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PubMed2006

Testing a conceptual model related to weight perceptions, physical activity and smoking in adolescents.

The purpose of this study was to test a conceptual model based on theoretical and empirically supported relationships related to the influences of weight perceptions, weight concerns, desires to change weight, friends, age and location in relation to physical activity (PA) and smoking in adolescents. A total of 1242 males and 1446 females (mean age = 15.6 +/- 1.3) were recruited from rural and urban Canadian schools. Study respondents provided self-reports of PA, 'smoking', 'perceived body weight', 'desire to change weight', 'concern about weight gain' and 'friends' smoking and PA behaviors'. Results revealed an acceptable fitting model chi2 (40) = 155.63, P < 0.05, root mean square error of approximation = 0.047 and comparative fit index = 0.98. Large effect sizes for both genders were observed between friends' and adolescents' smoking behavior, and between perceived body weight and desire to change weight. Further, significant differences were identified between the male and female models [chi2 difference (24) = 65.28, P < 0.05]. Several findings of this study point to the need to design programs to motivate adolescent females to adopt healthy weight-control practices and to target young peoples' social networks to promote health behaviors, especially with regard to smoking.

Adolescent↗
PubMed1999

Healthy pets, healthy people.

Zoonoses, diseases that can be transmitted from animals to humans, can pose serious health risks to immunocompromised people. Although pets can carry zoonoses, owning and caring for animals can benefit human health. Information exists about preventing transmission of zoonoses, but not all physicians and veterinarians provide adequate and accurate information to immunocompromised pet owners. This disease prevention/health promotion project provides physicians and veterinarians with information, created specifically to share with patients and clients, about the health risks and benefits of pet ownership. Further, "Healthy Pets, Healthy People" encourages communication between veterinarians, physicians, clients, and patients and can serve as a model program for a nation-wide effort to aid health professionals in making recommendations about pet ownership for immunocompromised people.

Animals↗
PubMedDate not supplied

[An evaluation of the antidiphtheria protection in the general population].

The assessment of the antidiphtheria protection in healthy population is common for a surveillance system within any National Program of Immunization. Our study is intending to measure the antidiphtheria immunity level in apparently healthy peoples living in the southern Romania. Our study were carried out on 8594 healthy subjects. Sample were stratified by nine age groups being representative for the above mentioned area. The titration of diphtheria antitoxin in our laboratory were performed by passive hemagglutination assay (PHA) and in vivo neutralization test (NT). In our study, we had considered as "protective immunity level" an antitoxin titers equal or above 1/640. The overall prevalence of protected peoples was 88.1% (C.I. 95%: 87.4%-88.8%). The prevalence of protected people against diphtheria decrease by age from 94.5% (1-9 years of age) to 82.4% (60 years and over). We think that overall, our national strategy for diphtheria control is quite efficient, but need to be sustained by specific actions concerning some high risk population groups.

Adolescent↗
PubMed2004

Pasos Adelante: the effectiveness of a community-based chronic disease prevention program.

BACKGROUND: Implementing programs that target primary prevention of chronic diseases is critical for at-risk populations. Pasos Adelante, or "Steps Forward," is a curriculum aimed at preventing diabetes, cardiovascular disease, and other chronic diseases in Hispanic populations. Pasos Adelante is adapted from the National Heart, Lung, and Blood Institute's cardiovascular disease prevention curriculum, Su Corazon, Su Vida, and includes sessions on diabetes and community advocacy and incorporates walking clubs. CONTEXT: The Pasos Adelante curriculum was implemented in two Arizona, United States-Sonora, Mexico border counties. Key issues in these communities are safety, access to recreational facilities, climate, and cultural beliefs. METHODS: Pasos Adelante is a 12-week program facilitated by community health workers. The program includes interactive sessions on chronic disease prevention, nutrition, and physical activity. Evaluation of the program included precurriculum and postcurriculum questionnaires with self-reported measures of physical activity and dietary patterns. Approximately 250 people participated in the program in Yuma and Santa Cruz counties. CONSEQUENCES: Postprogram evaluation results demonstrate a significant increase in moderate to vigorous walking among participants and shifts in nutritional patterns. INTERPRETATION: The Pasos Adelante program demonstrates that an educational curriculum in conjunction with the support of community health workers can motivate people in Arizona/Sonora border communities to adopt healthy lifestyle behaviors.

