that professional practitioners involved in the management of sexual assault be sensitised regarding the ordeal experienced by women and stop perceiving survivors as crime scene ‘clients’ from whom only medico-legal evidence has to be collected. Professional practitioners and family members must be supportive, non-judgemental and considerate of the dignity of survivors. The establishment of sexual assault response teams (SART is also recommended. There should also be inter-professional education for better coordination of services rendered to sexually assaulted women.
Elaine Hyshka; Jalene Anderson-Baron; Kamagaju Karekezi; Lynne Belle-Isle; Richard Elliott; Bernie Pauly; Carol Strike; Mark Asbridge; Colleen Dell; Keely McBride; Andrew Hathaway; T Cameron Wild
.... We examined the quality of current provincial and territorial harm reduction policies in Canada, relative to how well official documents reflect internationally recognized principles and attributes...
Shibata, Ai; Ishii, Kaori; Oka, Koichiro
Background In the rapidly developing use of the Internet in society, eHealth literacy—having the skills to utilize health information on the Internet—has become an important prerequisite for promoting healthy behavior. However, little is known about whether eHealth literacy is associated with health behavior in a representative sample of adult Internet users. Objective The aim of this study was to examine the association between eHealth literacy and general health behavior (cigarette smoking, physical exercise, alcohol consumption, sleeping hours, eating breakfast, eating between meals, and balanced nutrition) among adult Internet users in Japan. Methods The participants were recruited among registrants of a Japanese Internet research service company and asked to answer a cross-sectional Internet-based survey in 2012. The potential respondents (N=10,178) were randomly and blindly invited via email from the registrants in accordance with the set sample size and other attributes. eHealth literacy was assessed using the Japanese version of the eHealth Literacy Scale. The self-reported health behaviors investigated included never smoking cigarettes, physical exercise, alcohol consumption, sleeping hours, eating breakfast, not eating between meals, and balanced nutrition. We obtained details of sociodemographic attributes (sex, age, marital status, educational attainment, and household income level) and frequency of conducting Internet searches. To determine the association of each health behavior with eHealth literacy, we performed a logistic regression analysis; we adjusted for sociodemographic attributes and frequency of Internet searching as well as for other health behaviors that were statistically significant with respect to eHealth literacy in univariate analyses. Results We analyzed the data of 2115 adults (response rate: 24.04%, 2142/10,178; male: 49.74%, 1052/2115; age: mean 39.7, SD 10.9 years) who responded to the survey. Logistic regression analysis
Rowlands, Ingrid Jean; Loxton, Deborah; Dobson, Annette; Mishra, Gita Devi
Relatively little is known about the extent to which young adults use the Internet as a health information resource and whether there are factors that distinguish between those who do and do not go online for health information. The aim was to identify the sociodemographic, physical, mental, and reproductive health factors associated with young women's use of the Internet for health information. We used data from 17,069 young women aged 18-23 years who participated in the Australian Longitudinal Study on Women's Health. Multivariable logistic regression was used to estimate the association between sociodemographic, physical, mental, and reproductive health factors associated with searching the Internet for health information. Overall, 43.54% (7433/17,069) of women used the Internet for health information. Women who used the Internet had higher odds of regular urinary or bowel symptoms (OR 1.44, 95% CI 1.36-1.54), psychological distress (very high distress: OR 1.24, 95% CI 1.13-1.37), self-reported mental health diagnoses (OR 1.16, 95% CI 1.09-1.23), and menstrual symptoms (OR 1.25, 95% CI 1.15-1.36) than women who did not use the Internet for health information. Internet users were less likely to have had blood pressure checks (OR 0.85, 95% CI 0.78-0.93) and skin cancer checks (OR 0.90, 95% CI 0.84-0.97) and to have had a live birth (OR 0.74, 95% CI 0.64-0.86) or pregnancy loss (OR 0.88, 95% CI 0.79-0.98) than non-Internet users. Women experiencing "stigmatized" conditions or symptoms were more likely to search the Internet for health information. The Internet may be an acceptable resource that offers "anonymized" information or support to young women and this has important implications for health service providers and public health policy.
Stenner, R.D.; Baechler, M.C.
Indoor air quality can be impacted by hundreds of different chemicals. More than 900 different organic compounds alone have been identified in indoor air. Health effects that could arise from exposure to individual pollutants or mixtures of pollutants cover the full range of acute and chronic effects, including largely reversible responses, such as rashes and irritations, to the irreversible toxic and carcinogenic effects. These indoor contaminants are emitted from a large variety of materials and substances that are widespread components of everyday life. Pacific Northwest Laboratory conducted a search of the peer-reviewed literature on health effects associated with indoor air contaminants for the Bonneville Power Administration to aid the agency in the preparation of environmental documents. Results are reported in two volumes. Volume 1 summarizes the results of the search of the peer-reviewed literature on health effects associated with a selected list of indoor air contaminants. In addition, the report discusses potential health effects of polychlorinated biphenyls and chlorofluorocarbons. All references to the literature reviewed are found in this document Volume 2. Volume 2 provides detailed information from the literature reviewed, summarizes potential health effects, reports health hazard ratings, and discusses quantitative estimates of carcinogenic risk in humans and animals. Contaminants discussed in this report are those that; have been measured in the indoor air of a public building; have been measured (significant concentrations) in test situations simulating indoor air quality (as presented in the referenced literature); and have a significant hazard rating. 38 refs., 7 figs., 23 tabs.
Studies have shown that the aquatic environment can be polluted by contaminates that are accumulated by freshwater fish and this may pose a health risk to the consumers of the contaminated fish. Developed counties like the United States of America have developed strategies and associated guidance documentation to ...
The aim of this study was to determine if the fish health assessment index (HAI) developed in the USA and associated parasite index (PI), when applied to Clarias gariepinus at two localities in the upper and middle Vaal River system, could distinguish between localities on the grounds of water quality. Elevated HAI values ...
Terwoert, J.; Ustailieva, E.
This e-fact provides information on the work-related risk factors and the occupational safety and health (OSH) issues associated the planning and construction of green buildings, their maintenance, renovation (retrofitting), demolition, on-site waste collection. Some of these OSH risks are new
... of hospital admission, 3 days of discharge or 30 days of an operation. They affect 1 in 10 patients admitted to hospital. Nosocomial infections are associated with a great deal of morbidity, mortality, and increased financial burden. Keywords: Infections, health problem, morbility, hospitals. Nigerian Medical Journal | Vol.
Urban agriculture has been identified as an important resource for meeting the challenges of rapidly growing cities, such that it serves as a coping mechanism among the poor in the cities. In spite of contributing to livelihood, it also has health and environmental problems associated with it. Therefore, this study investigated ...
Farmers' perceived impacts of agrochemical usage included getting sick, deaths of people and animals and environmental pollution. Information obtained from this study was used to identify appropriate foci and target groups for interventions to reduce the health risks associated with the usage of agrochemicals in the area.
Sabol, Terri J.; Hoyt, Lindsay Till
The current study examines the extent to which participation in preschool at age 4 is associated with blood pressure, body mass index, and awakening cortisol at age 15. We capitalize on data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development to examine differences in adolescent health…
Purpose: To evaluate the association between patient's knowledge of Hepatitis-B and Health Related Quality of Life (HRQoL). Methods: A cross sectional, descriptive study was undertaken with 390 hepatitis-B patients attending two public hospitals in Quetta City, Pakistan. Knowledge of hepatitis-B was assessed using a ...
Swimming exposure to fecally-contaminated oceans and lakes has been associated with an increased risk of gastrointestinal (GI) illness. Although treated and untreated sewage are often discharged to rivers, the health risks of swimming exposure on rivers has been less frequently ...
Smith, Samuel G; Curtis, Laura M; Wardle, Jane; von Wagner, Christian; Wolf, Michael S
There is ongoing debate on whether health literacy represents a skill-based construct for health self-management, or if it also more broadly captures personal 'activation' or motivation to manage health. This research examines 1) the association between patient activation and health literacy as they are most commonly measured and 2) the independent and combined associations of patient activation and health literacy skills with physical and mental health. A secondary analysis of baseline cross-sectional data from the LitCog cohort of older adults was used. Participants (n = 697) were recruited from multiple US-based health centers. During structured face-to-face interviews, participants completed the Test of Functional Health Literacy in Adults (TOFHLA), the Patient Activation Measure (PAM), the SF-36 physical health summary subscale, and Patient Reported Outcomes Measurement Information Service (PROMIS) short form subscales for depression and anxiety. The relationship between health literacy and patient activation was weak, but significant (r = 0.11, pdefinition. Deficits in either construct could be useful targets for behavioral intervention.
Liu, Lige; Brown, Melissa J.; Feldman, Marcus W.
Since the 1990s, inter-provincial female migration for marriage has become important in central and eastern rural China. Using survey data from X County in rural Anhui Province, we explore the arrangement of inter-provincial marriages, as well as the characteristics of husbands and wives, marital satisfaction, and marital stability for these marriages. We find that inter-provincial marriage is an important option for local men to respond to the marriage squeeze and the increasing expense of marriage. It helps to relieve the shortage of marriageable women in the local marriage market. Because this kind of marriage is based on economic exchange, but not affection, it is often subject to a higher risk of marriage instability, and can lead to such illegal behaviors as marriage fraud and mercenary marriage. PMID:26594102
Waller, Michael; McGuire, Annabel C L; Dobson, Annette J
This study assessed the extent to which alcohol consumption in a military group differed from the general population, and how alcohol affected the military group's health and social functioning. A cross sectional survey of military personnel (n = 5311) collected self-reported data on alcohol use (AUDIT scale) and general health, role limitations because of physical health problems (role physical), and social functioning scores (SF36 subscales). Logistic regression was used to compare drinking behaviours between the military sample and a general population sample, using the categories risky drinkers (>2 units per day), low risk drinkers (≤2 standard drinks per day) and abstainers. Groups in the military sample with the highest levels of alcohol misuse (harmful drinking AUDIT ≥ 16, alcohol dependence AUDIT ≥ 20, and binge drinking) were also identified. Linear regression models were then used to assess the association between alcohol misuse and SF36 scores. There were fewer risky drinkers in the military sample than in the general population sample. There were also fewer abstainers, but more people who drank at a lower risk level (≤2 standard drinks per day), than in a sample of the general population. Harmful drinking and alcohol dependence were most commonly observed in men, younger age groups, non-commissioned officers and lower ranks as well as reserve and ex-serving groups. Alcohol misuse was clearly associated with poorer general health scores, more role limitations because of physical health problems, and lower social functioning. Although risky drinking was lower in the military group than in the general population, drinking was associated with poorer health, more limitations because of physical health problems, and poorer social functioning in Defence members. These results highlight the potential benefits for Defence forces in reducing alcohol use among members, in both those groups identified at highest risk, and across the military
De Jesus, Maria; Puleo, Elaine; Shelton, Rachel C; Emmons, Karen M
This study examined the associations between social networks, social support, social cohesion, and perceived neighborhood safety among an ethnically diverse sample of 1352 residents living in 12 low-income public housing sites in Boston, Massachusetts. For males and females, social cohesion was associated with perceived safety. For males, a smaller social network was associated with greater feelings of safety. Social support was not a significant predictor of perceived safety. The findings reported here are useful in exploring a potential pathway through which social environmental factors influence health and in untangling the complex set of variables that may influence perceived safety. Copyright 2010 Elsevier Ltd. All rights reserved.
Sloan, Denise M; Feinstein, Brian A; Marx, Brian P
This study examined the durability of benefits associated with expressive writing. Sixty-eight college undergraduates completed measures of physical and psychological health at the beginning of their first year and were then randomized to either an expressive writing or a control writing condition. Changes in physical health, psychological health (i.e., depression, stress, and anxiety), and academic performance were assessed two, four, and six months later. Findings indicated that participants assigned to the expressive writing condition reported less depression symptom severity at the two-month follow-up assessment relative to participants assigned to the control condition. However, these symptom reductions were not observed at any of the subsequent follow-up assessments. No significant changes were reported for physical health complaints, stress symptoms,anxiety symptoms, or academic performance. These findings suggest that,among first-year college students, expressive writing may provide some shortterm relief for certain symptoms.
Adrian, Molly; Charlesworth-Attie, Sarah; Vander Stoep, Ann; McCauley, Elizabeth; Becker, Linda
The purpose of this study is to estimate the proportion of adolescents meeting Healthy People 2020 health behavior recommendations for the prevention of chronic disease and to determine the association between mental health status (depression and/or conduct problems) and the likelihood of meeting these recommendations. The data used for this study are from the 2010 Washington State Healthy Youth Survey. Descriptive statistics and linear regression were utilized to estimate the proportion of adolescents meeting recommendations and associations between youth mental health status indicators and health-promoting behaviors. A small minority (5.8 %) of youth met all six recommendations in domains of tobacco abstinence, substance use abstinence, daily physical activity, breakfast consumption, weight below obese levels, and adequate sleep, though most (84.3 %) met at least three. At the aggregate level, the proportion of Washington State youth who met Healthy People 2020 guidelines exceeded targets, with the exception of substance use abstinence. A minority of youth reported guideline levels of daily physical activity (23.3 %) and sleep (39.8 %). Mental health status was strongly associated with the number of health-promoting behaviors adolescents endorsed. Interventions to increase the adoption of sleep hygiene and exercise habits should be added to an integrative positive youth development framework within school-, community-, and primary care-based adolescent health initiatives. Attention to adolescent mental health and shared risk factors may be critical for reducing barriers to healthy behavior.
Fleury, Marie-Josée; Grenier, Guy; Bamvita, Jean-Marie; Chiocchio, François
This study investigates work performance among 79 mental health teams in Quebec (Canada). We hypothesized that work performance was positively associated with the use of standardized clinical tools and clinical approaches, integration strategies, "clan culture," and mental health funding per capita. Work performance was measured using an adapted version of the Work Role Questionnaire. Variables were organized into four key areas: (1) team attributes, (2) organizational culture, (3) inter-organizational interactions, and (4) external environment. Work performance was associated with two types of organizational culture (clan and hierarchy) and with two team attributes (use of standardized clinical tools and approaches). This study was innovative in identifying associations between work performance and best practices, justifying their implementation. Recommendations are provided to develop organizational cultures promoting a greater focus on the external environment and integration strategies that strengthen external focus, service effectiveness, and innovation.
Wild, T Cameron; Pauly, Bernie; Belle-Isle, Lynne; Cavalieri, Walter; Elliott, Richard; Strike, Carol; Tupper, Kenneth; Hathaway, Andrew; Dell, Colleen; MacPherson, Donald; Sinclair, Caitlin; Karekezi, Kamagaju; Tan, Benjamin; Hyshka, Elaine
Access to harm reduction interventions among substance users across Canada is highly variable, and largely within the policy jurisdiction of the provinces and territories. This study systematically described variation in policy frameworks guiding harm reduction services among Canadian provinces and territories as part of the first national multimethod case study of harm reduction policy. Systematic and purposive searches identified publicly-accessible policy texts guiding planning and organization of one or more of seven targeted harm reduction services: needle distribution, naloxone, supervised injection/consumption, low-threshold opioid substitution (or maintenance) treatment, buprenorphine/naloxone (suboxone), drug checking, and safer inhalation kits. A corpus of 101 documents written or commissioned by provincial/territorial governments or their regional health authorities from 2000 to 2015 were identified and verified for relevance by a National Reference Committee. Texts were content analyzed using an a priori governance framework assessing managerial roles and functions, structures, interventions endorsed, client characteristics, and environmental variables. Nationally, few (12%) of the documents were written to expressly guide harm reduction services or resources as their primary named purpose; most documents included harm reduction as a component of broader addiction and/or mental health strategies (43%) or blood-borne pathogen strategies (43%). Most documents (72%) identified roles and responsibilities of health service providers, but fewer declared how services would be funded (56%), specified a policy timeline (38%), referenced supporting legislation (26%), or received endorsement from elected members of government (16%). Nonspecific references to 'harm reduction' appeared an average of 12.8 times per document-far more frequently than references to specific harm reduction interventions (needle distribution=4.6 times/document; supervised injection
Full Text Available This study aims to analyze the relationship remained the state with the provincial towns of Buenos Aires during the first years of Peronism, which was introduced as a particular feature of progressive intervention of the provincial government on communal administrations. This trend helped the formation of a centralized state that was characterized, among other things, limit the autonomy of municipal governments. Also this method was accompanied by a devaluation of the growing political role of the mayors, to benefit other areas of the state apparatus and the party itself, and its conversion into a single functionary.
A major deflection from the exponential growth patterns seen hitherto can be anticipated only once all or most of the highly populated provinces have traversed their respective points of inflection. Directorate: Health Systems Research, Department ofHealth, Pretoria. J P Swanevelder, BComm, BSc Hons, MSc. H G V Kiistner ...
Parker, Eleanor J; Jamieson, Lisa M
To determine oral health literacy (REALD-30) and oral health literacy-related outcome associations, and to calculate if oral health literacy-related outcomes are risk indicators for poor self-reported oral health among rural-dwelling Indigenous Australians. 468 participants (aged 17-72 years, 63% female) completed a self-report questionnaire. REALD-30 and oral health literacy-related outcome associations were determined through bivariate analysis. Multivariate modelling was used to calculate risk indicators for poor self-reported oral health. REALD-30 scores were lower among those who believed teeth should be infrequently brushed, believed cordial was good for teeth, did not own a toothbrush or owned a toothbrush but brushed irregularly. Tooth removal risk indicators included being older, problem-based dental attendance and believing cordial was good for teeth. Poor self-rated oral health risk indicators included being older, healthcare card ownership, difficulty paying dental bills, problem-based dental attendance, believing teeth should be brushed infrequently and irregular brushing. Perceived need for dental care risk indicators included being female and problem-based dental attendance. Perceived gum disease risk indicators included being older and irregular brushing. Feeling uncomfortable about oro-facial appearance risk indicators included problem-based dental attendance and irregular brushing. Food avoidance risk indicators were being female, difficulty paying dental bills, problem-based dental attendance and irregular brushing. Poor oral health-related quality of life risk indicators included difficulty paying dental bills and problem-based dental attendance. REALD-30 was significantly associated with oral health literacy-related outcomes. Oral health literacy-related outcomes were risk indicators for each of the poor self-reported oral health domains among this marginalised population.
Jamieson Lisa M
Full Text Available Abstract Objectives To determine oral health literacy (REALD-30 and oral health literacy-related outcome associations, and to calculate if oral health literacy-related outcomes are risk indicators for poor self-reported oral health among rural-dwelling Indigenous Australians. Methods 468 participants (aged 17-72 years, 63% female completed a self-report questionnaire. REALD-30 and oral health literacy-related outcome associations were determined through bivariate analysis. Multivariate modelling was used to calculate risk indicators for poor self-reported oral health. Results REALD-30 scores were lower among those who believed teeth should be infrequently brushed, believed cordial was good for teeth, did not own a toothbrush or owned a toothbrush but brushed irregularly. Tooth removal risk indicators included being older, problem-based dental attendance and believing cordial was good for teeth. Poor self-rated oral health risk indicators included being older, healthcare card ownership, difficulty paying dental bills, problem-based dental attendance, believing teeth should be brushed infrequently and irregular brushing. Perceived need for dental care risk indicators included being female and problem-based dental attendance. Perceived gum disease risk indicators included being older and irregular brushing. Feeling uncomfortable about oro-facial appearance risk indicators included problem-based dental attendance and irregular brushing. Food avoidance risk indicators were being female, difficulty paying dental bills, problem-based dental attendance and irregular brushing. Poor oral health-related quality of life risk indicators included difficulty paying dental bills and problem-based dental attendance. Conclusions REALD-30 was significantly associated with oral health literacy-related outcomes. Oral health literacy-related outcomes were risk indicators for each of the poor self-reported oral health domains among this marginalised population.
Turley, Marianne; Garrido, Terhilda; Lowenthal, Alex; Zhou, Yi Yvonne
To examine the association between patient loyalty, as measured by member retention in the health plan, and access to My Health Manager (MHM), Kaiser Permanente's PHR, which is linked to its electronic health record, KP HealthConnect. We conducted a retrospective cohort observational quality improvement project from the third quarter of 2005 to the fourth quarter of 2008 for approximately 394,000 Kaiser Permanente Northwest members. To control for self-selection bias, we used propensity scores to perform exact 1-to-1 matching without replacement between MHM users and nonusers. We estimated retention rates of the matched data and assessed the association between MHM use and retention versus voluntary termination. We also estimated odds ratios of significant variables impacting member retention. The probability of remaining a member or being involuntarily terminated versus voluntary termination was 96.7% for users (95% confidence interval [CI], 96.6%-96.7%) and 92.2% for nonusers (95% CI, 92.1%-92.4%; P <.001). In the logistic model, MHM use was a significant predictor; only tenure and illness burden were stronger predictors. Users were 2.578 (95% CI, 2.487%-2.671%) times more likely to choose to remain members than were nonusers. The impact was more substantial among newer members. MHM use was significantly associated with voluntary membership retention. An indicator of patient loyalty, retention is critical to healthcare organizations.
Buden, Jennifer C; Dugan, Alicia G; Faghri, Pouran D; Huedo-Medina, Tania B; Namazi, Sara; Cherniack, Martin G
Correctional employees exhibit elevated obesity rates. This study examines interrelations among health behaviors, health climate, body mass index (BMI), and work schedule. Using survey results from correctional supervisors (n = 157), mediation and moderated-mediation analyses were performed to examine how health behaviors explain relationships between obesity, work health climate (WHC) and family health climate (FHC), and work schedule. Over 85% of the sample was overweight/obese (mean BMI = 30.20). Higher WHC and FHC were associated with lower BMI, mediated by nutrition, and physical activity. The interaction effect between health behavior and work schedule revealed a protective effect on BMI. Overtime shift work may share a relationship with BMI. Findings may have implications for reexamining organizational policies on maximum weekly overtime in corrections. They provide direction for targeted obesity interventions that encourage a supportive FHC and promote healthy behaviors among supervisors working overtime.
Yu, J; Wang, S; Yu, X
Chronic health problems are prevalent in China and may lead to loss of work productivity through presenteeism. To investigate the prevalence of potential risk factors for presenteeism in Chinese workers and the strength of their association with reported presenteeism. A cross-sectional survey of employees in a Chinese petrochemical corporation included a medical examination report and questionnaire data on demographic characteristics, potential risk factors for presenteeism and presenteeism evaluation. Data were analysed using Pearson's chi-square tests, t-tests and logistic regression modelling. There were 1506 responses available for analysis; response rate 92%. The prevalence of presenteeism was 15%. Univariate analysis indicated a significantly higher prevalence of presenteeism in employees who were male, age ≤35 years, single, divorced or widowed and overweight or obese. Higher presenteeism was found in participants with high blood pressure, hypertriglyceridemia, hypercholesterolemia, insufficient physical activity, cigarette smoking, alcohol use, insufficient cereal intake, life dissatisfaction and job dissatisfaction. The prevalence of presenteeism was significantly associated with the number of potential risk factors. Logistic regression disclosed six independent risk factors associated with presenteeism: hypercholesterolemia, high blood pressure, insufficient physical activity, alcohol drinking, insufficient cereal intake and life dissatisfaction. Chronic conditions, health risk factors and presenteeism were prevalent in employees of a Chinese petrochemical corporation. Risk factors for other health conditions were associated with presenteeism. Health management programmes should be implemented to reduce risk factors and promote the health of employees in an effort to reduce presenteeism. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: email@example.com.
Strazdins, Erika; Nie, Yu Feng; Ramli, Raziqah; Palesy, Tom; Christensen, Jenna M; Marcells, George Nicholas; Harvey, Richard John
Mental health issues are thought to be overrepresented among patients undergoing rhinoplasty and may be associated with patient presentation prior to surgery. To assess the association of poor mental health with perception of nasal function. A cross-sectional study of patients presenting for airway assessment was performed from December 1, 2011, to October 31, 2015, at 2 tertiary rhinoplasty centers in Sydney, Australia. Mental health was independently defined preoperatively by the Mental Component Summary of the 36-item Short Form Health Survey version 2 (a score of Scale (a score of 11 indicated above-average dysmorphic concerns). Nasal function was assessed with patient-reported outcome measures, including the Nasal Obstruction Symptom Evaluation Scale, the 22-item Sinonasal Outcome Test, a visual analog scale to rate ease of breathing on the left and right sides, and Likert scales to assess overall function and nasal obstruction. Nasal airflow was assessed by nasal peak inspiratory flow, nasal airway resistance, and minimum cross-sectional area. Among 495 patients in the study (302 women and 193 men; mean [SD] age, 36.5 [13.6] years), compared with patients with good mental health, those with poor mental health had poorer scores in all patient-reported outcome measures, including the visual analog scale for the left side (mean [SD], 51  vs 42 ; P = .001), visual analog scale for the right side (mean [SD], 54  vs 45 ; P Scale (mean [SD], 2.64 [0.95] vs 1.96 [1.04]; P perception of nasal function compared with those who are mentally healthy with clinically similar nasal airflow. Clinicians should be aware that patients with poor mental health reporting obstructed airflow may in part be representing an extension of their negative emotions rather than true obstruction and may require further assessment prior to surgery. NA.
Hensel, Devon J; Nance, Jennifer; Fortenberry, J Dennis
Developmental models link sexual well-being to physical, mental/emotional, and social well-being, yet little empirical literature evaluates these relationships in adolescents. Better understanding of how and when sexuality complements other aspects of health may yield important points to enhance existing health education and prevention efforts. Data were drawn from a 10-year longitudinal cohort study of sexual relationships and sexual behavior among adolescent women (N = 387; 14-17 years at enrollment). Sexual health data were drawn from quarterly partner-specific interviews and were linked to physical, mental/emotional, and social health information in annual questionnaires. Random intercept, mixed effects linear, ordinal logistic, or binary logistic regression were used to estimate the influence of sexual health on health and well-being outcomes (Stata, v.23, StataCorp, College Station, TX). All models controlled for participant age and race/ethnicity. Higher sexual health was significantly associated with less frequent nicotine and substance use, lower self-reported depression, lower thrill seeking, higher self-esteem, having fewer friends who use substances, higher religiosity, better social integration, lower frequency of delinquent behavior and crime, and more frequent community group membership. Sexual health was not associated with the number of friends who used cigarettes. Positive sexually related experiences in romantic relationships during adolescence may complement physical, mental/emotional, and social health. Addressing specific aspects of healthy sexual development during clinical encounters could dually help primary prevention and health education address other common adolescent health issues. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Full Text Available To explore the association between health literacy and levels of three types of core activities among health promotion volunteers (developing a healthy lifestyle, outreach to family, and outreach to community members.A cross-sectional, anonymous, self-administered postal survey of registered health promotion volunteers in the Konan area in Shiga Prefecture in Japan, conducted in January 2010. The study sample was 575 registered health promotion volunteers.The survey collected data on health literacy, gender, age, education, self-rated health, perceptions about the volunteer organization, and perceptions of recognition in the community. The level of engagement in health promotion activities was measured by the extent to which the participants engaged in seven healthy behaviors and promoted them to family members and the community. The authors compared the health literacy level and other characteristics of the participants by core health promotion activities, using a chi-squared test, to examine the associations between demographic and other variables and the three core activities (healthy lifestyle, outreach to family, and outreach to community.Logistic regression analysis was conducted to examine the association between the degree to which the volunteers engaged in core activities ("healthy lifestyle," "outreach to family," "outreach to community" and the levels of health literacy (low, medium, high among health promotion volunteers, controlling for the effects of age, gender, health condition, education which may also have an impact on volunteers' outreach activities.Four hundred and fifty-four questionnaires were returned, a 79.0% response rate. Excluding 16 cases with missing values on health literacy or the degree of health promotion activities, 438 research subjects were included in the analysis (valid response rate: 76.2%. Health literacy and a few demographic and other characteristics of the volunteers were associated with the three core
Walker, Lorraine O; Xie, Bo; Hendrickson, Sherry G; Sterling, Bobbie S
To test the association of behavioral and psychosocial health domains with contextual variables and perceived health in ethnically and economically diverse postpartum women. Mail survey of a stratified random sample. Southwestern community in Texas. Non-Hispanic White, African American, and Hispanic women (N = 168). A questionnaire was sent to a sample of 600 women. The adjusted response rate was 32.8%. The questionnaire covered behavioral (diet, physical activity, smoking, and alcohol use) and psychosocial (depression symptoms and body image) health, contextual variables (race/ethnicity, income, perceived stress, and social support), and perceived health. Hypotheses were tested using linear and logistic regression. Body image, dietary behaviors, physical activity behaviors, and depression symptoms were all significantly correlated (Spearman ρ = -.15 to .47). Higher income was associated with increased odds of higher alcohol use (more than 1 drink on 1 to 4 days in a 14-day period). African American ethnicity was correlated with less healthy dietary behaviors and Hispanic ethnicity with less physical activity. In multivariable regressions, perceived stress was associated with less healthy dietary behaviors, increased odds of depression, and decreased odds of higher alcohol use, whereas social support was associated with less body image dissatisfaction, more physical activity, and decreased odds of depression. All behavioral and psychosocial domains were significantly correlated with perceived health, with higher alcohol use related to more favorable perceived health. In regressions analyses, perceived stress was a significant contextual predictor of perceived health. Stress and social support had more consistent relationships to behavioral and psychosocial variables than race/ethnicity and income level. Copyright © 2016 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.
Komenaka, Ian K; Nodora, Jesse N; Hsu, Chiu-Hsieh; Martinez, Maria Elena; Gandhi, Sonal G; Bouton, Marcia E; Klemens, Anne E; Wikholm, Lauren I; Weiss, Barry D
To investigate the relationship of health literacy and screening mammography. All patients seen at a breast clinic underwent prospective assessment of health literacy from January 2010 to April 2013. All women at least 40 years of age were included. Men and women diagnosed with breast cancer before age 40 years were excluded. Routine health literacy assessment was performed using the Newest Vital Sign. Demographic data were also collected. Medical records were reviewed to determine if patients had undergone screening mammography: women aged 40-49 years were considered to have undergone screening if they had another mammogram within 2 years. Women 50 years or older were considered to have undergone screening mammography if they had another mammogram within 1 year. A total of 1,664 consecutive patients aged 40 years or older were seen. No patient declined the health literacy assessment. Only 516 (31%) patients had undergone screening mammography. Logistic regression analysis that included ethnicity, language, education, smoking status, insurance status, employment, income, and family history found that only three factors were associated with not obtaining a mammogram: low health literacy (odds ratio [OR] 0.27, 95% confidence interval [CI] 0.19-0.37; P<.001), smoking (OR 0.64, 95% CI 0.47-0.85; P=.002), and being uninsured (OR 0.66, 95% CI 0.51-0.85; P=.001). Of all the sociodemographic variables examined, health literacy had the strongest relationship with use of screening mammography.
Lämmle, Lena; Woll, Alexander; Mensink, Gert B. M.; Bös, Klaus
Objective: The aim of the present paper was to analyze factors affecting distal and proximal health behavior within a biopsychosocial model for examining their interactions and associations with respect to health. Methods: Path analysis was based on the nationwide, cross-sectional German Health Interview and Examination Survey for Children and Adolescents (2003 to 2006). The data was collected from 4,529 participants with an average age of 9.45 years (SD = 4.01). Socio-demographic data, psychosocial factors and health behavior were assessed via questionnaire. Participants also underwent physical fitness tests and a medical examination. Results: Over the five levels of the model analyzed with socioeconomic status, immigration background, and rural-urban differences on the first level; physical activity of relatives and peers, intrinsic motivation, and quality of life on the second level; eating patterns, sedentary behavior, and physical activity on the third level; physical fitness and objective health on the fourth level; and health complaints and subjective health on the fifth level; direct, moderation, and mediation effects could be shown. Conclusions: Several distal and proximal factors are needed to take account of the multivariate complexity of health: e.g., immigration background affected health behaviors only indirectly and the effect of physical activity on objective health was mediated by physical fitness. PMID:23863614
Full Text Available Abstract Background Amount of sleep is an important indicator of health and well-being in children and adolescents. Adequate sleep (AS: adequate sleep is defined as 6–8 hours per night regularly is a critical factor in adolescent health and health-related behaviors. The present study was based on a health promotion project previously conducted on adolescents in Tao-Yuan County, Taiwan. The aim was to examine the relationship between AS during schooldays and excessive body weight, frequency of visiting doctors and health-related behaviors among Taiwanese adolescents. Methods A cross-sectional study design, categorical and multivariate data analyses were used. The hypotheses investigated were: high frequency of AS is positively associated with lack of obesity and less frequent visits to doctors; and high frequency AS is positively associated with health-related behavior. Results A total of 656 boys (53.2% and girls (46.8%, ranging in age from 13–18 years were studied between January and June 2004. Three hundred and fifty seven subjects (54% reported that they slept less than the suggested 6–8 hours on schooldays. A significant negative association was found between low sleep and of the following health-related behaviors: (1 life appreciation; (2 taking responsibility for health; (3 adopting healthy diet; (4 effective stress management; (5 regular exercise; and (6 total AHP score. High frequency AS was associated with low frequencies of obesity after potential confounding factors were controlled. Junior high school adolescents reported significantly higher frequencies of AS than high school participants. Gender, family structure, home location and frequency of television watching or computer use were not significantly associated with AS. Conclusion These findings support the proposition that AS is associated with good health status and high-frequency adoption of health-related behavior. Furthermore, these findings suggest that inadequate
Hall, Martica H; Mulukutla, Suresh; Kline, Christopher E; Samuelsson, Laura B; Taylor, Briana J; Thayer, Julian F; Krafty, Robert T; Frank, Ellen; Kupfer, David J
The mechanisms linking short sleep duration to cardiovascular disease (CVD) are poorly understood. Emerging evidence suggests that endothelial dysregulation may lie along the causal pathway linking sleep duration to cardiovascular risk, although current evidence in humans is based on cross-sectional studies. Our objective was to evaluate the prospective association between objectively assessed sleep duration and clinical indices of endothelial health. A total of 141 medically healthy adults underwent an overnight laboratory sleep study when they were between the ages of 21 and 60 years. Total sleep time was objectively assessed by polysomnography at study entry. Endothelial health, including brachial artery diameter (BAD) and flow-mediated dilation (FMD), was measured 18.9 ± 4.6 years later. Medical health and psychiatric status were assessed at both time points. Approximately half of the sample had a lifetime history of major depressive disorder. In univariate analyses, shorter sleep duration was associated with increased BAD (β = -0.24, p = .004) and decreased FMD (β = 0.17, p = .042). BAD, but not FMD, remained significantly associated with sleep duration after adjusting for sex, age, body mass index (BMI), smoking, diabetes, hypertension, and lifetime history of major depressive disorder (MDD) at T2. The association between sleep duration and BAD was stronger than the association between BAD and an aggregate measure of CVD risk including three or more of the following risk factors: male sex, age ≥ 65 years, smoker, BMI ≥ 30, diabetes, hypertension, and MDD. Objectively assessed short sleep duration was prospectively associated with increased BAD over a 12- to 30-year period.
Full Text Available During the last decade in Argentina, the growth of open pit mining has faced strong social resistance and provincial laws prohibiting such activity. This work aims to analyse the ways in which the different subnational political regimes and economic systems impact upon the possibility of incidence of social resistance on provincial mining legislation, looking at the cases of Cordoba and Catamarca.
Araújo, Márcio Flávio Moura de; Freitas, Roberto Wagner Júnior Freire de; Lima, Adman Câmara Soares; Pereira, Dayse Christina Rodrigues; Zanetti, Maria Lúcia; Damasceno, Marta Maria Coelho
To associate the sleep quality of Brazilian undergraduate students with health indicators. A cross-sectional study was developed with a random sample of 662 undergraduate students from Fortaleza, Brazil. The demographic data, Pittsburgh Sleep Quality Index and health data indicators (smoking, alcoholism, sedentary lifestyle, nutritional condition and serum cholesterol) were collected through a self-administered questionnaire. Blood was collected at a clinical laboratory. In order to estimate the size of the associations, a Poisson Regression was used. For students who are daily smokers, the occurrence of poor sleep was higher than in non-smokers (prate values were nevertheless close to 1. The likelihood of poor sleep is almost the same in smokers and in alcoholics.
