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PubMed1993

Age, sex, educational attainment, and race/ethnicity in relation to consumption of specific foods contributing to the atherogenic potential of diet.

BACKGROUND: We examined which specific foods contributed to the atherogenic potential of diet in population segments defined by age, sex, educational attainment, and race/ethnicity. Data from the 1989 New York State Healthy Heart Program baseline survey were analyzed. METHODS: This telephone survey was conducted in eight communities (total population approximately 1.24 million people) in New York State. Response rate was 65.5% (N = 4,179); 3,606 subjects ages 20 to 64 years who reported their level of educational attainment with self-described ethnicity of white (N = 1,935), black (N = 1,035), or Hispanic (N = 636) were retained in the analysis. Diet was assessed using a 17-item food frequency questionnaire which focused on commonly eaten food high in saturated fat and cholesterol. Connor's cholesterol/saturated-fat index was used as a scale of the atherogenic potential of the diet. RESULTS: Eggs, whole milk, cheese, beef, and butter/margarine were the foods contributing most to the cholesterol/saturated-fat index score in all age-, sex-, and race/ethnicity-specific population segments examined, together contributing a total of 52 to 72% of the cholesterol/saturated-fat index score as measured by the 17-item diet questionnaire. CONCLUSIONS: The implication for public health campaigns directed at reducing the atherogenic potential of diet atherogenicity and for primary care practitioners seeking to influence the diet of patients with high blood cholesterol is that substitutions of less atherogenic food choices for these five foods would appear to be appropriate for most adults.

Adult↗
PubMed2000

Chronic renal insufficiency: current understandings and their implications.

Chronic renal insufficiency (CRI) is underrecognized and undertreated even in sophisticated health care systems. This is particularly distressing in light of the growing number of effective interventions available to slow the progression of kidney disease and ameliorate many of its comorbid conditions. Progress, to a certain extent, is impeded by the lack of generally accepted definitions, clear diagnostic criteria, and practical screening tests. Available epidemiologic data suggest that 800,000 Americans have creatinine levels >/=2.0 mg/dL and over 6 million have levels >/=1.5 mg/dL. Population-based surveys show that age, male gender, and black race are predictors of kidney disease. For reasons that are not well understood, the incidence of kidney failure has nearly doubled over the last 15 years, indicating a parallel increase in CRI. This trend has significant economic implications. Other implications of CRI related to the use and availability of health care resources are appropriate referrals to nephrologists and early intervention to optimize care of patients with CRI. A multipronged approach to providing optimal care involves interventions that may delay the progression of renal dysfunction, proactive prevention of uremic complications, measures to forestall the progress of comorbid conditions, and timely preparation of patients for renal replacement therapy. Early recognition of CRI, expeditious referral for specialty care, and the utilization of a comprehensive program of care optimization will help meet the nation's goals as articulated in the National Institutes of Health's Healthy People 2010: Chronic Kidney Disease.

Humans↗
PubMed2004

The role of dental hygienists in oral health prevention.

Most dental diseases are preventable. This indicates that the main concept of dentistry could be changed to a situation in which the dental hygienist becomes the principal oral care professional. The competencies of dental hygienists focus on disease prevention and oral health promotion; thus referral to a dentist would only become necessary in the event of a failure in the preventive program where disease cannot be controlled. Future oral health care personnel need to be better educated to encourage people to implement healthy lifestyles rather than to treat teeth. In addition, the connection between oral health, general health and health-related quality of life will necessitate a multidisciplinary approach to prevention and oral health promotion. To focus strictly on oral health would too narrowly define the role of the dental hygienist in comprehensive prevention and health promotion. There is no precise boundary between the oral cavity and the rest of the body. Dietary advice to prevent dental caries and smoking cessation counseling to prevent periodontal disease and oral cancer also promote general health. Consequently the focus on prevention and health promotion makes the dental hygienist a very important person in the dental team of the future.

Counseling↗
PubMed2000

The effect of indomethacin on hepatitis B virus replication in chronic healthy carriers.

