SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
American recruiters are busily trying to coax Canadian physicians to move south of the border to practise, but Canadians must remember that the immigration process can be both lengthy and complicated. In this article, immigration lawyer Henry Chang looks at the requirements that must be met before permanent-resident status is granted by the US.
The use of hospital beds by elderly patients admitted to a Dublin teaching hospital was examined. Using objective pre-determined criteria, each day of hospital stay was evaluated in terms of whether the services provided or the patient's condition justified hospitalisation on a particular day. For days where the criteria were not met, the principal causative factor was identified. Of a total of 2,724 days of care reviewed, 792 (29.1%) were considered inappropriate. Female sex, age over 75, single status, residence with another adult or visits by the public health nurse prior to admission, and entitlement to free medical care were associated with inappropriate days of care. Self-referral, admissions to medical wards, for observation, social or multiple reasons and an admission diagnosis of cerebro-vascular disease were also associated with hospital misutilisation. The probability of a day being judged inappropriate became more likely with increasing lengths of stay. Physician and hospital factors accounted for almost one-half rehabilitation services only accounted for a quarter and lack of availability of alternative care facilities accounted for 39.5% of inappropriate beddays identified. Recommendations are made on how to improve appropriateness of care for elderly patients in acute hospitals.
This prospective study was undertaken to evaluate the significance of factors such as age, sex family history, educational status, residence area, H pylori antral colonization, smoking, alcohol consumption, coffee and cola drinking in Greek patients suffering from functional dyspepsia (FD), duodenal ulcer (DU), and gastric ulcer (GU). The study groups were chosen among consecutive outpatients who had undergone an upper gastro-intestinal (GI) endoscopy during a ten-month period because of dyspepsia, and who completed a suitable questionnaire; 295 patients aged 18-85 years (M: 185, F: 110) were finally included as follows: 54 patients aged 18-80 years M: 21, F: 33) with FD, 166 aged 19-85 years (M: 117, F: 49) with DU, and 75 aged 24-85 years (M: 47, F: 28) with GU. As controls for FD patients, 54 previously studied, healthy non-dyspeptic people, well matched for age and sex, were used. No differences were found between them and FD patients. On the contrary, we found that the 3 groups of patients differed significantly for age (p = 1.07 x 10(-3)) and sex (p = 1.67 x 10(-4)) distribution. There was a rather even age distribution and a discrete female predominance in the FD group. Positive family history for peptic ulcer disease (PUD) was found in 19% of patients with FD as compared with 48.2% (DU) and 37% (GU) (p = 4.84 x 10(-4)). Significantly more patients with PUD were smokers (p = 6.16 x 10(-3)) and alcohol drinkers (p = 1.84 x 10(-4)). H pylori antral colonization was found in 61% of patients with FD as compared with 74% (GU) and 85% (DU) (p = 8.65 x 10(-4)) of patients. Finally, factors such as educational level, area of residence, and cola drink consumption did not differ in the studied groups of patients.
Proposition 187 was passed by California voters in 1994. Although ruled partially unconstitutional in the lower courts and currently enjoined, it prohibits people lacking legal residency status from obtaining any but emergency medical care at any health facility receiving public funds. Proposition 187 came in response to the surge in immigration to California during the 1980s and early 1990s and to the state's economic situation. We interviewed immigrant women to explore how they view Proposition 187, what they know about it, and how related fears may influence their use of health services. The women perceived Proposition 187 as discriminatory and directed primarily at Latinos, building on existing fears about their economically and socially marginalized position. Strategies the women used to maintain health services are discussed.
This paper presents data gathered in an operational research project undertaken in a geriatric centre providing care for approximately 400 long-term residents. The centre supplies nursing, medical, paramedical, day hospital and home care services. Programmes of social and diversional activities are provided and residents are also visited by various community groups. However, the long-term residents participating in this project represent a section of the population unable to utilize or participate in the social and diversional programmes usually offered. The aim of the study was to determine whether the dependency status of residents receiving long-term care is affected by nursing and/or medical patterns of institutional management. The project was carried out in two stages: 1 a habit training toileting programme intended to improve continent status; 2 activity programmes at differing levels of intensity and specifically designed to increase mental, social and physical stimulation.
Twenty-six residents watched a videotape of the mental status examination of a psychotic patient, then wrote their assessment of the patient's mental status. The residents' reports were independently graded by the authors. The residents' marks were compared to performance on departmental oral examinations. Results showed that global or qualitative assessment of mental status performance was reliable. Excellent interrater reliability was achieved when the assessment criteria for sub-items of the mental status were well defined.
An increase in dependent elderly people together with a change in social structure from extended to nuclear families is resulting in institutionalization of the elderly. Since training of health care personnel is not keeping pace with the demands for health care, many institutions for the elderly are forced to function without the necessary health personnel. The purpose of the present study was to examine the functional status of the residents of one geriatric facility without health care personnel in Durban, South Africa. Functional status of each of the 101 residents was assessed using the Barthel Index. The results show that although overall Barthel Index scores showed that ageing or pathology did not influence numbers of functional elderly, individual analysis of items indicated that the majority of the residents could not perform basic functional tasks like feeding, bathing and climbing stairs.