Márcio Flávio Moura de Araújo
Full Text Available Objective To associate the sleep quality of Brazilian undergraduate students with health indicators. Method A cross-sectional study was developed with a random sample of 662 undergraduate students from Fortaleza, Brazil. The demographic data, Pittsburgh Sleep Quality Index and health data indicators (smoking, alcoholism, sedentary lifestyle, nutritional condition and serum cholesterol were collected through a self-administered questionnaire. Blood was collected at a clinical laboratory. In order to estimate the size of the associations, a Poisson Regression was used. Results For students who are daily smokers, the occurrence of poor sleep was higher than in non-smokers (p<0.001. Prevalence rate values were nevertheless close to 1. Conclusion The likelihood of poor sleep is almost the same in smokers and in alcoholics.
Márcio Flávio Moura de Araújo
Full Text Available Objective To associate the sleep quality of Brazilian undergraduate students with health indicators. Method A cross-sectional study was developed with a random sample of 662 undergraduate students from Fortaleza, Brazil. The demographic data, Pittsburgh Sleep Quality Index and health data indicators (smoking, alcoholism, sedentary lifestyle, nutritional condition and serum cholesterol were collected through a self-administered questionnaire. Blood was collected at a clinical laboratory. In order to estimate the size of the associations, a Poisson Regression was used. Results For students who are daily smokers, the occurrence of poor sleep was higher than in non-smokers (p<0.001. Prevalence rate values were nevertheless close to 1. Conclusion The likelihood of poor sleep is almost the same in smokers and in alcoholics.
Nania Mohamed Pakkir Maideen
Full Text Available Introduction: Millions of Muslims across the world observe Islamic fasting during the holy month of Ramadan, as well as the other specific dates in the lunar calendar year. While fasting during this month, Muslims refrain from eating or drinking from dawn to dusk. Islamic fasting is similar to alternate day fasting (ADF since it incorporates an average of 12 hours of fasting and 12 hours of feasting periods. This present review study is aimed to find out the common adverse health effects associated with Islamic fasting and the preventive measures to be followed to avoid them. Methods: The literature was reviewed through searching in databases such as PubMed, Google Scholar, and reference lists to identify the related articles. Results: Many health benefits have been attributed to Islamic fasting, including the reduced risk of cardiovascular diseases, diabetes, cancer, hypertension, and asthma. On the other hand, some studies have mentioned a few health problems associated with Islamic fasting, such as headaches, heartburn, constipation, dehydration, decreased sleep quality, and anemia, which may occur in some fasting individuals during Ramadan. Conclusion: Islamic fasting could be beneficial for health if it is performed correctly. During Ramadan, fasting individuals are advised to adhere to a balanced diet that contains sufficient portions of fruits and vegetables, whole grains, pulses, meat, fish, milk, and dairy products. Moreover, fasting individuals must drink adequate fluids, such as water, fresh fruit juices, and soups, in order to prevent the possible adverse health effects associated with Islamic fasting.
Salazar, Christian R.; Francois, Fritz; Corby, Patricia; Hays, Rosemary; Leung, Celine; Bedi, Sukhleen; Segers, Stephanie; Queiroz, Erica; Sun, Jinghua; Wang, Beverly; Ho, Hao; Craig, Ronald; Cruz, Gustavo D.; Blaser, Martin J.; Perez-Perez, Guillermo; Hayes, Richard B.; Dasanayake, Ananda; Pei, Zhiheng; Chen, Yu
Although recent studies have suggested that tooth loss is positively related to the risk of gastric non-cardia cancer, the underlying oral health conditions potentially responsible for the association remain unknown. We investigated whether clinical and behavioral measures of oral health are associated with the risk of gastric precancerous lesions. We conducted a cross-sectional study of 131 patients undergoing upper gastrointestinal endoscopy. Cases were defined as those with gastric precancerous lesions including intestinal metaplasia or chronic atrophic gastritis on the basis of standard biopsy review. A validated structured questionnaire was administered to obtain information on oral health behaviors. A comprehensive clinical oral health examination was performed on a subset of 91 patients to evaluate for periodontal disease and dental caries experience. A total of 41 (31%) cases of gastric precancerous lesions were identified. Compared with non-cases, cases were significantly more likely to not floss their teeth [odds ratio (OR) = 2.89, 95% confidence interval (CI): 1.09–7.64], adjusting for age, sex, race, body mass index, smoking status, educational attainment and Helicobacter pylori status in serum. Among participants who completed the oral examination, cases (n = 28) were more likely to have a higher percentage of sites with gingival bleeding than non-cases [OR = 2.63, 95% CI: 1.37–5.05 for a standard deviation increase in bleeding sites (equivalent to 19.7%)], independent of potential confounders. Our findings demonstrate that specific oral health conditions and behaviors such as gingival bleeding and tooth flossing are associated with gastric precancerous lesions. PMID:22139442
Kovaleva, Julia; Degener, John E.; van der Mei, Henny C.
Methylobacterium species are a cause of health care-associated infection, including infections in immunocompromised hosts. The ability of Methylobacterium species to form biofilms and to develop resistance to high temperatures, drying, and disinfecting agents may explain the colonization of Methylobacterium in the hospital environment in, e. g., endoscopes. Due to its slow growth, it can be easily missed during microbiological surveillance of endoscope reprocessing. The purpose of this minire...
Nassiri Koopaei, Nasser; Abdollahi, Mohammad
The overwhelming population growth in recent decades and water crisis along with limited and uneven geographical distribution of fresh water resources is a growing challenge for the economic and human development. Wastewater reclamation and use could be an alternative for intact water sources and a promising solution to water scarcity and unequal distribution. However, wastewater is a double-edged resource both as an accessible water source for food production and human usage and concurrently may carry uncharacterized content with unknown toxicological profile causing acute or long-term health risks. Pharmaceuticals, cosmeceuticals, nanomaterials and their chemical decomposition derivatives found in wastewater are not well known in many cases. Their unknown toxicity, teratogenicity and carcinogenicity profile associated with lack of monitoring and control measures impose a significant hazard risk on the public health. This paper reviews the evidence on the health risks associated with the wastewater use for irrigated food production and the imposed risk on the end consumers mainly from pharmaceutical industry and related research facilities. Then, we suggest an applied framework for planning and policy-making to mitigate the health risks and optimally employ reclaimed wastewater for human purposes.
Jimmy, David H; Sundufu, Abu J; Malanoski, Anthony P; Jacobsen, Kathryn H; Ansumana, Rashid; Leski, Tomasz A; Bangura, Umaru; Bockarie, Alfred S; Tejan, Edries; Lin, Baochuan; Stenger, David A
Human health depends on reliable access to safe drinking water, but in many developing countries only a limited number of wells and boreholes are available. Many of these water resources are contaminated with biological or chemical pollutants. The goal of this study was to examine water access and quality in urban Bo, Sierra Leone. A health census and community mapping project in one neighborhood in Bo identified the 36 water sources used by the community. A water sample was taken from each water source and tested for a variety of microbiological and physicochemical substances. Only 38.9% of the water sources met World Health Organization (WHO) microbial safety requirements based on fecal coliform levels. Physiochemical analysis indicated that the majority (91.7%) of the water sources met the requirements set by the WHO. In combination, 25% of these water resources met safe drinking water criteria. No variables associated with wells were statistically significant predictors of contamination. This study indicated that fecal contamination is the greatest health risk associated with drinking water. There is a need to raise hygiene awareness and implement inexpensive methods to reduce fecal contamination and improve drinking water safety in Bo, Sierra Leone.
Studnicki, James; Gipson, Linda S; Berndt, Donald J; Fisher, John W; Callandar, Matthew; Pracht, Etienne; Langland-Orban, Barbara
Locally generated special healthcare taxes are an important component of community infrastructure, but their impact on the health status of populations has not been systematically addressed. Florida counties were segmented on the basis of the use/nonuse of locally generated tax dollars for health care during the 1992-1996 period and analyzed in 2004. Linear mixed-effects regression analysis was used to test a model in which taxing behavior served as the primary predictor variable for total age-adjusted and selected cause-specific mortality. Race/ethnicity, rurality, poverty, access to a public hospital, and physician availability were controlled. Local taxation was associated with lower total age-adjusted mortality, and lower mortality for the major causes of death, except stroke, when compared to the state mean. Local taxation is protective relative to total age-adjusted mortality (odds ratio [OR]=0.63, 95% confidence interval [CI]=0.40-0.98) and age-adjusted mortality from chronic obstructive lung disease (OR=0.50, CI=0.32-0.79), cancers (OR=0.53, CI=0.34-0.084), and intentional injury (OR=0.50, CI=0.38-0.92). Locally generated tax revenues used for the provision of healthcare services are consistently associated with improved health outcomes of major public health importance. The means by which this advantage is achieved will require additional research.
Basu, R.; Gavin, L.; Pearson, D.; Malig, B. J.; Ebisu, K.
Background: The association between temperature and morbidity from some specific causes has been well established. However, the association between temperature and mental health effects has not been examined closely, although those with mental illnesses may be susceptible to temperature. Methods: We obtained daily counts of emergency room visits and hospitalizations (ICD-9 codes) from the California Office of Statewide Health Planning and Development from 16 California climate zones from 2005 - 2013. Mean apparent temperature was determined by combining monitored temperature and humidity data from the US EPA, California Irrigation Management Information System, and the National Oceanic Atmospheric Administration and weighting monitor values by distance to zip code tabulation areas (ZCTA) and ZCTA populations in the same climate zone as each monitor. We used a two-stage hierarchical model to analyze this data, adjusted by the following independent variables: mean daily apparent temperature, holiday, day of the week, and a natural spline smoothing function of time. The regression was performed for both warm (5/1 - 10/31) and cold (11/1 - 4/30) seasons. Results were stratified by race/ethnicity and age group. Results: We observed an association between same-day mean apparent temperature and mental health outcomes during the warm and cold seasons. We also observed associations between temperature and suicide/self-injury and homicide/assault injury. A 10°F increase in mean apparent temperature was associated with a 4.98% [95% confidence interval, 3.73-6.23], 5.82% [4.34-7.30], and 7.43% [6.75-8.12], increase in mental health events, suicide, and homicide events during the warm season, respectively. Similar results were observed during the cold season. Effect modification by race/ethnic and age groups was observed for some outcomes for both seasons. Conclusions: Increase in mean apparent temperature was found to have same-day associations with several mental health
Bax, C.A. & Jagtman, H.M.
This study investigates what information provinces use in decision-making about the construction of infrastructural road safety measures on provincial 80km/h roads. The following questions are answered in this study: ? Do provinces use general information about costs and effects, and specific
The aim of the study was to identify the most preferred post-match recovery methods utilized by U19 and U21 provincial rugby union players (n=97; Mean age: ± 20.2 years) in Gauteng Province of South Africa. Questionnaire-based data were collected from a purposive sample size of 97 rugby players. The findings ...
Burnett, Kristin; Skinner, Kelly; Hay, Travis; LeBlanc, Joseph; Chambers, Lori
This paper looks at the market food environments of First Nations communities located in the provincial Norths by examining the potential retail competition faced by the North West Company (NWC) and by reporting on the grocery shopping experiences of people living in northern Canada. We employed two methodological approaches to assess northern retail food environments. First, we mapped food retailers in the North to examine the breadth of retail competition in the provincial Norths, focussing specifically on those communities without year-round road access. Second, we surveyed people living in communities in northern Canada about their retail and shopping experiences. Fifty-four percent of communities in the provincial Norths and Far North without year-round road access did not have a grocery store that competed with the NWC. The provinces with the highest percentage of northern communities without retail competition were Ontario (87%), Saskatchewan (83%) and Manitoba (72%). Respondents to the survey (n = 92) expressed concern about their shopping experiences in three main areas: the cost of food, food quality and freshness, and availability of specific foods. There is limited retail competition in the provincial Norths. In Manitoba, Saskatchewan and Ontario, the NWC has no store competition in at least 70% of northern communities. Consumers living in northern Canada find it difficult to afford nutritious foods and would like access to a wider selection of perishable foods in good condition.
Bukin, V. P.
A survey conducted in two provincial areas of Russia provides the basis for an examination of the relation between the self-identification and the social status affiliation of young people. Self-assessments serve as the basis for a model of the social structure and a typology of the younger generation in these regions, in accordance with their…
Vanderloo, Leigh M; Tucker, Patricia; Ismail, Ali; van Zandvroort, Melissa M
Preschoolers spend a substantial portion of their day in childcare; therefore, these centers are an ideal venue to encourage healthy active behaviors. It is important that provinces'/territories' childcare legislation encourage physical activity (PA) opportunities. The purpose of this study was to review Canadian provincial/territorial childcare legislation regarding PA participation. Specifically, this review sought to 1) appraise each provincial/territorial childcare regulation for PA requirements, 2) compare such regulations with the NASPE PA guidelines, and 3) appraise these regulations regarding PA infrastructure. A review of all provincial/territorial childcare legislation was performed. Each document was reviewed separately by 2 researchers, and the PA regulations were coded and summarized. The specific provincial/territorial PA requirements (eg, type/frequency of activity) were compared with the NASPE guidelines. PA legislation for Canadian childcare facilities varies greatly. Eight of the thirteen provinces/territories provide PA recommendations; however, none provided specific time requirements for daily PA. All provinces/territories did require access to an outdoor play space. All Canadian provinces/territories lack specific PA guidelines for childcare facilities. The development, implementation, and enforcement of national PA legislation for childcare facilities may aid in tackling the childhood obesity epidemic and assist childcare staff in supporting and encouraging PA participation.
This article focuses on the physical composition of the Eastern Indonesian provincial town of Kupang, a town thought to be characterized by interethnic tensions. I examine the assumption that social segmentation is explainable in terms of ethnicity. In order to show that ethnicity not the sole
Linden, van der J.; Poelmans, W.
Since 1987 the distribution of many plant species in the central and eastern parts of the province Noord-Brabant has been mapped for country use planning by the Provincial Authorities. Distribution maps (with a 5 x 5 km² grid) of the Potamogeton (broad-leaved pondweed) species, which are important
Leydesdorff, L.; Perevodchikov, E.; Uvarov, A.
We measure synergy for the Russian national, provincial, and regional innovation systems as reduction of uncertainty using mutual information among the 3 distributions of firm sizes, technological knowledge bases of firms, and geographical locations. Half a million units of data at firm level in
José Luis Merlo Fuertes
Full Text Available This article will analyze the urban plans of those municipalities in the Province of Valencia that embraced the technical assistance given by the Provincial Council for the planning composition, at the time of Luis Albert Ballesteros, the provincial council architect. Those first urban plans of the Provincial Council make up a homogeneous set of documents since they respond to a unique style of urban planning that varies as much as the original core of the population does. The common element is the ground plan centrality that would be highlighted by an area or a protected green zone that will somehow link to the urban proposals connected to the city-garden model by Howard. Commencement of which began at a time characterized mainly by the co-existence of a great diversity of laws and percepts, making it so that the meaning of the term urban planning could be applied in a variety of ways. The urban plans of the Provincial Council represent the latest inheritance of the extension models and interior remodeling. In the transition to the Land Planning Act (Ley de Suelo of 1956, these plans have the interest in being, in addition to the last examples of the so-called urbanism in the municipal tradition, one of the ancestors of the current master plans of urban development (plan general de ordenación urbana.
After the fall of Soeharto in 1998, and an increased connection to the global world, politics at the local level in Indonesia have changed significantly. This has contributed to a change in how business is conducted in provincial towns. This thesis explores the changing relationship between the
Chemistry 300. Administration Manual for Supervising Teachers, Provincial Examination, Answer Key--Multiple-Choice and Written-Answer Questions, and Provincial Summary Report = Chimie 300. Guide d'administration a l'intention des surveillants d'examen, Examen provincial, Cle de correction--Questions choix multiple et Questions responses ouvertes, et Rapport sommaire provincial.
Manitoba Dept. of Education and Training, Winnipeg.
This collection of manuals contains the Manitoba Provincial Chemistry Examination for students seeking credit in Senior 4 Chemistry (Chemistry 300) and instructions for its use and grading. The examination is based on the Core Topics of the Senior 4 Chemistry course and accounts for 30% of the student's final grade in the course. The examination…
Full Text Available Introduction: This paper looks at the market food environments of First Nations communities located in the provincial Norths by examining the potential retail competition faced by the North West Company (NWC and by reporting on the grocery shopping experiences of people living in northern Canada. Methods: We employed two methodological approaches to assess northern retail food environments. First, we mapped food retailers in the North to examine the breadth of retail competition in the provincial Norths, focussing specifically on those communities without year-round road access. Second, we surveyed people living in communities in northern Canada about their retail and shopping experiences. Results: Fifty-four percent of communities in the provincial Norths and Far North without year-round road access did not have a grocery store that competed with the NWC. The provinces with the highest percentage of northern communities without retail competition were Ontario (87%, Saskatchewan (83% and Manitoba (72%. Respondents to the survey (n = 92 expressed concern about their shopping experiences in three main areas: the cost of food, food quality and freshness, and availability of specific foods. Conclusion: There is limited retail competition in the provincial Norths. In Manitoba, Saskatchewan and Ontario, the NWC has no store competition in at least 70% of northern communities. Consumers living in northern Canada find it difficult to afford nutritious foods and would like access to a wider selection of perishable foods in good condition.
M. Grandia Mantas
De Provincial Reconstruction Teams (PRT’s) zijn voor de NAVO het belangrijkste middel geweest om haar gebiedsuitbreiding naar geheel Afghanistan te realiseren. Daarnaast zijn PRT’S populair bij de media omdat ze veel met de lokale bevolking werken en projecten opzetten. De PRT’s zijn er in
Walker, Lorraine O; Mackert, Michael S; Ahn, Jisoo; Vaughan, Misha W; Sterling, Bobbie S; Guy, Sarah; Hendrickson, Sherry
Guided by the Uses and Gratifications approach, to examine mothers' use and preference of e-Health media, and associated contextual factors. Cross-sectional survey of 165 mothers (White, African-American, and Hispanic) from a stratified random sample. Use of online media about mother-baby care; favorite websites about motherhood and best-liked features of Web sites; channel preferences (Web site, postal mail, text) for receiving three types of health information; and contextual factors, e.g., education. Media use ranged from 96% for health information searches about babies to 46% for YouTube viewing about mother-baby topics. Contextual factors, such as education, were associated with media use. Babycenter was the most frequently reported favorite Web site and rich, relevant information was the best-liked feature. Across three health topics (weight, stress/depression, parenting) mothers preferred receiving information by Web site, followed by postal mail and least by text messaging (χ2 statistics, p used e-Health related media, but use was associated with contextual factors. In public health efforts to reach new mothers, partnering with mother-favored Web sites, focusing on audience-relevant media, and adopting attributes of successful sites are recommended strategies. © 2017 Wiley Periodicals, Inc.
Wilson, Robert S; Yu, Lei; James, Bryan D; Bennett, David A; Boyle, Patricia A
We tested the hypothesis that higher financial and health literacy is associated with better cognitive health in 755 older persons who completed a literacy measure (M = 67.9, SD = 14.5) and then had annual clinical evaluations for a mean of 3.4 years. In proportional hazards models, higher literacy was associated with decreased risk of developing incident Alzheimer's disease (n = 68) and results were similar for financial and health literacy subscales and after adjustment for potential confounders. In mixed-effects models, higher literacy was related to higher baseline level of cognition and reduced cognitive decline in multiple domains. Among the 602 persons without any cognitive impairment at baseline, higher literacy was associated with a reduced rate of cognitive decline and risk of developing incident mild cognitive impairment (n = 142). The results suggest that higher levels of financial and health literacy are associated with maintenance of cognitive health in old age.
Ansari, Walid El; Suominen, Sakari; Berg-Beckhoff, Gabriele
' eating habits with the three components of health complaints, controlling for the same confounders. Fruits and raw and cooked vegetable consumption, dietary guideline adherence index and subjective importance of healthy eating were highest among students with excellent/very good self-reported health...... (sweets, cakes and snacks; and fruits and vegetables), a dietary guideline adherence index and the subjective importance of healthy eating. Multinomial logistic regression assessed the association of students' nutrition behaviour with three levels of self-reported health, controlling for many potential......We examined nutrition behaviour, self-reported health and 20 health complaints of undergraduates in Finland. Students at the University of Turku in Finland participated in a cross-sectional online survey (N = 1189). For nutrition behaviour, we computed two composite food intake pattern scores...
Fatores associados ao sobrepeso e à obesidade em estudantes do ensino médio da rede pública estadual do município de Caruaru (PE Factores asociados al sobrepeso y la obesidad en estudiantes de la secundaria de la red pública provincial del municipio de Caruaru (Pernambuco, Brasil Factors associated with overweight and obesity among public high school students of the city of Caruaru, Northeast Brazil
Marina de Moraes V Petribú
Full Text Available OBJETIVO: Investigar a prevalência e os fatores associados ao sobrepeso e obesidade em estudantes do ensino médio da rede pública estadual do município de Caruaru (PE. MÉTODOS: Estudo transversal, com amostra representativa. Foram avaliadas variáveis antropométricas (peso e estatura, sociodemográficas e econômicas (sexo, idade, estado civil, local de residência, renda familiar e série escolar e relacionadas ao estilo de vida (atividade física, comportamento sedentário, consumo alimentar, nível de estresse, tabagismo, etilismo e qualidade de sono. Realizou-se regressão logística binária, adotando-se a ocorrência do sobrepeso e obesidade como desfechos. Para as análises inferenciais, considerou-se significante pOBJETIVOS: Investigar la prevalencia y los factores asociados al sobrepeso y la obesidad en estudiantes de la secundaria de la red pública provincial del municipio de Caruaru (Pernambuco, Brasil. MÉTODOS: Estudio transversal, con muestra representativa. Se evaluaron variables antropométricas (peso y estatura, sociodemográficas y económicas (sexo, edad, situación civil, local de residencia, ingresos familiares, año y turno escolar y relacionadas al estilo de vida (actividad física, comportamiento sedentario, consumo alimentar, nivel de estrés, tabaquismo, alcoholismo y calidad del sueño. Se realizó regresión logística binaria, adoptándose la ocurrencia del sobrepeso y la obesidad como desenlaces. Para los análisis inferenciales, se consideró significante pOBJECTIVE: To investigate the prevalence and factors associated with overweight and obesity among public high school students of Caruaru, Northeast Brazil. METHODS: Cross-sectional study, with a representative sample. The study evaluated anthropometric (weight and height, socio-demographic and economic variables (gender, age, marital status, place of residence, family income and school grade and those related with lifestyle (physical activity, sedentary
Padilla-Moledo, Carmen; Ruiz, Jonatan R; Ortega, Francisco B; Mora, Jesús; Castro-Piñero, José
We examined the association of muscular fitness with psychological positive health, health complaints, and health risk behaviors in 690 (n = 322 girls) Spanish children and adolescents (6-17.9 years old). Lower body muscular strength was assessed with the standing long jump test, and upper-body muscular strength was assessed with the throw basketball test. A muscular fitness index was computed by means of standardized measures of both tests. Psychosocial positive health, health complaints, and health risk behaviors were self-reported using the items of the Health Behavior in School-aged Children questionnaire. Psychological positive health indicators included the following: perceived health status, life satisfaction, quality of family relationships, quality of peer relationships, and academic performance. We computed a health complaints index from 8 registered symptoms: headache, stomach ache, backache, feeling low, irritability or bad temper, feeling nervous, difficulties getting to sleep, and feeling dizzy. The health risk behavior indicators studied included tobacco use, alcohol use, and getting drunk. Children and adolescents with low muscular fitness (below the mean) had a higher odds ratio (OR) of reporting fair (vs. excellent) perceived health status, low life satisfaction (vs. very happy), low quality of family relationships (vs. very good), and low academic performance (vs. very good). Likewise, children and adolescents having low muscular fitness had a significantly higher OR of reporting smoking tobacco sometimes (vs. never), drinking alcohol sometimes (vs. never), and getting drunk sometimes (vs. never). The results of this study suggest a link between muscular fitness and psychological positive health and health risk behavior indicators in children and adolescents.
Adler-Milstein, Julia; Landefeld, John; Jha, Ashish K
Regional Health Information Organizations (RHIOs) will likely play a key role in our nation's effort to catalyze health information exchange. Yet we know little about why some efforts succeed while others fail. We sought to identify factors associated with RHIO viability. Using data from a national survey of RHIOs that we conducted in mid-2008, we examined factors associated with becoming operational and factors associated with financial viability. We used multivariate logistic regression models to identify unique predictors. We classified RHIOs actively facilitating data exchange as operational and measured financial viability as the percent of operating costs covered by revenue from participants in data exchange (0-24%, 25-74%, 75-100%). Predictors included breadth of participants, breadth of data exchanged, whether the RHIO focused on a specific population, whether RHIO participants had a history of collaborating, and sources of revenue during the planning phase. Exchanging a narrow set of data and involving a broad group of stakeholders were independently associated with a higher likelihood of being operational. Involving hospitals and ambulatory physicians, and securing early funding from participants were associated with a higher likelihood of financial viability, while early grant funding seemed to diminish the likelihood. Finding ways to help RHIOs become operational and self-sustaining will bolster the current approach to nationwide health information exchange. Our work suggests that convening a broad coalition of stakeholders to focus on a narrow set of data is an important step in helping RHIOs become operational. Convincing stakeholders to financially commit early in the process may help RHIOs become self-sustaining.
Full Text Available Abstract There exists a disconnection between evolving policies in the policy arenas of mental health, housing, and income support in Canada. One of the complexities associated with analysing the intersection of these policies is that federal, provincial, and municipal level policies are involved. Canada is one of the few developed countries without a national mental health policy and because of the federal policy reforms of the 1970s, the provincial governments now oversee the process of deinstitutionalization from the hospital to the community level. During this same period the availability of affordable housing has decreased as responsibility for social housing has been transfered from the federal government to the provincial and/or municipal levels of government. Canada also stands alone in terms of being a developed nation without national housing policy instead what is considered "affordable" housing is partially dependant upon individuals' personal economic resources. As well, over the past decade rates of income supports have also been reduced. Psychiatric survivors have long been identified as being at risk for homelessness, with the disconnection existing between housing, income and mental health policies and the lack of a national policy in any of these policies areas further contributing to this risk.
Forchuk, Cheryl; Joplin, Libbey; Schofield, Ruth; Csiernik, Rick; Gorlick, Carolyne; Turner, Katherine
There exists a disconnection between evolving policies in the policy arenas of mental health, housing, and income support in Canada. One of the complexities associated with analysing the intersection of these policies is that federal, provincial, and municipal level policies are involved. Canada is one of the few developed countries without a national mental health policy and because of the federal policy reforms of the 1970s, the provincial governments now oversee the process of deinstitutionalization from the hospital to the community level. During this same period the availability of affordable housing has decreased as responsibility for social housing has been transfered from the federal government to the provincial and/or municipal levels of government. Canada also stands alone in terms of being a developed nation without national housing policy instead what is considered "affordable" housing is partially dependant upon individuals' personal economic resources. As well, over the past decade rates of income supports have also been reduced. Psychiatric survivors have long been identified as being at risk for homelessness, with the disconnection existing between housing, income and mental health policies and the lack of a national policy in any of these policies areas further contributing to this risk. PMID:18072980
Haswell, Melissa R; Bethmont, Anna
Many governments globally are investigating the benefits and risks associated with unconventional gas mining for shale, tight and coal seam gas (coalbed methane) to determine whether the industry should proceed in their jurisdiction. Most locations likely to be developed are in rural areas, with potential impact on farmers and small communities. Despite significant health concerns, public health knowledge and growing evidence are often overlooked in decision-making. It is difficult to gain a broad but accurate understanding of the health concerns for rural communities because the evidence has grown very recently and rapidly, is complex and largely based in the USA, where the industry is advanced. In 2016, a concerned South Australian beef and lamb farmer in an area targeted for potential unconventional gas development organised visits to homes in developed unconventional gas areas of Pennsylvania and forums with leading researchers and lawyers in Pennsylvania and New York. Guided by priorities identified during this trip, this communication concisely distils the research evidence on these key concerns, highlighting the Australian situation where evidence exists. It summarises key information of particular concern to rural regions, using Australia as an example, to assist rural health professionals to be better prepared to engage in decision-making and address the challenges associated with this new industry. Discussions with communities and experts, supported by the expanding research from the USA and Australia, revealed increasing health concerns in six key areas. These are absence of a safe solution to the toxic wastewater management problems, air pollution, land and water competition, mental health and psychosocial wellbeing risks, fugitive methane emissions and lack of proven regulatory regimes. Emerging epidemiological studies suggesting interference with foetal development and birth outcomes, and exacerbation of asthma conditions, are particularly concerning
Khubchandani, Jagdish; Price, James H
Perceived job insecurity and health risk factors have not been well studied in the United States (US) workforce. The purpose of this study was to assess the association of specific health risk factors and morbidities with perceived job insecurity in a large national random sample of working adults in the US. The National Health Interview Survey data were analyzed for this study. We computed the prevalence of perceived job insecurity by demographic characteristics and tested the relative association between perceived job insecurity and selected health risk factors using logistic regression analysis with adjusted odds ratios (AORs). A total of 17,441 working adults were included in the study: 75 % Whites, 51.5 % females, 73.3 % worked for a private company, and 82.6 % were 25-64 years of age. One in three (33 %) workers perceived their job to be insecure. Those who reported job insecurity had significantly higher odds of: being obese, sleeping less than 6 h/day, smoking every day, having work loss days >2 weeks, and worsening of general health in the past year. Job insecure individuals had a likelihood of serious mental illness within the past 30 days almost five times higher than those who were not job insecure. In addition, job insecure individuals were significantly more likely to report pain conditions (i.e. headaches, neck pain, and low back pain), and lifetime histories of having ulcers, diabetes, hypertension, angina pectoris, and coronary heart diseases. Job insecurity is associated with poor health and health risk behaviors in American adults. Potential interventions to address job insecurity and improve the health and well-being of working adults have been discussed based on study findings.
Pozzetto, Bruno; Memmi, Meriam; Garraud, Olivier; Roblin, Xavier; Berthelot, Philippe
Hepatitis C virus (HCV) is a blood-borne pathogen that has a worldwide distribution and infects millions of people. Care-associated HCV infections represented a huge part of hepatitis C burden in the past via contaminated blood and unsafe injections and continue to be a serious problem of public health. The present review proposes a panorama of health care-associated HCV infections via the three mode of contamination that have been identified: (1) infected patient to non-infected patient; (2) infected patient to non-infected health care worker (HCW); and (3) infected HCW to non infected patient. For each condition, the circumstances of contamination are described together with the means to prevent them. As a whole, the more important risk is represented by unsafe practices regarding injections, notably with the improper use of multidose vials used for multiple patients. The questions of occupational exposures and infected HCWs are also discussed. In terms of prevention and surveillance, the main arm for combating care-associated HCV infections is the implementation of standard precautions in all the fields of cares, with training programs and audits to verify their good application. HCWs must be sensitized to the risk of blood-borne pathogens, notably by the use of safety devices for injections and good hygiene practices in the operating theatre and in all the invasive procedures. The providers performing exposed-prone procedures must monitor their HCV serology regularly in order to detect early any primary infection and to treat it without delay. With the need to stay vigilant because HCV infection is often a hidden risk, it can be hoped that the number of people infected by HCV via health care will decrease very significantly in the next years.
Full Text Available Abstract Background Depression and anxiety disorders have a high disease burden and as many as 15% of young people report mental health problems. Binge drinking, which is a particularly harmful way of consuming alcohol, is common among secondary school students. The aim of this study was to examine the association between binge drinking and self-reported mental health in boys and girls aged 12 to 18 years. Findings This cross-sectional analysis was performed on data collected by the Community Health Service (GGD Brabant Zuidoost, the Netherlands, in 2007. In this Youth Survey, 10 090 randomly selected adolescents aged 12 tot 18 years were each sent a letter, a questionnaire, and a user name and log-in code for if they preferred to complete the Internet version of the questionnaire. Mental health was assessed using the Mental Health Inventory (MHI-5, a short 5-item questionnaire to detect feelings of depression and anxiety. Participants were asked about current alcohol consumption, their relationship with their parents, drug use, and sociodemographic data. Corrected for confounders, binge drinking and mental health problems were associated in the 12 to 15 year old girls (OR 2.43; 95% CI 1.86-3.17, p = 0.000 and boys (OR 1.64, 95% CI 1.19-2.27, p = 0.003. The majority of the 16 to 18 year old adolescents had been binge drinking in the previous 4 weeks (69.6% boys and 56.8% girls. In this age group, boys with mental health problems were less likely to be classified as binge drinkers than were boys without mental health problems (OR 0.63, 95% CI 0.45-0.87, p = 0.005. No such association between binge drinking and mental health was found in girls of this age. Conclusion Girls and boys aged 12-15 years were classified as binge drinkers significantly more often when they reported poor mental health. Because binge drinking damages the brain, especially at a young age, it is important that health professionals are alert to possible binge drinking when
Nathalie T Burkert
Full Text Available Population-based studies have consistently shown that our diet has an influence on health. Therefore, the aim of our study was to analyze differences between different dietary habit groups in terms of health-related variables. The sample used for this cross-sectional study was taken from the Austrian Health Interview Survey AT-HIS 2006/07. In a first step, subjects were matched according to their age, sex, and socioeconomic status (SES. After matching, the total number of subjects included in the analysis was 1320 (N = 330 for each form of diet - vegetarian, carnivorous diet rich in fruits and vegetables, carnivorous diet less rich in meat, and carnivorous diet rich in meat. Analyses of variance were conducted controlling for lifestyle factors in the following domains: health (self-assessed health, impairment, number of chronic conditions, vascular risk, health care (medical treatment, vaccinations, preventive check-ups, and quality of life. In addition, differences concerning the presence of 18 chronic conditions were analyzed by means of Chi-square tests. Overall, 76.4% of all subjects were female. 40.0% of the individuals were younger than 30 years, 35.4% between 30 and 49 years, and 24.0% older than 50 years. 30.3% of the subjects had a low SES, 48.8% a middle one, and 20.9% had a high SES. Our results revealed that a vegetarian diet is related to a lower BMI and less frequent alcohol consumption. Moreover, our results showed that a vegetarian diet is associated with poorer health (higher incidences of cancer, allergies, and mental health disorders, a higher need for health care, and poorer quality of life. Therefore, public health programs are needed in order to reduce the health risk due to nutritional factors.
Bruno Pereira Nunes
Full Text Available ABSTRACT OBJECTIVE Evaluate the association of multimorbidity, primary health care model and possession of a private health plan with hospitalization. METHODS A population-based cross-sectional study with 1,593 elderly individuals (60 years old or older living in the urban area of the city of Bagé, State of Rio Grande do Sul, Brazil. The outcome was hospitalization in the year preceding the interview. The multimorbidity was evaluated through two cut-off points (≥ 2 and ≥ 3. The primary health care model was defined by residence in areas covered by traditional care or by Family Health Strategy. The older adults mentioned the possession of a private health plan. We performed a gross and adjusted analysis by Poisson regression using a hierarchical model. The adjustment included demographic, socioeconomic, functional capacity disability and health services variables. RESULTS The occurrence of overall and non-surgical hospitalization was 17.7% (95%CI 15.8–19.6 and 10.6% (95%CI 9.1–12.1, respectively. Older adults with multimorbidity were admitted to hospitals more often when to older adults without multimorbidity, regardless of the exhibition’ form of operation. Having a private health plan increased the hospitalization by 1.71 (95%CI 1.09–2.69 times among residents in the areas of the Family Health Strategy when compared to elderly residents in traditional areas without a private health plan. CONCLUSIONS The multimorbidity increased the occurrence of hospitalizations, especially non-surgical ones. Hospitalization was more frequent in older adults with private health plan and those living in Family Health Strategy areas, regardless of the presence of multiple diseases.