Chronic Disease↗
PubMed1993

Efficacy of a home-based human immunodeficiency virus prevention video program for teens and parents.

Family-based communication about sexual behavior and sexuality is a predominate theme in the key risk reduction and service objectives for human immunodeficiency virus (HIV) prevention and related issues in Healthy People 2000. These recommendations are particularly poignant for younger adolescents who are not yet sexually active and whose social orientation is primarily to family and parents. A family-centered, home-based, video program to foster parent and teen knowledge and communication regarding issues related to HIV prevention and to increase family and teen communication skills was used in an intensive field test of program efficacy. Sixty-nine families with at least one adolescent age 12 to 14 years were recruited through their primary-care physicians and were randomly assigned to either experimental (video with information and skills training) or control (video with information only) conditions in a pre-posttest with a 4-month follow-up design. Both versions of the video program resulted in substantial increases in HIV-related knowledge for parents and teens, but only the skill-training (experimental) version produced increases in knowledge of communication skills and behavioral demonstrations of family problem solving. Approaches for a broader and more effective parent-training video program and for dissemination through primary-care physicians are discussed.

Adolescent↗
PubMedDate not supplied

Using YPLL in health planning.

OBJECTIVE: The measurement of years of potential life lost before age 65 (YPLL) is one of the Health Outcome Indicators defined by the state of Florida to measure progress toward Healthy People 2000 objectives. The authors describe the outcomes of their work with county health agencies to encourage use of the YPLL statistic. METHODS: Calculations of the 1993 YPLL rates for Florida counties with populations greater than 50,000 and of inter-county variability in YPLL rates were used to train county health agencies in the use of YPLL. RESULTS: Sixty-eight percent of all years of potential life lost in Florida in 1993 were attributed to 10 causes. While the total YPLL rates ranged from 3500 per 100,000 to 7000 per 100,000 across Florida counties, the leading causes differed substantially across counties. The YPLL measure was found to be useful in helping county health agencies plan programs to reduce premature mortality. CONCLUSIONS: Federal, state, and county health units can use YPLL rates to help guide activities toward Healthy People 2000 and to help identify new health problems that require forming new community alliances, but staff members must be trained to use the YPLL statistic appropriately. Causes that vary little across counties enable the implementation of statewide prevention approaches while causes that differ greatly by county will require locally designed interventions.

Cause of Death↗
PubMedDate not supplied

The effect of employment status on breastfeeding in the United States.

BACKGROUND: In the United States, more new mothers are part of the work force than ever before. This trend has implications for many child-rearing practices, including breastfeeding. METHODS: Based on a national sample of new mothers (n = 228,000), this study considered the prevalence of the initiation and duration of breastfeeding to 6 months after delivery in 2003 among women who were employed full time, who worked part time, or who were not employed outside the home. Breastfeeding trends since 1984 were also considered. RESULTS: In 2003, at the national level, the prevalence of the initiation of breastfeeding and breastfeeding to 6 months after delivery were 66.0% and 32.8%, respectively. In the hospital, mothers who worked part time had a significantly (p <0.05) higher rate of breastfeeding (68.8%) than those who were employed full time (65.5%), or who were not employed (64.8%). Working full time had a (p <0.05) negative effect on breastfeeding duration. By 6 months after delivery, 26.1% of mothers employed full time, 36.6% of mothers working part time, and 35.0% of nonworking mothers breastfed their infant. Mothers who were not employed were more than twice as likely to breastfeed at 6 months than mothers who worked full time. Breastfeeding trends since 1984 indicated a large increase in the rate of breastfeeding at 6 months after delivery among full-time working mothers (204.5%). However, rates for these women have not yet reached those of mothers who worked part time or were not employed. CONCLUSIONS: To ensure that the Healthy People 2010 goals for breastfeeding are achieved (75% in the hospital and 50% at 6 months), programs designed to support working mothers who choose to breastfeed must be continued and strengthened.

