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PubMed1986

The New York City school system's Family Life Education program.

The issue of adolescent pregnancy is one which physicians, social workers, ministers, politicians, parents and other concerned citizens now recognize as being of paramount importance. The New York City Board of Education, in accepting its responsibility for helping young people to live healthy and fulfilling lives, has approved an innovative curriculum, "Family Living Including Sex Education". The curriculum is designed to help youngsters through the anxieties they feel and to help them develop positive attitudes toward their own bodies. The program was designed to supplement whatever information was being supplied in the home, and to be taught from kindergarten through high school. During the 1984-85 school year six highly qualified coordinators were hired, 30-hour staff training programs for approximately 1,100 teachers and supervisors were conducted, the program was implemented in nine community school districts and 75 high schools. Advisory Councils were formed and parent programs were established for 2,000 parents. A twenty-minute slide presentation and videotape which provide a comprehensive overview of the curriculum are available for use in schools and districts, upon request from the Health and Physical Education Unit.

Adolescent↗
PubMed1994

Healthy People 2000: participation in prevention.

The US spends more on health care and has worse health outcomes than some nations that have nowhere near its resources. The federal government launched this program to address both costs of care and health status of Americans.

Community Health Services↗
PubMed2005

Functional-task exercise versus resistance strength exercise to improve daily function in older women: a randomized, controlled trial.

OBJECTIVES: To determine whether a functional-task exercise program and a resistance exercise program have different effects on the ability of community-living older people to perform daily tasks. DESIGN: A randomized, controlled, single-blind trial. SETTING: Community leisure center in Utrecht, the Netherlands. PARTICIPANTS: Ninety-eight healthy women aged 70 and older were randomly assigned to the functional-task exercise program (function group, n=33), a resistance exercise program (resistance group, n=34), or a control group (n=31). Participants attended exercise classes three times a week for 12 weeks. MEASUREMENTS: Functional task performance (Assessment of Daily Activity Performance (ADAP)), isometric knee extensor strength (IKES), handgrip strength, isometric elbow flexor strength (IEFS), and leg extension power were measured at baseline, at the end of training (at 3 months), and 6 months after the end of training (at 9 months). RESULTS: The ADAP total score of the function group (mean change 6.8, 95% confidence interval (CI)=5.2-8.4) increased significantly more than that of the resistance group (3.2, 95% CI=1.3-5.0; P=.007) or the control group (0.3, 95% CI=-1.3-1.9; P<.001). Moreover, the ADAP total score of the resistance group did not change significantly compared with that of the control group. In contrast, IKES and IEFS increased significantly in the resistance group (12.5%, 95% CI=3.8-21.3 and 8.6%, 95% CI=3.1-14.1, respectively) compared with the function group (-2.1%, 95% CI=-5.4-1.3; P=.003 and 0.3%, 95% CI=-3.6-4.2; P=.03, respectively) and the control group (-2.7%, 95% CI=-8.6-3.2, P=.003 and 0.6%, 95% CI=-3.4-4.6; P=.04, respectively). Six months after the end of training, the increase in ADAP scores was sustained in the function group (P=.002). CONCLUSION: Functional-task exercises are more effective than resistance exercises at improving functional task performance in healthy elderly women and may have an important role in helping them maintain an independent lifestyle.

Activities of Daily Living↗
PubMed2005

The feasibility of FOBT tests in colorectal cancer screening in Dobrogea.