Full Text Available Cisplatin is an effective drug used in the treatment of many cancers, yet its ototoxic potential places cancer patients, exposed to this drug, at risk of hearing loss, thus negatively impacting further on a patient’s quality of life. It is paramount for health care practitioners managing such patients to be aware of cisplatin’s ototoxic properties and the clinical signs to identify patients at risk of developing hearing loss. English peer-reviewed articles from January 1975 to July 2015 were assessed from PubMed, Science Direct, and Ebscohost. Seventy-nine articles and two books were identified for this review, using MeSH terms and keywords such as “ototoxicity”, “cisplatin”, “hearing loss”, and “ototoxicity monitoring”. This review provides an up-to-date overview of cisplatin-associated ototoxicity, namely, its clinical features, incidence rates, and molecular and cellular mechanisms and risk factors, to health care practitioners managing the patient with cancer, and highlights the need for a team-based approach to complement an audiological monitoring programme to mitigate any further loss in the quality of life of affected patients, as there is currently no otoprotective agent recommended routinely for the prevention of cisplatin-associated ototoxicity. It also sets the platform for effective dialogue towards policy formulation and strengthening of health systems in developing countries.
Kim, Joowon; Hwang, Yunji; Kang, Seungheon; Kim, Minhye; Kim, Tae-Shin; Kim, Jay; Seo, Jeongmin; Ahn, Hyojeong; Yoon, Sungjoon; Yun, Jun Pil; Lee, Yae Lim; Ham, Hyunsoo; Yu, Hyeong Gon; Park, Sue K
Smartphone use has dramatically increased in recent years. Smartphones may have adverse health effects, particularly on the eyes, because users stare at the screen for a much longer time than they do with ordinary mobile phones. The objective of this study was to elucidate the relationship between smartphone use and ocular symptoms among adolescents. Information on smartphone use and ocular symptoms (blurring, redness, visual disturbance, secretion, inflammation, lacrimation and dryness) related to eye fatigue and strain from 715 adolescent subjects from three cities in Korea was obtained using a structured questionnaire. Ocular health was scored using number of ocular symptoms. Odds ratios (ORs), 95% confidence intervals (95% CIs) and p-values for ocular symptoms were calculated with binomial and multinomial logistic regression models. Higher prevalence rates for ocular symptoms were observed in groups with greater exposure to smartphones (p smartphone use was associated with a higher likelihood of having multiple ocular symptoms (5-7 symptoms out of 7 symptoms; p = 0.005). Excessive/intermittent use (>2 hours daily and ≤2 hours continuously) and excessive/persistent use (>2 hours daily and >2 hours continuously) compared to shorter use (smartphones was associated with a higher likelihood of having multiple ocular symptoms (OR 3.05, 95% CI 1.51-6.19; p = 0.001). Increasing exposure to smartphones can have a negative impact on ocular health in adolescents.
Araújo, Carmem Emmanuely Leitão; Gonçalves, Guilherme Quaresma; Machado, José Angelo
In a context that combines decentralization and underfunding of public health policy, Brazilian municipalities expressively extend their spending in this sector, allocating a proportion of their own revenues (direct taxation added to the mandatory intergovernmental transfers from the Union and the states) at levels above the ones that are constitutionally determined. However, there have been incipient studies investigating the expenditure composition on health in these federative units, in order to describe its main characteristics and explanations. In order to contribute to eliminating this gap, this article explores some associations between attributes of the municipalities (population size, region of the country, the proportion of older adults, child mortality, hiring private services and SUS transfer) and health expenditure implemented with the municipalities' own recipes. The study used descriptive statistics and multiple linear regressions in order to investigate such associations with data for 2010. The results point to tax inequities in the sector when comparing municipalities of different population groups and socioeconomic conditions, including the perception of important differences in terms of per capita spending on the analyzed expenditure items.
Park, Young-Taek; Lee, Junsang; Lee, Jinhyung
Health information technology (IT) can assist healthcare providers in ordering medication and adhering to guidelines while improving communication among providers and the quality of care. However, the relationship between health IT and Case Mix Index (CMI) has not been thoroughly investigated; therefore, this study aimed to clarify this relationship. To examine the effect of health IT on CMI, a generalized estimation equation (GEE) was applied to two years of California hospital data. We found that IT was positively associated with CMI, indicating that increased IT adoption could lead to a higher CMI or billing though DRG up-coding. This implies that hospitals' revenue could increase around $40,000 by increasing IT investment by 10%. The positive association between IT and CMI implies that IT adoption itself could lead to higher patient billings. Generally, a higher CMI in a hospital indicates that the hospital provides expensive services with higher coding and therefore receives more money from patients. Therefore, measures to prevent upcoding through IT systems should be implemented.
Kennedy, Rebekah; Lappin, David Francis; Dixon, Padraic Martin; Buijs, Mark Johannes; Zaura, Egija; Crielaard, Wim; O'Donnell, Lindsay; Bennett, David; Brandt, Bernd Willem; Riggio, Marcello Pasquale
Equine periodontal disease is a common and painful condition and its severe form, periodontitis, can lead to tooth loss. Its aetiopathogenesis remains poorly understood despite recent increased awareness of this disorder amongst the veterinary profession. Bacteria have been found to be causative agents of the disease in other species, but current understanding of their role in equine periodontitis is extremely limited. The aim of this study was to use high-throughput sequencing to identify the microbiome associated with equine periodontitis and oral health. Subgingival plaque samples from 24 horses with periodontitis and gingival swabs from 24 orally healthy horses were collected. DNA was extracted from samples, the V3-V4 region of the bacterial 16S rRNA gene amplified by PCR and amplicons sequenced using Illumina MiSeq. Data processing was conducted using USEARCH and QIIME. Diversity analyses were performed with PAST v3.02. Linear discriminant analysis effect size (LEfSe) was used to determine differences between the groups. In total, 1308 OTUs were identified and classified into 356 genera or higher taxa. Microbial profiles at health differed significantly from periodontitis, both in their composition (p periodontitis group samples showed higher diversity (3.16, SD 0.98) and were dominated by the genera Prevotella and Veillonella. It is concluded that the microbiomes associated with equine oral health and periodontitis are distinct, with the latter displaying greater microbial diversity.
De Maio, Fernando G
Despite a large body of empirical literature, a consensus has not been reached concerning the health effects of income inequality. This study contributes to ongoing debates by examining the robustness of the income inequality-population health relationship in Argentina, using five different income inequality indexes (each sensitive to inequalities in differing parts of the income spectrum) and five measures of population health. Cross-sectional, ecological study. Income and self-reported morbidity data from Argentina's 2001 Encuesta de Condiciones de Vida (Survey of living conditions) were analysed at the provincial level. Provincial rates of male/female life expectancy and infant mortality were drawn from the Instituto Nacional de Estadistica y Censos database. Life expectancy was correlated in the expected direction with provincial-level income inequality (operationalized as the Gini coefficient) for both males (r=-0.55, P<0.01) and females (r=-0.61, P<0.01), but this association was not robust for all five income inequality indexes. In contrast, infant mortality, self-reported poor health and self-reported activity limitation were not correlated with any of the income inequality indexes. This study adds further complexity to the literature on the health effects of income inequality by highlighting the important effects of operational definitions. Mortality and morbidity data cannot be used as reasonably interchangeable variables (a common practice in this literature), and the choice of income inequality indicator may influence the results.
Vardas, Panos; Boriani, Giuseppe
The management of healthcare is becoming extremely complex in developed countries, as a result of increasing age of the population and increasing costs of care, coupled with diminishing resources due to global financial crisis. This situation threatens access to appropriate care, and a more or less explicit rationing of some types of treatment may occur in 'real world' clinical practice. This is particularly true for those treatments or interventions with a relatively high up-front cost, such as cardioverter defibrillators, devices for cardiac resynchronization therapy or ablation procedures for atrial fibrillation. The European Heart Rhythm Association (EHRA) is strongly convinced that the skills of electrophysiologists and cardiologists responsible for the management of rhythm disorders have to evolve, also embracing the knowledge of health economics, clinical epidemiology, health-care management and outcome research. These disciplines do not belong to what is considered as the conventional cultural background of physicians, but knowledge of comparative cost effectiveness and of other economic approaches nowadays appears fundamental for a dialogue with a series of stakeholders, such as policy makers, politicians, and administrators, involved in budgeting the activity of hospitals and health-care services, as well as in approaching health technology assessment.
Haar, Mindy; Scanlan, Craig
Over the last decade, there has been a substantial increase in online education in the health professions, as well as growing recognition that teamwork and collaboration are essential to success. While the impact of students' sense of community on factors such as course satisfaction and retention has been studied among college enrollees in general, there is little research exploring this concept among allied health students. To address this shortcoming, a convenience sample of students enrolled in a large northeastern school of health-related professions was surveyed to gather information on their demographics, curriculum and selected course attributes, perceived instructor teaching perspectives, and sense of community. Univariate analysis indicated that entry-level students experienced a greater sense of community than post-professional students. Multivariate analysis revealed that instructor-determined factors of encouraging discussion, encouraging expression of opinions, and specifying response times best predicted sense of community. With all other variables controlled, perceptions of community were significantly lower in online courses, among students for whom English was their second language, and in courses where instructors were perceived as focused primarily on content delivery. This study supports promoting selected course and instructor-related attributes associated with sense of community in allied health education, with a particular focus on both non-native English speakers and post-professional students. Enhancement of online courses with strategies that increase instructor presence, better engage students, and facilitate interaction also are warranted.
Burgette, J M; Lee, J Y; Baker, A D; Vann, W F
The objectives of this study were to examine the pattern of association between dental utilization and oral health literacy (OHL). As part of the Carolina Oral Health Literacy Project, clients in the Women, Infants, and Children's Special Supplemental Nutrition Program completed a structured 30-min in-person interview conducted by 2 trained interviewers at 9 sites in 7 counties in North Carolina. Data were collected on clients' OHL, sociodemographics, dental utilization, self-efficacy, and dental knowledge. The outcome, OHL, was measured with a dental word recognition test (30-item Rapid Estimate of Adult Literacy in Dentistry). Descriptive and multiple linear regression methods were used to examine the distribution of OHL and its association with covariates. After adjusting for age, education, race, marital status, self-efficacy, and dental knowledge, multiple linear regression showed that dental utilization was not a significant predictor of OHL (P > 0.05). Under the conditions of this study, dental utilization was not a significant predictor of OHL. © International & American Associations for Dental Research 2015.
beef and lamb feedlots, five forage sites, two packing sheds, six feed mills, an olive factory, 10 strawberry farms, 20 farmer associations, over 500...comparison to the world: 144 Male: 68.6 years Female: 71.34 years (2009 estimate) Total fertility rate: 3.86 children born/woman (2009 estimate) Country
Thomson, Hilary; Thomas, Sian; Sellstrom, Eva; Petticrew, Mark
identified. These were studies of warmth improvements (n = 7) and rehousing (n = 5). Three qualitative studies were excluded from the synthesis due to lack of clarity of methods. Six of the included qualitative studies also reported quantitative data which was included in the review.Very little quantitative synthesis was possible as the data were not amenable to meta-analysis. This was largely due to extreme heterogeneity both methodologically as well as because of variations in the intervention, samples, context, and outcome; these variations remained even following grouping of interventions and outcomes. In addition, few studies reported data that were amenable to calculation of standardized effect sizes. The data were synthesised narratively.Data from studies of warmth and energy efficiency interventions suggested that improvements in general health, respiratory health, and mental health are possible. Studies which targeted those with inadequate warmth and existing chronic respiratory disease were most likely to report health improvement. Impacts following housing-led neighbourhood renewal were less clear; these interventions targeted areas rather than individual households in most need. Two poorer quality LMIC studies reported unclear or small health improvements. One better quality study of rehousing from slums (pre-1960) reported some improvement in mental health. There were few reports of adverse health impacts following housing improvement. A small number of studies gathered data on social and socio-economic impacts associated with housing improvement. Warmth improvements were associated with increased usable space, increased privacy, and improved social relationships; absences from work or school due to illness were also reduced.Very few studies reported differential impacts relevant to equity issues, and what data were reported were not amenable to synthesis. Housing investment which improves thermal comfort in the home can lead to health improvements, especially
Samietz, Stefanie; Jürgens, Clemens; Ittermann, Till; Holtfreter, Birte; Pink, Christiane; Schipf, Sabine; Biffar, Reiner; Völzke, Henry; Kocher, Thomas; Tost, Frank
To investigate the relation between oral health status and microcirculation we analyzed the association between periodontitis and number of teeth with retinal vessel diameters. We analyzed data from 4420 subjects from the Study-of-Health-in-Pomerania-TREND (SHIP-TREND). All subjects (3183 for number of teeth, 3013 for mean probing depth, 2894 for mean attachment level) underwent nonmydriatic funduscopy and dental examination. We measured central retinal arteriolar (CRAE), venular (CRVE) vessel diameters and calculated arterio-venous-ratio (AVR) from static-vessel-analysis. Periodontal status was assessed using the case definition of the Center-for-Disease-Control-and-Prevention/American-Academy-of-Periodontology (CDC/AAP). Data were analyzed by linear (CRAE,CRVE,AVR) and logistic regression (AVRassociations were found between periodontal and retinal conditions. Severe periodontitis [β=-0.0120 (-0.0218;-0.0007 95%-CI)] and mean probing depth [β=-0.0054 (-0.0105;-0.0002 95%-CI)] were significantly inversely associated with AVR; severe periodontitis [β=3.80 (0.61;6.98 95%-CI)], mean probing depth [β=1.86 (0.23;3.49 95%-CI)] and mean attachment level [β=1.31 (0.34;2.27 95%-CI)] with CRVE and mean attachment level with CRAE [β=0.91 (0.14;1.69 95%-CI)]. Our results point to an association between periodontal conditions and AVR in men. Periodontitis may impact microvascular endothelium function. Improving oral health to reduce periodontitis might lead to reduced risk for other age-related diseases. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Full Text Available Introduction: Although indoor tanning causes cancer, it remains relatively common among adolescents. Little is known about indoor tanning prevalence and habits in Canada, and even less about associated behaviours. This study explores the prevalence of adolescent indoor tanning in Manitoba and its association with other demographic characteristics and health behaviours. Methods: We conducted secondary analyses of the 2012/13 Manitoba Youth Health Survey data collected from Grade 7 to 12 students (n = 64 174 and examined associations between indoor tanning (whether participants had ever used artificial tanning equipment and 25 variables. Variables with statistically significant associations to indoor tanning were tested for collinearity and grouped based on strong associations. For each group of highly associated variables, the variable with the greatest effect upon indoor tanning was placed into the final logistic regression model. Separate analyses were conducted for males and females to better understand sex-based differences, and analyses were adjusted for age. Results: Overall, 4% of male and 9% of female students reported indoor tanning, and prevalence increased with age. Relationships between indoor tanning and other variables were similar for male and female students. Binary logistic regression models indicated that several variables significantly predicted indoor tanning, including having part-time work, being physically active, engaging in various risk behaviours such as driving after drinking for males and unplanned sex after alcohol/drugs for females, experiencing someone say something bad about one's body shape/size/appearance, identifying as trans or with another gender, consuming creatine/other supplements and, for females only, never/rarely using sun protection. Conclusion: Indoor tanning among adolescents was associated with age, part-time work, physical activity and many consumption behaviours and lifestyle risk factors. Though
Harland, E; Griffith, J; Lu, H; Erickson, T; Magsino, K
Although indoor tanning causes cancer, it remains relatively common among adolescents. Little is known about indoor tanning prevalence and habits in Canada, and even less about associated behaviours. This study explores the prevalence of adolescent indoor tanning in Manitoba and its association with other demographic characteristics and health behaviours. We conducted secondary analyses of the 2012/13 Manitoba Youth Health Survey data collected from Grade 7 to 12 students (n = 64 174) and examined associations between indoor tanning (whether participants had ever used artificial tanning equipment) and 25 variables. Variables with statistically significant associations to indoor tanning were tested for collinearity and grouped based on strong associations. For each group of highly associated variables, the variable with the greatest effect upon indoor tanning was placed into the final logistic regression model. Separate analyses were conducted for males and females to better understand sex-based differences, and analyses were adjusted for age. Overall, 4% of male and 9% of female students reported indoor tanning, and prevalence increased with age. Relationships between indoor tanning and other variables were similar for male and female students. Binary logistic regression models indicated that several variables significantly predicted indoor tanning, including having part-time work, being physically active, engaging in various risk behaviours such as driving after drinking for males and unplanned sex after alcohol/drugs for females, experiencing someone say something bad about one's body shape/size/appearance, identifying as trans or with another gender, consuming creatine/other supplements and, for females only, never/rarely using sun protection. Indoor tanning among adolescents was associated with age, part-time work, physical activity and many consumption behaviours and lifestyle risk factors. Though legislation prohibiting adolescent indoor tanning is critical
Morrison, Lynn A; Larkspur, Louona; Calibuso, Marites J; Brown, Susan
To examine the relationships between attitudes towards menstruation, health, and behavioral characteristics. The 136 women who completed questionnaires varied in their sexual activity, sexual orientation, and use of hormonal contraception. Women's estimated cycle length was accurate when compared to observed cycle length (F (3,156) = .05; P = .98). Smokers had decreased durations of flow (P menstruation as natural compared to abstinent, sexually active heterosexuals or those using traditional oral contraception (F (5,141) = 2.43; P = .04). Hormonal contraception use, but not sexual orientation, was associated with attitudes about menstruation.
Cohen, Beth E; Maguen, Shira; Bertenthal, Daniel; Shi, Ying; Jacoby, Vanessa; Seal, Karen H
An increasing number of women serve in the military and are exposed to trauma during service that can lead to mental health problems. Understanding how these mental health problems affect reproductive and physical health outcomes will inform interventions to improve care for women veterans. We analyzed national Department of Veterans Affairs (VA) data from women Iraq and Afghanistan veterans who were new users of VA healthcare from October 7, 2001, through December 31, 2010 (n = 71,504). We used ICD-9 codes to categorize veterans into five groups by mental health diagnoses (MH Dx): Those with no MH Dx, posttraumatic stress disorder (PTSD), depression, comorbid PTSD and depression, and a MH Dx other than PTSD and depression. We determined the association between mental health category and reproductive and other physical health outcomes defined by ICD-9 codes. Categories included sexually transmitted infections, other infections (e.g., urinary tract infections), pain-related conditions (e.g., dysmenorrhea and dsypareunia), and other conditions (e.g., polycystic ovarian syndrome, infertility, sexual dysfunction). Models were adjusted for sociodemographic and military service factors. There were 31,481 patients (44%) who received at least one mental health diagnosis. Women veterans with any mental health diagnosis had significantly higher prevalences of nearly all categories of reproductive and physical disease diagnoses (p mental health diagnoses had significantly greater prevalences of several important reproductive and physical health diagnoses. These results provide support for VA initiatives to address mental and physical health concerns and improve comprehensive care for women veterans. Published by Elsevier Inc.
Gahagan, Jacqueline C; Fuller, Janice L; Delpech, Valerie C; Baxter, Larry N; Proctor-Simms, E Michelle
Nova Scotia, as a small province in Atlantic Canada, provides health care professionals and policy analysts with unique challenges for developing and implementing a strategy for accessible and acceptable HIV counselling and testing. Despite universal health care in Canada, barriers and challenges persist in relation to HIV counselling and testing programs and services in Nova Scotia. It is therefore necessary to examine the unique circumstances in the provision of programs and services in Nova Scotia prior to the possibility of adopting international HIV counselling and testing standards and guidelines being implemented in other jurisdictions. Nova Scotia's provincial strategy on HIV/AIDS promotes a harm-reduction approach for different populations in various service settings, recognizing the diverse circumstances and experiences of people living in Nova Scotia. By contrast, the Centers for Disease Control (CDC) recommended strategy promotes opt-out testing and in some instances alters the requirement of informed consent. As the Public Health Agency of Canada (PHAC) revises the national HIV counselling and testing policies, it is imperative to address the unique characteristics of Nova Scotia's provision of services, and how divergent strategies have the potential to address or compound the barriers to access that exist in this province's communities.
Sadatsafavi, Mohsen; Lynd, Larry; Marra, Carlo; Carleton, Bruce; Tan, Wan C; Sullivan, Sean; FitzGerald, J Mark
BACKGROUND: A better understanding of health care costs associated with asthma would enable the estimation of the economic burden of this increasingly common disease. OBJECTIVE: To determine the direct medical costs of asthma-related health care in British Columbia (BC). METHODS: Administrative health care data from the BC Linked Health Database and PharmaNet database from 1996 to 2000 were analyzed for BC residents five to 55 years of age, including the billing information for physician visits, drug dispensations and hospital discharge records. A unit cost was assigned to physician/emergency department visits, and government reimbursement fees for prescribed medications were applied. The case mix method was used to calculate hospitalization costs. All costs were reported in inflation-adjusted 2006 Canadian dollars. RESULTS: Asthma resulted in $41,858,610 in annual health care-related costs during the study period ($331 per patient-year). The major cost component was medications, which accounted for 63.9% of total costs, followed by physician visits (18.3%) and hospitalization (17.8%). When broader definitions of asthma-related hospitalizations and physician visits were used, total costs increased to $56,114,574 annually ($444 per patient-year). There was a statistically significant decrease in the annual per patient cost of hospitalizations (P<0.01) over the study period. Asthma was poorly controlled in 63.5% of patients, with this group being responsible for 94% of asthma-related resource use. CONCLUSION: The economic burden of asthma is significant in BC, with the majority of the cost attributed to poor asthma control. Policy makers should investigate the reason for lack of proper asthma control and adjust their policies accordingly to improve asthma management. PMID:20422063
Clark, Wayne Voisey
This article highlights findings from research conducted with the Manitoba Urban Inuit Association with regard to culturally safe practices for communicating personal health information services related to a provincial integrated electronic health record. By applying a "two-eyed seeing research approach," which incorporates traditional and Western scientific perspectives, the author describes Inuit cultural considerations when communicating electronic health concepts with a vision of advancing toward program evaluation opportunities. The research is supported by two Inuit-driven focus groups, interviews with three jurisdictional representatives of electronic health program delivery agencies and one interview with an Inuk elder. Copyright © 2014 Longwoods Publishing.
Deriba, Beyazin Kebede; Sinke, Shimele Ololo; Ereso, Berhane Megersa; Badacho, Abebe Sorsa
Human resources are vital for delivering health services, and health systems cannot function effectively without sufficient numbers of skilled, motivated, and well-supported health workers. Job satisfaction of health workers is important for motivation and efficiency, as higher job satisfaction improves both employee performance and patient satisfaction. Even though several studies have addressed job satisfaction among healthcare professionals in different part of the world, there are relatively few studies on healthcare professionals' job satisfaction in Ethiopia. A facility-based cross-sectional study was conducted among health professionals working in health centers in April 2015 using self-administered structured questionnaires. All 322 health professionals working in 23 randomly selected public health centers were included. Factor scores were computed for the identified items by varimax rotation to represent satisfaction. Multivariate linear regression analysis was performed, and the effect of independent variables on the regression factor score quantified. Three hundred eight respondents participated with a response rate of 95.56%. The overall level of job satisfaction was 41.46%. Compensation (benefits) (beta 0.448 [95% CI 0.341 to 0.554]), recognition by management (beta 0.132 [95% CI 0.035 to 0.228]), and opportunity for development (beta 0.123 [95% CI 0.020 to 0.226]) were associated with job satisfaction. A unit increase in salary and incentives and recognition by management scores resulted in 0.459 (95% CI 0.356 to 0.561) and 0.156 (95% CI 0.065 to 0.247) unit increases in job satisfaction scores, respectively. The overall level of job satisfaction in health professionals was low. Salary and incentives, recognition by management, developmental opportunities, and patient appreciation were strong predictors of job satisfaction.
van Holland, Berry J; Soer, Remko; de Boer, Michiel R; Reneman, Michiel F; Brouwer, Sandra
Workers' health surveillance (WHS) programs commonly measure a large number of indicators addressing health habits and health risks. Recently, work ability and functional capacity have been included as important risk measures in WHS. In order to address work ability appropriately, knowledge of associations with work and health measures is necessary. The objective of this study was to evaluate which of the factors measured in a WHS are independently associated with work ability in a group of meat processing workers. A cross-sectional study was performed in a large meat processing company in The Netherlands. Data were collected during a WHS between February 2012 and March 2014. Personal characteristics, health habits and health-risk indicators, functional capacity, and work-related factors were measured. Work ability was measured with the Work Ability Index and was used as dependent variable. Univariable and multivariable logistic regression analyses were conducted, a receiver operating characteristic curve was constructed and the area under the curve (AUC) was calculated. Data sets from 230 employees were used for analyses. The average age was 53 years and the average work ability index score was 39.3. In the final multivariable model age (OR 0.94), systolic blood pressure (OR 1.03), need for recovery (OR 0.56), and overhead work capacity (OR 3.95) contributed significantly. The AUC for this model was 0.81 (95% CI 0.75-0.86). Findings from the current study indicate that multifactorial outcomes (age, systolic blood pressure, need for recovery, and overhead work capacity) from a WHS were independently associated with work ability. These factors can be used to assess employees at risk for low work ability and might provide directions for interventions.
Thorpe, Lilian U; Whiting, Susan J; Li, Wenbin; Dust, William; Hadjistavropoulos, Thomas; Teare, Gary
Hip fractures (HFs) represent an important cause of morbidity and mortality among adults in long-term care (LTC), but lack of detailed epidemiological data poses challenges to intervention planning. We aimed to determine the incidence of HFs among permanent LTC residents in Saskatchewan between 2008 and 2012, using linked, provincial administrative health databases, exploring associations between outcomes and basic individual and institutional characteristics. We utilized the Ministry of Health databases to select HF cases based on ICD 10 diagnoses fracture of head and neck of femur, pertrochanteric fracture and subtrochanteric fracture of femur. HF incidence rates in LTC were compared to older adults in the general population. LTC residents were more likely to be female overall (65.5%), although this varied by age, with only 46.6% female in those under 65, but 77% female among those 90 years and older. Mean age of residents was highest in rural centres (85.2 yrs) and lowest in medium-large centres (81.0 yrs). Of 6,230 cases of HFs in the province during the study period, 2,743 (44%) were in the LTC cohort. Incidence rates per 1,000 person years increased with age and were higher in the LTC group (F = 68.6, M = 49.8) than the overall population (F = 1.62, M = 0.73). Rates of HFs in the province and in LTC were higher in females than males in all age groups, except for the youngest (< 65 years), where males had higher rates, and the oldest category (90+) where rates were similar. Women 90+ years in larger LTC had significantly higher (p = .035) HF rates than those in smaller LTC, and also had significantly (p = .001) higher rates in medium-large compared to smaller population centres. However, after age standardization to the overall SK population, it was apparent that the larger LTC facilities and the medium-large population centres had overall lower HF rates than the small and medium LTC facilities and the small urban and rural PCs, respectively. One health region
Huarcaya Godoy, Madison
El presente trabajo de investigación: "Aplicación del Mentoring para lograr una gestión eficiente en la Municipalidad Provincial del Callao", es producto de un estudio y análisis de la gestión pública de la Municipalidad Provincial del Callao, con el objeto de determinar la eficiencia en el desempeño de los colaboradores, de niveles jerárquicos, órganos intermedios y órganos operativos de la Municipalidad Provincial del Callao a fin de mejorar la gestión de la provincia. El resultado, de la p...
Full Text Available Abstract Background There is a significant gap in the knowledge translation literature related to how research evidence actually contributes to health care decision-making. Decisions around what care to provide at the population (rather than individual level are particularly complex, involving considerations such as feasibility, cost, and population needs in addition to scientific evidence. One example of decision-making at this "population-policy" level involves what screening questions and intervention guides to include on standardized provincial prenatal records. As mandatory medical reporting forms, prenatal records are potentially powerful vehicles for promoting population-wide evidence-based care. However, the extent to which Canadian prenatal records reflect best-practice recommendations for the assessment of well-known risk factors such as maternal smoking and alcohol consumption varies markedly across Canadian provinces and territories. The goal of this study is to better understand the interaction of contextual factors and research evidence on decision-making at the population-policy level, by examining the processes by which provincial prenatal records are reviewed and revised. Methods Guided by Dobrow et al.'s (2004 conceptual model for context-based evidence-based decision-making, this study will use a multiple case study design with embedded units of analysis to examine contextual factors influencing the prenatal record revision process in different Canadian provinces and territories. Data will be collected using multiple methods to construct detailed case descriptions for each province/territory. Using qualitative data analysis techniques, decision-making processes involving prenatal record content specifically related to maternal smoking and alcohol use will be compared both within and across each case, to identify key contextual factors influencing the uptake and application of research evidence by prenatal record review
Smith, Harry A; Gonzalez, Javier T; Thompson, Dylan; Betts, James A
The role of dietary carbohydrates in the development of obesity and associated metabolic dysfunction has recently been questioned. Within the last decade, the Scientific Advisory Committee on Nutrition carried out a comprehensive evaluation of the role of dietary carbohydrates in human health. The current review aims to complement and extend this report by providing specific consideration of the effects of the component parts of energy balance, their interactions, and their culmination on energy storage and health. PubMed was searched for all published trials that had a minimum follow-up period of 3 months and were designed to manipulate dietary carbohydrate intake, irrespective of resultant differences in absolute carbohydrate dose (grams per day). Dietary carbohydrate manipulation has little effect on the individual components of energy balance that have been assessed. However, the role of dietary carbohydrates in influencing physical activity has yet to be assessed using gold-standard measurement tools. Moreover, adherence to a diet of modified carbohydrate content has not been found to result in a consistent pattern of changes in weight or indirect measures of metabolic health. However, certain markers of cardiovascular disease risk (ie, blood triglycerides and high-density lipoprotein cholesterol) may respond positively to a reduction in dietary carbohydrates. © The Author(s) 2017. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: firstname.lastname@example.org.
Hoban, Christopher; Sareen, Jitender; Henriksen, Christine A; Kuzyk, Lorraine; Embil, John M; Trepman, Elly
The purpose of this study was to evaluate the effect of foot problems on mental health in diabetic patients and their caregivers. Diabetic patients (47 patients with and 49 patients without foot problems), and 21 caregivers of patients with foot problems, completed outcome surveys. Foot problems included ulcers (41 patients [87%]), osteomyelitis (9 patients [19%]), and Charcot foot (8 patients [17%]). In contrast with diabetic patients having no foot problems, diabetic patients with foot problems had, on average, significantly greater symptoms of diabetes (Diabetes Symptom Checklist-2 score), greater depression symptoms (Hospital Anxiety and Depression Scale [HADS]-Depression score), worse health-related quality of life (Medical Outcome Study Short Form 36 [SF-36]: Physical Component Summary score and 6 of 8 subscales), greater pain (Short-Form McGill Pain Questionnaire), and greater suicidal behavior (Suicidal Behaviors Questionnaire-Revised). There were no significant differences in alcohol use (mean Alcohol Use Disorder Identification Test score), anxiety (HADS-Anxiety score), or SF-36 Mental Component Summary score between patients with and without foot problems. Caregivers had marked caregiver burden (average Montgomery Caregiver Burden Assessment score) and frequently had mild to moderate depression and anxiety. Foot problems are significantly associated with mental health symptoms in diabetic patients and caregivers. This may affect treatment in the foot clinic, outcome, and quality of life. Copyright © 2014. Published by Elsevier Ltd.
Alcañiz, Manuela; Brugulat, Pilar; Guillén, Montserrat; Medina-Bustos, Antonia; Mompart-Penina, Anna; Solé-Auró, Aïda
OBJECTIVE To analyze the prevalence of individuals at risk of dependence and its associated factors. METHODS The study was based on data from the Catalan Health Survey, Spain conducted in 2010 and 2011. Logistic regression models from a random sample of 3,842 individuals aged ≥ 15 years were used to classify individuals according to the state of their personal autonomy. Predictive models were proposed to identify indicators that helped distinguish dependent individuals from those at risk of dependence. Variables on health status, social support, and lifestyles were considered. RESULTS We found that 18.6% of the population presented a risk of dependence, especially after age 65. Compared with this group, individuals who reported dependence (11.0%) had difficulties performing activities of daily living and had to receive support to perform them. Habits such as smoking, excessive alcohol consumption, and being sedentary were associated with a higher probability of dependence, particularly for women. CONCLUSIONS Difficulties in carrying out activities of daily living precede the onset of dependence. Preserving personal autonomy and function without receiving support appear to be a preventive factor. Adopting an active and healthy lifestyle helps reduce the risk of dependence. PMID:26018786
McCague, Anna-Binney; Cox-Ganser, Jean M.; Harney, Joshua M.; Alwis, K. Udeni; Blount, Benjamin C.; Cummings, Kristin J.; Edwards, Nicole; Kreiss, Kathleen
Background Health risks of using styrene to manufacture windblades for the green energy sector are unknown. Methods Using data collected from 355 (73%) current windblade workers and regression analysis, we investigated associations between health outcomes and styrene exposure estimates derived from urinary styrene metabolites. Results The median current styrene exposure was 53.6 mg/g creatinine (interquartile range: 19.5–94.4). Color blindness in men and women (standardized morbidity ratios 2.3 and 16.6, respectively) was not associated with exposure estimates, but was the type previously reported with styrene. Visual contrast sensitivity decreased and chest tightness increased (odds ratio 2.9) with increasing current exposure. Decreases in spirometric parameters and FeNO, and increases in the odds of wheeze and asthma-like symptoms (odds ratios 1.3 and 1.2, respectively) occurred with increasing cumulative exposure. Conclusions Despite styrene exposures below the recommended 400 mg/g creatinine, visual and respiratory effects indicate the need for additional preventative measures in this industry. PMID:26305283
Burgette, J.M.; Lee, J.Y.; Baker, A.D.; Vann, W.F.
The objectives of this study were to examine the pattern of association between dental utilization and oral health literacy (OHL). As part of the Carolina Oral Health Literacy Project, clients in the Women, Infants, and Children’s Special Supplemental Nutrition Program completed a structured 30-min in-person interview conducted by 2 trained interviewers at 9 sites in 7 counties in North Carolina. Data were collected on clients’ OHL, sociodemographics, dental utilization, self-efficacy, and dental knowledge. The outcome, OHL, was measured with a dental word recognition test (30-item Rapid Estimate of Adult Literacy in Dentistry). Descriptive and multiple linear regression methods were used to examine the distribution of OHL and its association with covariates. After adjusting for age, education, race, marital status, self-efficacy, and dental knowledge, multiple linear regression showed that dental utilization was not a significant predictor of OHL (P > 0.05). Under the conditions of this study, dental utilization was not a significant predictor of OHL. PMID:26567035
Ding, Xuejie; Billari, Francesco C; Gietel-Basten, Stuart
To document the association between economic development, income inequality, and health-related public infrastructure, and health outcomes among Chinese adults in midlife and older age. We use a series of multi-level regression models with individual-level baseline data from the China Health and Retirement Longitudinal Survey (CHARLS). Provincial-level data are obtained both from official statistics and from CHARLS itself. Multi-level models are estimated with different subjective and objective health outcomes. Economic growth is associated with better self-rated health, but also with obesity. Better health infrastructure tends to be negatively associated with health outcomes, indicating the likely presence of reverse causality. No supportive evidence is found for the hypothesis that income inequality leads to worse health outcomes. Our study shows that on top of individual characteristics, provincial variations in economic development, income inequality, and health infrastructure are associated with a range of health outcomes for Chinese midlife and older adults. Economic development in China might also bring adverse health outcomes for this age group; as such specific policy responses need to be developed.