OBJECTIVE: To compare rates of change in South Australian children's body composition between 1997 and 2002 in subsamples based on location of residence and socioeconomic status. METHODS: Year 6 children from randomly selected South Australian schools in 1997 (32 schools, n=1,423) and 2002 (29 schools, n=992) were compared on: body mass index (BMI), sum of triceps and abdominal skinfolds (skinfold sum) and waist girth. Samples were partitioned into urban (population >20,000) and rural (<10,000) subsamples, and low, medium and high SES. ANCOVA, controlling for boys' decimal age and girls' predicted menarcheal age, was conducted for the whole sample, and where interactions were significant, separately in socio-demographic strata. RESULTS: Between surveys, there were significant increases in boys' waist girth (p=0.004) and skinfold sum (p=0.007), and girls' BMI (p=0.0005) and skinfold sum (p<0.0001). There were significant interactions of survey year and sociodemographic variables among girls only. While there were no significant changes in anthropometric variables among rural and high SES girls, urban girls increased in skinfold sum (p<0.0001), waist girth (p=0.033) and BMI (p=0.0007). Low (p<0.0001) and medium (p=0.001) SES girls' skinfold sum increased between surveys. CONCLUSIONS: Secular trends in Australian children's body fatness are continuing. Further, the rates of change in girls are affected by the socio-demographic milieu. IMPLICATIONS: The development of targeted interventions to combat child obesity will depend on a clearer understanding of how environmental influences on weight status are distributed across the sociodemographic landscape.
The purpose of the present study was to statistically analyse the relationship between subjective evaluation of chewing ability and self-rated general health status in elderly Japanese residents. Interviews were conducted with 1,544 respondents over 65 years of age in Yamanashi Prefecture, Japan. The interviews included questions concerning age, sex, health status, capacity to understand conversation, chewing ability, and ADL status. First, the age-adjusted odds ratio between subjective evaluation of chewing ability and self-rated health status was 2.242 (p < or = 0.01). Second, the age-adjusted odds ratio between respondentive evaluation of chewing ability and ADL status was 2.572 (p < or = 0.01). Third, the age-adjusted odds ratio between self-assessment of chewing ability and the degree of understanding conversations was 5.290 (p < or = 0.01). These results suggest that chewing ability is related to self-rated general health, ADL status, and the degree of understanding conversation among the elderly.
The status of neurology in family practice residency programs was determined. Of 373 programs surveyed by questionnaire, 266 responded (71.3%). Neurology is a required rotation in 48% of the programs, most frequently done during the second year of residency. Preceptors are mainly neurologists in private practice. There is a need for cooperation between neurologists and family practitioners to develop appropriate educational experiences for family practice residents.
INTRODUCTION: The study objectives were to assess the effect of age, to evaluate the impact of smoking, and to determine the effect of rural residence on tumor characteristics, treatment modalities, and outcomes for Kentucky's endometrial cancer patients. METHODS: The Kentucky Cancer Registry identified Kentucky residents diagnosed with endometrial cancer from 1995 to 2002. Data abstracted included demographics, tumor characteristics, treatment, and recurrence/survival status. RESULTS: Three thousand five hundred and sixty-two women were diagnosed with endometrial cancer. Mean age at diagnosis decreased significantly (P=0.0388) over the 7-year period. Smokers had higher grade, stage, and worse outcomes. Rural women more often lacked commercial insurance, underwent less comprehensive surgical evaluation, and had less multimodality treatment. Increasing age (P<0.0001), positive or unknown smoking status (P=0.0003), black race (P<0.0001), no commercial insurance (P<0.0001), increasing grade or advanced stage (P<0.0001), small size of treating hospital (P<0.0001), and unknown nodal status (P<0.0001) were negatively associated with disease-specific survival. Lymph node sampling was performed in only 38.6% of women. On multivariate analysis, age (RR 1.38 for 10 year increments; P<0.0001), smoking (RR 1.38; P=0.008), no commercial insurance or Medicaid (RR 1.87; P=0.0007), rural residence (RR 0.77; P=0.011), advanced stage and grade (RR 7.96, 3.96; P<0.0001), and no nodal evaluation or unknown nodal status (RR 2.32, 2.51; P<0.0001) significantly effected disease-specific survival. CONCLUSIONS: Our data support a trend toward a younger age for endometrial cancer diagnosis, confirm the adverse impact of smoking and socioeconomic factors, and demonstrate an association between incomplete surgical staging and decreased survival.
In a 1972 Chicago area survey of 2,299 adult community residents the prevalence of several psychologic measures were outlined along major demographic dimensions. Measures of psychologic status included a psychiatric symptom index, number of psychosomatic disorders, recent use of psychoactive drugs, and indexes of self-esteem and of self-efficacy. Results for psychiatric symptomatology showed it to be decidely higher among women, those in the lowest socioeconomic level, and those who are separated from their spouses. Blacks and whites showed no differences in symptomatology. Using multiple regression analysis, the combined effects of sex, age, marital status, and income accounted for 7% of the total variance of psychiatric symptoms. In a like manner, the prevalence of the other four psychologic characteristics has been viewed in the context of major demographic variables, with each showing a specific pattern of relationships.