Adult↗
PubMed1989

Health care and the elderly.

Western values have long emphasized an interventionist approach to problems of health and health care. Yet, as medical technology becomes increasingly expensive and as the number of older people grows, proposed changes often are now governed more by considerations of cost than by quality of services. This tension between cost and quality also affects public willingness to invest in social components of health care despite their importance in enhancing quality of life. The tension emerges in sharpest contrast as scarce resources are allocated by gatekeepers in health maintenance organizations and in the arrangements for long-term care. With respect to financing, what seems to be needed is a creative mix of voluntary inputs from the community, private initiatives, and new programs of public entitlements. With respect to quality of care, what has often been overlooked is the recognition that gains in the quality of life require programs that encourage older people's continued involvement and participation in social life and in active and healthy life-styles. This article discusses the evolving balance between these two types of interventions: the medical and the social.

Aged↗
PubMedDate not supplied

Relationship between use of food labels and nutrition knowledge of people with diabetes.

PURPOSE: The purpose of this study was to identity how people with diabetes use food labels to manage their intake of specific nutrients, which information is used on the Nutrition Facts label, and the relationship between food label use and nutrition knowledge. METHODS: A total of 190 individuals participated in this study. Data were collected at six different locations in New Jersey using a four-page questionnaire. Descriptive statistics were employed to assess demographic and clinical characteristics of the participants; chi-square was used to test significance of nominal and ordinal data. RESULTS: People with diabetes read food label information more often than general consumers; checking sugar content ranked highest. Only 59% of label users referred to the total carbohydrate listings. The level of nutrition knowledge for the majority of participants was "fair" or less, with the remaining scoring "good" and above. The use of nutrition labeling has a limited effect on nutrition knowledge gain. CONCLUSIONS: Individuals who received most of their information from healthcare providers had a "good" or better nutrition knowledge score. An education program is needed that teaches people how to apply information from the Nutrition Facts label to make healthy food choices.

Adult↗
PubMedDate not supplied

[Work with youth--the basis of educational programs aimed at the prevention of HIV infection].

During the recent 10 years, 1987-1997, syphilis morbidity was found to increase 60-fold in Omsk Province. In 1997 adolescents constituted 6.0% in the structure of persons who contacted the disease. In this year more than 500 adolescent using drugs were registered in the region. The introduction of drugs by injection was practiced by 9.6% of the adolescents. The program aimed mainly at changing the behavior of young people with orientation on the choice of a healthy mode of life and theirs information about risk factors associated with sex transmitted diseases particularly HIV infection is discussed.

Adolescent↗
PubMed2005

Prevalence and predictors of smoking behavior among Samoans in three geographical regions.

OBJECTIVES: Provide comprehensive data on smoking behavior among Samoans. DESIGN: Cross-sectional, using systematic random sampling procedures, and in-person interviews. SETTING: US Territory of American Samoa, Hawaii, and Los Angeles, California. PARTICIPANTS: 1834 adult, non-institutionalized Samoans. INTERVENTION: None. MAIN OUTCOME MEASURES: Prevalence and independent predictors of smoking. RESULTS: Approximately one fourth (26.6%) of Samoans were current smokers, with 31.4% of men and 22.5% of women currently smoking. More current smokers were found in American Samoa (28.9%), followed by Hawaii (26.9%) and Los Angeles (24.1%, P<.001). At each site, Samoan men compared with the women were significantly more likely to smoke (P<.001), initiate smoking earlier (P<.05), and smoke more cigarettes (P<.05). Cessation rates for the sample were very low. Predictors of smoking included being younger, male, married, less educated, with lower income, and more acculturated. CONCLUSION: The high smoking and low cessation rates indicate that smoking-related diseases will be significant causes of morbidity and mortality for Samoans for many years. The findings further underscore the importance of documenting smoking patterns and their determinants for subgroups rather than aggregates such as Asian American and Pacific Islanders. If Samoans are to meet the Healthy People 2010 tobacco goals, there is a need to: 1) develop tailored tobacco awareness and cessation programs based on the recommendations made by the Taskforce on Community Preventive Services; 2) understand the complex interactions between social, cultural, and psychological determinants of smoking and cessation behaviors; and 3) develop policies to limit availability of tobacco, environmental exposure from tobacco, and increase cessation efforts.