Bhatia, Surya; Simpson, Scot H; Bungard, Tammy
In the past decade, pharmacist practice has evolved tremendously in Canada, but the scope of practice varies substantially from one province to another. To describe pharmacists' scopes of practice relevant to prescribing within various jurisdictions of Canada, using the prescribing model in Alberta (authors' province) as the reference point. This cross-sectional survey consisted of clinical scenarios for emergency prescribing, adapting or renewing a prescription, and initial-access prescribing for a chronic disease. Pharmacists were asked about their ability to administer injections and to order or access the results of laboratory tests, as well as certification and training requirements and reimbursement models. Thirteen pharmacists representing Canadian provinces other than Alberta were surveyed in late 2015, for comparison with Alberta. With specific reference to the scenarios presented, pharmacists were able to prescribe in an emergency in 9 of the 10 provinces, renew prescriptions in all provinces, and adapt prescriptions in 6 provinces. Three provinces required that pharmacists have collaborative practice agreements identifying a specific practice area in order to initiate a prescription for a chronic disease (with 6-12 pharmacists per province having such agreements). Alberta required pharmacists to have authorization, based on a detailed application, in order to initiate any provincially regulated drug (with about 1150 pharmacists having this authorization). Pharmacists were allowed to administer vaccines in 9 provinces, and 5 provinces allowed pharmacists to administer drugs by injection. Three provinces had systems in place for pharmacists to access laboratory test results, and 2 allowed pharmacists to order laboratory tests. Five provinces had government-reimbursed programs in place for select prescribing services; however, all 9 provinces with public vaccination programs reimbursed pharmacists for this service. Pharmacist prescribing differs among
Joaquín Martínez Pino
Full Text Available Recoge este artículo la labor desarrollada por la Comisión Provincial de Monumentos de Murcia desde su creación en 1844 hasta su reorganización en 1865. Procura este estudio también plasmar las actividades llevadas a cabo por la Comisión Científico Artística de Murcia, como organismo precedente de las Comisiones de Monumentos.This article puts forward the work developed by the Provincial Commission on Monuments of Murcia (Spain since it was created in 1844 until its reorganization in 1865. This research also tries to capture the activities carried out by the Scientific Artistic Commission of Murcia (Spain, as the predecessor of the Commission on Monuments.
Hu, Song Bo; Wang, Fang; Yu, Chuan Hua
To assess the data quality and estimate the provincial infant mortality rate (1q0) from China's sixth census. A log-quadratic model is applied to under-fifteen data. We analyze and compare the average relative errors (AREs) for 1q0 between the estimated and reported values using the leave-one-out cross-validation method. For the sixth census, the AREs are more than 100% for almost all provinces. The estimated average 1q0 level for 31 provinces is 12.3‰ for males and 10.7‰ for females. The data for the provincial 1q0 from China's sixth census have a serious data quality problem. The actual levels of 1q0 for each province are significantly higher than the reported values. Copyright © 2015 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.
Ye, Z.; Xiang, H.
The paper discusses the basic principles and the problem solutions during the design and implementation of the mobile GIS system, and base on the research result, we developed the General Provincial Situation Visualization System Based on iOS of Shandong Province. The system is developed in the Objective-C programming language, and use the ArcGIS Runtime SDK for IOS as the development tool to call the "World-map Shandong" services to implement the development of the General Provincial Situation Visualization System Based on iOS devices. The system is currently available for download in the Appstore and is chosen as the typical application case of ESRI China ArcGIS API for iOS.
Full Text Available Beginning in 1909, mainland Chinese governments routinely held elections, and lawmakers devoted considerable resources to writing and revising election laws. The earliest elections, held under the late Qing and the early Republic, utilized laws based on restricted electorates and indirect voting. By contrast, election laws designed during the provincial autonomy movement of the 1920s and the post-1927 Nationalist government featured direct voting in elections with (near-universal adult suffrage. Each of these two systems of electoral law incorporated different elements of foreign electoral practice with concerns and ideas that arose from the experiences and ideals of late imperial Chinese political thought. The transition between these two systems highlights the surprising influence of the short-lived provincial autonomy movement on the legal structures of the centralized one-party states that followed.
Nellis, Jason C; Ishii, Masaru; Bater, Kristin L; Papel, Ira D; Kontis, Theda C; Byrne, Patrick J; Boahene, Kofi D O; Ishii, Lisa E
To date, the impact of rhinoplasty surgery on social perceptions has not been quantified. To measure the association of rhinoplasty with observer-graded perceived attractiveness, success, and overall health. In a web-based survey, blinded casual observers viewed independent images of 13 unique patient faces before or after rhinoplasty. Delphi method was used to select standardized patient images, confirming appropriate patient candidacy and overall surgical effect. Observers rated the attractiveness, perceived success, and perceived overall health for each patient image. Facial perception questions were answered on a visual analog scale from 0 to 100, where higher scores corresponded to more positive responses. A multivariate mixed-effects regression model was used to determine the effect of rhinoplasty while accounting for observer biases. To further characterize the effect of rhinoplasty, estimated ordinal rank change was calculated for each domain. The primary objective was to measure the effect of rhinoplasty on observer-graded perceived attractiveness, success, and overall health. A total of 473 observers (mean age, 29 years [range, 18-73 years]; 305 [70.8%] were female) successfully completed the survey. On multivariate regression, patients after rhinoplasty were rated as significantly more attractive (rhinoplasty effect, 6.26; 95% CI, 5.10-7.41), more successful (rhinoplasty effect, 3.24; 95% CI, 2.32-4.17), and overall healthier (rhinoplasty effect, 3.78; 95% CI, 2.79-4.81). The ordinal rank change for an average individual's perceived attractiveness, success, and overall health was a positive shift of 14, 9, and 10 out of 100 rank positions, respectively. As perceived by casual observers, rhinoplasty surgery was associatedwith perceptions that in patients appeared significantly more attractive, more successful, and healthier. These results suggest patients undergoing rhinoplasty may derive a multifaceted benefit when partaking in social interactions
Fahy, Amanda E; Stansfeld, Stephen A; Smuk, Melanie; Smith, Neil R; Cummins, Steven; Clark, Charlotte
Cyberbullying differs from face-to-face bullying and may negatively influence adolescent mental health, but there is a lack of definitive research on this topic. This study examines longitudinal associations between cyberbullying involvement and adolescent mental health. Participants were 2,480 teenagers taking part in the Olympic Regeneration in East London study. We collected information from participants when they were 12-13 years old and again 1 year later to examine links between involvement in cyberbullying and future symptoms of depression and social anxiety, and mental well-being. At baseline, 14% reported being cybervictims, 8% reported being cyberbullies, and 20% reported being cyberbully-victims in the previous year. Compared to uninvolved adolescents, cybervictims and cyberbully-victims were significantly more likely to report symptoms of depression (cybervictims: odds ratio [OR] = 1.44, 95% confidence interval [CI] [1.00, 2.06]; cyberbully-victims: OR = 1.54, 95% CI [1.13, 2.09]) and social anxiety (cybervictims: OR = 1.52, 95% CI [1.11, 2.07]; cyberbully-victims: OR = 1.44, 95% CI [1.10, 1.89]) but not below average well-being (cybervictims: relative risk ratio = 1.28, 95% CI [.86, 1.91]; cyberbully-victims: relative risk ratio = 1.38, 95% CI [.95, 1.99]) at 1 year follow-up, after adjustment for confounding factors including baseline mental health. This study emphasizes the high prevalence of cyberbullying and the potential of cybervictimization as a risk factor for future depressive symptoms, social anxiety symptoms, and below average well-being among adolescents. Future research should identify protective factors and possible interventions to reduce adolescent cyberbullying. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Represión en Sevilla: el tribunal de responsabilidades políticas. Fondo del Archivo Histórico Provincial de Sevilla (Repression in Seville: the court of political responsibilities. Fund of the Historical Provincial Archive of Seville)
Rosa Félix, Antonio
... situación anterior a la reforma agraria.Abstract: The Historical Provincial Archive of Seville keeps a collection of files record of Political Responsibilities, proceeding from the Court of The First Instance and Sanlúcar's Instruction...
Sara F. L. Kirk
Full Text Available Healthy public policy plays a central role in creating environments that are supportive of health. Breastfeeding, widely supported as the optimal mode for infant feeding, is a critical factor in promoting infant health. In 2005, the Canadian province of Nova Scotia introduced a provincial breastfeeding policy. This paper describes the process and outcomes of an evaluation into the implementation of the policy. This evaluation comprised focus groups held with members of provincial and district level breastfeeding committees who were tasked with promoting, protecting and supporting breastfeeding in their districts. Five key themes were identified, which were an unsupportive culture of breastfeeding; the need for strong leadership; the challenges in engaging physicians in dialogue around breastfeeding; lack of understanding around the International Code of Marketing of Breast-milk Substitutes; and breastfeeding as a way to address childhood obesity. Recommendations for other jurisdictions include the need for a policy, the value of leadership, the need to integrate policy with other initiatives across sectors and the importance of coordination and support at multiple levels. Finally, promotion of breastfeeding offers a population-based strategy for addressing the childhood obesity epidemic and should form a core component of any broader strategies or policies for childhood obesity prevention.
Kirk, Sara F. L.; Sim, Sarah Meaghan; Hemmens, Erin; Price, Sheri L.
Healthy public policy plays a central role in creating environments that are supportive of health. Breastfeeding, widely supported as the optimal mode for infant feeding, is a critical factor in promoting infant health. In 2005, the Canadian province of Nova Scotia introduced a provincial breastfeeding policy. This paper describes the process and outcomes of an evaluation into the implementation of the policy. This evaluation comprised focus groups held with members of provincial and district level breastfeeding committees who were tasked with promoting, protecting and supporting breastfeeding in their districts. Five key themes were identified, which were an unsupportive culture of breastfeeding; the need for strong leadership; the challenges in engaging physicians in dialogue around breastfeeding; lack of understanding around the International Code of Marketing of Breast-milk Substitutes; and breastfeeding as a way to address childhood obesity. Recommendations for other jurisdictions include the need for a policy, the value of leadership, the need to integrate policy with other initiatives across sectors and the importance of coordination and support at multiple levels. Finally, promotion of breastfeeding offers a population-based strategy for addressing the childhood obesity epidemic and should form a core component of any broader strategies or policies for childhood obesity prevention. PMID:22690194
Pringle, Simone; Lippitt, Alex
As patients receive medical care, their clinical history may be tracked and recorded by multiple electronic systems developed by independent vendors. Medical providers might use electronic health record (EHR) software tailored to the needs of trained medical personnel, whereas patients may interact with personal health records (PHR). The purpose of this essay is to identify the key interoperability issues associated with the information exchange between these two types of systems and offer an approach for enhancing interoperability. This article is part of a series of unpublished essays titled A Community View on How Personal Health Records Can Improve Patient Care and Outcomes in Many Healthcare Settings, a collaborative project of Northern Illinois Physicians For Connectivity and the Coalition for Quality and Patient Safety of Chicagoland. For further information on how you can obtain copies of the complete work, contact the principle Dr. Stasia Kahn at Stash5@sbcglobal.net.
Hindar, A.; Henriksen, A.
Calculations of critical loads for inputs of strong acids to lakes and exceedances of critical load can be a useful tool for the management of polluted areas. In Sudbury, Canada, large emissions of sulfur dioxide have resulted in widespread lake acidification in parts of northeastern Canada. Due to its vicinity to Sudbury, extensive lake acidification and fish loss has occurred in the Killarney Provincial Park. We have linked measured water quality to critical loads and strong acid deposition...
Nielsen, Thomas Alexander Sick
This paper presents the results from a detailed study of the land use ? transport connection, with special emphasis on the location of residences, in the context of a larger Danish provincial city (the city of Aalborg with approx. 120.000 inhabitants, situated in North Jutland). The study...... was carried out as a part of the authors PhD-work and as part of the research programme: Transportation and urban structure at Aalborg University....
ZHOU Li¡¯an; Tao, Jing
Using a panel data at the provincial level during the period of 1989–2004, this paper examines the effects of social and economic factors such as government scale, privatization, openness, and education on regional corruption. Applying a fixed-effect model and IV estimation, we find that government size positively affects the incidence rate of corruption, and the effect becomes larger with the increase in the size of the core department of the government. 1% increase in the core department of...
Miro, Alice; Kishchuk, Natalie A; Perrotta, Kim; Swinkels, Helena M
The Healthy Canada by Design (HCBD) CLASP (Coalitions Linking Action and Science for Prevention) Initiative promotes the building of communities that support health by 1) facilitating the integration of health evidence into built environment decision-making; 2) developing new, cross-sector collaboration models and tools; and 3) fostering a national community of practice. A coalition of public health professionals, researchers, professional planners and non-governmental organization (NGO) staff from across Canada developed, implemented and participated in the Initiative. In the first phase, HCBD interventions took place for the most part in large urban and suburban settings in Quebec, Ontario and British Columbia. National knowledge transfer and exchange (KTE) activities were delivered both locally and nationally. Project participants developed tools or processes for collaboration between the health and the community planning sectors. These were designed to increase the capacity of the health sector to influence decisions about land use and transportation planning. Tool or process development was accompanied by pilot testing, evaluation, and dissemination of findings and lessons learned. On a parallel track, NGOs involved with HCBD led national KTE interventions. The first phase of HCBD demonstrated the potential for public health organizations to influence the built environment determinants of cancer and chronic diseases. Public health authorities forged relationships with several organizations with a stake in built environment decisions, including municipal and regional planning departments, provincial governments, federal government agencies, researchers, community groups and NGOs. The Initiative accomplished the following: 1) created new relationships across sectors and across health authorities; 2) improved the knowledge and skills for influencing land use planning processes among public health professionals; 3) increased awareness of health evidence and intent
Robert J. Craig
Full Text Available I examined lists of endangered species from northeastern and midwestern United States to assess the extent to which they were dominated by species considered rare due to their vulnerability to anthropogenic stressors or, instead, by species whose rarity might be explained otherwise. Northeastern states had longer species lists than midwestern states, and more species associated with locally rare prairie habitats. More species at the edge of their geographic range appeared on lists from the Northeast than the Midwest. About 70% of listed species overall have shown either no significant population trend, or increases, at the continental scale, but wetland and prairie species were frequently listed, consistent with the generally acknowledged, widespread loss of these habitats. Curiously, midwestern states tended to list fewer forest species, despite evidence that forest fragmentation there has had strongly deleterious effects on regional bird populations. Overall, species appear to be listed locally for a variety of reasons not necessarily related to their risk of extinction generally, potentially contributing to inefficient distributions of limited resources to deal effectively with species that legitimately require conservation attention. I advocate a continental perspective when listing species locally, and propose enhanced criteria for characterizing species as endangered at the local level.
Bonnet, Maryline; San, Kim Chamroeun; Pho, Yati; Sok, Chandara; Dousset, Jean-Philippe; Brant, William; Hurtado, Northan; Eam, Khun Kim; Ardizzoni, Elisa; Heng, Seiha; Godreuil, Sylvain; Yew, Wing-Wai; Hewison, Cathy
Prevalence of nontuberculous mycobacteria (NTM) disease is poorly documented in countries with high prevalence of tuberculosis (TB). We describe prevalence, risk factors, and TB program implications for NTM isolates and disease in Cambodia. A prospective cohort of 1,183 patients with presumptive TB underwent epidemiologic, clinical, radiologic, and microbiologic evaluation, including >12-months of follow-up for patients with NTM isolates. Prevalence of NTM isolates was 10.8% and of disease was 0.9%; 217 (18.3%) patients had TB. Of 197 smear-positive patients, 171 (86.8%) had TB confirmed (167 by culture and 4 by Xpert MTB/RIF assay only) and 11 (5.6%) had NTM isolates. HIV infection and past TB were independently associated with having NTM isolates. Improved detection of NTM isolates in Cambodia might require more systematic use of mycobacterial culture and the use of Xpert MTB/RIF to confirm smear-positive TB cases, especially in patients with HIV infection or a history of TB.
Quick, J.C.; Brill, T.
We observe a 1.3 kg C/net GJ variation of carbon emissions due to inertinite abundance in some commercially available bituminous coal. An additional 0.9 kg C/net GJ variation of carbon emissions is expected due to the extent of coalification through the bituminous rank stages. Each percentage of sulfur in bituminous coal reduces carbon emissions by about 0.08 kg C/net GJ. Other factors, such as mineral content, liptinite abundance and individual macerals, also influence carbon emissions, but their quantitative effect is less certain. The large range of carbon emissions within the bituminous rank class suggests that rank- specific carbon emission factors are provincial rather than global. Although carbon emission factors that better account for this provincial variation might be calculated, we show that the data used for this calculation may vary according to the methods used to sample and analyze coal. Provincial variation of carbon emissions and the use of different coal sampling and analytical methods complicate the verification of national greenhouse gas inventories. Published by Elsevier Science B.V.
Full Text Available The relationship between urbanization, economic growth, and water use change is one of the key issues for China’s sustainable development, as rapid urbanization and continuous economic growth are accompanied by a steady water stress. Thus, we applied a cointegration test and a VECM (vector error correction model Granger causality test to investigate the causal relationship between the urbanization level, the economic development level, and the total water use in China and its 31 provincial administrative regions during 1997–2013. Results show that the three indicators have a long-run equilibrium relationship in most provincial administrative regions in China. However, the short-run effects and Granger causal relationship are insignificant for China and most provincial administrative regions. Therefore, that an idea such as urbanization as the engine or major driving force of economic growth, and that China’s urbanization and economic growth will bring a water crisis and will be strongly constrained by water resources, might be properly weakened. Targeted and relatively separate policies should be emphasized more for the coordinated development of China’s urbanization, economy, and water resources.
Poompruek, Panoopat; Boonmongkon, Pimpawun; Guadamuz, Thomas E.
Background The Thai term kathoei refers to non-gender-normative females, males and intersexual individuals at different stages of the transitional spectrum with recognized social and cultural roles in society. Nevertheless, kathoeis are only tolerated in Thai society. Many kathoeis seek social acceptance through beauty and turn to the off-label injection of various ‘beauty drugs’. Methods The first author conducted an ethnographic study of injection parties at a wedding studio in a Central Thai provincial city between April and September 2011. Data were gathered through participant observation, focus group discussions and narrative interviews with six participants. All data were collected and analyzed in Thai, and later translated. Findings While injection parties provide opportunities for kathoeis to socialize, bond, and share experiential knowledge on chemically-assisted transformation, they also reproduce ideologies of gender, beauty and sexuality that reinforce the notion that if a kathoei is to maintain her beauty, she must use medicines more frequently and in higher doses. Conclusion Injection parties among Thai kathoeis feature drug use that is entirely reasonable in terms of their own lay knowledge. Empowering kathoeis, by providing accessible information on chemicals and health in a way that reflects the complexity and diversity of their practices, would be one way to reduce health risks. Society must give more long-term options to kathoeis to build their sense of self, based on things besides being beautiful. PMID:25047007
... Accreditation Association for Ambulatory Health Care (AAAHC) Application for Continuing CMS Approval of Its Ambulatory Surgical Center Accreditation Program AGENCY: Centers for Medicare and Medicaid Services, HHS... Association for Ambulatory Health Care (AAAHC) for continued recognition as a national accrediting...
Walker, Michael; McArthur, William; Ramsay, Cynthia
.... Since health expenditures are one of the largest and fastest growing segments of provincial budgets, much of the fiscal reform taking place across the country has centred around cuts to health funding...
Ye, Yong-ling; Wang, Pei-gang; Qu, Geng-cong; Yuan, Shuai; Phongsavan, Philayrath; He, Qi-qiang
Although there is substantial evidence that health risk behaviors increase risks of premature morbidity and mortality, little is known about the multiple health risk behaviors in Chinese college students. Here, we investigated the prevalence of multiple health risk behaviors and its relation to mental health among Chinese college students. A cross-sectional study was conducted in Wuhan, China from May to June 2012. The students reported their health risk behaviors using self-administered questionnaires. Depression and anxiety were assessed using the self-rating depression scale and self-rating anxiety scale, respectively. A total of 2422 college students (1433 males) aged 19.7 ± 1.2 years were participated in the study. The prevalence of physical inactivity, sleep disturbance, poor dietary behavior, Internet addiction disorder (IAD), frequent alcohol use and current smoking was 62.0, 42.6, 29.8, 22.3, 11.6 and 9.3%, respectively. Significantly increased risks for depression and anxiety were found among students with frequent alcohol use, sleep disturbance, poor dietary behavior and IAD. Two-step cluster analysis identified two different clusters. Participants in the cluster with more unhealthy behaviors showed significantly increased risk for depression (odds ratio (OR): 2.21; 95% confidence interval (CI): 1.83, 2.67) and anxiety (OR: 2.32; 95% CI: 1.85, 2.92). This study indicates that a relatively high prevalence of multiple health risk behaviors was found among Chinese college students. Furthermore, the clustering of health risk behaviors was significantly associated with increased risks for depression and anxiety.
Chauvin, James; Shukla, Mahesh; Rice, James; Rispel, Laetitia
National public health associations (PHAs) are key partners with governments and communities to improve, protect and promote the public's health. Governance and organizational capacity are among the key determinants of a PHA's effectiveness as an advocate for appropriate public health policies and practice. During 2014, the World Federation of Public Health Associations (WFPHA) conducted an on-line survey of its 82 PHA members, to identify the state of organizational governance of national public health associations, as well as the factors that influence optimal organizational governance. The survey consisted of 13 questions and focused on the main elements of organizational governance: cultivating accountability; engaging stakeholders; setting shared direction; stewarding resources; and, continuous governance enhancement. Four questions included a qualitative open-ended response for additional comments. The survey data were analyzed using Microsoft Excel. The qualitative data was analyzed using thematic content analysis Responses were received from 62 PHAs, constituting a 75.6 % response rate. The two most important factors that support governance effectiveness were a high degree of integrity and ethical behavior of the PHA's leaders (77 %) and the competence of people serving on the PHA's governing body (76 %). The lack of financial resources was considered as the most important factor that negatively affected organizational governance effectiveness (73 %). The lack of mentoring for future PHA leaders; ineffective or incompetent leadership; lack of understanding about good governance practices; and lack of accurate information for strategic planning were identified as factors influencing PHA governance effectiveness. Critical elements for PHA sustainability included diversity, gender-responsiveness and inclusive governance practices, and strategies to build the future generation of public health leaders. National PHA have a responsibility to put into place
Full Text Available Abstract Background National public health associations (PHAs are key partners with governments and communities to improve, protect and promote the public’s health. Governance and organizational capacity are among the key determinants of a PHA’s effectiveness as an advocate for appropriate public health policies and practice. Methods During 2014, the World Federation of Public Health Associations (WFPHA conducted an on-line survey of its 82 PHA members, to identify the state of organizational governance of national public health associations, as well as the factors that influence optimal organizational governance. The survey consisted of 13 questions and focused on the main elements of organizational governance: cultivating accountability; engaging stakeholders; setting shared direction; stewarding resources; and, continuous governance enhancement. Four questions included a qualitative open-ended response for additional comments. The survey data were analyzed using Microsoft Excel. The qualitative data was analyzed using thematic content analysis Results Responses were received from 62 PHAs, constituting a 75.6 % response rate. The two most important factors that support governance effectiveness were a high degree of integrity and ethical behavior of the PHA’s leaders (77 % and the competence of people serving on the PHA’s governing body (76 %. The lack of financial resources was considered as the most important factor that negatively affected organizational governance effectiveness (73 %. The lack of mentoring for future PHA leaders; ineffective or incompetent leadership; lack of understanding about good governance practices; and lack of accurate information for strategic planning were identified as factors influencing PHA governance effectiveness. Critical elements for PHA sustainability included diversity, gender-responsiveness and inclusive governance practices, and strategies to build the future generation of public health
Chari, Roopa; Warsh, Joel; Ketterer, Tara; Hossain, Jobayer; Sharif, Iman
We tested the association between child and parental health literacy (HL) and odds of child and adolescent obesity. We conducted an anonymous cross-sectional survey of a convenience sample of English-speaking child-parent dyads. Newest Vital Sign (NVS) measured HL. We used multivariable logistic regression to test adjusted association between child and parental NVS and obesity. Analyses were stratified for school-aged children (aged 7-11) vs. adolescents (aged 12-19). We surveyed 239 child-parent dyads. Median child age was 11 [inter-quartile range 9-13]; 123 (51%) were male; 84% Medicaid recipients; 27% obese. For children, the odds of obesity [adjusted odds ratio (95% confidence interval)] decreased with higher parent NVS [0.75 (0.56,1.00)] and increased with parent obesity [2.53 (1.08,5.94)]. For adolescents, odds of obesity were higher for adolescents with the lowest category of NVS [5.00 (1.26, 19.8)] and older parental age [1.07 (1.01,1.14)] and lower for Medicaid recipients [0.21 (0.06,0.78)] and higher parental education [0.38 (0.22,0.63)]. Obesity in school-aged children is associated with parental factors (obesity, parental HL); obesity in adolescents is strongly associated with the adolescent's HL. Strategies to prevent and treat obesity should consider limited HL of parents for child obesity and of adolescents for adolescent obesity. Copyright © 2013. Published by Elsevier Ireland Ltd.
Razouki, Zayd; Knighton, Troy; Martinello, Richard A; Hirsch, Pamela R; McPhaul, Kathleen M; Rose, Adam J; McCullough, Megan
.... We sought to characterize organizational factors and practices that were associated with vaccination campaign success among six sites within the Veterans Health Administration, where receipt of flu...
Paul, Debarati; Manna, Sounik; Mandal, Santi M
The gut microbiota plays significant roles in the human body during all spheres' of life and influences innate immunity, promotes granulocyte signaling and provides resistance during pathogenic colonization of the gut; crucial for a healthy life. Antibiotics directly affect the gut microbiota that consequently alter the basic biological processes, and imposes severe consequences in population falling under different age groups. In this article, we have assessed the differences in microbial colonization and immune function of the intestinal tract in infants, adults, and the aged people and also have examined the recent reports describing the impacts of antibiotics on infant microbiome assembly and functioning. The age old techniques have been compared to modern ones in relation to the functioning of the gut microbiome to draw inferences on significant impacts of various microbiota on human life starting from the womb, through infancy, adulthood and old age. It was observed that data is limited to different classes or origin of populace depicting variations in food habits and/or suffering from heavy metal associated diseases after continuous exposure to heavy metals/ metalloids/ biocides. Such extreme environmental factors significantly modulate the microbiota and assist in creating a 'co-resistant' gene pool that impacts gut health. In the light of this finding, it is important to analyze the 'co-resistant' gene pool existing in gut-microbiome which supports to recoup and establish a healthy life. The hypothesis of 'postbiotics' is under process and their associations with antibiotic turns a new-insight in antibiotic therapy. On one hand, postbiotics provide an immense opportunity to understand the mechanism of action against pathobionts and on the other; they lead to postulation of newer pharmabiotic products and pharmacological strategies for better gut health. Copyright© Bentham Science Publishers; For any queries, please email at email@example.com.
Conclusions: We recommend the provision of screening programs and health education programs, including dietary programs and physical and exercise programs, by the occupational health nursing (OHN program, to prevent and reduce health problems in the agricultural sector.
Stenner, R.D.; Baechler, M.C.
Indoor air quality can conceivably be impacted by hundreds of different chemicals. More than 900 different organic compounds alone have been identified in indoor air. The health effects that could potentially arise from exposure to individual pollutants or mixtures of pollutants cover the full range of acute and chronic effects, including largely reversible responses, such as rashes and irritations, as well as irreversible toxic and carcinogenic effects. These indoor contaminants are emitted from a large variety of materials and substances that are widespread components of everyday life. Pacific Northwest Laboratory conducted a search of the peer-reviewed literature on health effects associated with indoor air contaminants for the Bonneville Power Administration to aid the agency in the preparation of environmental documents. The results of this search are reported in two volumes. Volume 1 is a summary of the results of the literature search; Volume 2 is the complete results of the literature search and contains all references to the material reviewed. 16 tabs.
Kim, Ki-Hyun; Kabir, Ehsanul; Jahan, Shamin Ara
Pesticides are used widely to control weeds and insect infestation in agricultural fields and various pests and disease carriers (e.g., mosquitoes, ticks, rats, and mice) in houses, offices, malls, and streets. As the modes of action for pesticides are not species-specific, concerns have been raised about environmental risks associated with their exposure through various routes (e.g., residues in food and drinking water). Although such hazards range from short-term (e.g., skin and eye irritation, headaches, dizziness, and nausea) to chronic impacts (e.g., cancer, asthma, and diabetes), their risks are difficult to elucidate due to the involvement of various factors (e.g., period and level of exposure, type of pesticide (regarding toxicity and persistence), and the environmental characteristics of the affected areas). There are no groups in the human population that are completely unexposed to pesticides while most diseases are multi-causal to add considerable complexity to public health assessments. Hence, development of eco-friendly pesticide alternatives (e.g., EcoSMART) and Integrated Pest Management (IPM) techniques is desirable to reduce the impacts of pesticides. This paper was hence organized to present a comprehensive review on pesticides with respect to their types, environmental distribution, routes of exposure, and health impacts. Copyright © 2016 Elsevier B.V. All rights reserved.
Behrman, Jere R; Xiong, Yanyan; Zhang, Junsen
Adult health outcomes and health behaviors are often associated with schooling. However, such associations do not necessarily imply that schooling has causal effects on health with the signs or magnitudes found in the cross-sectional associations. Schooling may be proxying for unobserved factors related to genetics and family background that directly affect both health and schooling. Recently several studies have used within-monozygotic (MZ) twins methods to control for unobserved factors shared by identical twins. Within-MZ estimates for developed countries are generally smaller than suggested by cross-sectional associations, consistent with positive correlations between unobserved factors that determine schooling and those that determine health. This study contributes new estimates of cross-sectional associations and within-MZ causal effects using the Chinese Adults Twins Survey, the first study of its type for developing countries. The cross-sectional estimates suggest that schooling is significantly associated with adult health-related behaviors (smoking, drinking, exercising) but not with own or spouse health outcomes (general health, mental health, overweight, chronic diseases). However, within-MZ-twins estimators change the estimates for approximately half of these health indicators, in one case declining in absolute magnitudes and becoming insignificant and in the other cases increasing in absolute magnitudes. Within-MZ estimates indicate significant pro-health effects for at least one of the indicators for own health (better mental health), own health-related behaviors (less smoking) and spouse health (less overweight). Copyright © 2014 Elsevier Ltd. All rights reserved.
Lee, Dong-Yun; Kim, Seo-Hee; Woo, Sook Young; Yoon, Byung-Koo; Choi, DooSeok
Abstract Homosexual adolescents may face significant health disparities. We examined health-risk behaviors and health cognition related to homosexual behavior in a representative sample of adolescents. Data were obtained from 129,900 adolescents between 2008 and 2012 over 5 cycles of the Korean Youth Risk Behavior Survey, a national survey of students in grades 7 to 12. Various health-risk behaviors and aspects of health cognition were compared between homosexual and heterosexual adolescents and analyzed with multiple logistic regression models. Compared with heterosexual adolescents (n = 127,594), homosexual adolescents (n = 2306) were more likely to engage in various health-risk behaviors and to have poor health cognition. In multiple logistic regression analysis, not living with parents, alcohol experience (adjusted odds ratio, 1.50; 95% confidence interval, 1.26–1.78 for males and 1.66; 1.33–2.07 for females), smoking experience (1.80; 1.54–2.10 for males and 3.15; 2.61–3.79 for females), and drug experience (3.65; 2.81–4.80 for males and 3.23; 2.35–4.46 for females) were associated with homosexual behavior. Homosexual adolescents were more likely to use adult internet content (2.82; 2.27–3.50 for males and 7.42; 4.19–13.15 for females), and to be depressed (1.21; 1.03–1.43 for males and 1.32; 1.06–1.64 for females). In addition, suicide ideation (1.51; 1.26–1.81 for males and 1.47; 1.16–1.86 for females) and attempts (1.67; 1.37–2.05 for males and 1.65; 1.34–2.03 for females) were significantly more prevalent among homosexual adolescents. Homosexual adolescents report disparities in various aspects of health-risk behavior and health cognition, including use of multiple substances, adult internet content and inappropriate weight loss methods, suicide ideation and attempts, and depressive mood. These factors should be addressed relevantly to develop specific interventions regarding sexual minorities. PMID:27227939
Swift, J A; Sheard, C; Rutherford, M
Trainee nurses, doctors and dietitians will direct the future of obesity treatment and prevention. To do so effectively, they must have sufficient knowledge regarding the health risks associated with obesity and feel that part of their professional role is to counsel obese patients regarding these risks. An online survey collected data on professional roles, training needs and the Obesity Risk Knowledge-10 (ORK-10) scale from 38 dietetic, 88 nursing (Diploma), 74 nursing (Masters) and 389 medical students. Final-year dietetic students demonstrated higher ORK-10 scale scores than final-year nursing (Dip), nursing (MSc) and medical students (P profession's role was to counsel obese patients about the health risks associated with obesity. Dietetic students were more satisfied with the teaching they had received than each of the other student groups (P professionals recognize their responsibility to communicate health risk information to obese patients. Dietetic students have a sound knowledge base to support them in this. Educators of trainee nurses and doctors may like to respond to their students' lower levels of knowledge and desire for more training.
Idrovo, Alvaro Javier
In the Old World, several researchers have indicated that adverse health effects were associated with exposure to arsenic, and that this influenced a change in the use of copper-arsenic alloys to others less toxic. This hypothesis was evaluated for three Pre-Columbian metallurgy traditions: Central Andes, Intermediate Area, and West Mexico. The metal artifacts from the Central Andes showed arsenic concentrations similar to those in the Old World (0.5%-1.0%). In the Intermediate Area the values were smallest; however, in West Mexico the arsenic content was very high (7%-25%). In Central Andes arsenical bronze was used initially, but copper-tin alloys when introduced were preferred and distributed throughout the Inca Empire. Osteological and artistic evidences of foot amputations among Moche individuals from Central Andes support the presence of "black foot disease" (a condition associated with arsenic poisoning) among Pre-Columbian populations. In conclusion, the adverse effects of arsenic have been observed in the New World, and that these effects promoted a change toward the use of less toxic alloys.
Hunt, E J F; Greenberg, N; Jones, N
Sleep difficulties, alcohol use and mental illness are often related; military studies suggest that post-deployment is a high-risk period for sleep problems. To examine the prevalence of post-deployment sleep difficulties in UK Armed Forces (UKAF) personnel and associations with alcohol use disorders (AUD) and any mental disorder (AMD) symptoms. A prospective, self-report, observational study of UKAF members returning from Afghanistan, questionnaire data were collected immediately following and 6 months post-deployment. A total of 1636 participants provided study data at both time points. Twenty-three per cent of personnel reported sleep difficulties at follow-up; 11% reported sleep-related interference with daily functioning. Sleep problems were significantly associated with AUD and AMD. Initial post-deployment sleep problems were predictive of AMD but not AUD at follow-up. The disclosure of alcohol misuse and mental ill-health in UKAF personnel is often inhibited by stigmatizing beliefs; detection could be enhanced by inquiring about sleep problems which may be less stigmatizing than direct enquiries about alcohol misuse and psychological well-being. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Räsänen, Tiina; Lintonen, Tomi; Tolvanen, Asko; Konu, Anne
Studies have shown that gambling is associated with poor health and health risk-taking behaviour. However, little is known about those factors that can influence the association between gambling, health risk-taking and health. Using a population-based School Health Promotion Study of eighth- and ninth-grade Finnish boys and girls (N = 62,956), we investigated the relationships between gambling frequency, health risk-taking and poor health as well as whether social support from parents, friends and school staff could mediate these associations. Path analysis was used to discover direct and indirect effects of health, health risk-taking and gambling. Social support from parents and school staff decreased gambling among boys and girls, whereas among boys support from friends increased gambling. However, the role of social support as a mediator was very weak. Overall poor health and health risk-taking were associated with increased gambling. CONCLUSIONS GAMBLING SHOULD BE CONSIDERED AN IMPORTANT PUBLIC HEALTH ISSUE BECAUSE IT CLUSTERS WITH OTHER UNHEALTHY BEHAVIOUR PATTERNS INTERVENTIONS CONCERNING ADOLESCENT GAMBLING SHOULD ALSO TAKE OTHER SIMULTANEOUS RISK-TAKING INTO CONSIDERATION ALSO SOCIAL SUPPORT FROM PARENTS AND SCHOOL SHOULD BE NOTED WHEN TRYING TO DECREASE ADOLESCENTS' GAMBLING. © 2016 the Nordic Societies of Public Health.
