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PubMed1992

A personal recovery program for codependent nurse practitioners.

Codependence is a progressive emotional and behavioral disease that makes life painful. Because of nursing's historical roots and the present role of advance-practice nurses in the health care system, nurse practitioners are at risk for developing this disease. Codependence interferes with nurse practitioner's job performance by causing dysfunctional interactions with supervisors, peers and subordinates. A personal program of recovery is the only way to halt the progress of this syndrome and to re-establish healthy work patterns. The stages of recovery from codependence are identification, awareness, reintegration and genesis. Tools of recovery include involvement in a 12 Step program, connecting with other recovering people, daily affirmations and meditations, and attending programs and workshops on codependence.

Compulsive Behavior↗
PubMed2000

Stages of dietary change and nutrition attitudes in the Spanish population.

UNLABELLED: A national survey was developed in a representative sample of the Spanish population (15 years old and upwards). This study belongs to a partnership in a pan-European survey about stages of dietary change where subjects were classified into six different categories according to their readiness for dietary change: precontemplation (not considering any changes), contemplation (considering changes), decision (making plans to change), action (carrying out the changes), maintenance (maintaining changes for more than six months) and relapse stage (reverting back to eating less healthily). The main objective was to investigate the distribution of the different stages of change concerning dietary habits across strata of socio-demographic variables (sex, age, educational level, socioeconomic level). Also, this study was conducted to assess the relationships between stages of dietary change and the influences on food choice as well as the definitions used to describe healthy eating. The survey was carried out, according to an established protocol, on a representative sample of 1009 Spanish subjects selected by an at random multistage procedure. Subjects completed a face-to-face interview-assisted questionnaire. To ensure representativeness data were weighted by population size, by sex, age and regional distribution. The proportion of subjects in precontemplation (56.0%) and maintenance (28.3%) stages was substantially larger than in the other stages of dietary change. More males (59.7%) and subjects from the oldest age groups (65.8%) were classified as belonging to the precontemplation stage, while more females (30.2%) and subjects between 25-34 years of age (34.5%) were in the maintenance stage. 'Trying to eat healthy' as an influence on food choice was more frequently mentioned by those in the dynamic and maintenance stages, while a high percentage of subjects from the precontemplation and relapse stages (61.1%) agreed they did not need to make changes to their diets because their diet was already sufficiently healthy. A very high proportion of the Spanish adult population do not contemplate a change in their dietary habits. Intervention strategies in health promotion programs should be available for people at the various stages of change. It would be more effective to attempt to increase people's awareness and personal concerns about nutrition and health, before introducing action strategies. IMPLICATIONS FOR RESEARCH AND PRACTICE: The adult population can be classified into different stages of dietary change, so the stages of change model may be applied to future nutrition interventions. This approach will help to focus more accurately strategies of nutrition education.

Adolescent↗
PubMed2003

[Estimation of motor ranges and muscle strength in cervical spine after total laryngectomy].

After total laryngectomy and after complementary treatment (radiotherapy) there are many functional disorders in the range of head and neck. It was observed, that muscles of this area became weakened with simultaneous increase of their rest tension. These changes affect reduction of physiological motor range of the cervical spine. Comparison of function of cervical muscle between patients after total laryngectomy and healthy people allows to characterize defects of neck movements. Detailed estimation of muscle strength and move range in cervical spine after total laryngectomy will enable application of effective physiotherapy program.

Adult↗
PubMed1986

Adolescent pregnancy: the perspective of the sisterhood of black single mothers.

The Sisterhood of Black Single Mothers Inc. (The Sisterhood) is an organization which exemplifies the considerable potential of community members united for a common good. The Sisterhood began eleven years ago under the leadership of Ms. Daphne Busby. The objective of the Sisterhood is "salvation of a generation subject to insensitivity and misunderstanding--through helping families, especially those headed by women and adolescent women--to establish a new and positive mind set." The Sisterhood regards individuals and social phenomenon as parts of a complex and dynamic whole and uses a positive approach to assessment of situations. Therefore, adolescents who come to the Sisterhood already parents, as well as those who may become parents in their formative years, are provided programming appropriate to their overall needs. They are given opportunities for help in such areas as: securing medical care, public assistance, counseling, housing and financial assistance. Outreach to other significant persons in the life of these adolescents includes intervention with the service providers with whom they come in contact (doctors, teachers, social workers etc.). In addition to addressing the practical needs of adolescents who come to the Sisterhood, positive examples of healthy ways of relating to others and presentation of a system of values consonant with self and family development are provided. Examples are: the Youth Awareness Project (YAP) which deals with concerns of young people as a specific group. The program's focus is bringing young people together who are growing in positive ways and encouraging continuation of that growth.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Periodontal condition of pregnant women assessed by CPITN.