BACKGROUND: A chronic HBsAg carrier state, a major cause of viral spread in a community, is one of the consequences of hepatitis B virus (HBV) infection. Although successful immunization programs have been initiated to eliminate the virus, there is still a large number of people with HBV infection worldwide. This study was designed to investigate the effect of indomethacin treatment on HBV markers in humans, in comparison with a control group. METHODS: In total, 65 chronic 'healthy' HBV carriers were involved in the study. Patients were divided randomly into two groups. Group I (n = 42) received oral indomethacin 75 mg daily for 6 months. Group II (n = 23) acted as control. Patients in both groups were followed up for 6 months, during which laboratory tests, including viral parameters, were performed periodically. Liver biopsy was done in 17 patients (11/42 of the indomethacin group and 6/23 of the control group). RESULTS: All liver biopsies showed grade 0-2 and stage 0-1 HBV in both groups (P > 0.05). HBsAg positivity did not change in any patient in either group. Five patients who had positive HBeAg in group I became negative 4 months later, while patients in group II continued to be positive at 6 months (P < 0.001). Similarly, all patients receiving indomethacin exhibited a total anti-HBeAg immunoglobulin response at 6 months, while the control group remained the same during this period (P < 0.05). HBV DNA, as detected by polymerase chain reaction in 20/22 (91%), was negative in group I at the end of 6 months. No change was observed in group II (P = 0.007). CONCLUSIONS: Although no biochemical analyses were performed on prostaglandins in the present study, the results suggest that the prostaglandin pathway may be involved in the pathogenesis of the immune response against HBV, and that the suppression of viral replication is achieved as indicated by the disappearance of HBeAg and HBV DNA in healthy chronic HBV carriers.

Adult↗
PubMedDate not supplied

Building relationships and resilience in the prevention of youth violence.

Self Enhancement, Inc., is a grassroots, community-service organization working in the most disadvantaged high-risk community in Portland, Oregon. Its violence-prevention program targets middle-school and high-school students by providing classroom and community activities to these young people. These activities are designed to enhance protective factors and build resilience in youths to enable them to attain healthy and productive lives and to resist the threats of gangs, violence, and drugs. RMC Research Corporation works in partnership with Self Enhancement, Inc., to conduct research and evaluation on the effectiveness of its programs. The Self Enhancement, Inc., program works primarily at the individual student and interpersonal relationship levels. Resilience Theory and its culturally specific Relationship Model drive the formulation of specific strategies and activities. Program staff mentor each student through his or her preadolescent and adolescent years, promoting positive, prosocial norms and expectations for behavior through their peer group activities. The Self Enhancement, Inc., program consists of three major components: classroom, exposure, and proactive education. Classroom education focuses on anger management, conflict resolution, and problem solving. Exposure education consists of quarterly field trips to agencies and organizations in the Portland area that deal with the causes and consequences of violence in the community. Proactive education includes newsletters, student-run assemblies and conferences, and radio/ television public service announcements that communicate antiviolence messages. The evaluation plan is a longitudinal matched comparison group designed to assess the outcomes of the violence-prevention program. Key outcomes are protective factors, health-risk behaviors, and academic measures. Standardized assessment instruments (the Individual Protective Factors Index and the Youth Risk Behavior Survey) were administered to all students during winter 1994. The instruments will be readministered during the same period in the following two years of the project. School records were extracted to assess students' attendance and progress through their academic programs. Of the 326 seventh-, eighth-, and ninth-grade students participating in this study, 95% are African Americans and 51% are boys. The prevalence of fighting (56%) during the past 12 months is higher than that among African-American high-school students nationally, but weapon carrying (27%), alcohol use (30%), and marijuana use (18%) are the same or lower than national averages for this group. All baseline indicators are equivalent between the program and comparison groups with the exception of weapon carrying. Program students report carrying weapons more than do their comparison group counterparts. Baseline indicators of violence-related behaviors clearly indicate the need for intervention in this highly disadvantaged, African-American community. Through its historical presence and recent program development efforts, Self Enhancement, Inc., is well positioned to make a difference in the lives of these young people. The equivalence of program and comparison group students on baseline indicators of violence bodes well for an unequivocal assessment of program effectiveness over time.