BACKGROUND AND AIM: The high incidence of colorectal cancer in Eastern Europe and the declining mortality due to this pathology in the Western World, where screening programs for cancer are available, prove the necessity of implementing colorectal cancer screening in Romania, too. The aim of our study was to detect colorectal cancer in asymptomatic stages, where surgical treatment could be curative. METHOD: The study was conducted in the Gastroenterology Department of Emergency Hospital, Constanta County, over a period of 18 months. We recruited apparently healthy people following all criteria recommended by the guidelines. RESULTS: From the total of 1098 patients included in the study, 162 patients with FOBT test positive followed the screening program undergoing colonoscopy or barium enema investigation. The rate of acceptance regarding the screening procedures was 70.3%. Advanced colon lesions were found in 14 patients (1.27%) and cancers in 7 cases (0.63%). According to TNM classification 5 cancers (71.4%) were surgically curative (TNM I/II/III) and 2 (28.5%) were advanced (TNM IV). The positive predictive value (PPVs) of FOBT for cancer was 4.7%. CONCLUSION: Even if the effect of screening on mortality was not demonstrated, our study results confirm the necessity of colorectal cancer screening in our country, as it is worldwide, detecting cancers in curative stages. The detection rate of FOBT positive tests for neoplasia was similar to other studies.

Aged↗
PubMedDate not supplied

Enhancing health knowledge, health beliefs, and health behavior in Poland through a health promoting television program series.

This study examined the impact of a health promoting television program series on health knowledge and the key factors of the health belief model (HBM) that have led people to engage in healthy behavior (exercising, losing weight, changing eating habits, and not smoking/quitting smoking). Using data from a posttest comparison field study with 15) viewers and 146 nonviewers in Poland, we found that hierarchical regression analysis showed stronger support for the HBM factors of efficacy, susceptibility, seriousness, and salience in their contribution toward health behavior among television viewers compared with nonviewers. Cues to action variables (including television viewing) and health knowledge boosted efficacy among viewers. Without the advantage of receiving health information from the television series, nonviewers relied on their basic disease fears on one hand, and interest in good health on the other to take steps toward becoming healthier. A health promoting television series can increase health knowledge and enhance health beliefs, which in turn contribute to healthy behaviors.

Adolescent↗
PubMedDate not supplied

Mammography and clinical breast examination among Korean American women in two California counties.

BACKGROUND: Mammography and clinical breast examination (CBE) are underutilized, especially by women from some racial/ethnic minorities. Few published studies of screening practices or correlates for these subgroups exist. METHODS: A population-based telephone survey of 1,090 Korean Americans living in two California counties was conducted. To produce population estimates of mammography and CBE testing, we adjusted frequencies to account for different selection probabilities. Multivariable logistic regression was performed to determine independent correlates of testing. RESULTS: Only 34% [95% confidence intervals (CI) 30%, 39%] of Korean American women age 50 and older were estimated to have had a mammogram in the past 2 years. Only 32% (95% CI 28%, 37%) had had a CBE in the past 2 years. The strongest independent correlate of testing was having a regular medical checkup [odds ratio (OR) for mammogram = 9.21, 95% CI 3.98, 21.35; OR for CBE = 11.58, 95% CI 4.71, 28.46]. CONCLUSIONS: These estimates are lower than the Healthy People 2000 objectives as well as published estimates for other populations in the United States. Planning and implementing tailored programs to improve screening are best done using a community-sensitive approach, which, because racial/ethnic subgroups are growing, will assume increasing public health importance.

Aged↗
PubMed2005

Preventing tobacco use among lesbian, gay, bisexual, and transgender youths.

A paucity of information regarding tobacco use among lesbian, gay, bisexual, and transgender (LGBT) youths impedes prevention programs. The aim of the present study was to conduct formative qualitative research regarding subpopulations at risk for tobacco use, protective factors, patterns of use, and approaches to prevention. This report focuses on participants' recommendations for the development of preventive intervention. Purposive sampling and maximum variation sampling were used to select 30 LGBT youths and 30 interactors for face-to-face interviews. NUD*IST6 text software was used for the indexing and thematic analysis of qualitative data, based on a grounded theory approach. All participants offered suggestions for tobacco prevention pertaining to the optimal process of prevention and cessation programs, specific strategies to promote tobacco prevention and cessation, and general strategies to foster nonsmoking. Several key themes regarding prevention emerged: LGBT youth should be involved in the design and implementation of interventions; prevention programs should support positive identity formation as well as nonsmoking; the general approach to prevention should be entertaining, supportive, and interactive; and the public might not distinguish primary prevention from cessation activities. All but one young smoker had attempted to quit at least once; but only one individual had succeeded. By way of implications, prevention programs should involve young people in enjoyable and engaging activities, address the psychosocial and cultural underpinnings of tobacco use, support healthy psychosocial development, and consider offering pharmacological smoking cessation aids.