Explore the source record for details and available documents.
Duplicate meals, serum, whole blood, and toenails were collected every 3 mo for 1 y from a group of 44 free-living adults residing in high-selenium areas of South Dakota and Wyoming to assess the relation of selenium intake to indices of selenium status. The average selenium values for the group were as follows: dietary intake, 174 +/- 91 micrograms/d (mean +/- SD), 2.33 +/- 1.08 micrograms/kg body wt; serum, 2.10 +/- 0.38 mumol/L; whole blood, 3.22 +/- 0.79 mumol/L; and toenails, 15.2 +/- 3.0 nmol/g. Selenium intake (micrograms/kg body wt) was strongly correlated (all values, P less than 0.01) with selenium concentration of serum (r = 0.63), whole blood (r = 0.62), and toenails (r = 0.59). Men and women had similar mean values of serum, whole blood, and toenail selenium despite higher selenium intakes in men. Smokers had lower tissue selenium concentrations than did nonsmokers due, at least in part, to lower selenium intake. Age was not associated with tissue selenium content. Of the variables examined selenium intake was clearly the strongest predictor of tissue selenium concentration.
Canada's health care system has undergone major changes since 1990. In Saskatchewan, 52 small rural hospitals funded for less than eight beds stopped receiving funding for acute care services in 1993. Most were subsequently converted to primary health care centers. Since then, concerns have been raised about the impact of the changes on rural residents' access to care, their health status, and the viability of rural communities. To assess the impact of hospital closures on the affected communities, we conducted a multi-faceted, province-wide study. We looked at hospital use patterns, health status, rural residents' perceptions of the impact of these hospital closures, and how communities responded to the changes. We found the hospital closures did not adversely affect rural residents' health status or their access to inpatient hospital services. Despite widespread fears that health status would decline, residents in these communities reported that hospital closures did not adversely affect their own health. Although some communities continue to struggle with changes to health care delivery, others appear to have adapted as a result of strong community leadership, the development of widely accepted alternative services, and local support for creating innovative solutions. Good rural health care does not depend on the presence of a very small hospital that cannot, in today's environment, provide genuinely acute care. It requires creative approaches to the provision of primary care, good emergency services, and good communication with the public on the intent and outcomes of change.
OBJECTIVE: To investigate the constitution and health status of the Beijing residents, and the primary influencing factors on nutrition and health, as to finding out the epidemiological characters and the changing trend of chronic diseases and to establish scientific basis for the establishment of public health and disease prevention policies of Beijing. METHODS: A stratified multi-stage cluster randomly sampling method was used. In total, 18 districts were surveyed, and among them, 9 were conducted dietary survey. The investigation was based on household, and all family members were surveyed at their home. After having got the compliance from the family members, question asking, medical examination, laboratory test and dietary investigation were carried out in these people. RESULTS: The incidence rate of hypertension was 25.0% for the resident > or = 15 year-old, and over 50% for middle-aged and elderly people (> or = 45 years old). The incidence of diabetes for those not younger than 15 years old was 7.7%. The over-weight rate and the obesity rate for adults were 35.1% and 20.6%, respectively. CONCLUSION: The following risk factors of chronic disease, such as unreasonable diet pattern, deficient intake of some micronutrients, over-weight and obesity, lack of physical examination, smoking and over-drinking, should be the important factors influencing the health of Beijing residents severely.
The aims of this study were (1) to compare various measures of I status, and (2) to assess urinary I and thyroid hormone status of residents of two areas of New Zealand where, before the iodization of salt, goitre was endemic due to low soil I. A total of 189 subjects (102 males, eighty-seven females) were recruited from the Dunedin Blood Transfusion Centre, and 144 (sixty-seven males, seventy-seven females) from the Waikato Blood Transfusion Centre between November 1993 and June 1994. Blood was taken for thyroid hormone assays, and subjects collected a fasting overnight urine specimen, a double-voided fasting urine sample, and a complete 24 h specimen for iodide and creatinine analyses. Positive correlations (P < 0.0001) between daily iodide excretion and iodide concentrations in fasting and double-voided fasting urines, identical median values for iodide concentrations in the three samples, and similar numbers of subjects classified as at risk from I deficiency disorders according to the International Committee for the Control of Iodine Deficiency Disorders/World Health Organization categories (World Health Organization, 1994) confirmed indications from earlier studies that fasting urine samples were suitable for population studies. However 24 h urinary iodide excretion remains the recommended measure for individual I status. Waikato residents excreted more iodide in urine and all measures were significantly greater than for Otago residents. However median urinary iodide excretions for both areas (60 and 76 microgram/d for Otago and Waikato respectively) were considerably lower than those reported previously for New Zealand. Thyroid hormone concentrations were within normal ranges. Our findings suggest that I status of New Zealanders may no longer be considered adequate and may once again be approaching levels of intake associated with clinical I deficiency.
Explore the source record for details and available documents.