Adolescent↗
PubMed1987

Health objectives for the nation: moving toward the 1990s.

The 1990 Objectives are an outgrowth of the 1979 Surgeon General's Report, Healthy People, which identified a set of five broad goals for improving the health of the American public through the decade of the 1980s. A year later, more than 500 health experts from the government and the private sector met to develop specific quantifiable objectives for each of the areas outlined in Healthy People. Fifteen topics, including improved nutrition, were used to formulate a framework for 227 objectives that give directions for a national program of health promotion and disease prevention. In 1980, the Public Health Service published the report Promoting Health/Preventing Disease: Objectives for the Nation. A mid-course review of the 1990 objectives has been conducted, and the results were published in 1986. In the nutrition area, it is apparent that some overall progress has been made, but data are insufficient to assess progress on several objectives, and others are unlikely of achievement by 1990. Ultimately, however, the success of the objectives depends on the recognition that they are national, not federal, goals that require commitment to their implementation by both the public and the private sector.

Adolescent↗
PubMed1994

One hospital's road to waste minimization.

There are many new and exciting waste minimization programs being offered to healthcare facilities. Companies are now making reusable operating packs and gowns that are more efficient than disposables. The selling point is that the system will save healthcare money! The reusable programs do save disposal costs for an institution. Shore Memorial has scheduled a trial evaluation for reusable operating room linens to begin May 1, 1994. The concept has not been difficult to sell to physicians and staff. Perhaps this is because people are generally more aware of their environment and the reasons why it should be protected. The hospital will also be evaluating an IV bottle and bag recycling program. The New Jersey Department of Environmental Protection Agency has given approval to proceed with this type of recycling program, and Shore Memorial is in the process of scheduling this trial program with a local vendor. Waste reduction and recycling in healthcare settings will continue to be challenging because of the diversity of the wastestream and the changing environment facing healthcare. Certainly, healthcare has as much of a responsibility to the well-being of patients as it does to keeping the environment healthy. Returning to the "old way" of doing things, such as reusables, does not have a negative impact on people, but it does have an impact on the environment. Shore Memorial believes it is moving in the right direction with its waste minimization program to make a positive environmental impact.

Conservation of Natural Resources↗
PubMed1985

The effect of verbal information and demonstration on denture hygiene in elderly people.

The purpose of the present study was to investigate the effect of two oral hygiene information programs on denture hygiene. The programs were provided individually to healthy elderly denture wearers. Totally, 150 edentulous persons between 67 and 89 years of age were selected and randomly assigned to two experimental groups and one control group. In one test group (INFO) the participants were only given individual verbal information on how to remove denture plaque. The participants of the second test group (DEMO) received individual demonstration of denture cleaning in addition. One hundred and thirty-eight persons completed the study. The percentage plaque covering the maxillary denture base was assessed by a morphometric point-estimator scoring method at the start of the study and after 14 and 180 days. Verbal information resulted only in a short-term effect (14 days), whereas demonstration on how to remove denture plaque gave long-term (180 days) improvement of denture hygiene.

Aged↗
PubMed2000

Healthy People 2010--vision objectives for the nation.

BACKGROUND: In January 2000, the U.S. Department of Health and Human Services released new national health goals and objectives in a report entitled Healthy People 2010. This national report includes specific objectives for improving the vision of people in the United States during the 2000-2010 decade through prevention, early detection, treatment, and rehabilitation. The vision objectives, along with other health objectives, are designed to help the nation achieve two major outcomes: (1) increase the quality and years of healthy life and (2) eliminate health disparities among different groups. These health objectives will strongly influence many health care programs and the provision of health care through laws, regulations, reimbursements, and clinical guidelines enacted by federal and state agencies. PURPOSE: The purpose of this article is to inform optometrists about the new Healthy People 2010 vision objectives. METHODS: A summary of the Healthy People process for developing the objectives--and the specific vision objectives--is provided. These objectives address many important areas, including: regular dilated eye examinations; vision screening for preschool children; uncorrected visual impairment due to refractive errors; blindness and visual impairment in children and adolescents; visual impairment due to diabetic retinopathy, glaucoma, and cataracts; occupational eye injury; the use of personal protective eye wear in recreational activities and hazardous situations around the home; and the use of vision rehabilitation services and adaptive devices by people with visual impairments. CONCLUSION: These new national health goals and objectives will impact optometrists. Therefore, it is important that optometrists understand these objectives and actively work to help implement them at the national, state, and local levels. By doing this, they can help provide the services needed to reduce visual impairments and improve the vision of people in their communities.