Adolescent↗
PubMedDate not supplied

Managed care and the nurse's ethical obligations to patients.

The goal of managed care is to control health care costs by such means as keeping people healthy and decreasing the length of hospital stays. This change in health care delivery has resulted in work redesign programs, lay-offs, cross-training, and the use of an increasing number of nonprofessional care providers. The challenge for nursing, as a result of these changes, is how to fulfill its obligations of fidelity and due care. The authors discuss these ethical responsibilities and the impact that managed care is having on the fiduciary relationship between nurse and patient. Four strategies that nurses can use to fulfill their obligations include engaging in personal reflection, communicating and collaborating, protecting patient's rights, and evaluating patient outcomes.

Beneficence↗
PubMed1992

Geriatric education. Part II: The effect of a well elderly program on medical student attitudes toward geriatric patients.

OBJECTIVE: To assess impact of exposure to healthy elderly on medical students' attitudes toward the elderly. DESIGN: Prospective, randomized, controlled intervention trial. SETTING: Community-based Well Elderly Program. PARTICIPANTS: Ninety-three fourth year medical students on a required Geriatric Medicine clerkship who were assigned to either a tertiary care university medical center or a teaching nursing home. INTERVENTION: Thirty-five students were randomly assigned to participate in a Well Elderly Program and were compared to a control group of 58 students at equivalent sites who did not participate. MEASUREMENTS: Pre- and post-rotation, students were given the Aging Semantic Differential (ASD), a validated geriatric attitudinal scale. MAIN RESULTS: By repeated measures analysis of variance, the difference between pre- and post-rotation ASD scores were most significant for students who participated in the Well Elderly Program; site did not exert a significant interaction effect. CONCLUSION: These results underscore the importance of exposure to healthy older people on effecting positive attitude changes among medical students on geriatrics rotations.

Adult↗
PubMed2001

Research capacity and closing the health gap.

In January 2000, the Healthy People 2010 initiative was introduced by the US Department of Health and Human Services (DHHS), which set the nation's health goals for the coming decade. In 1990, a previous DHHS administration had released the Healthy People 2000 initiative, which set goals to be met by the year 2000. In 1979, the first set of health goals for the nation was released, titled Healthy People. Thus, Healthy People 2010 is the third iteration of such goals. This effort has achieved momentum and indeed is paying off handsomely. The framework of the Healthy People initiatives, however, is just one gauge of US public health care status; it and a myriad of other programs and studies in recent decades reflect the gains and shortcomings of our complex health care system. In several areas, minority health disparities continue to be the weakness in our capacity building to achieve the nation's health goals.

Health Planning↗
PubMed2001

Research capacity and closing the health gap.

In January 2000, the Healthy People 2010 initiative was introduced by the US Department of Health and Human Services (DHHS), which set the nation's health goals for the coming decade. In 1990, a previous DHHS administration had released the Healthy People 2000 initiative, which set goals to be met by the year 2000. In 1979, the first set of health goals for the nation was released, titled Healthy People. Thus, Healthy People 2010 is the third iteration of such goals. This effort has achieved momentum and indeed is paying off handsomely. The framework of the Healthy People initiatives, however, is just one gauge of US public health care status; it and a myriad of other programs and studies in recent decades reflect the gains and shortcomings of our complex health care system. In several areas, minority health disparities continue to be the weakness in our capacity building to achieve the nation's health goals.

Health Planning↗
PubMed1992

Selling health promotion programs: recommendations for occupational health nurses.