Dizon, Janine Margarita; Grimmer, Karen; Machingaidze, Shingai; McLaren, Pam; Louw, Quinette
Little is known about allied health (AH) clinical practice guideline (CPG) activity in South Africa, and particularly in relation to primary health care (PHC). This paper reports on a scoping study undertaken to establish a reference framework, from which a comprehensive maximum variation sample could be selected. This was required to underpin robust sampling for a qualitative study aimed at understanding South African primary care AH therapy CPG activities. This paper builds on findings from the South African Guidelines Evaluation (Project SAGE) Flagship grant. South African government websites were searched for structures of departments and portfolios, and available CPGs. Professional AH association websites were searched for CPGs, purposively-identified key informants were interviewed, and CPGs previously identified for priority South African primary care conditions were critiqued for AH therapy involvement. Key informants described potentially complex relationships between players who may be engaged in South African AH CPGs, in both public and private sectors. There were disability/rehabilitation portfolios at national and provincial governments, but no uniformity in provincial government organisation of, or support for, PHC AH services. There were no AH primary care therapy CPGs on government websites, although there was 'clinical guidance' in various forms on professional association websites. Only two CPGs of priority South African PHC conditions included mention of any AH therapy (physiotherapy for adult asthma and chronic obstructive pulmonary disease). A comprehensive and wide-reaching stakeholder reference framework would be required in order to capture the heterogeneity of AH primary care CPG activity in South Africa. This should involve the voices of national and purposively-selected provincial governments, academic institutions, consultants, public sector managers and clinicians, private practitioners, professional associations, and private sector
an internal as well as international migration of health workers (3)”. “Within a region is also movement from poorer to richer countries, for example from Zambia to. South Africa, or from Tanzania to Botswana. (3)”. The rural health facilities have been facing severe shortage of health workers due to migration to urban health ...
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
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
Yang, Shu-Ching; Luo, Yi-Fang; Chiang, Chia-Hsun
eHealth literacy is gaining importance for maintaining and promoting health. Studies have found that individuals with high eHealth literacy are more likely to adopt healthy eating, exercise, and sleep behaviors. In addition, previous studies have shown that various individual factors (eg, frequency of seeking information on health issues, degree of health concern, frequency of eating organic food, and students' college major) are associated with eHealth literacy and health-promoting lifestyles. Nevertheless, few studies have explored the associations among individual factors, eHealth literacy, and health-promoting lifestyles among college students. Moreover, there is a lack of studies that focus on eHealth literacy as a predictor of psychological health behaviors. To examine the associations among various individual factors, eHealth literacy, and health-promoting lifestyles. The eHealth Literacy Scale is a 12-item instrument designed to measure college students' functional, interactive, and critical eHealth literacy. The Health-promoting Lifestyle Scale is a 23-item instrument developed to measure college students' self-actualization, health responsibility, interpersonal support, exercise, nutrition, and stress management. A nationally representative sample of 556 valid college students in Taiwan was surveyed. A questionnaire was administered to gather the respondents' background information, including the frequency of seeking information on health issues, the frequency of eating organic food, the degree of health concern, and the students' major. We then conducted a multiple regression analysis to examine the associations among individual factors, eHealth literacy, and health-promoting lifestyles. The study found that factors such as medical majors (t550=2.47-7.55, Pcollege students' 4-6 health-promoting lifestyle dimensions and the 3 dimensions of eHealth literacy. Moreover, critical eHealth literacy positively predicted all 6 health-promoting lifestyle
Tran, Antoine; Tran, Laurie; Geghre, Nicolas; Darmon, David; Rampal, Marion; Brandone, Diane; Gozzo, Jean-Michel; Haas, Hervé; Rebouillat-Savy, Karine; Caci, Hervé; Avillach, Paul
The first year of university is a particularly stressful period and can impact academic performance and students' health. The aim of this study was to evaluate the health and lifestyle of undergraduates and assess risk factors associated with psychiatric symptoms. Between September 2012 and June 2013, we included all undergraduate students who underwent compulsory a medical visit at the university medical service in Nice (France) during which they were screened for potential diseases during a diagnostic interview. Data were collected prospectively in the CALCIUM database (Consultations Assistés par Logiciel pour les Centres Inter-Universitaire de Médecine) and included information about the students' lifestyle (living conditions, dietary behavior, physical activity, use of recreational drugs). The prevalence of psychiatric symptoms related to depression, anxiety and panic attacks was assessed and risk factors for these symptoms were analyzed using logistic regression. A total of 4,184 undergraduates were included. Prevalence for depression, anxiety and panic attacks were 12.6%, 7.6% and 1.0%, respectively. During the 30 days preceding the evaluation, 0.6% of the students regularly drank alcohol, 6.3% were frequent-to-heavy tobacco smokers, and 10.0% smoked marijuana. Dealing with financial difficulties and having learning disabilities were associated with psychiatric symptoms. Students who were dissatisfied with their living conditions and those with poor dietary behavior were at risk of depression. Being a woman and living alone were associated with anxiety. Students who screened positively for any psychiatric disorder assessed were at a higher risk of having another psychiatric disorder concomitantly. The prevalence of psychiatric disorders in undergraduate students is low but the rate of students at risk of developing chronic disease is far from being negligible. Understanding predictors for these symptoms may improve students' health by implementing targeted
Full Text Available The first year of university is a particularly stressful period and can impact academic performance and students' health. The aim of this study was to evaluate the health and lifestyle of undergraduates and assess risk factors associated with psychiatric symptoms.Between September 2012 and June 2013, we included all undergraduate students who underwent compulsory a medical visit at the university medical service in Nice (France during which they were screened for potential diseases during a diagnostic interview. Data were collected prospectively in the CALCIUM database (Consultations Assistés par Logiciel pour les Centres Inter-Universitaire de Médecine and included information about the students' lifestyle (living conditions, dietary behavior, physical activity, use of recreational drugs. The prevalence of psychiatric symptoms related to depression, anxiety and panic attacks was assessed and risk factors for these symptoms were analyzed using logistic regression.A total of 4,184 undergraduates were included. Prevalence for depression, anxiety and panic attacks were 12.6%, 7.6% and 1.0%, respectively. During the 30 days preceding the evaluation, 0.6% of the students regularly drank alcohol, 6.3% were frequent-to-heavy tobacco smokers, and 10.0% smoked marijuana. Dealing with financial difficulties and having learning disabilities were associated with psychiatric symptoms. Students who were dissatisfied with their living conditions and those with poor dietary behavior were at risk of depression. Being a woman and living alone were associated with anxiety. Students who screened positively for any psychiatric disorder assessed were at a higher risk of having another psychiatric disorder concomitantly.The prevalence of psychiatric disorders in undergraduate students is low but the rate of students at risk of developing chronic disease is far from being negligible. Understanding predictors for these symptoms may improve students' health by
McGrath, Jennifer J.
Objective To examine the effects of provincial income inequality (disparity between rich and poor), independent of provincial income and family socioeconomic status, on multiple adolescent health outcomes. Methods Participants (aged 12–17 years; N = 11,899) were from the Canadian National Longitudinal Survey of Children and Youth. Parental education, household income, province income inequality, and province mean income were measured. Health outcomes were measured across a number of domains, including self-rated health, mental health, health behaviors, substance use behaviors, and physical health. Results Income inequality was associated with injuries, general physical symptoms, and limiting conditions, but not associated with most adolescent health outcomes and behaviors. Income inequality had a moderating effect on family socioeconomic status for limiting conditions, hyperactivity/inattention, and conduct problems, but not for other outcomes. Conclusions Province-level income inequality was associated with some physical and mental health outcomes in adolescents, which has research and policy implications for this age-group. PMID:25324533
Quon, Elizabeth C; McGrath, Jennifer J
To examine the effects of provincial income inequality (disparity between rich and poor), independent of provincial income and family socioeconomic status, on multiple adolescent health outcomes. Participants (aged 12-17 years; N = 11,899) were from the Canadian National Longitudinal Survey of Children and Youth. Parental education, household income, province income inequality, and province mean income were measured. Health outcomes were measured across a number of domains, including self-rated health, mental health, health behaviors, substance use behaviors, and physical health. Income inequality was associated with injuries, general physical symptoms, and limiting conditions, but not associated with most adolescent health outcomes and behaviors. Income inequality had a moderating effect on family socioeconomic status for limiting conditions, hyperactivity/inattention, and conduct problems, but not for other outcomes. Province-level income inequality was associated with some physical and mental health outcomes in adolescents, which has research and policy implications for this age-group. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: email@example.com.
Area air and breathing-zone samples were analyzed for nitrous oxide at Dental Health Associates, Paoli, Pennsylvania on August 2, 1984. The evaluation was requested by a dental assistant because of general concern about the extent of nitrous oxide exposure, especially since the office was not equipped with a waste-anesthetic gas-scavenging system. The author recommends installing a waste anesthetic gas scavenging system with a dedicated exhaust. The nitrous oxide delivery and mixing system should be checked for leaks monthly and work practices for handling nitrous oxide should be improved.
Husson, O.; Mols, F.; Fransen, M.P.; Poll-Franse, L.V. van de; Ezendam, N.P.
BACKGROUND: The objectives of the study were to examine the prevalence of health literacy (HL) among colorectal cancer (CRC) survivors and the relation between HL and health behaviors and to explore whether or not HL and health behaviors are independently associated with health-related quality of
Vander Wekken, Suzanne; Sørensen, Susanne; Meldrum, John; Naylor, Patti-Jean
To explore industry perspectives on the transition to healthier food and beverage sales in publicly funded recreation facilities and specifically (a) the awareness of the BC provincial Guidelines and implementation supports; (b) challenges encountered in the transition to healthier products; and (c) thoughts on future trends and opportunities in the snack and beverage business. We used a qualitative research design (semi-structured interviews) with thematic analysis to explore the data collected. Overall, the industry was aware of the BC Guidelines and philosophically supported the transition to healthier choices in public recreation facilities. Main challenges in implementing the Guidelines were the: (1) perceived limitations of the Guidelines; (2) issues stocking healthy products; (3) competition in food sales environments; and (4) negative impact on profits. Interviewees believed that consumer choice is increasingly influenced by environmental and health priorities and that adapting to these trends would be important for future business success. The food and beverage industry needs time, resources and expertise to adapt their business model and to find new palatable products that meet healthy Guidelines. Strategies that strengthen accountability, provide opportunities for economic development and enhance private-public sector communication will help industry partners support implementation of nutrition policies. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Jarcuska, P.; Bobakova, D.; Uhrin, J.; Bobak, L.; Babinska, I.; Kolarcik, P.; Veselska, Z.; Madarasova-Geckova, A.
The health of Roma has been found to be poorer than that of the majority population. The aim of this study was to explore the differences between Roma and non-Roma regarding perceived barriers in accessing health services. Furthermore, we aimed to assess the association between self-rated health
Jane E. Gallagher
Full Text Available Abstract Background Advocates for environmental justice, local, state, and national public health officials, exposure scientists, need broad-based health indices to identify vulnerable communities. Longitudinal studies show that perception of current health status predicts subsequent mortality, suggesting that self-reported health (SRH may be useful in screening-level community assessments. This paper evaluates whether SRH is an appropriate surrogate indicator of health status by evaluating relationships between SRH and sociodemographic, lifestyle, and health care factors as well as serological indicators of nutrition, health risk, and environmental exposures. Methods Data were combined from the 2003–2006 National Health and Nutrition Examination Surveys for 1372 nonsmoking 20–50 year olds. Ordinal and binary logistic regression was used to estimate odds ratios and 95 % confidence intervals of reporting poorer health based on measures of nutrition, health condition, environmental contaminants, and sociodemographic, health care, and lifestyle factors. Results Poorer SRH was associated with several serological measures of nutrition, health condition, and biomarkers of toluene, cadmium, lead, and mercury exposure. Race/ethnicity, income, education, access to health care, food security, exercise, poor mental and physical health, prescription drug use, and multiple health outcome measures (e.g., diabetes, thyroid problems, asthma were also associated with poorer SRH. Conclusion Based on the many significant associations between SRH and serological assays of health risk, sociodemographic measures, health care access and utilization, and lifestyle factors, SRH appears to be a useful health indicator with potential relevance for screening level community-based health and environmental studies.
Chang, Leanne; Chiuan Yen, Ching; Xue, Lishan; Choo Tai, Bee; Chuan Chan, Hock; Been-Lirn Duh, Henry; Choolani, Mahesh
This study examined effects of age and social psychological factors on women's willingness to be mobile health information seekers. A national survey of 1,878 Singaporean women was conducted to obtain information on women's mobile phone usage, experiences of health information seeking, and appraisals of using mobile phones to seek health information. Results showed that young, middle-aged, and older women exhibited distinct mobile phone usage behaviors, health information-seeking patterns, and assessments of mobile health information seeking. Factors that accounted for their mobile information-seeking intention also varied. Data reported in this study provide insights into mobile health interventions in the future.
Arria, Amelia M; Caldeira, Kimberly M; Vincent, Kathryn B; Winick, Emily R; Baron, Rebecca A; O'Grady, Kevin E
This study examined the prospective relationship of substance use and mental health problems with risk of discontinuous enrollment in college. Participants were 1,145 students at a large public university who were interviewed annually for four years beginning at college entry in 2004 (year 1). Discontinuous enrollment was defined as a gap in enrollment of one or more semesters during the first two years (early discontinuity) or the second two years (late discontinuity) versus continuous enrollment throughout all four years. Explanatory variables measured in year 1 were scores on the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory, childhood conduct problems, cannabis use, number of illicit drugs used, and alcohol consumption. In years 3 and 4, participants reported lifetime history of clinically diagnosed attention-deficit hyperactivity disorder, depression, and anxiety, including age at diagnosis. Multinomial logistic regression models were developed to evaluate the association between the independent variables and discontinuous enrollment while holding constant background characteristics. Higher BDI scores predicted early discontinuity but not late discontinuity, whereas cannabis and alcohol use predicted only late discontinuity. Receiving a depression diagnosis during college was associated with both early and late discontinuity. Self-reported precollege diagnoses were not related to discontinuous enrollment once background characteristics were taken into account. Students who experience depressive symptoms or seek treatment for depression during college might be at risk of interruptions in their college enrollment. Cannabis use and heavy drinking appear to add to this risk. Students entering college with preexisting psychiatric diagnoses are not necessarily at risk of enrollment interruptions.
Sinokki, M; Hinkka, K; Ahola, K; Koskinen, S; Klaukka, T; Kivimäki, M; Puukka, P; Lönnqvist, J; Virtanen, M
Depression, anxiety and alcohol use disorders are common mental health problems in the working population. However, the team climate at work related to these disorders has not been studied using standardised interview methods and it is not known whether poor team climate predicts antidepressant use. This study investigated whether team climate at work was associated with DSM-IV depressive, anxiety and alcohol use disorders and subsequent antidepressant medication in a random sample of Finnish employees. The nationally representative sample comprised 3347 employees aged 30-64 years. Team climate was measured with a self-assessment scale. Diagnoses of depressive, anxiety and alcohol use disorders were based on the Composite International Diagnostic Interview. Data on the purchase of antidepressant medication in a 3-year follow-up period were collected from a nationwide pharmaceutical register of the Social Insurance Institution. In the risk factor adjusted models, poor team climate at work was significantly associated with depressive disorders (OR 1.61, 95% CI 1.10 to 2.36) but not with alcohol use disorders. The significance of the association between team climate and anxiety disorders disappeared when the model was adjusted for job control and job demands. Poor team climate also predicted antidepressant medication (OR 1.53, 95% CI 1.02 to 2.30). A poor team climate at work is associated with depressive disorders and subsequent antidepressant use.
Adisasmito, Wiku; Aisyah, Dewi Nur; Aditama, Tjandra Yoga; Kusriastuti, Rita; Trihono; Suwandono, Agus; Sampurno, Ondri Dwi; Prasenohadi; Sapada, Nurshanty A; Mamahit, M J N; Swenson, Anna; Dreyer, Nancy A; Coker, Richard
Indonesia has had more recorded human cases of influenza A H5N1 than any other country, with one of the world's highest case fatality rates. Understanding barriers to treatment may help ensure life-saving influenza-specific treatment is provided early enough to meaningfully improve clinical outcomes. Data for this observational study of humans infected with influenza A H5N1 were obtained primarily from Ministry of Health, Provincial and District Health Office clinical records. Data included time from symptom onset to presentation for medical care, source of medical care provided, influenza virology, time to initiation of influenza-specific treatment with antiviral drugs, and survival. Data on 124 human cases of virologically confirmed avian influenza were collected between September 2005 and December 2010, representing 73% of all reported Indonesia cases. The median time from health service presentation to antiviral drug initiation was 7.0 days. Time to viral testing was highly correlated with starting antiviral treatment (p influenza H5N1 in Indonesia appear related to delays in diagnosis rather than presentation to health care settings. Either cases are not suspected of being H5N1 cases until nearly one week after presenting for medical care, or viral testing and/or antiviral treatment is not available where patients are presenting for care. Health system delays have increased since 2007.
Hall, Kelli Stidham; Moreau, Caroline; Trussell, James
An understanding of the association between adolescents' sexual and reproductive health knowledge and their use of relevant services is needed to improve young people's sexual and reproductive health. Data from the National Survey of Family Growth were used to examine associations between sexual and reproductive health communication (parental and formal) and service use among 2,326 U.S. women aged 15-19 in 2002 and 2006-2008. Chi-square tests and multivariate logistic regression were used to assess relationships between adolescents' receipt of sexual and reproductive health communication from parents and formal (school, church, community) sources and their use of sexual and reproductive health services. The majority of adolescents had received parental (75%) and formal (92%) sexual and reproductive health communication; 43% reported recent service use. In unadjusted analyses, parental and formal communication were positively associated with service use. In regression models, overall parental communication remained positively associated with service use (odds ratio, 1.6); parental abstinence-only communication, which was not significant in 2002, was associated with reduced odds of service use for the pooled sample (0.4) and in 2006-2008 (0.3). Formal communication was not associated with service use. Further research is needed to assess whether comprehensive sexual and reproductive health communication facilitates adolescents' health care utilization. Examination of how communication sources, quality and content are related to service use is needed to understand adolescents' sexual and reproductive health knowledge and needs. Copyright © 2012 by the Guttmacher Institute.
Podubinski, Tegan; Lee, Stuart; Hollander, Yitzchak; Daffern, Michael
Aggression in mental health units is a significant and pervasive problem. However, the characteristics of patients associated with increased aggression propensity remain unclear and there are few attempts to expand understanding of these characteristics by drawing upon contemporary aggression theory. This study assessed the influence of interpersonal (hostile-dominance) and personality (psychopathy), General Aggression Model-specified (aggressive script rehearsal, attitudes towards violence, and trait anger), and clinical (psychiatric symptoms) factors on aggression during psychiatric hospitalization in 200 inpatients (132 men and 68 women; 19-64 years, M=38.32 years, S.D.=11.13 years). Patient characteristics were assessed on admission using structured interviews and self-report psychological tests. Patients' files were reviewed and nurses were interviewed after patients were discharged to establish whether patients were aggressive during their hospital stay. Results of univariate analyses showed that higher levels of interpersonal hostile-dominance, psychopathy and aggressive script rehearsal, positive attitudes towards violence, trait anger, and disorganized and excited type psychiatric symptoms all predicted aggression. In the final multivariable logistic regression model, only hostile-dominance remained as a significant predictor of aggressive behavior. This important personality characteristic should be considered in violence risk assessments and aggression prevention strategies. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.
Caballero Martín, M; Bermejo Fernández, F; Nieto Gómez, R; Caballero Martínez, F
The main objective was to determine the prevalence of the burnout syndrome among health workers and its distribution by social, demographic and work variables. The secondary aim was to detect potentially modifiable causes. Descriptive cross-sectional study. Primary care. All the 354 doctors, nurses and clinical auxiliaries belonging to the 22 primary care teams of Area VI, Madrid. A self-administered, anonymous questionnaire was sent out by internal mail. This had three instruments: a questionnaire on social and demographic variables, the validated questionnaire known as the Maslach Burnout Inventory and an open opinion section. High levels of burnout were detected: 30.6% in the high range on the emotional tiredness sub-scale, with higher scores among men (p = 0.026). There were also more paediatric staff affected in personal achievements. There was scant relationship of the syndrome to social variables. 43.9% thought they suffered or had suffered from some kind of physical or psychological disorder directly related to exercising their profession. 38.3% associated directly their burnout with the excess demand habitually experienced in clinics. We detected worryingly high levels of this syndrome among our professionals, similar to other surveys in Spain. The subjects of the survey linked their unease with certain work factors that could easily be modified. The training received in techniques of self-control and stress management is clearly insufficient.
McHugh, Joanna Edel; Lawlor, Brian A
Perceived health status does not always reflect actual health status. We investigated the association between objective and self-rated measures of health status and hours of exercise per week in older adults. As part of the TRIL clinic assessment, we gathered information from 473 community dwelling adults over the age of 65, regarding hours spent per week exercising, depression, personality, perceived health status, and objective health status (in the form of a comorbidity count). Regression analyses were performed on these data to investigate whether perceived health status, objective health status, personality and mood are associated with hours of exercise per week. Perceived and objective health status were significantly but weakly correlated. Both perceived and objective health status, as well as depression, were independently associated with hours of exercise per week. We conclude that exercise uptake in older adults is contingent on both perceived and objective health status, as well as depression. Perceived health status has a stronger association with exercise uptake in older adults with lower depression levels. The current findings have implications for designing exercise interventions for older adults.
Full Text Available City green economy plays an important role in the development of low-carbon economy and the achievement of sustainable development of economy, society and ecological environment. From the perspective of economy, society, environment and resources, the evaluation of the green economy in urban areas tends to offer us a new insight into the green economy of cities. This paper is about the creation of a novel urban green economy evaluation model and its application. First of all, we established a city green economy evaluation index system based on R cluster analysis and coefficient of variation. Secondly, based on the nonlinear weighted utilizing entropy weight method, a city green economy evaluation model is established based on inferior constraints. Thirdly, by comparing the differences between evaluation rankings under inferior constraints and non-inferior constraints, the advantageous factors and the disadvantageous ones in urban green economy development are obtained. The proposed model has been verified with the data on 15 sub-provincial cities in China. Empirical analysis results show that: (1 The proposed approach can accurately find out the advantageous and disadvantageous factors for each sub-provincial city; (2 In the evaluation of green economy development, the order of importance of the three criterion layers is X1 Economy development > X2 Social livelihood of the people > X3 Resources and environment; (3 Local governments should implement differential, reasonable policies in order to improve their green economy development. Moreover, our research is not only significant for developing green economy in China’s sub-provincial cities, but also serves as a reference for the development of green economy in other cities in the world.
Mar 30, 2014 ... among homeless youth reported in. Ethiopia.. This study tried to assess street youths‟ pattern of health service utilization and barrier and found out that only 15.1% of youth reported that they visited health institutions in the three months prior to the study, which is lower than the prevalence health service ...
Background: Street youth are predisposed to sexual and reproductive health challenges. Most of the street children live in severe deprivation, which make them liable to various forms of health risks. Street youth have risky sexual behaviours that increase the likelihood of adverse sexual and reproductive health ...
Paredes Vílchez, Margarita Eulalia; Hospital Provincial Docente Belén de Lambayeque; País Lescano, Doris; Hospital Provincial Docente Belén de Lambayeque
El objetivo fue determinar el nivel de satisfacción laboral de las enfermeras/os con la finalidad de proponer estrategias de mejora mediante un estudio descriptivo transversal en 55 Enfermeras/os de los diferentes servicios del Hospital Provincial Docente Belén de Lambayeque, durante julio – agosto del 2012. Como técnica de recolección de datos se utilizó, la encuesta y como instrumento el Cuestionario "Satisfacción Laboral del Enfermero" elaborada por el Ministerio de Salud en el 2002, agru...
David F. Mitchell
Full Text Available This article introduces a new provincial-level dataset on non-governmental organizations (NGOs in Afghanistan. The data—which are freely available for download—provide information on the locations and sectors of activity of 891 international and local (Afghan NGOs that operated in the country between 2000 and 2014. A summary and visualization of the data is presented in the article following a brief historical overview of NGOs in Afghanistan. Links to download the full dataset are provided in the conclusion.
Chira Sosa, Jorge Luis; Universidad Nacional Pedro Ruiz Gallo; Sosa Flores, Jorge Luis; Universidad Nacional Pedro Ruiz Gallo
El nacimiento pretérmino es la mayor causa de morbilidad y mortalidad neonatal y responsable de 75 a 90% de las muertes neonatales no relacionadas con malformaciones congénitas. Determinar los factores de riesgo del parto pretérmino en el Hospital Provincial Docente Belén de Lambayeque durante el año enero-diciembre 2010. El presente estudio es analítico, de casos y controles pareados de tipo retrospectivo, descriptivo comparativo, trasversal en el que se analizaron las historias clínicas de ...
Raynor, Douglas A.; Levine, Heidi
Objective: In fall 2006, the authors examined associations between the five-factor model of personality and several key health behaviors. Methods: College students (N = 583) completed the American College Health Association-National College Health Assessment and the International Personality Item Pool Big Five short-form questionnaire. Results:…
Chester, Kayleigh L.; Spencer, Neil H.; Whiting, Lisa; Brooks, Fiona M.
Background: Bullying is a public health concern for the school-aged population, however, the health outcomes associated with the subtype of relational bullying are less understood. The purpose of this study was to examine the association between relational bullying and health-related quality of life (HRQL) among young people. Methods: This study…
Townsend, Lisa; Musci, Rashelle; Stuart, Elizabeth; Ruble, Anne; Beaudry, Mary B.; Schweizer, Barbara; Owen, Megan; Goode, Carly; Johnson, Sarah L.; Bradshaw, Catherine; Wilcox, Holly; Swartz, Karen
Background: Although school climate is linked with youth educational, socioemotional, behavioral, and health outcomes, there has been limited research on the association between school climate and mental health education efforts. We explored whether school climate was associated with students' depression literacy and mental health stigma beliefs.…
Denny, Simon; Farrant, Bridget; Utter, Jennifer; Fleming, Theresa; Bullen, Pat; Peiris-John, Roshini; Clark, Terryann
Despite numerous calls to improve training in adolescent health, there is little known about the prevalence or effectiveness of specialized training in adolescent health. A two-stage random sampling cluster design was used to collect nationally representative data from 8,500 students from 91 high schools. Student data were linked to data from a survey of school health clinicians from participating schools on their level of training in youth health. Multilevel models accounting for demographic characteristics of students were used to estimate the association between nurses and physicians training in youth health and health outcomes among students. Almost all nurses and physicians reported some training in youth health, either having attended lectures or study days in youth health (n = 60, 80%) or completed postgraduate papers in youth health (n = 13, 17.3%). Students in schools where the nurses and physicians had received postgraduate training in youth health were less likely than students from schools with clinicians having attended lectures or study days in youth health to report emotional and behavior difficulties (11.8 vs. 12.7, p = .002) and binge drinking (19.6% vs. 24.9%, p = .03). There were no significant associations between depressive symptoms, suicide risk, cigarette, marijuana, contraception use, or motor vehicle risk behaviors among students and level of training among clinicians in their schools' health service. Postgraduate training in youth health among nurses and physicians in school health services is associated with fewer students reporting mental health difficulties and binge alcohol use. These findings support specialized training in youth health for clinicians working predominantly with young people. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
The significance of Herbert Spencer's evolutionary philosophy has been generally recognized for over a century, as the familiarity of his phrase "survival of the fittest" indicates, yet accounts of the origins of his system still tend to follow too closely his own description, written many decades later. This essay argues that Spencer's own interpretation of his intellectual development gives an inadequate impression of the debt he owed to provincial scientific culture and its institutions. Most important, it shows that his evolutionism was originally stimulated by his association with the Derby philosophical community, for it was through this group--of which his father, who also appears to have espoused a deistic evolutionary theory, was a member--that he was first exposed to progressive Englightenment social and educational philosophies and to the evolutionary worldview of Erasmus Darwin, the first president of the Derby Philosophical Society. Darwin's scheme was the first to incorporate biological evolution, associationist psychology, evolutionary geology, and cosmological developmentalism. Spencer's own implicit denials of the link with Darwin are shown to be implausible in the face of Darwin's continuing influence on the Derby savants, the product of insecurity in his later years when he feared for his reputation as Lamarckism became increasingly untenable.
Mohib, Milad; Moser, Nicholas; Kim, Richard; Thillai, Maathavan; Gringmuth, Robert
Introduction: With over 200 million amateur players worldwide, soccer is one of the most popular and internationally recognized sports today. By understanding how and why soccer injuries occur we hope to reduce prevalent injuries amongst elite soccer athletes. Methods: Via a prospective cohort, we examined both male and female soccer players eligible to train with the Ontario Soccer Association provincial program between the ages of 13 to 17 during the period of October 10, 2008 and April 20, 2012. Data collection occurred during all player exposures to potential injury. Exposures occurred at the Soccer Centre, Ontario Training grounds and various other venues on multiple playing surfaces. Results: A total number of 733 injuries were recorded. Muscle strain, pull or tightness was responsible for 45.6% of all injuries and ranked as the most prevalent injury. Discussion: As anticipated, the highest injury reported was muscular strain, which warrants more suitable preventive programs aimed at strengthening and properly warming up the players’ muscles. PMID:25550661
Oliveira, Max Moura de; Andrade, Silvânia Suely Caribé de Araújo; Campos, Maryane Oliveira; Malta, Deborah Carvalho
The objectives of this study were to describe the demand for health services by adolescents and to identify associated factors. The study analyzed data from the National School Health Survey 2012 and calculated prevalence rates and 95% confidence intervals (95%CI). Data analysis used age-adjusted logistic regression. Half of all students required health services and the proportion was higher in girls. Factors associated with demand for health services were white skin color, enrollment in private school, maternal schooling ≥ 12 years, sexual activity, injuries, toothache, attempts to maintain, lose, or gain weight, wheezing, appropriate hygiene, and parents knowing what their children did in their free time. The highest demand for health services was mainly by girls, and demand was associated with socio-demographic characteristics, symptoms, and health risk/protective behaviors.
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services Health Insurance Exchanges; Approval of an...\\ Health Insurance Exchanges; Application by the Accreditation Association for Ambulatory Health Care To Be...
Walid El Ansari; Christiane Stock
This study explored the associations between health awareness, health behaviour, subjective health status, and satisfaction of students with their educational experience as independent variables...
Britt, Rebecca Katherine; Collins, William Bart; Wilson, Kari; Linnemeier, Georgiann; Englebert, Andrew Mark
The eHealth Literacy Scale (eHEALS) has been widely adopted by researchers to understand how eHealth literacy can be put into context. eHealth researchers need to know how to promote positive health behavior changes across college students, given the importance of the Internet to acquire and use health information. The American College Health Association identified a set of key health issues that affect college students today. By understanding how eHEALS might be related to college students' maintenance of their health and their use of online health resources, researchers will be provided with a better understanding of eHealth literacy and its pragmatic implications for health campaigns and future interventions. The goal of the study was to examine what eHEALS reveals about college student health behaviors identified by the American College Health Association. To understand college student current health maintenance and their intentions to maintain their health and use online resources, the theory of planned behavior was used as the theoretical framework for the study. Data were collected via a survey of 422 college students that included the eHEALS measure and questions about health issues based on the recommendations of the American College Health Association. These questions asked about college student current health, subsequent use of online health resources, and their intention to maintain their health and make use of such resources in the future. eHEALS was positively and significantly associated with all 8 areas of health issues identified by the American College Health Association for college student current maintenance of health and use of online health resources and for future intention of health maintenance and use of online resources. Key issues that emerged with eHealth literacy were maintaining safe sex practices and seeking out related information, seeking out information on an exercise regime, information on vaccinations, and maintaining a balanced
Park, Barbara Z; Cantrell, Letitia; Hunt, Holly; Farris, Rosanne P; Schumacher, Patricia; Bauer, Ursula E
The National Center for Chronic Disease Prevention and Health Promotion at the Centers for Disease Control and Prevention funds a program to boost progress in reducing the prevalence and incidence of multiple chronic diseases and their associated risk factors. This article describes the program, State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors, and Promote School Health, and the program's action model, design, and administration and management structure. This program is based on 4 domains of public health action: 1) epidemiology and surveillance, 2) environmental approaches, 3) health care system interventions, and 4) community programs linked to clinical services. The 4 domains of public health action leverage data to inform action, support healthy choices and behaviors, strengthen delivery of clinical preventive services, and help Americans better manage their health.
Full Text Available Abstract Background This study investigates factors determining the timing of antenatal care (ANC visit and the type of delivery assistant present during delivery among a national representative sample of Ghanaian women. Method Data for the study was drawn from the women questionnaire (N=4,916 of the 2008 Ghana Demographic and Health Survey among 15–49-years-old women. Multivariate logistic regression analysis was used to explore factors determining the type of delivery assistance and timing of ANC visit for live births within five years prior to the survey. Results Majority of Ghanaian women attended ANC visit (96.5% but many (42.7% did so late (after the first trimester, while 36.5% had delivery without the assistance of a trained personnel (30.6% or anyone (5.9%. Age (OR=1.5, CI=1.1-1.9, OR for 25-34-year-olds compared to 15-24-year-olds, religion (OR=1.8, CI=1.2-2.8, OR for Christians versus Traditional believers wealth index (OR=2.6, CI=1.7-3.8, OR for the richest compared to the poorest were independently associated with early ANC visit. Likewise, age, place of residence, education and partner’s education were associated with having a delivery assisted by a trained assistant. Also, Christians (OR=1.8, CI=1.1-3.0 and Moslems (OR=1.9, CI=1.1-3.3 were more likely to have trained delivery assistants compared to their counterparts who practised traditional belief. Furthermore, the richer a woman the more likely that she would have delivery assisted by a trained personnel (OR=8.2, CI= 4.2-16.0, OR for the richest in comparison to the poorest. Conclusions Despite the relatively high antenatal care utilisation among Ghanaian women, significant variations exist across the socio-demographic spectrum. Furthermore, a large number of women failed to meet the WHO recommendation to attend antenatal care within the first trimester of pregnancy. These findings have important implications for reducing maternal mortality ratio by three-quarters by the
Gill, Tiffany K; Price, K; Dal Grande, E; Daly, A; Taylor, A W
Feeling angry about their health status may influence disease progression in individuals, creating a greater burden on the health care system. Identifying associations between different variables and feeling angry about health status may assist health professionals to improve health outcomes. This study used path analysis to explore findings from a population-based survey, informed by qualitative descriptions obtained from focus groups, to determine the prevalence of health-related anger within the community and variables associated with reporting health-related anger. A population-based Computer Assisted Telephone Interview (CATI) survey of 3003 randomly selected adults Australia-wide was conducted to examine the prevalence of health-related anger. A wide range of other covariates were included in the survey. Multivariable logistic regression and path analysis were undertaken to identify the relationships between different variables associated with feeling angry about the health status of people, to explore the direction of these associations and as a consequence of the results, consider implications for health service use and delivery. Overall, 18.5 % of the population reported feeling angry about their health "some of the time", "most of the time" or "all of the time". People who felt angry about their health were more likely to have a severe health condition, at least one chronic condition, high psychological distress, fair to poor health status, and needed to adjust their daily lives because of a health condition. Having a tertiary level education was protective. Receiving some form of social support, usually from a support group, and not always doing as advised by a doctor, were also associated with a higher likelihood of being angry about their health. People living with significant health problems are more likely to feel angry about their health. The path between illness and anger is, however, complex. Further research is needed to understand the extent
Tiffany K. Gill
Full Text Available Abstract Background Feeling angry about their health status may influence disease progression in individuals, creating a greater burden on the health care system. Identifying associations between different variables and feeling angry about health status may assist health professionals to improve health outcomes. This study used path analysis to explore findings from a population-based survey, informed by qualitative descriptions obtained from focus groups, to determine the prevalence of health-related anger within the community and variables associated with reporting health-related anger. Methods A population-based Computer Assisted Telephone Interview (CATI survey of 3003 randomly selected adults Australia-wide was conducted to examine the prevalence of health-related anger. A wide range of other covariates were included in the survey. Multivariable logistic regression and path analysis were undertaken to identify the relationships between different variables associated with feeling angry about the health status of people, to explore the direction of these associations and as a consequence of the results, consider implications for health service use and delivery. Results Overall, 18.5 % of the population reported feeling angry about their health “some of the time”, “most of the time” or “all of the time”. People who felt angry about their health were more likely to have a severe health condition, at least one chronic condition, high psychological distress, fair to poor health status, and needed to adjust their daily lives because of a health condition. Having a tertiary level education was protective. Receiving some form of social support, usually from a support group, and not always doing as advised by a doctor, were also associated with a higher likelihood of being angry about their health. Conclusions People living with significant health problems are more likely to feel angry about their health. The path between illness and
Flessa, Steffen; Dung, Nghiem Tran
The People's Republic of Vietnam is currently in a period of transition from a purely socialistic country towards a so-called socialist market economy. Since the introduction of the Doi Moi policy in 1987, health care services have been liberalized, medical practitioners have received the right to open private hospitals and private pharmacies are booming. However, the majority of inhabitants strongly depends on governmental hospital services. These services are currently going through a financial crisis. This demands the quest for efficiency and the wise allocation of public funds. The efficient allocation of funds depends on the quotient between costs and health outcomes, but the costs of health services in Vietnamese hospitals are unknown. Therefore the study analysed five hospitals in Vietnam and determined the average costs as well as the main cost drivers. The full costs of five hospitals were analysed, including depreciation and the value of donations. The costs were allocated to cost centres and cost units by a stepping-stone method. As expected, the average costs per inpatient day at a central hospital are about 300% of the costs of provincial hospitals and about 600% of the costs of district hospitals. However, the costs of some laboratory procedures and operations done at district hospitals are higher than those of provincial or even central hospitals. The main reason for the high costs of some procedures at district hospitals was the low quantity of these procedures at that level. This is a strong indicator that some procedures, in particular major operations, should not be performed in Vietnamese district hospitals.