Health Promotion↗
PubMed2005

Increasing lifestyle physical activity in patients with depression or other serious mental illness.

People with severe and persistent mental illness are more likely to be overweight and to suffer from obesity-related illnesses such as diabetes and heart disease than healthy individuals. Lifestyle change interventions that emphasize integrating physical activity into daily life have not been studied extensively in people with mental illness. The authors present the results of an initial feasibility study of a lifestyle modification program for individuals with serious mental illness. Thirty-nine individuals with depression or other serious mental illness were recruited from three different mental health facilities to attend an 18-week lifestyle intervention program promoting physical activity and healthy eating. At each session, participants discussed topics related to healthy lifestyle changes and participated in group walks. Data were collected at baseline, 6 weeks, and 18 weeks. The results demonstrated that individuals who have depression and other serious mental illnesses can participate in a lifestyle intervention program. Participants who attended the final follow-up session had lost weight over the course of the intervention. Study retention was a problem. However, the cost of this type of group-based lifestyle intervention was relatively low, so that such an intervention for this high-risk group may still be cost-effective.

Bipolar Disorder↗
PubMed1993

[Monitoring of arterial pressure according to the "womb to tomb" program taking into account the human chronome].

The concept of "chronome" is discussed in this article. A lot of data of monitoring of arterial blood pressure in healthy people from babies till senile people are reported. This chronobiologic approach allows to optimize diagnosis in a group of people with elevated blood pressure and to exclude people with false positive and false negative diagnosis of hypertension. At the same time physicians can optimize therapy of hypertensive people with taking into account chronotherapy principle.

Adolescent↗
PubMed2005

The ABCs of engagement in out-of-school-time programs.

The rapid growth of out-of-school time programs over the past five years has resulted in a dramatic increase in opportunities for young people. However, many programs have been ill defined, without appropriate attention to the developmental needs of children and adolescents and without the necessary elements in place to fully capture the interests and talents of youth. In this chapter, the author shows how constructs drawn from research in education can be applied to research and practice in the out-of-school-time arena, in an effort to learn how the field can more fully engage young people in activities and programs. With more and more research indicating positive connections between participation in safe, supportive, and challenging activity settings and healthy psychological and social adjustment, attempts to encourage engagement rather than casual participation are warranted. Researchers and practitioners need to be mindful that engagement results not just from showing up, but from the interplay of the affective, behavioral, and cognitive experiences of youth in these settings. Suggestions for designing growth-enhancing contexts that increase the likelihood of engagement are offered, as are suggestions for future research in this area.

Adolescent↗
PubMed1993

The year 2000 initiative: implications for comprehensive school health.

Implementing comprehensive school health programs presents one of our nation's key challenges for the 1990s and beyond. Whether we are talking about Goals 2000 or Healthy People 2000, we will meet the challenge only through the combined efforts of the education and health sectors working as partners at the national, state, and community levels and, perhaps most importantly, at the level of the individual elementary and secondary schools.

Adolescent↗
PubMed2006

Lower breastfeeding rates persist among the Special Supplemental Nutrition Program for Women, Infants, and Children participants, 1978-2003.