Adolescent↗
PubMed1995

Programmed cell death and the gene behind spinal muscular atrophy.

A gene involved in the development of spinal muscular atrophy (SMA) has been found on human chromosome 5 after a 4-year search. Named the neuronal apoptosis inhibitor protein (NAIP) gene, it is believed to inhibit the normal process of apoptosis--the disintegration of single cells that results from programmed cell death--in motor neurons. The researchers who found the NAIP gene also discovered that healthy people carry one complete copy of the gene along with many other partial copies. Many children with SMA have the partial copies but not the complete gene. This discovery facilitates the accurate genetic diagnosis of SMA. But gene therapy for SMA will not be possible until researchers find a suitable vector to stably introduce activated and intact copies of the gene into the motor neurons of children with SMA in time to stop motor neuron loss.

Apoptosis↗
PubMed1998

[Breast cancer as a social problem and common aspects with other oncologic patients].

Problems of peculiar relationships between oncologists, society and general public, on the one hand, and cancer patients, on the other, are discussed with respect to breast cancer. It is suggested that if one's right to take care of one's life is to be honored, cancer patients are to have access to more information on their disease must doctor should be prepared to give away more of it in their conversations. Once one is aware of responsibility for one's health, the advantages of an earlier visit to a doctor and, conversely, the tragedy of a belated call become quite apparent. Such awareness is not feasible unless society becomes the patients ally in every-day activities of cancer control. This approach calls for a revision of somewhat out-dated deontological principles as well as measures aimed at getting the public to change their attitudes towards cancer patients. Simultaneously, the medical profession must receive an education in dealing healthy people and cancer patients. The engagement of former cancer patients, who have an experience of a program of social rehabilitation, will make the efforts to cure those who are still sick more meaningful and boost their morale.

Breast Neoplasms↗
PubMedDate not supplied

The Toronto Cardiac Rehabilitation and Secondary Prevention Program: 1968 into the new millennium.

Given our approach to the cardiac rehabilitation process, which is reflected in the program structure and services and our high patient volume, this program model is effective for us. The model permits us to treat relatively large number of patients with relatively small numbers of staff. On average, a patient attends 32 supervised exercise sessions at the Centre over the course of 12 months. This is actually fewer supervised sessions than the popular model of 3 times per week for 12 weeks. However, the 12-month program provides an additional 9 months to work with patients on heart-healthy lifestyle modifications. At the same time, we realize our model is not the model of choice for all people in all settings for a variety of reasons. We trust that some elements of our program may be of interest and beneficial to some readers. Undoubtedly, the program will continue to evolve and develop into the future. Currently, we are conducting a cardiac rehabilitation outcomes study in an effort to determine the appropriate duration of cardiac rehabilitation to achieve optimal physiological, psychological, and cost benefits for patients. This study involves more than 700 patients and the results are intended to help us further refine the program structure and selected program elements. As the new millennium approaches, healthcare system reforms and continuing changes in the delivery of medical care to cardiac patients present opportunities, challenges, and some uncertainties for cardiac rehabilitation. To continue our services to patients and the medical community, cardiac rehabilitation programs will need to identify and develop even more innovative and effective concepts in response to ever-changing local, regional, and national issues.

Coronary Disease↗
PubMed2001

Preventing falls in older people: outcome evaluation of a randomized controlled trial.