Mukthar, V K; Maranga, A K; Kulei, S J; Chemoiwa, R K
To determine the uptake ana factors associated with the uptake of modern contraceptives among women of reproductive age (15-49 years) attending Maternal Child Health and Family Planning Clinics/Units in Rift Valley Provincial Hospital in Kenya. A descriptive cross-sectional study. Rift Valley Provincial hospital which is a level five health facility situated in Nakuru County, Kenya. Women of reproductive age (15-49 years) who were attending Maternal Child Health and Family Planning Clinics at the Rift Valley Provincial Hospital. The respondents were identified by systematic random sampling Modern contraceptive uptake is over ninety percent (90.4, n = 218). The factors that are significantly associated with uptake of modern contraceptives are perceived convenience to use modern contraceptives (OR 0.39, CI: 0.16 - 0.93, p value- 0.04), experience of unmet needs of contraception (OR 0.08, CI: 0.03 - 0.2, p value- 0.001), history of a modern contraception discontinuation (OR 5.5, CI: 1.7 - 9.2, p value- 0.036) and knowledge of modern contraceptives (OR 19.1, CI: 12.3 - 27.5, p value-0.001). Conclusion: This study concluded that uptake of modern contraceptive is relatively high in Nakuru, Kenya and there is need for programmes to focus more on the client of modern contraceptive and the attributes of the modern contraceptives in up-scaling the uptake of modern contraceptives.
Benito, Natividad; Miró, José M.; de Lazzari, Elisa; Cabell, Christopher H.; del Río, Ana; Altclas, Javier; Commerford, Patrick; Delahaye, Francois; Dragulescu, Stefan; Giamarellou, Helen; Habib, Gilbert; Kamarulzaman, Adeeba; Kumar, A. Sampath; Nacinovich, Francisco M.; Suter, Fredy; Tribouilloy, Christophe; Venugopal, Krishnan; Moreno, Asuncion; Fowler, Vance G.; Gordon, David; Devi, Uma; Spelman, Denis; van der Meer, Jan T. M.; Kauffman, Carol; Bradley, Suzanne; Armstrong, William; Giannitsioti, Efthymia; Lerakis, Stamatios; Mestres, Carlos A.; Pare, Carlos; de la Maria, Cristina Garcia; Marco, Francesc; Gatell, Jose M.; Almela, Manuel; Azqueta, Manuel; Jiménez-Expósito, Maria Jesús; Sitges, Marta; Claramonte, Xavier; Armero, Yolanda; Cervera, Carlos; Falces, Carlos; Heras, Magda; Miro, José M.; Fernandez-Hidalgo, Nuria; de Vera, Pablo Rodriguez; Tornos, Pilar; Falco, Vicente; Sidani, Nisreen; Kanj-Sharara, Souha; Kanafani, Zeina; Raglio, Annibale; Goglio, Antonio; Gnecchi, Fabrizio; Valsecchi, Grazia; Rizzi, Marco; Ravasio, Veronica; Hoen, Bruno; Chirouze, Catherine; Giannitsiot, Efthymia; Leroy, Joel; Plesiat, Patrick; Bernard, Yvette; Casey, Anna; Lambert, Peter; Watkin, Richard; Elliott, Tom; Baddley, John; Patel, Mukesh; Dismukes, William; Caros, Giampiero; Mathiron, Amel Brahim; Goissen, Thomas; Delahaye, Armelle; Delahaye, François; Vandenesch, François; Vizzotti, Carla; Marin, Marcelo; Trivi, Marcelo; Lombardero, Martin; Cortes, Claudia; Casabe, José Horacio; Kogan, Silvia; Clara, Liliana; Sanchez, Marisa; Commerford, Anita; Hansa, Cass; Deetlefs, Eduan; Ntsekhe, Mpiko; Wray, Dannah; Steed, Lisa L.; Church, Preston; Cantey, Robert; Morris, Arthur; Holland, David; Murdoch, David; Chambers, Stephen; Read, Kerry; Raymond, Nigel; Lang, Selwyn; Kotsanas, Despina; Korman, Tony M.; Peterson, Gail; Southern, Paul M.; Shah, Manisha; Bedimo, Roger; Reddy, Arjun; Levine, Donald; Dhar, Gaurav; Hanlon-Feeney, Alanna; Hannan, Margaret; Kelly, Sinead; Wang, Andrew; Woods, Christopher W.; Sexton, Daniel J.; Corey, Ralph; Drew, Laura; Lalani, Tahaniyat; Chu, Vivian H.; Mazaheri, Bahram; Neuerburg, Carl; Naber, Christoph; Athan, Eugene; Henry, Margaret; Harris, Owen; Alestig, Eric; Olaison, Lars; Wikstrom, Lotta; Snygg-Martin, Ulrika; Francis, Johnson; Nair, Lathi; Thomas, Vinod; Chaiworramukkun, Jaruwan; Pachirat, Orathai; Chetchotisakd, Ploenchan; Suwanich, Tewan; Tamin, Syahidah Syed; Premru, Manica Mueller; Logar, Mateja; Lejko-Zupanc, Tatjana; Orezzi, Christina; Klein, John; Bouza, Emilio; Moreno, Mar; Rodríguez-Créixems, Marta; Marín, Mercedes; Fernández, Miguel; Muñoz, Patricia; Fernández, Rocío; Ramallo, Victor; Raoult, Didier; Thuny, Franck; Casalta, Jean-Paul; Fournier, Pierre-Edouard; Chipigina, Natalia; Kirill, Ozerecky; Vinogradova, Tatiana; Kulichenko, Vadim P.; Butkevich, O. M.; Lion, Christine; Selton-Suty, Christine; Alla, François; Coyard, Hélène; Doco-Lecompte, Thanh; Durante-Mangoni, Emanuele; Ragone, Enrico; Dialetto, Giovanni; Tripodi, Marie Françoise; Utili, Riccardo; Casillo, Roberta; Sharma, Gautam; Dickerman, Stuart A.; Street, Alan; Eisen, Damon Peter; McBryde, Emma Sue; Grigg, Leeanne; Abrutyn, Elias; Michelet, Christian; Tattevin, Pierre; Donnio, Pierre Yves; Fortes, Claudio Querido; Edathodu, Jameela; Al-Hegelan, Mashael; Font, Bernat; Anguera, Ignasi; Guma, Joan Raimon; Cereceda, M.; Oyonarte, Miguel J.; Mella, Rodrigo Montagna; Garcia, Patricia; Jones, Sandra Braun; de Oliveira Ramos, Auristela Isabel; Paiva, Marcelo Goulart; de Medeiros Tranchesi, Regina Aparecida; Woon, Lok Ley; Lum, Luh-Nah; Tan, Ru-San; Rees, David; Kornecny, Pam; Lawrence, Richard; Dever, Robyn; Post, Jeffrey; Jones, Phillip; Ryan, Suzanne; Harkness, John; Feneley, Michael; Rubinstein, Ethan; Strahilewitz, Jacob; Ionac, Adina; Mornos, Cristian; Forno, Davide; Cecchi, Enrico; de Rosa, Francesco; Imazio, Massimo; Trinchero, Rita; Wiesbauer, Franz; Gattringer, Rainer; Deans, Greg; Andrasevic, Arjana Tambic; Barsic, Bruno; Klinar, Igor; Vincelj, Josip; Bukovski, Suzana; Krajinovic, Vladimir; Corey, G. Ralph; Stafford, Judy; Baloch, Khaula; Redick, Thomas; Harding, Tina; Karchmer, A. W.; Bayer, Arnie; Durack, David T.; Moreillon, Phillipe; Eykyn, Susannah
BACKGROUND: The clinical profile and outcome of nosocomial and non-nosocomial health care-associated native valve endocarditis are not well defined. OBJECTIVE: To compare the characteristics and outcomes of community-associated and nosocomial and non-nosocomial health care-associated native valve
de Geus, E.J.C.; de Moor, M.H.M.
Regular exercise is associated with better mental health. This association is widely assumed to reflect causal effects of exercise. In this paper we propose that two additional mechanisms contribute to the association between exercise and mental health in the population-at-large: genetic pleiotropy
affect the development of adverse health conditions. The present study was designed to test the explanation proposed by the Loneliness Model. The sample consisted of 8.593 elderly ranging from 65 to 103 years participating in the 2013 Public Health Survey; “How are you?”. Results showed that loneliness...... was significantly associated with poor self-rated health, cardiovascular disease, diabetes, and migraine. In addition, high perceived stress, physical inactivity, problems with alcohol, and poor sleep demonstrated an indirect effect on the association between loneliness and adverse health conditions. The findings...
Erving, Christy L
Despite an abundant literature on social support and health, relatively less is known about how support and its impact on physical health vary within the Black population. Using the National Survey of American Life (NSAL), this paper examines which sources and types of support are associated with physical health among African Americans, U.S.-born Caribbean Blacks and foreign-born Caribbean Blacks. The results showed that for U.S.-born Caribbean Blacks, being married was especially beneficial to health. Closeness to family was associated with better health while negative interactions with family members was associated with worse health for African Americans and foreign-born Caribbean Blacks. Different sources of instrumental support affected all three groups. Overall, the findings reveal that, among Black Americans, the association between social support and physical health is contingent upon ethnicity, nativity, and the ways in which social support and health are operationalized.
Olesen, Kasper; F. Reynheim, Anne Louise; Joensen, Lene
Aim: Self-management of diabetes is influenced by a range of factors including the ability to access, understand, appraise, and use of health information in everyday life, which can collectively be called health literacy. We investigated associations between nine domains of health literacy and HbA1...... across eight of nine health literacy domains. This association remained significant after adjusting for educational attainment. Among the domains, 'Actively managing my health' had the strongest impact on HbA1c. This was in turn predicted by 'Appraising health information', 'Having sufficient information......c level in people with type 1 diabetes. Methods: A cross-sectional study was conducted with 1399 people with type 1 diabetes attending a Danish specialist diabetes clinic. Health literacy was assessed using the nine-domain Health Literacy Questionnaire. The association between health literacy and Hb...
Xu, W.; Kruminaite, M.; Onrust, B.; Liu, H.; Xiong, Q.; Zlatanova, S.
3D models are more powerful than 2D maps for indoor navigation in a complicate space like Hubei Provincial Museum because they can provide accurate descriptions of locations of indoor objects (e.g., doors, windows, tables) and context information of these objects. In addition, the 3D model is the preferred navigation environment by the user according to the survey. Therefore a 3D model based indoor navigation system is developed for Hubei Provincial Museum to guide the visitors of museum. The system consists of three layers: application, web service and navigation, which is built to support localization, navigation and visualization functions of the system. There are three main strengths of this system: it stores all data needed in one database and processes most calculations on the webserver which make the mobile client very lightweight, the network used for navigation is extracted semi-automatically and renewable, the graphic user interface (GUI), which is based on a game engine, has high performance of visualizing 3D model on a mobile display.
Chen, Nengcheng; Xu, Lei
Air pollution in China has become increasingly severe with rapid economic growth in recent years. We analyzed the relationship between the gross regional product (GRP) per capita and the Integrated Air Pollution Index (IAPI) in all the provincial capital cities in China from 2003 to 2014 and clustered them into six urban development patterns. These patterns are as follows: inverse U-shaped, N-1-shaped, N-2-shaped, U-shaped, linear decline, and stable. The majority of the provincial capitals are N-1, N-2, and U types, suggesting that the air quality is deteriorating currently or will deteriorate in the future. Meteorological conditions and industrial structure are taken into consideration when testing the environmental Kuznets curve (EKC) hypothesis between the economy and air pollutant concentration. Results show that there exists no direct relationship between three main pollutants and GRP per capita, while an inverse U-shaped relationship with the secondary industry and a U-shaped relationship with the tertiary industry. These results will be a meaningful reference for policy makers to develop policies that coordinate the environmental protection and economic development.
Guilherme Oliveira de Arruda
Full Text Available OBJECTIVE To assess the association of sociodemographic and self-rated health in the presence of cardiovascular diseases and the association of this perception with the type of disease. METHODS A cross-sectional population survey study carried out with 1,232 individuals aged between 20 and 59 years of both genders living in the metropolitan region of Maringá-PR. Data were analyzed using multiple and simple logistic regression. RESULTS In multivariate analysis, the age range and self-rated health were associated with cardiovascular disease, and in the univariate analysis self-rated regular health was associated with arterial hypertension, while self-rated poor health was associated to heart failure, stroke, and to acute myocardial infarction (heart attack. CONCLUSION The differences in association of self-rated health with these diseases can indicate how individuals with certain characteristics cope with the disease, allowing for more individualized and specific health care.
Walid El Ansari
Full Text Available We examined nutrition behaviour, self-reported health and 20 health complaints of undergraduates in Finland. Students at the University of Turku in Finland participated in a cross-sectional online survey (N = 1189. For nutrition behaviour, we computed two composite food intake pattern scores (sweets, cakes and snacks; and fruits and vegetables, a dietary guideline adherence index and the subjective importance of healthy eating. Multinomial logistic regression assessed the association of students’ nutrition behaviour with three levels of self-reported health, controlling for many potential confounders (age, sex, living with partner, economic situation, moderate physical activity, Faculty and BMI. Factor analysis of the 20 health complaints revealed three components (psychological, pains/aches and circulatory/breathing symptoms. Multiple linear regression tested the association of students’ eating habits with the three components of health complaints, controlling for the same confounders. Fruits and raw and cooked vegetable consumption, dietary guideline adherence index and subjective importance of healthy eating were highest among students with excellent/very good self-reported health, exhibiting a decreasing trend for those individuals with poor/fair self-reported health. High levels of psychological symptoms were associated with decreased consumption of fruits and vegetables, less dietary guideline adherence and less subjective importance of healthy eating. Pain/aches symptoms were associated with a higher consumption of sweets, cookies and snacks and a lower adherence to dietary guidelines. More healthy nutrition behaviour was consistently associated with better self-reported health and less health complaints. Of the four nutrition behaviour indicators we employed, the dietary guideline adherence index was the best indicator and exhibited the most consistent associations with self-reported health and health complaints.
Dec 6, 2011 ... disease for South Africa, leading to serious health and social consequences.35 The absence of the RPWC high. WC female group's odds of presenting with increased alcohol abuse should be noted. Possibly, this is indicative of a good perception of own health and that alcohol was not needed as a coping ...
Bivariate analysis and logistic regression were conducted and a significance level of 5% was considered for interpretation. ... (OR=28.3), perceived transport cost (OR=3.6), perceived treatment cost (OR=0.15) and distance to the nearest health center or hospital (OR=2.9) were found to be predictors of utilization of health
using logistic regression; sex (OR=0.23), marital status (OR=8.1), household income (OR=0.70), socioeconomic status (OR=3.5), presence of ... health care changes with age, gender, and marital status, utilization of health services also ..... When we measured satisfaction of the respondents on a previous visit to one of the.
Donners, A.; Bury, D.; Fernstrand, A.; Garssen, J.|info:eu-repo/dai/nl/086369962; Roth, T.; Verster, J.|info:eu-repo/dai/nl/241442702
Introduction: Impaired sleep can have a significant impact on perceived health status. The aim of the current study was to examine the relationship between perceived health status and sleep quality, total sleep time, and insomnia. Materials and methods: A survey was conducted among Dutch university
Son, Youn-Jung; Kim, Sun-Hee; Kim, Gi Yon; Son, Heesook
This cross-sectional study aimed to examine the association between health literacy, cancer-related knowledge, and preventive health behaviors among community-dwelling adults in Korea. Data were collected from 542 adults aged ≥ 18 years living in five big provinces in Korea (Seoul, Gyeonggi-do, Gyeongsang-do, Chungcheong-do, and Gangwon-do). Socio-demographic and health-related characteristics were determined using structured questionnaires. Health literacy, cancer-related knowledge, and engagement in preventive health behaviors were measured using validated instruments. These three variables differed according to socio-demographic and health-related characteristics, such as education, sex, age, and marital status. In the hierarchical regression analysis, health literacy (β = 0.26, p cancer-related knowledge (β = 0.21, p Cancer-related knowledge partially mediated the effect of health literacy on preventive health behaviors. Health literacy can play a key role in cancer prevention. It is important for healthcare providers to know how to deliver cancer-related knowledge and how to help people with low health literacy to engage in preventive health behaviors, using a variety of health information resources. Further research is needed to develop the instruments to assess comprehension of spoken and written health messages for cancer prevention and screening.
Primack, Brian A.; Land, Stephanie R.; Fan, Jieyu; Kim, Kevin H.; Rosen, Daniel A.
Associations between the emerging trend of waterpipe tobacco smoking and mental health among college students have not been sufficiently explored. This study analyzed data collected from 152 academic institutions that participated in the National College Health Assessment during the 2008–2009 academic year to examine associations between mental health and waterpipe tobacco smoking among college students (N=100,891). For comparison, cigarette smoking was also examined. Associations with mental...
Baheiraei, Azam; Bakouei, Fatemeh; Mohammadi, Eesa; Montazeri, Ali; Hosseni, Mostafa
Prioritizing women's health helps achievement of the 4(th) and 5(th) goals of Millennium Development Program. This study aimed to investigate association between social determinants of health and women's health of reproductive age. This population-based cross-sectional study, using multi-stage sampling procedure was conducted on 770, 15 to 49-year-old women residing in any one of the 22 municipality zones across Tehran, Iran. Eligible women were interviewed at home with SF-36 (Short Form Health Survey) and socio-demographic questionnaires. Social determinants of health contains; ethnicity, education, job, income, and crowding index. Data were analyzed by ANOVA and Multiple Linear Regression using SPSS-16. The threshold of P.V was considered 0.05. Overall, 770 women with mean age 33.9±9.3 years were interviewed. Majority of them were married (72.27%), housewives (62.2%), of Persian ethnicity (64.3%), and educated to high school level (43.8%). Age with dimensions of health except role emotional, mental health, and social functioning had significant association with B from -0.65 to -0.16.educational level with dimensions of health except role emotional andsocial functioning had significant association with B from 3.61 to 6.43 (PIncome with dimensions of health except role physical had significant association with B from -9.97 to -4.42. Reflection of unfavorable economic conditions and low education level on negative women' health experiences are alarming. Interaction between social determinants of health and health status must be considered in policymaking, and there is a need for policies that would enhance health of women in the low education and income brackets.
Gabardo, Marilisa Carneiro Leão; Moysés, Simone Tetu; Moysés, Samuel Jorge
To systematically evaluate the literature to investigate associations between social, demographic, economic, psychosocial, and behavioral factors and the self-perception of oral health measured using the Oral Health Impact Profile (OHIP). In this systematic review of the literature, the Preferred Reporting Items for Systematic Reviews (PRISMA) were adapted for the performance of a qualitative metasummary, without meta-analysis. Articles about oral health and associated factors with implications for quality of life were selected, with a focus on the tool for self-rating of the oral health-disease process, the OHIP. Pubmed/National Library of Medicine (NLM) and the Virtual Health Library (Biblioteca Virtual em Saúde - BVS/BIREME) were searched. Articles published between 2001 and 2011 were included. The following Medical Subject Headings (MeSH) were employed: oral health, quality of life, sickness impact profile, and socioeconomic factors. Of 57 articles identified, 20 met the inclusion criteria. The metasummary revealed that a poor self-perception of oral health was associated with unfavorable social, economic, demographic, and psychosocial factors, as well as with undesirable habits and poor clinical oral conditions. There is consensus in the literature about the influence of the investigated factors on the self-perception of oral health and on quality of life. The OHIP is an important aid for determining oral health needs and for developing strategies to control/reduce disease and promote oral health, with a consequent positive impact on quality of life.
Park, Soo Kyung; Rhee, Min-Kyoung; Barak, Michàlle Mor
Although nonregular workers experience higher job stress, poorer mental health, and different job stress dimensions relative to regular workers, little is known about which job stress dimensions are associated with poor mental health among nonregular workers. This study investigated the association between job stress dimensions and mental health among Korean nonregular workers. Data were collected from 333 nonregular workers in Seoul and Gyeonggi Province, and logistic regression analysis was conducted. Results of the study indicated that high job insecurity and lack of rewards had stronger associations with poor mental health than other dimensions of job stress when controlling for sociodemographic and psychosocial variables. It is important for the government and organizations to improve job security and reward systems to reduce job stress among nonregular workers and ultimately alleviate their mental health issues.
Xavier García Ferrandis
Full Text Available Due to its geostrategic condition during the Spanish Civil War, Valencia became one of the Republican cities welcoming more refugees, including many children. In this scenario of demographic and health crisis, the town had to restructure the assistance network in order to accommodate thousands of displaced children, who often had their relatives in faraway places. The paper focuses in the progressive rehabilitation undertaken by the Inclusa of Valencia, which was the provincial foundling hospital. This included deep changes both in its operation and in the admission criteria, particularly following the transfer of the Inclusa of Madrid to Valencia. The resulting overcrowding encouraged the degradation of healthcare and the spread of infectious diseases among the welcomed children.
Compen, F R; Adang, E M M; Bisseling, E M; Van der Lee, M L; Speckens, A E M
The mental burden of cancer might elicit additional health care utilization. However, it is unclear how psychiatric disorder and psychological distress relate to health care utilization. Therefore, this study explores associations between psychiatric disorder, psychological distress, and health care utilization. It was hypothesized that presence of psychiatric disorder and psychological distress was associated with increased health care utilization and costs. The current study consisted of secondary analyses of baseline data of a larger randomized controlled trial. Two hundred forty-five mixed-cancer patients with at least mild symptoms of psychological distress (Hospital Anxiety and Depression Scale-T ≥ 11) were mainly recruited via online media, participating centers and patient associations. Patients were assessed with Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID-I) for depressive, anxiety, and/or adjustment disorder. Psychological distress was measured by the Hospital Anxiety and Depression Scale. Retrospective self-reported health care utilization in the past 3 months was collected. Associations between predictors and health care utilization in terms of incidence rate ratios (IRR) and costs per category (mental, primary, somatic, and complementary) were assessed by negative binomial, logistic, and gamma regression. Eighty-nine (36.3%) patients suffered from psychiatric disorder, which was associated with mental health care utilization (IRR = 1.63) and costs (OR = 3.11). We observed a nonsignificant trend of somatic health care utilization in patients with psychiatric disorder. Psychological distress was associated with mental health care utilization (IRR = 1.09) and costs (OR = 1.09). Psychological distress was also associated with complementary health care utilization (IRR = 1.03). Psychiatric disorder and psychological distress were associated with mental health care use and costs. Psychological distress was associated
Mattila, K. J; Nieminen, M. S; Valtonen, V. V; Rasi, V. P; Kesäniemi, Y. A; Syrjälä, S. L; Jungell, P. S; Isoluoma, M; Hietaniemi, K; Jokinen, M. J
.... The association remained valid after adjustment for age, social class, smoking, serum lipid concentrations, and the presence of diabetes. Further prospective studies are required in different populations to confirm the association and to elucidate its nature.
Nunes, Bruno Pereira; Soares, Mariangela Uhlmann; Wachs, Louriele Soares; Volz, Pâmela Moraes; Saes, Mirelle de Oliveira; Duro, Suele Manjourany Silva; Thumé, Elaine; Facchini, Luiz Augusto
Evaluate the association of multimorbidity, primary health care model and possession of a private health plan with hospitalization. A population-based cross-sectional study with 1,593 elderly individuals (60 years old or older) living in the urban area of the city of Bagé, State of Rio Grande do Sul, Brazil. The outcome was hospitalization in the year preceding the interview. The multimorbidity was evaluated through two cut-off points (≥ 2 and ≥ 3). The primary health care model was defined by residence in areas covered by traditional care or by Family Health Strategy. The older adults mentioned the possession of a private health plan. We performed a gross and adjusted analysis by Poisson regression using a hierarchical model. The adjustment included demographic, socioeconomic, functional capacity disability and health services variables. The occurrence of overall and non-surgical hospitalization was 17.7% (95%CI 15.8-19.6) and 10.6% (95%CI 9.1-12.1), respectively. Older adults with multimorbidity were admitted to hospitals more often when to older adults without multimorbidity, regardless of the exhibition' form of operation. Having a private health plan increased the hospitalization by 1.71 (95%CI 1.09-2.69) times among residents in the areas of the Family Health Strategy when compared to elderly residents in traditional areas without a private health plan. The multimorbidity increased the occurrence of hospitalizations, especially non-surgical ones. Hospitalization was more frequent in older adults with private health plan and those living in Family Health Strategy areas, regardless of the presence of multiple diseases. Avaliar a associação da multimorbidade, modelo de atenção básica e posse de plano de saúde com hospitalização. Estudo transversal de base populacional com 1.593 idosos (60 anos ou mais) residentes na zona urbana do município de Bagé, Rio Grande do Sul. O desfecho foi a hospitalização no ano anterior à entrevista. A
Parker, Kristin M; Wilson, Mark G; Vandenberg, Robert J; DeJoy, David M; Orpinas, Pamela
This study tests the hypothesis that employees with comorbid physical health conditions and mental health symptoms are less productive than other employees. Self-reported health status and productivity measures were collected from 1723 employees of a national retail organization. chi2, analysis of variance, and linear contrast analyses were conducted to evaluate whether health status groups differed on productivity measures. Multivariate linear regression and multinomial logistic regression analyses were conducted to analyze how predictive health status was of productivity. Those with comorbidities were significantly less productive on all productivity measures compared with all other health status groups and those with only physical health conditions or mental health symptoms. Health status also significantly predicted levels of employee productivity. These findings provide evidence for the relationship between health statuses and productivity, which has potential programmatic implications.
) on dental caries and gum disease ... Key words: oral health, dental caries, gum disease, knowledge, adults, Tanzania. Introduction .... lesion. Absence of carious lesions on root tips, such as in erosion or trauma, the tooth was scored other ...
Chen, Xuefeng; Wang, Zhen; Gao, Jing; Hu, Weipeng
To explore the mediator effects of social anxiety on college students' life stress and mental health. 1430 college students were tested by revised Adolescent Self-Rating Life Events Check List (ASLEC), General Health Questionnaire (GHQ12) and social anxiety scale chose from Self-Consciousness Scale. 1. Social anxiety was the mediator variable between stress and mental health. 2. Female students were easily suffered from higher losing stress and human relationship stress in comparision with male. 3. Non-only child Students got a higher score in social anxiety and lower GHQ in comparision with only child. It may be helpful to improve the stress management and mental health of college students by testing and intervening their social anxiety perception.
Hussein M. A. Ageely
The purpose of this review is to describe briefly the adverse consequences of habitual chewing of Khat on health, and help educate the general public. The study is based on literature review that includes internet search and journals.
Key words: Mycobacterium tuberculosis, health service delays, South Sudan. Background. Tuberculosis (TB) is caused by the bacterium. Mycobacterium tuberculosis and occasionally by other species of Mycobacterium tuberculosis complex that includes. Mycobacterium bovis,Mycobacterium africanum and Mycobacterium.
van Hooijdonk, Carolien; Droomers, Mariël; Deerenberg, Ingeborg M.; Mackenbach, Johan P.; Kunst, Anton E.
BACKGROUND: Literature on the effect of community social capital on health is inconsistent and could be related to differences in social capital measures, health outcomes, population groups and locations studied. Therefore this study examines the diversity in associations between community social
Objective: To determine the associations between health literacy, the reasons for seeking health information, and the information sources utilized by Taiwanese adults. Method: A cross-sectional survey of 752 adults residing in rural and urban areas of Taiwan was conducted via questionnaires. Chi-squared tests and logistic regression were used for…
Joung, I. M.; Stronks, K.; van de Mheen, H.; Mackenbach, J. P.
To describe the differences in health behaviours in disparate marital status groups and to estimate the extent to which these can explain differences in health associated with marital status. Baseline data of a prospective cohort study were used. Directly age standardised percentages of each marital
Olesen, Kasper; F. Reynheim, Anne Louise; Joensen, Lene
Aim Self-management of diabetes is influenced by a range of factors including the ability to access, understand, appraise, and use of health information in everyday life, which can collectively be called health literacy. We investigated associations between nine domains of health literacy and HbA1c...... of nine health literacy domains. This association remained significant after adjusting for educational attainment. Among the domains, ‘Actively managing my health’ had the strongest impact on HbA1c. This was in turn predicted by ‘Appraising health information’, ‘Having sufficient information to manage...... level in people with type 1 diabetes. Methods A cross-sectional study was conducted with 1399 people with type 1 diabetes attending a Danish specialist diabetes clinic. Health literacy was assessed using the nine-domain Health Literacy Questionnaire. The association between health literacy and HbA1c...
Mishra, Sandeep; Carleton, R Nicholas
Substantial epidemiological evidence has shown that income inequality and objective measures of relative deprivation are associated with poorer health outcomes. However, surprisingly little research has examined whether subjective feelings of relative deprivation are similarly linked with poorer health outcomes. The relative deprivation hypothesis suggests that inequality affects health at the individual level through negative consequences of social comparison. We directly examined the relationship between subjective feelings of personal relative deprivation and self-reported physical and mental health in a diverse community sample (n = 328). Results demonstrated that subjective feelings of personal relative deprivation are associated with significantly poorer physical and mental health. These relationships held even when accounting for covariates that have been previously associated with both relative deprivation and health. These results further support the link between relative deprivation and health outcomes and suggest that addressing root causes of relative deprivation may lead to greater individual health. Copyright © 2015 Elsevier Ltd. All rights reserved.
Zou, Christopher; Andersen, Judith P; Blosnich, John R
Research suggests that lesbian, gay, and bisexual (LGB) populations experience higher prevalence of school bullying than heterosexuals. We examined if (a) verbal versus physical bullying were differentially associated with physical health among sexual minorities and (b) if sexual identity (i.e., homosexual [i.e., lesbian/gay] vs. bisexual) moderated the association of bullying on physical health. LGB adults aged 18 to 66 years (n = 463) were recruited online. Participants reported high school experiences of verbal and physical bullying and physician-diagnosed health conditions. Physical and verbal bullying were related to physical health conditions (ps bullying had a significant negative impact on physical health for bisexual persons (p bullying in high school was associated with physical health problems in adulthood. Bullying had a different relationship with health problems for bisexually identified individuals compared to lesbian/gay individuals. Future research should strive to disentangle potential differences in the relationship between bullying and health within sexual minority groups.
Rodríguez Valero, Francisco Javier; Gualteros, Julian Alberto; Torres, Jorge Andres; Umbarila Espinosa, Luz Marina; Ramírez-Velez, Robinson
... disease have also been negatively associated with muscle strength in adulthood. The aim of this study was to examine whether the association between muscular fitness and physical health status among children and adolescents from Bogotá, Colombia...
Lee, Dong-Yun; Kim, Seo-Hee; Woo, Sook Young; Yoon, Byung-Koo; Choi, DooSeok
Abstract Homosexual adolescents may face significant health disparities. We examined health-risk behaviors and health cognition related to homosexual behavior in a representative sample of adolescents. Data were obtained from 129,900 adolescents between 2008 and 2012 over 5 cycles of the Korean Youth Risk Behavior Survey, a national survey of students in grades 7 to 12. Various health-risk behaviors and aspects of health cognition were compared between homosexual and heterosexual adolescents ...
Salinero-Fort, Miguel Á; Jiménez-García, Rodrigo; del Otero-Sanz, Laura; de Burgos-Lunar, Carmen; Chico-Moraleja, Rosa M; Martín-Madrazo, Carmen; Gómez-Campelo, Paloma
The aims of this study are to compare self-reported health status between Spanish-born and Latin American-born Spanish residents, adjusted by length of residence in the host country; and additionally, to analyse sociodemographic and psychosocial variables associated with a better health status. This is a cross-sectional population based study of Latin American-born (n = 691) and Spanish-born (n = 903) in 15 urban primary health care centres in Madrid (Spain), carried out between 2007 and 2009. The participants provided information, through an interview, about self-reported health status, socioeconomic characteristics, psychosocial factors and migration conditions. Descriptive and multiple logistic regression analyses were conducted. The Spanish-born participants reported a better health status than the Latin America-born participants (79.8% versus 69.3%, pimmigrants with a better health status is greater in those who have been in Spain for less than five years compared to those who have stayed longer. Better health status is significantly associated with being men, under 34 years old, being Spanish-born, having a monthly incomes of over 1000 euros, and having considerable social support and low stress. Better self-reported health status is associated with being Spanish-born, men, under 34 years old, having an uppermiddle-socioeconomic status, adequate social support, and low stress. Additionally, length of residence in the host country is seen as a related factor in the self-reported health status of immigrants.
Carrotte, Elise R; Vella, Alyce M; Hellard, Margaret E; Lim, Megan S C
Poor mental health has previously been associated with risky sexual health behaviours among young people internationally and in clinical samples, but little is known about this relationship in non-clinical settings. We conducted a cross-sectional survey with a convenience sample of 1345 Australians aged 15-29. Multivariable logistic regression was used to identify sexual health behaviours independently associated with recent poor mental health including contraception use, STI testing, sexting and age at first sexual intercourse. Recent poor mental health was reported by 29.7 % of participants and independently associated with female gender (OR 1.8; 95 % CI 1.4-2.4), not identifying as heterosexual (OR 3.0; 95 % CI 2.1-4.4) and young age at first sexual intercourse among female participants (OR 1.4; 95 % CI 1.0-2.0). Results suggest mental health is largely driven by variables other than sexual health behaviours, although youth mental health services should consider inclusion of sexual health promotion within the scope of their services.