OBJECTIVE: We set out to compare rates of breastfeeding between women who participated in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) with those of non-WIC mothers from 1978 to 2003. METHODS: The Ross Laboratories Mothers Survey is a national survey designed to determine patterns of milk feeding during infancy. Mothers were asked to recall the type of milk fed to their infant in the hospital and during each month of age. Rates of breastfeeding in the hospital and at 6 months of age were evaluated. Logistic regression analyses identified significant predictors of breastfeeding in 2003. RESULTS: From 1978 through 2003, rates for the initiation of breastfeeding among WIC participants lagged behind those of non-WIC mothers by an average of 23.6 +/- 4.4 percentage points. At 6 months of age, the gap between WIC participants and non-WIC mothers (mean: 16.3 +/- 3.1 percentage points) steadily increased from 1978 through 2003 and exceeded 20% by 1999. Demographic factors that were significant and positive predictors of breastfeeding initiation in 2003 included some college education, living in the western region of the United States, not participating in the WIC program, having an infant of normal birth weight, primipary, and not working outside the home. For mothers of infants 6 months of age, WIC status was the strongest determinant of breastfeeding: mothers who were not enrolled in the WIC program were more than twice as likely to breastfeed at 6 months of age than mothers who participated in the WIC program. CONCLUSIONS: Breastfeeding rates among WIC participants have lagged behind those of non-WIC mothers for the last 25 years. The Healthy People 2010 goals for breastfeeding will not be reached without intervention. Food package and programmatic changes are needed to make the incentives for breastfeeding greater for WIC participants.

Animals↗
PubMed2000

Care for older persons. Are divisional programs meeting needs?

BACKGROUND: A national forum on healthy ageing was convened for divisions of general practice in November 1998. OBJECTIVE: Views of delegates were sought regarding divisional programs for older people related to the following areas: working in collaboration; integration; the context of the older person; ageism; and structural barriers. These areas were felt to influence success of current prospects for future programs for older people. DISCUSSION: Further communication, collaboration and integration appears essential to realise the potential that general practice offers to programs for older people. Issues from the forum are discussed in relation to relevant National General Practice Strategy Review and the changes introduced into the Medical Benefits Schedule in November 1999. Consideration of these themes will aid future divisional programs for older people.

Aged↗
PubMed2004

Childbearing practices in anadier Mennonite women.

Cross-cultural nursing practices call for attention to be paid to the unique beliefs and practices of the groups with which nurses come in contact. The Kanadier Mennonites are a conservative religious group who live in Alberta, Manitoba and Ontario. An exploratory, descriptive study was conducted with this group in southern Alberta to generate information about their health and illness beliefs. This article focuses on their knowledge, beliefs and practices in relation to childbearing. Interviews were conducted with 45 women, the majority of whom were married and had been born in Mexico. Among the sample there had been a range of one to 16 pregnancies. The participants noted that childbearing is not a topic openly discussed with others. Women learn about childbearing from their mothers and other women but also from physicians and books. During pregnancy there are particular activities to be avoided including the use of strong cleaning fluids and hand milking of cows. Foods such as milk need to be ingested to ensure a healthy pregnancy Prenatal care was not emphasized in Mexico nor has it become a customary practice in Canada but deliveries in hospital are the norm in both these countries. During the postpartum the women receive support from their immediate and extended family in order to recuperate. Nurses need to explore individual Kanadier Mennonite beliefs regarding childbearing and work with this group in developing acceptable health promotion programs to help ensure healthy pregnancy outcomes. The blending of nursing practice knowledge in a non-intrusive manner with a group of people with differing belief systems is a necessary and achievable goal.

Adult↗
PubMedDate not supplied

How can patient education help attain the objectives for the nation?

The publication of Healthy People and Promoting Health/Preventing Disease represents a milestone in the development of a national health promotion policy. The growth of patient education programs, one component of clinical preventive medicine, suggests an avenue for achievement of these health promotion objectives. I report the findings of surveys of patient education activities and programs, which found that a substantial number of patient education efforts address the Objectives for the Nation. I then discuss the results of an analysis of the Objectives for the Nation that found that 15.7% of the 370 measures pertain, either implicitly or explicitly, to patient education. I conclude by making suggestions for strengthening the links between patient education and health promotion policy.

American Hospital Association↗