OBJECTIVES: To evaluate the outcome of an intervention to reduce hazards in the home on the rate of falls in seniors. DESIGN: Randomized controlled trial, with follow-up of subjects for 1 year. SETTING: Community-based study in Perth, Western Australia. PARTICIPANTS: People age 70 and older. INTERVENTION: One thousand eight hundred seventy-nine subjects were recruited and randomly allocated by household to the intervention and control groups in the ratio 1:2. Because of early withdrawals, 1,737 subjects commenced the study. All members of both groups received a single home visit from a research nurse. Intervention subjects (n = 570) were offered a home hazard assessment, information on hazard reduction, and the installation of safety devices, whereas control subjects (n = 1,167) received no safety devices or information on home hazard reduction. MEASUREMENTS: Both groups recorded falls on a daily calendar. Reported falls were confirmed by a semistructured telephone interview and were assigned to one of three overlapping categories: all falls, falls inside the home, and falls involving environmental hazards in the home. Analysis was by multivariate modelling of rate ratios and odds ratios for falls, corrected for household clustering, using Poisson regression and logistic regression with robust variance estimation. RESULTS: Overall, 86% of study subjects completed the 1 year of follow-up. The intervention was not associated with any significant reduction in falls or fall-related injuries. There was no significant reduction in the intervention group in the incidence rate of falls involving environmental hazards inside the home (adjusted rate ratio, 1.11; 95% CI = 0.82-1.50), or the proportion of the intervention group who fell because of hazards inside the home (adjusted odds ratio, 0.97; 95% CI = 0.74-1.28). No reduction was seen in the rate of all falls (adjusted rate ratio, 1.02; 95% CI = 0.83-1.27) or the rate of falls inside the home (adjusted rate ratio, 1.17; 95% CI = 0.85-1.60). There was no significant reduction in the rate of injurious falls in intervention subjects (adjusted rate ratio, 0.92; 95% CI = 0.73-1.14). CONCLUSIONS: The intervention failed to achieve a reduction in the occurrence of falls. This was most likely because the intervention strategies had a limited effect on the number of hazards in the homes of intervention subjects. The study provides evidence that a one-time intervention program of education, hazard assessment, and home modification to reduce fall hazards in the homes of healthy older people is not an effective strategy for the prevention of falls in seniors.

Accidental Falls↗
PubMedDate not supplied

[Equipment for programmed multi-channel electric stimulation of the motor neuro-muscular structures in man].

It appears possible to apply electric action not only for medical purposes, but also in stimulating the locomotor apparatus of healthy people. To achieve an effective influence on the neuro-muscular structure of the locomotor apparatus in man all-purpose multichannel on the neuro-muscular structure of the locomotor apparatus in man an all-purpose multichannel programmed electric stimulator with an autonomously pre-set program that permits it to form an arbitrary structure of stimulation signals, capable of being reconstructed in the course of the action, is proposed. This makes it possible to more flexibly and accurately take account of a naturally coordinated interaction of the muscles. A simplified portable version of an all-purpose stimulator is discussed.

Action Potentials↗
PubMedDate not supplied

Development of healthy public policy: feminist analysis of conflict, collaboration and social change.

In the past two decades, the need for economic restructuring has served as a rationale for dismantling social programs in Canada. As it has been enacted, such social restructuring has disproportionately affected marginalized people, particularly women. In this article we explore the schism between the principles that underlie the development of healthy public policy and those that are driving current social policy development. Through this analysis we discuss the implications of policy development that is based upon principles of inequity, and we suggest that implementation of healthy public policy requires transformational change in the underlying principles of the social system. A policy shift based upon principles of equity and social justice has been espoused throughout the health promotion literature. We suggest that such a shift will be facilitated by strengthening collaborative relations among points of conflict within society and among policy makers and women's organizations.

Canada↗
PubMedDate not supplied

A federal agency's role in fulfilling the public health core functions: the childhood lead poisoning prevention program model.

The Institute of Medicine identified 3 core functions of public health: assessment, policy development, and assurance. Federal, state, and local public health agencies all have an obligation to provide these vital functions to ensure conditions in which people can be healthy. However, the few publications that provide core function applications only focus on applications at the local or state levels. The Centers for Disease Control and Prevention's Childhood Lead Poisoning Prevention Program uses a comprehensive public health approach. This article describes the Centers for Disease Control and Prevention's leading role in applying the core public health functions to prevent childhood lead poisoning.

Centers for Disease Control and Prevention, U.S.↗