Asociación de los ingresos económicos con la utilización y la accesibilidad de los servicios sanitarios en España al inicio del siglo XXI Association of income with use of and access to health services in Spain at the beginning of the XXI century
Full Text Available Objetivo: Estimar la asociación de los ingresos económicos del hogar y de la renta provincial con las consultas al médico general y al especialista y con la hospitalización. Estimar si el tiempo de espera para acceder a esos servicios varía con esas características. Método: Datos de la Encuesta Nacional de Salud de 2001. La asociación se estimó mediante la odds ratio, ajustada por edad y sexo, y en el caso de la renta per cápita se ajustó también por los ingresos económicos del hogar. Se estimaron los percentiles y la media geométrica de los tiempos de espera en cada servicio sanitario y se evaluó la significación estadística de su asociación con ambas variables económicas. Resultados: Los sujetos con menores ingresos económicos presentan la mayor frecuencia de consultas al médico general y hospitalización, aunque esperan más tiempo para ser hospitalizados. Estos sujetos presentan la menor frecuencia de consultas al especialista: la odds ratio en el cuartil más bajo de ingresos frente al más alto fue 0,73 (intervalo de confianza del 95%, 0,62-0,87, aunque en las consultas financiadas públicamente la menor frecuencia se observa en los sujetos con mayores ingresos. No se han encontrado diferencias en la utilización y en los tiempos de espera según la renta provincial. Conclusiones: La frecuencia de consultas al especialista según los ingresos económicos del hogar muestra un patrón distinto al observado en las consultas al médico general y en la hospitalización. El mayor tiempo de espera para hospitalización se observa en los sujetos con menores ingresos económicos.Objective: To estimate the association of household income and provincial income with visits to general practitioners and specialists and with hospitalization and to determine whether waiting times to access these services vary with both economic variables. Method: Data from the 2001 National Health Survey were used. The association was estimated by sex
Hou, Changrong; Lü, Bin; Lu, Zuxun; Qin, Shilong
In order to study the association of each item of a health examination and lifestyles with health-related quality of life (HRQoL), a cross-sectional survey by a self-administered questionnaire using the 12-Item Short Form Health Survey (SF-12, version 1) was conducted on 145 government managers that took health examinations in Tongji Hospital, Wuhan, China during 2005. The results showed that the determinations of organic functions including BMI, hemoglobin, blood platelet count, urine protein, urine WBC and lipid metabolism (LDL) were associated with HRQoL. The lifestyle items including age, sex, life satisfaction drinking alcohol and kind of alcohol drunk, drinking tea, sleep quality and adhering to bedtime, working overtime, work stress were associated with HRQoL in the multiple regression models. Sex, age and life satisfaction were the lifestyle items most closely associated with HRQoL, while LDL, hemoglobin and urine protein were the health examination items most closely associated HRQoL. This study revealed that both lifestyle and health examination items were associated with HRQoL.
Lee, Hyo Jung; Ju, Young Jun; Park, Eun-Cheol
Despite the positive effect of community-based mental health centers, the utilization of professional mental health services appears to be low. Therefore, we analyzed the relationship between regional recognition of mental health centers and utilization of professional mental health services. We used data from the Community Health Survey (2014) and e-provincial indicators. Only those living in Seoul, who responded that they were either feeling a lot of stress or depression, were included in the study. Multiple logistic regression analysis using generalized estimating equations was performed to examine both individual- and regional-level variables associated with utilization of professional mental health services. Among the 7338 participants who reported depression or stress, 646 (8.8%) had consulted a mental health professional for their symptoms. A higher recognition rate of mental health centers was associated with more utilization of professional mental health services (odds ratio [OR]=1.05, 95% confidence interval [CI]=1.03-1.07). Accessibility to professional mental health services could be improved depending on the general population's recognition and attitudes toward mental health centers. Therefore, health policy-makers need to plan appropriate strategies for changing the perception of mental health services and informing the public about both the benefits and functions of mental health centers. Copyright © 2017. Published by Elsevier B.V.
Full Text Available In order to meet the dual requirements of economic development and energy consumption, the Chinese government has adopted a series of measures and policies to improve energy efficiency. However, the developing characteristics are not the same in different regions. Thus, it is necessary to analyze the actual energy efficiency levels in a more targeted manner. In this paper, 30 provinces in China will be adopted to study energy efficiency based on the statistical data from National Energy Administration and National Bureau of Statistics. With the trends of Chinese energy consumption and economy development, the Lorenz curve between Chinese energy consumption and GDP is fitted firstly. The Lorenz coefficient (0.1562 shows that the energy allocation in China is neither reasonable nor balanced. Then, by cluster analysis, the regions of different provinces are newly divided into five divisions from the dimensions of economy and energy, i.e., (high development level and high consumption level, HH, (moderate development level and moderate consumption level, MM, (moderate development level and low consumption level, ML, (low development level and low consumption level, LL, and (low development level and moderate consumption level, LM. Based on the division results, the provincial promotion potentialities are estimated quantitatively according to the absolute convergence feature of energy efficiency promotion. The provinces that have more promotion potentialities of energy efficiency are located, such as Hebei (56.29% in division (HH, Liaoning (38.15% in division (MM, Anhui (44.17% in division (ML, Ningxia (71.63% in division (LL, and Xinjiang (35.26% in division (LM, According to the different provincial potentialities, energy efficiency in China needs to improve more, but the improvement approaches should be specific and differential. Driven by technology, policy and mechanism, and industrial restructuring, the Chinese economy and energy resources
Bhat, Ramesh V
Scientific and technological developments in the agricultural sectors in the recent past has resulted in increased food production and at the same time led to certain public health concerns. Unseasonal rains at the time of harvest and improper post harvest technology often results in agricultural commodities being contaminated with certain fungi and results in the production of mycotoxins. Consumption of such commodities has resulted in human disease outbreaks. Naturally occurring toxins, inherently present in foods and either consumed as such or mixed up with grains, had been responsible for disease outbreaks. Other possible causes of health concern include the application of various agrochemicals such as pesticides and the use of antibiotics in aquaculture and veterinary practices. Foodborne pathogens entering the food chain during both traditional and organic agriculture pose a challenge to public health. Modern biotechnology, producing genetically modified foods, if not regulated appropriately could pose dangers to human health. Use of various integrated food management systems like the Hazard Analysis and critical control system approach for risk prevention, monitoring and control of food hazards are being emphasized with globalization to minimise the danger posed to human health from improper agricultural practices.
Zeegers Paget, Dineke; Barnhoorn, Floris; McCarthy, Mark; Alexanderson, Kristina; Conceição, Claudia; Devillé, Walter; Grimaud, Olivier; Katreniakova, Zuzana; Narkauskaité, Laura; Saliba, Amanda; Sammut, Marvic; Voss, Margaretha
The European Public Health Association (EUPHA) proposed and led PHIRE (Public Health Innovation and Research in Europe), with co-financing by the European Commission, to assess public health innovation and research at national level in Europe. PHIRE was also designed to promote organizational development and capacity building of EUPHA. We assess the success and limitations of using EUPHA's participative structures. In total, 30 European countries were included-27 EU countries, Iceland, Norway and Switzerland. EUPHA thematic section presidents were asked to identify country informants to report, through a web-based questionnaire, on eight public health innovations. National public health associations (EUPHA member organizations) were requested to identify their national public health research programmes and calls, review the health research system, coordinate a stakeholder workshop and provide a national report. The section and national reports were assessed for responses and completeness. Half of the final responding CIs were members of EUPHA sections and the other half gained from other sources. Experts declined to respond for reasons including lack of time, knowledge of the innovation or funding. National public health associations held PHIRE workshops with Ministries of Health in 14 countries; information for 10 countries was gained through discussions within the national association, or country visits by PHIRE partners. Six countries provided no response. Some national associations had too weak organizational structures for the work or insufficient financial resources or criticism of the project. EUPHA is the leading civil society organization giving support to public health research in Europe. PHIRE created new knowledge and supported organizational development. EUPHA sections gained expert reports on public health innovations in European countries and national public health associations reported on national public health research systems. Significant advances
Canadian Healthcare Practitioners’ Access to Evidence Based Information Is Inequitable. A Review of: Chatterley, T., Storie, D., Chambers, T., Buckingham, J., Shiri, A., & Dorgan, M. (2012. Health information support provided by professional associations in Canada. Health Information & Libraries Journal, 29(3, 233-241.
Full Text Available Objective – To determine what services and resources are available to health professionals through national Canadian and Alberta based health professional associations and licensing colleges and if those resources and services are being used. Also, to assess the associations’ perceptions of what resources and services Canadian health professionals actually need and if those needs are being met, membership satisfaction with the resources and services provided, and challenges the associations have with providing resources and services.Design – Structured telephone interview.Setting – Health professional associations and licensing colleges in Canada.Subjects – 23 health professional associations: 9 Alberta-based associations and 14 national-level professional associations and licensing colleges.Methods – A librarian, communications officer, or another individual in a comparable position at each association was invited via email to participate in the study. Individuals willing to participate in the interview were emailed the interview questions in advance. Telephone interviews were conducted in July and August of 2009. For those who did not respond to the email request or who did not wish to participate in the interviews, information was collected from the association’s website.Main Results – Of the 23 contacted associations 12 agreed to be interviewed: less than 50% response rate. Data was collected from websites of seven associations that either declined to be interviewed or did not respond to the authors’ email request. Data were unavailable for four associations due to data being in members only sections of the websites. Data were analyzed both qualitatively and quantitatively.Resources and services provided by the associations and licensing colleges range from none to reference services provided by a librarian and access to licensed databases.None of the three licensing colleges or the two provincial associations interviewed
Hansen, Kristian Schultz; Enemark, Ulrika; Foldspang, Anders
OBJECTIVE: To study changes in health services consumption following substantial reduction in the availability of local emergency services in a small municipality population. METHOD: A dynamic cohort (21,000 residents of Viborg County, Denmark, of which 2,300 from Morsø municipality) was followed......, 1997-2003. Data were extracted from administrative registries including information on individual use of emergency services and other hospital care, contact with GPs and socioeconomic background. Health services' use by the Morsø population was measured before reduction in emergency room opening hours...... of substitute health services. By contrast, Morsø women compared to the rest of Viborg county reduced their use of GP services in terms of face-to-face visits (β = -0.08, P = 0.020), telephone consultations (β = -0.11, P = 0.007), home visits (β = -0.48, P = 0.009), and their inpatient hospital utilization (β...
Amber R. Massey
Full Text Available Background. This exploratory study uses a multimethod approach to examine the relationship between social strategy usage and overall health in preschool children. Methods. Children's temperament, social strategies, and health assessments were obtained via reported behavior from parents and teachers. In addition, children's use of prosocial and coercive strategies was observed and recorded via one-way windows in the preschool facility. Results. Results revealed that the temperament characteristic of effortful control was related to the observed use of coercive strategies and that coercive strategies were not observed by teachers, who viewed these children as primarily prosocial. The reported use of both coercive and prosocial strategies was also related to decrease in illness. Conclusion. These findings in relation to previous work suggest that using both prosocial and coercive strategies can elevate status as well as maintain health even in young children.
Boyle, Michael P; Fearon, Alison N
The aim of this study was to identify potential relationships between self-stigma (stigma awareness and stigma application) and stress, physical health, and health care satisfaction among a large sample of adults who stutter. It was hypothesized that both stigma awareness and stigma application would be inversely related to measures of physical health and health care satisfaction, and positively related to stress. Furthermore, it was anticipated that stress mediated the relationship between self-stigma and physical health. A sample of adults who stutter in the United States (n=397) completed a web survey that assessed levels of stigma awareness and stigma application, stress, physical health, and health care satisfaction. Correlational analyses were conducted to determine the relationships between these variables. Higher levels of stigma awareness and stigma application were associated with increased stress, decreased overall physical health, and decreased health care satisfaction (i.e., discomfort obtaining health care due to stuttering, and adverse health care outcomes due to stuttering), and these relationships were statistically significant. Stress was identified as a mediator between stigma application and physical health. Because adults who stutter with higher levels of self-stigma are at risk for decreased physical health through increased stress, and lower satisfaction with their health care experiences as a result of stuttering, it is important for professionals to assess and manage self-stigma in clients who stutter. Self-stigma has implications for not only psychological well-being, but stress, physical health, and health care satisfaction as well. Copyright © 2017 Elsevier Inc. All rights reserved.
Vella, Stewart A; Swann, Christian; Allen, Mark S; Schweickle, Matthew J; Magee, Christopher A
This study aimed to investigate potential bidirectional relationships between sport participation and mental health during early adolescence. Data were taken from wave 5 (2012) and wave 6 (2014) of the K cohort of the Longitudinal Study of Australian Children. In total, there were 4023 participants (mean age = 12.41 yr, SD = 0.49 yr, at baseline), and this sample was followed up 24 months later. Cross-lagged panel models were used to examine bidirectional relationships between sport participation (hours per week for team, individual, and total sport participation) and mental health (total psychological difficulties, internalizing problems, and externalizing problems) as measured by the parent-report version of the Strengths and Difficulties Questionnaire (SDQ). Bidirectional relationships were evident between time involved in sport and overall mental health (Sport12→SDQ14: β = -0.048; SDQ12→Sport14: β = -0.062). Bidirectional relationships were also evident between time involved in sport participation and internalizing (social and emotional) problems (Sport12→SDQ14: β = -0.068; SDQ12→Sport14: β = -0.067). The relationship between time in organized sport and externalizing problems (conduct problems and inattention/hyperactivity problems) was not bidirectional. Externalizing problems predicted later sports participation (β = -0.039), but not vice versa. Findings demonstrate bidirectional relationships between sport participation and adolescent mental health. The design and implementation of youth sport programs should maximize mental health benefits, and programs should be designed, implemented, and marketed to be attractive to participants with poor psychosocial health.
Swinkels, Cindy M; Ulmer, Christi S; Beckham, Jean C; Buse, Natalie; Calhoun, Patrick S
Short and long sleep duration have been linked with higher rates of comorbid medical and mental health issues, as well as increased mortality. The current study examined the association between sleep duration, mental health problems, and health risk behaviors in a large sample of U.S. Afghanistan/Iraq era veterans. NA. Mid-Atlantic VA Medical Center(s). The sample (N = 1,640) included 20% women (n = 333) and had an average age of 37 years (SD = 10.0). NA. Results from logistic regression analyses that included age, minority status, gender, military rank, number of deployments, combat exposure, and health risk behaviors as covariates indicated that very short sleep duration (≤ 5 h of sleep) and long sleep duration (≥ 9 h) were each associated with increased odds of current post traumatic stress disorder (PTSD), major depressive disorder (MDD), and smoking; while poor sleep quality was associated with PTSD, panic disorder (PD), MDD, suicidal ideation (SI), and risky drinking. Sleep duration may be an important marker for psychiatric and health risk behavior problems, and our results suggest that clinical assessment of sleep disturbance in this veteran group is warranted to assess for both short and long sleep. Swinkels CM; Ulmer CS; Beckam JC; Buse N; the VA Mid-Atlantic MIRECC Registry Workgroup; Calhoun PS. The association of sleep duration, mental health, and health risk behaviors among U.S. Afghanistan/Iraq era veterans. SLEEP 2013;36(7):1019-1025.
Schmidt, B.; Loerbroks, A.; Herr, R.M.; Wilson, M.G.; Jarczok, M.N.; Litaker, D.; Mauss, D.; Bosch, J.A.; Fischer, J.E.
Background: Protecting the health of the work force has become an important issue in public health research. Purpose: This study aims to explore potential associations between supportive leadership style (SLS), an aspect of leadership behavior, and self-rated health (SRH) among employees. Method: We
Zijlema, Wilma L; Klijs, Bart; Stolk, Ronald P; Rosmalen, Judith G M
BACKGROUND: Research has shown that health differences exist between urban and rural areas. Most studies conducted, however, have focused on single health outcomes and have not assessed to what extent the association of urbanity with health is explained by population composition or socioeconomic
Zijlema, Wilma L.; Klijs, Bart; Stolk, Ronald P.; Rosmalen, Judith G. M.
Background Research has shown that health differences exist between urban and rural areas. Most studies conducted, however, have focused on single health outcomes and have not assessed to what extent the association of urbanity with health is explained by population composition or socioeconomic
Chaney, Elizabeth H.; Chavarria, Enmanuel; Stellefson, Michael L.; Birch, David A.; Spear, Caile
The American Association for Health Education (AAHE), a national health education organization with the mission of advancing the profession of health education, launched the 2011 AAHE membership survey between October 13, 2011 and November 1, 2011, under the leadership of the AAHE Board of Directors and AAHE Staff. The primary objective of the…
Chassin, Laurie; Macy, Jon T.; Seo, Dong-Chul; Presson, Clark C.; Sherman, Steven J.
The current study examined the association between membership in the sandwich generation, defined as providing care to both children and parents or in-laws, and five health behaviors: checking the food label for health value when buying foods, using a seat belt, choosing foods based on health value, exercising regularly, and cigarette smoking.…
SIMON, G; ORMEL, J; VONKORFF, M; BARLOW, W
Objective: The authors examined the overall health care costs associated with depression and anxiety among primary care patients. Method: Of 2,110 consecutive primary care patients in a health maintenance organization, 1,962 were screened with the 12-item General Health Questionnaire. A stratified
Nelson, Timothy D.; Smith, Tori R.; Duppong Hurley, Kristin; Epstein, Michael H.; Thompson, Ronald W.; Tonniges, Thomas F.
Youth in residential treatment settings often present with a complex combination of mental and physical health problems. Despite an emerging literature documenting significant associations between mental health and physical health, the relationship between these two areas of functioning has not been systematically examined in youth presenting to…
Flores, M.; Kalwij, Adriaan
We use data from the Survey of Health, Aging, and Retirement in Europe to estimate for thirteen European countries the associations of early life circumstances—measured by childhood health and socioeconomic status (SES)—with educational attainment, and later life health and employment (at ages
Utter, Jennifer; Denny, Simon; Teevale, Tasileta; Sheridan, Janie
With the increase in popularity of energy drinks come multiple concerns about the associated health indicators of young people. The current study aims to describe the frequency of consumption of energy drinks in a nationally representative sample of adolescents and to explore the relationship between energy drink consumption and health risk behaviours, body size and mental health. Data were collected as part of Youth'12, a nationally representative survey of high school students in New Zealand (2012). In total, 8500 students answered a comprehensive questionnaire about their health and well-being, including multiple measures of mental well-being, and were weighed and measured for height. More than one-third (35%) of young people consumed energy drinks in the past week, and 12% consumed energy drinks four or more times in the past week. Energy drink consumption was significantly associated with greater depressive symptoms, greater emotional difficulties and lower general subjective well-being. Frequent energy drink consumption was also associated with binge drinking, smoking, engagement in unsafe sex, violent behaviours, risky motor vehicle use and disordered eating behaviours. There was no association between consumption of energy drinks and student body size. Consumption of energy drinks is associated with a range of health risk behaviours for young people. Strategies to limit consumption of energy drinks by young people are warranted. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).
Damman, O.C.; Boer, D. de; Hendriks, M.; Meuwissen, L.E.; Rademakers, J.; Delnoij, D.M.J.; Groenewegen, P.P.
When comparing health care providers, patient experience data are usually adjusted for case-mix associations to ensure fair comparisons. Previous studies in the United States showed that case-mix associations sometimes vary across health care providers. Such variation could indicate differential
Van Dijk, Martin; Savelberg, Hans; Verboon, Peter; Kirschner, Paul A.; De Groot, Renate
The majority of studies investigating associations between physical activity and mental health in adolescents have been cross-sectional in design. Potential associations between physical activity and mental health may be better examined longitudinally as physical activity levels tend to decrease in
Conclusion: Our results suggest that active transport use has been associated with a better perceived general health and a healthy body weight. However, more research is needed to be able to elucidate which factors cause this better health. No associations were observed between transport choice and perceived psychological wellbeing.
Primack, Brian A; Land, Stephanie R; Fan, Jieyu; Kim, Kevin H; Rosen, Daniel
Associations between the emerging trend of waterpipe tobacco smoking and mental health among college students have not been sufficiently explored. This study analyzed data collected from 152 academic institutions that participated in the National College Health Assessment during the 2008-2009 academic year to examine associations between mental health and waterpipe tobacco smoking among college students (N = 100,891). For comparison, cigarette smoking was also examined. Associations with mental health variables were very strong for cigarette smoking but only moderate for waterpipe smoking. Study implications and limitations are noted.
Rosenthal, Lisa; Earnshaw, Valerie A; Carroll-Scott, Amy; Henderson, Kathryn E; Peters, Susan M; McCaslin, Catherine; Ickovics, Jeannette R
Stigma-based bullying is associated with negative mental and physical health outcomes. In a longitudinal study, surveys and physical assessments were conducted with mostly Black and Latino, socioeconomically disadvantaged, urban students. As hypothesized, greater weight- and race-based bullying each was significantly indirectly associated with increased blood pressure and body mass index, as well as decreased overall self-rated health across 2 years, through the mechanism of more negative emotional symptoms. Results support important avenues for future research on mechanisms and longitudinal associations of stigma-based bullying with health. Interventions are needed to reduce stigma-based bullying and buffer adolescents from adverse health effects. PMID:24155192
Brennan, David S; Keuskamp, Dominic; Balasubramanian, Madhan; Amarasena, Najith
Our aim was to examine the associations between general health and well-being with living conditions, oral health and degree of dependency. We surveyed people from a primary care service and collected data on sociodemographic characteristics, general health, health utility, well-being, activities, living conditions and oral health impact. Overall, 459 participated (78% response rate). Poor general health was associated with decreased instrumental activities of daily living scores (18% of those with poor general health were independent vs 60% with good general health). Greater oral health impact was also related to poor general health. Health utility was lower for some dependency, for renting and oral health impact. Well-being was also lower for some dependency, for renting, not speaking English and oral health impact. In addition to the well-known association of poor general health with dependency, our results also illustrate the potential importance of living conditions and oral health. © 2017 AJA Inc.
Krüger, Marta Silveira da Mota; Casarin, Renata Picanço; Gonçalves, Letycia Barros; Pappen, Fernanda Geraldo; Bello-Correa, Fernanda Oliveira; Romano, Ana Regina
Objective. The aims of this study were to evaluate the periodontal health of pregnant women and to investigate the association of periodontal status with demographic and socioeconomic characteristics, as well as medical and dental history. Materials and Methods. A total of 311 pregnant women were interviewed to obtain sociodemographic data along with medical and dental histories. Clinical examinations were performed to record the presence of visible plaque, gingival bleeding, and caries activity. The periodontal condition was evaluated by Community Periodontal Index of Treatment Needs (CPITN) in one tooth of each sextant (16, 11, 26, 36, 31, and 46). Results. After the adjustment analysis, the presence of visible plaque remained the main determinant of gingival bleeding (OR = 2.91, CI = 1.91-4.48). First-trimester pregnancy status was also a predictor, with a lower prevalence of gingival bleeding observed in the second (OR = 0.87, CI = 0.77-0.99) and third (OR = 0.82, CI = 0.73-0.93) trimesters. Conclusion. In pregnant women, the presence of dental plaque and first-trimester pregnancy status were the main implicated factors predicting gingival bleeding.
Marta Silveira da Mota Krüger
Full Text Available Objective. The aims of this study were to evaluate the periodontal health of pregnant women and to investigate the association of periodontal status with demographic and socioeconomic characteristics, as well as medical and dental history. Materials and Methods. A total of 311 pregnant women were interviewed to obtain sociodemographic data along with medical and dental histories. Clinical examinations were performed to record the presence of visible plaque, gingival bleeding, and caries activity. The periodontal condition was evaluated by Community Periodontal Index of Treatment Needs (CPITN in one tooth of each sextant (16, 11, 26, 36, 31, and 46. Results. After the adjustment analysis, the presence of visible plaque remained the main determinant of gingival bleeding (OR = 2.91, CI = 1.91–4.48. First-trimester pregnancy status was also a predictor, with a lower prevalence of gingival bleeding observed in the second (OR = 0.87, CI = 0.77–0.99 and third (OR = 0.82, CI = 0.73–0.93 trimesters. Conclusion. In pregnant women, the presence of dental plaque and first-trimester pregnancy status were the main implicated factors predicting gingival bleeding.
This paper proposes new approach for modelling self-assessed health. We find that the concept of health is too complicated to measure effects of health determinants using a one-dimensional econometric model. We apply two-dimensional stereotype logistic model that allows capturing nonmonotonicity in effects of factors and revealing significant effects that remain unrevealed if single dimension models, such as ordered logit or ordered probit, are used. Modelling self-assessed health using multi...
Zhao, Xiaofeng; Huang, Xianjin; Liu, Yibo
A spatial autocorrelation analysis method is adopted to process the spatial dynamic change of industrial Chemical Oxygen Demand (COD) discharge in China over the past 15 years. Studies show that amount and intensity of industrial COD discharges are on a decrease, and the tendency is more remarkable for discharge intensity. There are large differences between inter-provincial discharge amount and intensity, and with different spatial differentiation features. Global spatial autocorrelation analysis reveals that Global Moran's I of discharge amount and intensity is on the decrease. In space, there is an evolution from an agglomeration pattern to a discretization pattern. Local spatial autocorrelation analysis shows that the agglomeration area of industrial COD discharge amount and intensity varies greatly in space with time. Stringent environmental regulations and increased funding for environmental protections are the crucial factors to cut down industrial COD discharge amount and intensity.
Full Text Available It is important that decision of asphalt pavement structure requires overall considerations of the performance and financial investment. To have asphalt pavement structure fulfilling good reliability, the asphalt pavement structure decision was researched based on value engineering theory. According to the national and provincial highway investigation data in Shandong Province during the last decade, the asphalt pavement performance attenuation rules of traffic levels and asphalt layer thicknesses were developed, and then the road performance evaluation method was presented. In addition, the initial investments, the costs of road maintenance, and middle-scale repair in a period were analyzed. For the light traffic and medium traffic example, using the value engineering method, the pavement performance and costs of which thickness varies from 6 cm to 10 cm were calculated and compared. It was concluded that value engineering was an effective method in deciding the asphalt pavement structure.
Full Text Available Since 2009, South Africa has seen a major shift in emphasis concerning monitoring and evaluation (M&E systems. This shift was partially stimulated by the South African government being faced with a number of pressures, key amongst which were persistent poverty and inequality and widespread service delivery protests. These pressures resulted ina greater willingness by government to address the poor quality of public services, and other governance problems that needed a greater focus on M&E to address these challenges. This led to the establishment of the Department of Performance Monitoring and Evaluation (DPME in early 2010. A comprehensive survey on the state and use of M&E systems in national and provincial government was conducted by the DPME as an attempt to understand the M&E landscape since 1994. The results were used to make informed policy and programme decisions. This paper outlines the findings of the survey.
A lack of congruency between the teaching and learning of science and the student’s personal worlds has long been recognised by the international science education community as an issue deserving space in the research agenda. The purpose of this study was to explore the diversity of student reactions when subcultures such as family, community peers, and personal worldviews are considered along side the subculture of school science. Two-hundred and fifty students from urban and provincial schools in the northeastern region of Colombia (South America) participated. From this group, 18 students were interviewed. It was observed that students adopt a compartmentalisation of knowledge that is evident as both an avoiding strategy in the classroom and as a mechanism to differentiate between the natural world of their everyday situations and the one portrayed by a Westernised science instruction in the classroom. The findings reflect how multiple worldviews correlate with student frameworks as implanted by school science.
van Holland, Berry J.; Soer, Remko; de Boer, Michiel R.; Reneman, Michiel F.; Brouwer, Sandra
Background Workers' health surveillance (WHS) programs commonly measure a large number of indicators addressing health habits and health risks. Recently, work ability and functional capacity have been included as important risk measures in WHS. In order to address work ability appropriately,
van Holland, B.J.; Soer, R.; de Boer, M.R.; Reneman, M.F.; Brouwer, S.
Background Workers’ health surveillance (WHS) programs commonly measure a large number of indicators addressing health habits and health risks. Recently, work ability and functional capacity have been included as important risk measures in WHS. In order to address work ability appropriately,
Wang, Linwei; Panagiotoglou, Dimitra; Min, Jeong Eun; DeBeck, Kora; Milloy, M J; Kerr, Thomas; Hayashi, Kanna; Nosyk, Bohdan
People who inject drugs (PWID) face barriers to healthcare due to reasons including comorbidity. We evaluated access to health and social services by three of the most prevalent comorbid conditions among PWID: HIV, hepatitis C (HCV), and mental health, in an urban setting in Canada. Data were derived from prospective cohorts of community-recruited PWID between 2005 and 2015. HIV and HCV serostatuses were based on antibody tests, while mental health conditions and inability to access health and social services (barriers to access) were determined by participants' self-report. We employed generalized linear mixed models controlling for confounders to examine associations between health conditions and barriers to access. Among 2494 participants, 1632 (65.4%) reported barriers to access at least once over a median of seven (IQR: 3, 12) semi-annual assessments. Mental health conditions were independently associated with increased odds of reporting barriers (adjusted Odds Ratio (aOR): 1.45, 95% Confidence Interval (CI): 1.32, 1.58), while HIV was not (aOR: 0.96, 95% CI: 0.85, 1.08), and HCV was associated with decreased odds (aOR: 0.80, 95% CI: 0.69, 0.93). The associations between mental health conditions and barriers to access were consistent among PWID without HIV/HCV (aOR: 1.35, 95% CI: 1.10, 1.65), with HCV mono-infection (aOR: 1.55, 95% CI: 1.37, 1.75), and HCV/HIV co-infection (aOR: 1.36, 95% CI: 1.15, 1.60). Targeted strategies to seek and treat mental health conditions in settings that serve PWID, and assist PWID with mental health conditions in navigating healthcare system may improve the publicly-funded health and social services. Copyright © 2016. Published by Elsevier Ireland Ltd.
Societal orientation places expectations about what it means to be a man and a woman, thus gender has a powerful influence on sexual behavior. Gender stereotypes of submissive females and powerful males can hinder communication and encourage risky behavior and increase vulnerability to sexual health threats such ...
Conclusion: A U-shaped relationship was observed between the self-reported sleep duration with risk prevalence and health outcome in the elderly population, although not all results showed a significant difference. A progressively higher change was observed during short and long sleep durations in our study.
of respondents disposed off the empty sachets in the dustbins within the school environment, and 22.2% dispose off the sachets indiscriminately. Government, they believed can contribute greatly to good water and environmental sanitation life of its citizens through health education (46.6%), regular environmental sanitation ...
Background: Migration is a demographic event which serves as a coping mechanism of poverty alleviation in developing countries, including Ethiopia. The living condition ... Results: The overall magnitude of health hazards was 41%: diarrhea 31.6% and malaria 10.5% were the leading acute illnesses. After controlling the ...
Background: Migration is a demographic event which serves as a coping mechanism of poverty alleviation in developing countries, including Ethiopia. The living ... Results: The overall magnitude of health hazards was 41%: diarrhea 31.6% and malaria 10.5% were the leading acute illnesses. After controlling the possible ...
Up to 84.9% knew that exposure to microwave radiation was harmful to the health, but only 49.8%, 43.0% and 53.2% knew that the microwave oven worked by the emission of microwave radiation, could not cook foods evenly, and could interfere with a heart pace maker respectively. The overall knowledge was poor with a ...
This study has investigated the uses to which Fore stomach digesta recovered from animals slaughtered at the abattoir in Sokoto, Nigeria, are put and the attendant health risks. From preliminary investigation, the digesta are used as sources of manure mainly for vegetable farming as well as a medium for incubation of eggs ...
This study on layer and broiler houses is expected to give basic information on the nature of microbes, their occurrence, health hazard they could constitute and the possibilities for disease control measures. Modern husbandry practices, state or local concentration of the industry, high stocking densities, uniform age ...
May 6, 2013 ... factors. Confounding variables such as smoking, age and fuel used at home were treated as independent factors in separate analyses. Although broader environmental factors such as temperature, humidity, air velocity, ambient air quality and others might have contributed to the observed respiratory health ...
May 6, 2013 ... of space with wire-mesh surrounding the entire wall of the kiosk especially in areas where customers were served, not in the kitchens. Only 29% of the enterprises were ..... Challenge. Bull World Health Organ. 2000;78(9):1078-92. PubMed | Google Scholar. 8. Ezzati M, Kammen DM. Indoor Air Pollution ...
Irina N. Litvinova
Full Text Available On the basis of for the first time the massif of new archival material introduced into scientific circulation in article the problem of consolidation of society of the Lower Volga province in the years of great tests of World War I is analyzed. Particular attention is paid to the practices used by local charitable committees and non-governmental organizations created in that period in Tsaritsyn. In particular, it analyzes the activities of local branches of the committees of the Grand Duchess Elizabeth, to assist the families of soldiers and Grand Duchess Tatiana – to support refugee families. The article was first introduced into scientific circulation new archival sources on the issue of the functioning of national non-governmental organizations based in the city of Lithuanian, Latvian, Polish and Jewish refugees who were engaged in assisting their fellow countrymen, to move from front-line areas in the new place of residence, in Tsaritsyn. The questions of organizational character connected with difficulties of official registration of the public unions by the provincial authorities are specified; severity of rules of the Ministry of Internal Affairs, when carrying out public monetary collecting by societies from the population. On the basis of concrete historical material, revealed new tricks and techniques used by charitable institutions for admission donations from citizens, as well as forms of voluntary activity themselves representatives of provincial society, to assist the families of the soldiers called to the front, wounded, children, refugees. The microanalysis of some unique historical sources which are of interest both for researchers of the region, and for experts of the "culture of the back" direction of times of World War I is carried out.
Goksel, Ali Gurel; Caz, Cagdas; Yazici, Omer Faruk; Ikizler, Huseyin Can
The purpose of this research is to study the relation between the level of organizational stress at the staff of the Youth Services and Sports Provincial Directorate and their performance. The study group of research, Istanbul province in the Uskudar district officials operating in the Youth Services and Sports Provincial Directorate constitute a…
Background Unemployment is associated with reduced physical and psychological well-being. Perceived health is an important factor influencing health outcomes as well as successful returns to work. This study aims to determine the extent to which perceived health correlates with mental health, various health risk characteristics and socio-demographic characteristics in a setting-selected sample of long-term unemployed persons. Methods Using SF-12, 365 long-term unemployed persons were assessed for self-perceived health and various socio-demographic and health characteristics. Perceived health data of the sample was compared to the German SF-12 reference population. Bivariate analyses and multiple linear regression models were applied to identify those variables significantly associated with perceived health. Results The study population reported poorer perceived health compared with the general population. Analyses showed that perceived mental health was significantly worse in women, among persons with heightened depression and anxiety scores, and in participants reporting reduced levels of physical activity. Perceived physical health was significantly lower among older persons, participants with a higher BMI, and participants with heightened depression and anxiety scores. Both mental and physical health were worse among the unemployed assigned to an employment center as compared to those engaged in the secondary labor market. In total, 36% of the variance in the SF-12 mental score and 20% of the variance in the SF-12 physical score were explained by the factors included in the final multiple linear regression models. Conclusions Perceived health among a select group of long-term unemployed is reduced to a clinically relevant extent compared to the general population. The preliminary findings underline an association between mental health and perceived health. Negative self-perceptions of health were also associated with the labor market setting and some of the
Full Text Available Abstract Background Unemployment is associated with reduced physical and psychological well-being. Perceived health is an important factor influencing health outcomes as well as successful returns to work. This study aims to determine the extent to which perceived health correlates with mental health, various health risk characteristics and socio-demographic characteristics in a setting-selected sample of long-term unemployed persons. Methods Using SF-12, 365 long-term unemployed persons were assessed for self-perceived health and various socio-demographic and health characteristics. Perceived health data of the sample was compared to the German SF-12 reference population. Bivariate analyses and multiple linear regression models were applied to identify those variables significantly associated with perceived health. Results The study population reported poorer perceived health compared with the general population. Analyses showed that perceived mental health was significantly worse in women, among persons with heightened depression and anxiety scores, and in participants reporting reduced levels of physical activity. Perceived physical health was significantly lower among older persons, participants with a higher BMI, and participants with heightened depression and anxiety scores. Both mental and physical health were worse among the unemployed assigned to an employment center as compared to those engaged in the secondary labor market. In total, 36% of the variance in the SF-12 mental score and 20% of the variance in the SF-12 physical score were explained by the factors included in the final multiple linear regression models. Conclusions Perceived health among a select group of long-term unemployed is reduced to a clinically relevant extent compared to the general population. The preliminary findings underline an association between mental health and perceived health. Negative self-perceptions of health were also associated with the labor market
Aug 28, 2017 ... 2017. How to cite this article: Pienaar M, Van Rooyen FC,. Walsh CM. ... clinical manifestations associated with HIV status in rural and urban communities. Methods: ..... On the other hand, significantly more HIV-uninfected rural.