1. Although some suggest that health promotion programs should not be conducted in the workplace, there is generally strong support for workplace programs by both the public and private sectors. 2. Many published reports of cost savings attributed to health promotion programs are available. The calculations of cost savings contain many flaws and generally do not reflect a comprehensive analysis of all costs associated with programs, especially those associated with changes in death rates and longevity. 3. Specific recommendations for occupational health nurses include: analysis of the corporate situation; integration of programs with occupational health and safety activities; involvement of all levels of workers in planning and promoting the programs; evaluation through employee participation and satisfaction, not by cost benefit analysis; and consideration of offering programs to family members. 4. Nursing as a whole should provide leadership for implementing programs to promote health and prevent disease. The worksite offers unique opportunities for occupational health nurses to implement the Healthy People 2000 objectives to enhance the health of working adults.

Cost Savings↗
PubMed1988

In-flight deaths during commercial air travel. How big is the problem?

Do passenger deaths occur during commercial air travel? If so, how often and from what causes? We reviewed information reported to the International Air Transport Association on in-flight deaths that occurred during commercial air travel for the eight years between 1977 and 1984. Of the 120 airlines in the International Air Transport Association, 42 carriers reported deaths during these eight years. A total of 577 in-flight deaths were recorded, for a reported average of 72 deaths per year. Deaths occurred at average rates of 0.31 per million passengers, 125 per billion passenger-kilometers, and 25.1 per million departures. The majority of those who died were men (66%, 382/577) and middle-aged (mean age, 53.8 years). Most of the individuals (77%, 399/515) reported no health problems prior to travel. Physicians aboard the aircraft offered medical assistance for 43% (247/577) of the deaths. More than half of the deaths (56%, 326/577) seemed to be related to cardiac problems. Sudden unexpected cardiac death was the cause of death in 63% (253/399) of the apparently healthy people and seems to be the major cause of death during air travel. These observations support the initiation of programs to train cabin personnel in the skills of basic cardiopulmonary resuscitation and in the use of automatic external defibrillators.

Adult↗
PubMed2001

Training to provide for healthy rural aging.

More than 60 percent of the worlds aged population is in developing countries, the majority living in rural and remote areas. Resources in these areas are scarce and there is a lack of services and programs, especially in the areas of health, housing and social welfare. The most serious deficiency faced by many countries in meeting the challenges of population aging is the pronounced scarcity of trained caregivers. Little attention has been given to developing effective training policies and programs. Most of the people providing a service to older people lack basic training and this is more so in rural and remote areas. The processes for extending healthy aging and postponing the onset of chronic diseases and disabling conditions exist already. Unfortunately, these processes are not disseminated in appropriate ways. It is therefore imperative to disseminate this information by training people at the grass roots level to reach the most vulnerable and isolated older people. Primary care workers should have the necessary skills, knowledge and techniques to facilitate good care of older people in their environment. This article reviews and analyzes attempts being made by a number of countries to meet this need. Though the basic issues dealt with are often the same, the approach used differs.

Aged↗
PubMed1999

Skin cancer prevention: the problem, responses, and lessons learned.

Skin cancer is one of the most common forms of cancer and has rapidly increased during the past three decades in the United States. More than 1 million new cases of skin cancer are estimated to be diagnosed in the United States each year. The National Skin Cancer Prevention Education Program (NSCPEP) was launched by the Centers for Disease Control and Prevention (CDC) in 1994 as a national effort to address the Healthy People 2000 objectives for skin cancer prevention. The NSCPEP is a comprehensive, multidimensional public health approach that includes (1) primary prevention interventions; (2) coalition and partnership development; (3) health communications and education; and (4) surveillance, research, and evaluation. In 1994, through support from the CDC, state health departments in Arizona, California, Georgia, Hawaii, and Massachusetts initiated primary prevention intervention projects to conduct and evaluate skin cancer prevention education. This article discusses the comprehensive, multidimensional public health approach highlighting examples from the state demonstration projects.

Adolescent↗