Willens, David E; Kripalani, Sunil; Schildcrout, Jonathan S; Cawthon, Courtney; Wallston, Ken; Mion, Lorraine C; Davis, Corinne; Danciu, Iona; Rothman, Russell L; Roumie, Christianne L
Health literacy impacts health outcomes. However, the relationship to blood pressure is inconsistent. This study aimed to determine whether health literacy, assessed by clinic staff, is associated with blood pressure among patients with hypertension. The design was a cross-sectional study of a large sample of primary care patient encounters in 3 academic medical center clinics in Nashville, Tennessee. Health literacy was assessed using the Brief Health Literacy Screen, with higher scores indicating higher health literacy. Blood pressure was extracted from the electronic health record. Using 23,483 encounters in 10,644 patients, the authors examined the association of health literacy with blood pressure in multivariable analyses, adjusting for age, gender, race, education, and clinic location. Independent of educational attainment, 3-point increases in health literacy scores were associated with 0.74 mmHg higher systolic blood pressure (95% CI [0.38, 1.09]) and 0.30 mmHg higher diastolic blood pressure (95% CI [0.08, 0.51]). No interaction between education and health literacy was observed (p = .91). In this large primary care population of patients with hypertension, higher health literacy, as screened in clinical practice, was associated with a small increase in blood pressures. Future research is needed to explore this unexpected finding.
Tam, Amy; Yue, Olivia; Atchison, Kathryn A; Richards, Jessica K; Holtzman, Jennifer S
The aim of this pilot study was to assess adult patients' ability to read and understand two communication tools at the University of California, Los Angeles, School of Dentistry: the dental school clinic website and a patient education brochure pertaining to sedation in children that was written by dental school personnel. A convenience sample of 100 adults seeking treatment at the school's general dental clinic during 2012-13 completed a health literacy screening instrument. They were then asked to read clinic educational and informational materials and complete a survey. Analyses were conducted to determine the association between the subjects' oral health literacy and sociodemographics and their ability to locate and interpret information in written oral health information materials. SMOG and Flesch-Kincade formulas were used to assess the readability level of the electronic and written communication tools. The results demonstrated an association between these adults' oral health literacy and their dental knowledge and ability to navigate health information website resources and understand health education materials. Health literacy was not associated with age or gender, but was associated with education and race/ethnicity. The SMOG Readability Index determined that the website and the sedation form were written at a ninth grade reading level. These results suggest that dental schools and other health care organizations should incorporate a health-literate approach for their digital and written materials to enhance patients' ability to navigate and understand health information, regardless of their health literacy.
Ma, J; Meng, X D; Luo, H M; Zhou, H C; Qu, S L; Liu, X T; Dai, Z
In order to understand the current management status on education/training and needs for training among new employees working at the provincial CDC in China during 2012-2014, so as to provide basis for setting up related programs at the CDC levels. Based on data gathered through questionnaire surveys run by CDCs from 32 provincial and 5 specifically-designated cities, microsoft excel was used to analyze the current status on management of education and training, for new employees. There were 156 management staff members working on education and training programs in 36 CDCs, with 70% of them having received intermediate or higher levels of education. Large differences were seen on equipment of training hardware in different regions. There were 1 214 teaching staff with 66 percent in the fields or related professional areas on public health, in 2014. 5084 new employees conducted pre/post training programs, from 2012 to 2014 with funding as 750 thousand RMB Yuan. 99.5% of the new employees expressed the needs for further training while. 74% of the new staff members expecting a 2-5 day training program to be implemented. 79% of the new staff members claimed that practice as the most appropriate method for training. Institutional programs set for education and training at the CDCs need to be clarified, with management team organized. It is important to provide more financial support on both hardware, software and human resources related to training programs which are set for new stuff members at all levels of CDCs.
Zhang, Shaohui; Worrell, Ernst; Crijns-Graus, Wina
China's cement industry is the second largest energy consumer and key emitter of CO
Yang, Yang; Hu, Jun; Lv, Yingchun; Zhang, Mu
As the tourism industry has gradually become the strategic mainstay industry of the national economy, the scope of the tourism discipline has developed rigorously. This paper makes a predictive study on the development of the scope of Guangdong provincial tourism discipline based on the artificial neural network BP model in order to find out how…
Veldhuis, A.J.; Reinders, Angelina H.M.E.
In this study we estimate the potential of off-grid PV systems in Indonesia at a provincial level as a follow-up of a study on the potential of grid-connected PV systems in Indonesia which we executed in 2012 . For this study we use an adapted methodology leading to cumulative numbers for the
Finn, Michael A; Stark, James F
The Cruelty to Animals Act 1876 was an important but ambiguous piece of legislation. For researchers it stymied British science, yet ensured that vivisection could continue under certain restrictions. For anti-vivisection protestors it was positive proof of the influence of their campaigns, yet overly deferent to Britain's scientific elite. In previous accounts of the Act and the rise of anti-vivisectionism, scientific medicine central to these debates has been treated as monolithic rather than a heterogeneous mix of approaches; and this has gone hand-in-hand with the marginalizing of provincial practices, as scholarship has focused largely on the 'Golden Triangle' of London, Oxford and Cambridge. We look instead at provincial research: brain studies from Wakefield and anthrax investigations in Bradford. The former case elucidates a key role for specific medical science in informing the anti-vivisection movement, whilst the latter demonstrates how the Act affected the particular practices of provincial medical scientists. It will be seen, therefore, how provincial medical practices were both influential upon, and profoundly affected by, the growth of anti-vivisectionism and the passing of the Act. This paper emphasises how regional and varied medico-scientific practices were central to the story of the creation and impact of the Cruelty to Animals Act. Copyright © 2014 Elsevier Ltd. All rights reserved.
A design for a speed measuring network on rural provincial roads (excluding the motorways) in the province of Zeeland has been made. In the design speed enforcement projects and a sustainable road safety demonstration project in West-Zeeuwsch-Vlaanderen (where also urban streets were incorporated)
Frijlink, Jan Hilco
From data, gathered by the author and his students, during a wolf study in Algonquin Provincial Park, Canada, six kills of white-tailed deer by wolf packs are described. Case histories are reconstructed by means of interpreting tracks. In one case a wolf was also killed, this animal turned out to
Full Text Available classification of the Gauteng provincial road network using the South African Road Classification and Access Management Manual (TRH26) as a guideline. In combination with high resolution up-to-date satellite reference imagery, dwelling and building inventories...
Sax, Joanna K; Doran, Neal
The food supply is complicated and consumers are increasingly calling for labeling on food to be more informative. In particular, consumers are asking for the labeling of food derived from genetically modified organisms (GMO) based on health, safety, and environmental concerns. At issue is whether the labels that are sought would accurately provide the information desired. The present study examined consumer (n = 181) perceptions of health, safety and the environment for foods labeled organic, natural, fat free or low fat, GMO, or non-GMO. Findings indicated that respondents consistently believed that foods labeled GMO are less healthy, safe and environmentally-friendly compared to all other labels (ps GMO food. These findings may provide insight for the development of labels that provide information that consumers seek.
Kjellberg, J; Jorgensen, A D; Vestergaard, P; Ibsen, R; Gerstoft, F; Modi, A
We estimated the rate of compliance with oral bisphosphonates among Danish women and examined its association with health care resource use and cost. Approximately 30 % of Danish females aged >55 who take bisphosphonates are noncompliant, and noncompliance is significantly associated with increased health care resource use and cost. Two objectives of this study were to estimate the rate of oral bisphosphonate compliance among Danish women and to examine the association of noncompliance with health care resource use and cost. Women ≥55 with an index prescription claim for an oral bisphosphonate were identified from Danish national health registries between 2003 and 2008. Compliance was measured as the medication possession ratio (MPR) during the first 12 months post-index. Cost and health care resource use were collected for the following 12 months. Among the 38,234 women meeting the study inclusion criteria, 29.9 % were noncompliant (MPR Danish females aged 55 or older who take bisphosphonates are noncompliant. Noncompliance is significantly associated with increased health care resource use and cost.
Godwin S Ashiabi
Full Text Available BACKGROUND: We examined a model of multiple mediating pathways of income poverty, material hardship, parenting factors, and child health status to understand how material hardship and parental factors mediate the effects of poverty on child health. We hypothesized that: (a poverty will be directly associated with material hardship, parental depression, and health status, and indirectly with parenting behaviors through its effects on parental depression and material hardship; (b material hardship will be associated with parental depression, parenting behaviors, and health status; and (c parental depression will be correlated with parenting behaviors, and that both parental depression and parenting behaviors will predict child health. METHODS AND RESULTS: We used data from the 2002 National Survey of American Families for a sample of 9,645 6-to-11 year-olds to examine a 4-step structural equation model. The baseline model included covariates and income poverty. In the hardship model, food insufficiency and medical need were added to the baseline model. The parental model included parental depression and parenting behavior and baseline model. In the full model, all the constructs were included. First, income poverty had a direct effect on health status, and an indirect effect through its association with material hardship, parental depressive affect, and parenting behaviors. Medical need and food insufficiency had negative effects on child health, and indirect effects on health through their association with parental depression and parenting behaviors. Finally, parental depression and parenting behaviors were associated with child health, and part of the effect of parental depression on health was explained by its association with parenting behaviors. CONCLUSIONS: Poverty has an independent effect on health, however, its effects are partially explained by material hardship, parental depression and parental behaviors. To improve children's health
Ashiabi, Godwin S.; O'Neal, Keri K.
Background We examined a model of multiple mediating pathways of income poverty, material hardship, parenting factors, and child health status to understand how material hardship and parental factors mediate the effects of poverty on child health. We hypothesized that: (a) poverty will be directly associated with material hardship, parental depression, and health status, and indirectly with parenting behaviors through its effects on parental depression and material hardship; (b) material hardship will be associated with parental depression, parenting behaviors, and health status; and (c) parental depression will be correlated with parenting behaviors, and that both parental depression and parenting behaviors will predict child health. Methods and Results We used data from the 2002 National Survey of American Families for a sample of 9,645 6-to-11 year-olds to examine a 4-step structural equation model. The baseline model included covariates and income poverty. In the hardship model, food insufficiency and medical need were added to the baseline model. The parental model included parental depression and parenting behavior and baseline model. In the full model, all the constructs were included. First, income poverty had a direct effect on health status, and an indirect effect through its association with material hardship, parental depressive affect, and parenting behaviors. Medical need and food insufficiency had negative effects on child health, and indirect effects on health through their association with parental depression and parenting behaviors. Finally, parental depression and parenting behaviors were associated with child health, and part of the effect of parental depression on health was explained by its association with parenting behaviors. Conclusions Poverty has an independent effect on health, however, its effects are partially explained by material hardship, parental depression and parental behaviors. To improve children's health would require a multi
Full Text Available Aim: To evaluate traditional baby care practices employed by mothers in the Turkish province of Trabzon. Materials and methods: This descriptive study was planned around babies born in the provincial center of Trabzon between 1 June and 31 December, 2005, and aged 6-12 months at the time of the research. Data were collected in July-September 2006. In order to determine sampling size the prevalence of mothers using traditional practices was calculated at 50%, with a deviation of 0.05, giving a sample size of 384 mothers, the final number being put at 400. The study was performed at six clinics selected on the basis of settlement location and socioeconomic level out of 11 health clinics in the city center of the province of Trabzon. Data in the study are presented as numbers, and percentage distributions as mean±standard deviation. Results: It was determined that 69.8% of mothers breastfed their babies immediately and that 91.3% gave them colostrum. It was also determined that 3.7% of mothers resorted to various practices in order to ensure a male or female baby, 44.5% in order to facilitate labor, 25% in order to avoid puerperal fever, 63.5% in order eliminate postnatal pain, 88% to prevent their babies smelling, 86.2% for the shedding of the umbilical cord, 54.2% to protect their babies against jaundice, 73.7% to protect their babies from the evil eye, 26.2% so their babies would be good-looking and 40.7% to safely complete the first 40 days after childbirth. The main practices having a harmful effect on health in the study were swaddling, salting the baby, waiting for the call to prayer before breastfeeding the baby after birth and not giving colostrum. Conclusions: Traditions were observed to have an impact and to be persisting in child care in Trabzon. This suggests it will be useful for health personnel working in the field of infant care to evaluate the traditional characteristics in the locations where they work and to correct negative
Stanton, Robert; Scott, David; Happell, Brenda
Governments invest heavily in health promotion strategies to improve physical health behaviours. However, the dietary and physical activity practices of many Australians fail to meet minimum levels for health, leading to the unacceptably high prevalence of chronic and complex illness. Health literacy is known to impact on health behaviour, and to be related to health knowledge; however, no studies have specifically examined knowledge of physical health behaviours in an Australian context. We assessed knowledge of physical health behaviours in 1244 adults in Queensland, Australia. Almost two-thirds of respondents had a 'Good' knowledge of physical health behaviour. People with 'Good' knowledge of physical health behaviours were more likely to be female, educated beyond secondary school, be employed and have an annual household income of >$52000 (Pphysical health behaviours were significantly more likely to report insufficient intake of vegetables and have at least one chronic illness (Pphysical health behaviours. Given the association between health knowledge and health literacy, assessment of the knowledge of physical health behaviours may provide considerable insight into the effectiveness of future health promotion interventions.
Ito, Miho; Matsushima, Eisuke
We identified coping behaviors during regular health check-ups and examined whether they were related to physical and mental health. We assessed coping strategies with the Brief COPE scale in 201 people who underwent a regular health check-up in a clinic. We found several significant relationships between coping and physical/psychological conditions presented in health check-up: Humor and systolic blood pressure, Substance use and high-density lipoprotein cholesterol, Venting and low-density lipoprotein cholesterol, Self-blame and depression, and Behavioral disengagement and sleep disorder. By evaluating coping strategies and screening depression as part of a regular health check-up, General practitioner can provide psychological intervention such as cognitive behavioral therapy which may improve both mental and physical health of the people.
Full Text Available Abstracts Background With regards to equity, the objective for health care systems is “equal access for equal needs”. We examined associations of predisposing, enabling and need factors with health facility utilization in areas with high HIV prevalence and few people being aware of their HIV status. Methods The data is from a population-based survey among adults aged 15years or older conducted in 2003. The current study is based on a subset of this data of adults 15–49 years with a valid HIV test result. A modified Health behaviour model guided our analytical approach. We report unadjusted and adjusted odds ratios and their 95% confidence intervals from logistic regression analyses. Results Totals of 1042 males and 1547 females in urban areas, and 822 males and 1055 females in rural areas were included in the study. Overall, 53.1% of urban and 56.8% of rural respondents utilized health facilities past 12 months. In urban areas, significantly more females than males utilized health facilities (OR=1.4 (95% CI [1.1, 1.6]. Higher educational attainment (10+ years of schooling was associated with utilization of health facilities in both urban (OR=1.7, 95% CI [1.3, 2.1] and rural (OR=1.4, 95% CI [1.0, 2.0] areas compared to respondents who attained up to 7 years of schooling. Respondents who self-rated their health status as very poor/ poor/fair were twice more likely to utilize health facilities compared to those who rated their health as good/excellent. Respondents who reported illnesses were about three times more likely to utilize health facilities compared to those who did not report the illnesses. In urban areas, respondents who had mental distress were 1.7 times more likely to utilize health facilities compare to those who had no mental distress. Compared to respondents who were HIV negative, respondents who were HIV positive were 1.3 times more likely to utilize health facilities. Conclusion The health care needs were the factors most
Shiferaw, Atsede Mazengia; Zegeye, Dessalegn Tegabu; Assefa, Solomon; Yenit, Melaku Kindie
Using reliable information from routine health information systems over time is an important aid to improving health outcomes, tackling disparities, enhancing efficiency, and encouraging innovation. In Ethiopia, routine health information utilization for enhancing performance is poor among health workers, especially at the peripheral levels of health facilities. Therefore, this study aimed to assess routine health information system utilization and associated factors among health workers at government health institutions in East Gojjam Zone, Northwest Ethiopia. An institution based cross-sectional study was conducted at government health institutions of East Gojjam Zone, Northwest Ethiopia from April to May, 2013. A total of 668 health workers were selected from government health institutions, using the cluster sampling technique. Data collected using a standard structured and self-administered questionnaire and an observational checklist were cleaned, coded, and entered into Epi-info version 3.5.3, and transferred into SPSS version 20 for further statistical analysis. Variables with a p-value of less than 0.05 at multiple logistic regression analysis were considered statistically significant factors for the utilization of routine health information systems. The study revealed that 45.8% of the health workers had a good level of routine health information utilization. HMIS training [AOR = 2.72, 95% CI: 1.60, 4.62], good data analysis skills [AOR = 6.40, 95%CI: 3.93, 10.37], supervision [AOR = 2.60, 95% CI: 1.42, 4.75], regular feedback [AOR = 2.20, 95% CI: 1.38, 3.51], and favorable attitude towards health information utilization [AOR = 2.85, 95% CI: 1.78, 4.54] were found significantly associated with a good level of routine health information utilization. More than half of the health workers working at government health institutions of East Gojjam were poor health information users compared with the findings of others studies. HMIS training, data
Gaffar, B O; El Tantawi, M; Al-Ansari, A; AlAgl, A S
This study assessed the association between oral health knowledge and practices of pregnant Saudi women selected from visitors to a government hospital in Dammam, Saudi Arabia in 2014. Women answered questions on oral health knowledge during pregnancy and knowledge of infant oral health. Most women (> 70%) knew that dental caries in children can be prevented, that pregnancy affects oral health and that dental treatment during pregnancy can negatively affect infants. Most women (> 80%) performed oral hygiene procedures but only 18% regularly visited the dentist. In a regression analysis, oral health knowledge was not significantly associated with reported oral hygiene practices. Women who visited the dentist regularly were more likely to know how to prevent caries in children, and that dental treatment during pregnancy and infant health were associated.
Baandrup, Lone; Sørensen, Jan; Lublin, Henrik Kai Francis
OBJECTIVE: To investigate the association of antipsychotic polypharmacy in schizophrenia with cost of primary and secondary health service use. METHOD: Comparative analysis of health service cost for patients prescribed antipsychotic polypharmacy versus antipsychotic monotherapy. Resource utilisa...... demonstrate that antipsychotic co-prescribing is associated with increased use of health care services, even though no causal relations can be inferred from an observational study.......OBJECTIVE: To investigate the association of antipsychotic polypharmacy in schizophrenia with cost of primary and secondary health service use. METHOD: Comparative analysis of health service cost for patients prescribed antipsychotic polypharmacy versus antipsychotic monotherapy. Resource...... at the two cross-sectional dates was recorded and used as proxy of polypharmacy exposure during the preceding year. A multivariate generalised linear model was fitted with total costs of primary and secondary health service use as dependent variable, and antipsychotic polypharmacy, diagnosis, age, gender...
Verhoeven, Aukje A C; Watson, Poppy; de Wit, Sanne
People often fail to adhere to food-related health information. Increasing evidence suggests that environmental stimuli interfere with good intentions by triggering choices relatively automatically. Using a Pavlovian-instrumental transfer (PIT) task, we examined whether food-associated stimuli reduce health warnings' effectiveness. We expected that people adhere to health warnings in the absence, but not presence, of food-associated stimuli. In addition, we examined timing effects, i.e., whether health warnings are more effective when they are given prior to associative learning rather than afterwards. In the PIT task, participants learned to press keys for two food rewards (instrumental learning) and associations between stimuli and these rewards (Pavlovian learning) in separated phases. Health warnings about one reward were given after associative learning (Study 1), or before versus afterwards (Study 2). During test phase, participants pressed for food outcomes while occasionally food-related stimuli were presented. In absence of food-related stimuli, participants increased responding for rewards perceived as more healthy. However, when stimuli were present, responding was biased towards the signaled outcome, regardless of health warnings or timing. Health messages influence food choice behavior, but are no longer effective when food-associated stimuli are present. This provides important insights why health warning effects might be limited in an obesogenic environment. Copyright © 2017 Elsevier Ltd. All rights reserved.
Moore, Brian; Woodcock, Stuart
Resilience is associated with bouncing back from adversity, and the term currently enjoys significant popular appeal. However, understanding of resilience is often superficial. The current paper examined 105 primary and high school students' experiences of resilience and bullying, and considered resilience as a hierarchical factorial model. The…
The aim of the thesis was to investigate which physical, chemical or oxidative characteristics of ambient PM have the most consistent associations with acute cardio-respiratory effects in human volunteers. During the first phase of the RAPTES project (“Risk of Airborne Particles: a
% of the participants were underweight, 60.5% had normal weight and 21.5% were overweight. Alcohol consumption and sight problems were found to have significant negative association with BMI (p=0.007 and p=0.005, respectively).
Nutritional dependence on termites for proteins could predispose consumers to various infections. This study was carried out to determine the infections associated with winged-reproductive edible termites at Ahiazu Mbaise Area of Imo State, Nigeria. Four hundred and forty five (445) termites were randomly sampled from ...
This article examined the association between household consumer durable assets and maternal health-seeking behavior. Several studies have suggested a relationship between households' socioeconomic status (SES) and health outcomes. However, SES is a multidimensional concept that encompasses variables, such as wealth, education, and income. By grouping these variables together as one construct, prior studies have not provided enough insight into possible independent associations with health outcomes. This study used data from the 2008 Ghana Demographic and Health Survey of 2,065 women aged between 15 and 49 years to examine the association between household consumer durables (a component of SES) and maternal health-seeking behavior in Ghana. Results from a set of generalized linear models indicated that household consumer durable assets were positively associated with four measures of maternal health-seeking behaviors, namely, seeking prenatal care from skilled health personnel, delivery by skilled birth attendant, place of delivery, and the number of antenatal visits. Also, households with more assets whose residents lived in urban areas were more likely to use skilled health personnel before and during delivery, and at an approved health facility, compared those who lived in rural areas. Implications for health interventions and policies that focus on the most vulnerable households are discussed.
José Ricardo Gutiérrez Quintanilla
Full Text Available This is an ex post facto study with a retrospective and cross sectional design, consisting of a random sample of 1,143 participants (538 men and 605 women, age range 17-56 or more. The measures used involved the Escala de estrés y ansiedad delincuencial, and the Cuestionario de salud general. Results revealed that approximately three fourths of the simple considered that the criminal violence context affected their mental health. Differences between men and women were established. Women and urban residents exhibited a greater number of stress symptoms and criminal anxiety. Recommendations for future studies are suggested.
José Ricardo Gutiérrez Quintanilla; Cecilia Beatriz Portillo García
This is an ex post facto study with a retrospective and cross sectional design, consisting of a random sample of 1,143 participants (538 men and 605 women), age range 17-56 or more. The measures used involved the Escala de estrés y ansiedad delincuencial, and the Cuestionario de salud general. Results revealed that approximately three fourths of the simple considered that the criminal violence context affected their mental health. Differences between men and women were established. Women and ...
Full Text Available Abstract Background The association between anxiety and depression, and eczema is well known in the literature, but factors underlying this association remain unclear. Low levels of omega-3 fatty acids and female gender have been found to be associated with both depression and eczema. Somatization and health anxiety are known to be associated with anxiety and depression, further, somatization symptoms and health anxiety have also been found in several dermatological conditions. Accordingly, omega-3 fatty acid supplement, female gender, somatization and health anxiety are possible contributing factors in the association between anxiety and depression, and eczema. The aim of the study is to examine the relevance of proposed contributing factors for the association between anxiety and depression, and eczema, including, omega-3 fatty acid supplement, female gender, health anxiety and somatization. Methods Anxiety and depression was measured in the general population (n = 15715 employing the Hospital Anxiety and Depression Scale (HADS. Information on eczema, female gender, omega-3 fatty acid supplement, health anxiety and somatization was obtained by self-report. Results Somatization and health anxiety accounted for more than half of the association between anxiety/depression, and eczema, while the other factors examined were of minor relevance for the association of interest. Conclusions We found no support for female gender and omega-3 fatty acid supplement as contributing factors in the association between anxiety/depression, and eczema. Somatization and health anxiety accounted for about half of the association between anxiety/depression, and eczema, somatization contributed most. The association between anxiety/depression, and eczema was insignificant after adjustment for somatization and health anxiety. Biological mechanisms underlying the mediating effect of somatization are yet to be revealed.
Kamran, Aziz; Sharifirad, Gholamreza; Shafaeei, Yousef; Mohebi, Siamak
Background: Although the frequency of self-medication has been well-documented in the public health literature, but no study has examined the relationship between health literacy and self-medication yet. This study was aimed to investigating the relationship between health literacy and self-medication in a community-based study. Methods: This cross-sectional study was conducted on 924 adults to survey association between health literacy and self-medication among peoples in Ardabil city in 2014 who were selected using a multi-stage random sampling method. Health literacy was measured by the test of functional health literacy in adults and general health status was measured by the 12-item General Health Questionnaire, and self-reported self-medication (overall, sedative, antibiotic and herbal) in last 3 months was assessed. All statistical analysis was performed using the SPSS version 18 and a P self-medication was 61.6%, and the percentage of self-administering antibiotics, sedative, and herbal medicines were 40%, 54.4%, and 59.1% in the last 3 months, respectively. Significant relationship was found between of total health literacy and general health status with self-medication. The prevalence of self-medication among participants with poor and very poor self-rated physical and mental health was significantly higher than other participants (P Self-medication had a significant relationship with health literacy and health status. Therefore, the design and implementation of training programs are necessary to increase the perception on the risk of self-medication. PMID:26288710
Geboers, Bas; de Winter, Andrea F.; Luten, Karla A.; Jansen, Carel J. M.; Reijneveld, Sijmen A.
Inadequate health literacy is a common problem among older adults and is associated with poor health outcomes. Insight into the association between health literacy and health behaviors may support interventions to mitigate the effects of inadequate health literacy. The authors assessed the
Asztalos, Melinda; Cardon, Greet; De Bourdeaudhuij, Ilse; De Cocker, Katrien
Sedentary behavior (including sitting) is negatively associated with physical health, independent from physical activity (PA). Knowledge on the associations with mental health is less elaborated. Therefore this study aims to investigate the relationship between sitting and 5 indices of mental health in adults (psychological distress, depression, anxiety, somatization, and sleeping problems), and between sitting interactions (sitting×gender, sitting×age, sitting×education, and sitting×PA) and these mental health indices. A cohort of Belgian adults (25-64 years; n = 4344) provided self-reported data on sitting and PA and on 5 mental health indices. Cross-sectional associations were examined using multiple linear regression analyses. Analyses adjusted for gender, age, education, and PA showed significant positive associations between sitting and the 5 mental health indices (P associations were true for both men and women, and for low and high educated individuals, while some were only found in older individuals (somatization, P associated with poorer mental health, independently of gender, age, education, and PA. Moderation analyses showed that these associations may differ according to age and PA levels.
Lappalainen, Kirsi; Manninen, Pirjo; Räsänen, Kimmo
The purpose of this study was to explore the associations of prolonged unemployment, health, and work ability among young workers using data from the 2008-2010 Occupational Health Counselling project in Kuopio, Eastern Finland. The total sample for this study was 190 young unemployed adults. The questionnaire included the Work Ability Index (WAI), the Beck Depression Inventory, the Alcohol Use Disorders Identification Test, and the Occupational Health Counselling Survey. Multivariate analyses revealed that men had a higher prevalence of prolonged unemployment than women. Using drugs for purposes other than treatment was associated independently with an increased prevalence of prolonged unemployment. Low WAI scores were associated with a higher prevalence of prolonged unemployment. This study showed that attention should be paid to male workers, those who have poor or moderate work ability and workers who use drugs. Young unemployed workers should be recognized at an early stage. A comprehensive, flexible network of community resources is essential to support young unemployed adults.
McLeish, A.C.; Zvolensky, M.J.; Smits, J.A.J.
The aim of this investigation was to evaluate the incremental validity of anxiety sensitivity (fear of arousal-related physical and psychological sensations) relative to health factors (smoking variables, alcohol use and exercise level), in predicting perceived health and disability among a sample
Seib, Katherine; Underwood, Natasha L; Gargano, Lisa M; Sales, Jessica M; Morfaw, Christopher; Weiss, Paul; Murray, Dennis; Vogt, Tara M; DiClemente, Ralph J; Hughes, James M
Four vaccines are routinely recommended for adolescents: tetanus, diphtheria, and acellular pertussis (Tdap); human papillomavirus (HPV); meningococcal-conjugate (MCV4); and a yearly seasonal influenza vaccine. Vaccination promotion and outreach approaches may need to be tailored to certain populations, such as those with chronic health conditions or without health insurance. In a controlled trial among middle and high school students in Georgia, 11 schools were randomized to one of three arms: no intervention, parent education brochure, or parent education brochure plus a student curriculum on the four recommended vaccines. Parents in all arms were surveyed regarding their adolescent's vaccine receipt, chronic health conditions, and health insurance status. Of the 686 parents, most (91%) reported their adolescent had received at least one of the four vaccines: Tdap (82%), MCV4 (59%), current influenza vaccine (53%) and HPV (48%). Twenty-three percent of parents reported that their adolescent had asthma. Most parents reported that their adolescent's insurance was Medicaid (60%) or private insurance (34%), and 6% reported no insurance. More adolescents with a chronic health condition received any adolescent vaccine than adolescents without a chronic health condition (p insurance, fewer had received any adolescent vaccine than those with Medicaid or private insurance (p health insurance). Our findings suggest that parents may not be aware of this program or eligibility for it, thus revealing a need for education or other fixes. Copyright © 2016 Society for Adolescent Health and Medicine. All rights reserved.
Brinksma, Aeltsje; Sanderman, Robbert; Roodbol, Petrie F.; Sulkers, Esther; Burgerhof, Johannes G. M.; de Bont, Eveline S. J. M.; Tissing, Wim J. E.
Malnutrition in childhood cancer patients has been associated with lower health-related quality of life (HRQOL). However, this association has never actually been tested. Therefore, we aimed to determine the association between nutritional status and HRQOL in children with cancer. In 104 children,
Brinksma, A.; Sanderman, Robbert; Roodbol, P.F.; Sulkers, E.; Burgerhof, J.G.M.; de Bont, E.S.J.M.; Tissing, W.J.E.
Purpose: Malnutrition in childhood cancer patients has been associated with lower health-related quality of life (HRQOL). However, this association has never actually been tested. Therefore, we aimed to determine the association between nutritional status and HRQOL in children with cancer. Methods:
Fitzpatrick, Maureen; Everett-Thomas, Ruth; Nevo, Igal; Shekhter, Ilya; Rosen, Lisa F; Scheinman, Stephen R; Arheart, Kristopher L; Birnbach, David J
Lack of hand hygiene by health-care workers is the most significant cause of health care-associated infection. This programme was designed to make health-care workers want to wash their hands, to change their knowledge regarding hand hygiene and health care-associated infection, and influence practice. Improvement between pre- and post-test scores was statistically significant. Compliance is a multifactorial problem that involves knowledge and behaviour. Educational awareness and frequent reminders are critical to maintain high rates of hand hygiene compliance. © 2011 Blackwell Publishing Asia Pty Ltd.
Bazie, Getaw Walle; Adimassie, Mhiret Teshome
Ethiopia is one of the developing countries with the poorest health status and the health services utilization is generally low with different patterns in different regions of the country. Therefore, the aim of this study was to assess utilization of modern health services and associated factors in Dessie, Ethiopia. A cross sectional study design was employed from January to March, 2015 in Dessie City. The total sample was 420 adults. Adults were selected by stratified random sampling. The strata were made using residence as urban and rural residents. The data was collected using pre-tested, interviewer administered questionnaire. The data was entered into Epi infoTM7 software and exported to Statistical Package for Social Sciences (SPSS) version 20 Software for analysis. Binary logistic regression was used to evaluate independent effect of each variable on modern health service utilization by controlling the effect of others. The strength of association between dependent variable and independent variables was expressed by odds ratio with 95% confidence interval. The overall modern health services utilization rate was 41.8%. Being Female sex, annual income greater than poverty line, poor perception of health status, high perceived severity of illness, two or more than two number of illnesses in the last 12 months prior to the survey and presence of chronic health problem were found to have a significant association with utilization of modern health services. Modern health services utilization was found to be low. Being female sex, annual income above poverty line, having poor perceived health status, having two or more than two illnesses, severe perceived severity of illness and having chronic health problem were found to have a statistically significant association with utilization. Therefore, efforts have to be made to increase utilization of modern health services through establishing systems like health extension workers and health development army.
Ohinmaa, Arto; Zheng, Yufei; Jeerakathil, Thomas; Klarenbach, Scott; Häkkinen, Unto; Nguyen, Thanh; Friesen, Dan; Ruseski, Jane; Kaul, Padma; Ariste, Ruolz; Jacobs, Philip
This study aimed to evaluate the trends and regional variation of stroke hospital care in 30-day in-hospital mortality, hospital length of stay (LOS), and 1-year total hospitalization cost after implementation of the Alberta Provincial Stroke Strategy. New ischemic stroke patients (N = 7632) admitted to Alberta acute care hospitals between 2006 and 2011 were followed for 1 year. We analyzed in-hospital mortality with logistic regression, LOS with negative binomial regression, and the hospital costs with generalized gamma model (log link). The risk-adjusted results were compared over years and between zones using observed/expected results. The risk-adjusted mortality rates decreased from 12.6% in 2006/2007 to 9.9% in 2010/2011. The regional variations in mortality decreased from 8.3% units in 2008/2009 to 5.6 in 2010/2011. The LOS of the first episode dropped significantly in 2010/2011 after a 4-year slight increase. The regional variation in LOS was 15.5 days in 2006/2007 and decreased to 10.9 days in 2010/2011. The 1-year hospitalization cost increased initially, and then kept on declining during the last 3 years. The South and Calgary zones had the lowest costs over the study period. However, this gap was diminishing. After implementation of the Alberta Provincial Stroke Strategy, both mortality and hospital costs demonstrated a decreasing trend during the later years of study. The LOS increased slightly during the first 4 years but had a significant drop at the last year. In general, the regional variations in all 3 indicators had a diminishing trend. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
After an extensive review of the literature and discussion of both national and state proposed health plans, the committee arrived at the following conclusions: 1. The issues that prompted development of the 1971 American Speech-Language-Hearing Association's (ASHA) Position Statement on National Health Care have not been resolved or altered. 2. Few significant national health plans or policies are being supported by the Bush Administration other than managed-care plans. 3. A national health policy will be driven by the development of state health policies and plans. 4. Implementation of national or state health plans will affect both professions at all service provision sites, including public schools. 5. Five general models apply to all existing or proposed national and state health policies or plans: single payer (e.g., a Canadian-style plan) minimum basic benefits ("play or pay") expanded Medicare or Medicaid benefits rationed healthcare (e.g., Oregon plan) managed care (e.g., health maintenance organizations) 6. There will be continued efforts to eliminate Medicaid mandates. 7. ASHA needs to advocate for the inclusion of rehabilitative services as basic rather than optional services in all health plans. 8. ASHA must advocate for adequate access to quality care regardless of healthcare or education provider setting.
Kelly, Deena; Kutney-Lee, Ann; Lake, Eileen T; Aiken, Linda H
Critically ill patients are susceptible to health care-associated infections because of their illnesses and the need for intravenous access and invasive monitoring. The critical care work environment may influence the likelihood of infection in these patients. To determine whether or not the critical care nurse work environment is predictive of nurse-reported health care-associated infections. A retrospective, cross-sectional design was used with linked nurse and hospital survey data. Nurses assessed the critical care work environment and provided the frequencies of ventilator-associated pneumonias, urinary tract infections, and infections associated with central catheters. Logistic regression models were used to determine if critical care work environments were predictive of nurse-reported frequent health care-associated infections, with controls for nurse and hospital characteristics. Results The final sample consisted of 3217 critical care nurses in 320 hospitals. Compared with nurses working in poor work environments, nurses working in better work environments were 36% to 41% less likely to report that health care-associated infections occurred frequently. Health care-associated infections are less likely in favorable critical care work environments. These findings, based on the largest sample of critical care nurses to date, substantiate efforts to focus on the quality of the work environment as a way to minimize the frequency of health care-associated infections.