The periodontal conditions of 2424 pregnant and 1565 non-pregnant women were assessed according to the community periodontal index of treatment needs (CPITN). The aim of this survey was to obtain information which is necessary for the planning of preventive programs of periodontal disease for pregnant women. 95% of the pregnant women and 96% of the non-pregnant women had some signs of periodontal disease. The % of pregnant women having 4 or 5 mm pockets was significantly higher than that of non-pregnant women, increased with the month of pregnancy, reached a maximum of 31% in the 8-month group, but decreased to the control level in the 9-month group. These changes were interpreted to suggest that the increase of pocket depth during pregnancy was caused by gingival enlargement rather than by periodontal destruction. The results show that pregnant women had a healthier periodontal condition when compared with non-pregnant women, i.e., the number of sextants with healthy periodontal tissues was higher, the % of people having deep pockets (6 mm or deeper) was lower, and the need for prophylaxis was lower in pregnant than in non-pregnant women. These findings suggest that a special program of periodontal disease prevention for pregnant women is not necessary.

Adolescent↗
PubMed1998

The anaerobic threshold in cystic fibrosis: comparison of V-slope method, lactate turn points, and Conconi test.

Physical exercise can improve sputum clearance in patients with cystic fibrosis (CF). To set up individual training protocols it is desirable to know the anaerobic threshold (AT). Established methods such as blood lactate measurements and ergometry can only be performed in specialized centers. Conconi showed that the heart rate threshold (HRT), i.e., the deflection point from the linear relationship between work load and heart rate, correlated significantly with the AT in healthy adults. To assess the reliability of the HRT in CF, we performed ergometry in 32 CF patients (mean age, 21.0 +/- 5.5 years; mean Shwachman score, 77.8 +/- 12.0) according to the Conconi protocol. The HRT was compared with the aerobic threshold (AeT) as determined by the V-slope method and with two turn points in the lactate performance curve (LTP1, LTP2). An HRT could be obtained in only 17 of the 32 patients (53%). In these 17 patients there was a significant correlation between HRT and the other thresholds, but the absolute values for the AT differed considerably: The mean HRT was 132% higher than the AeT according to Beaver, 107% higher than LTP1, and 19% higher than LTP2. Exercise protocols that rely solely on the HRT in CF will lead to excessive exertion during exercise training programs in these patients. According to these results the HRT of Conconi is not a suitable method to determine appropriate exercise levels in CF training programs and might even be harmful in CF patients. These results also indicate the need to test the reliability of a diagnostic procedure that has been developed only for healthy people.

Adolescent↗
PubMed1995

Public education projects in skin cancer. Experience of the Canadian Dermatology Association.

The mandate of the Canadian Dermatology Association's Sun Awareness Program is to increase awareness of the dangers of the sun's ultraviolet (UV) rays and to provide information on prevention and early detection of skin cancer. Major projects include an annual national press campaign, which reaches an increasing number of Canadians each year, and the production and distribution of educational materials. Each year during Sun Awareness Week, screening stations have been established across the country, staffed by volunteer dermatologists and members of the Canadian Cancer Society. In Vancouver between 1991 and 1993, 1767 people were screened for skin cancer. Results indicate that these events can attract people at risk for skin cancer, even though people older than age 65 are probably underrepresented as a group. Although popular with the public, these screenings are difficult to organize and are limited by human resources. These events continue in limited numbers, because they provide an excellent venue for the dissemination of educational material. Cooperation with federal agencies has been a major focus of the program. For the past 2 years, educational material on protecting newborns and children from the sun has been made available free to every new mother in Canada, while Environment Canada's Ultraviolet index program provides daily information on UV intensity along with public health messages. With the realization that health promotion requires a sustained change in behavior of an individual, we are now embarking on a national program to evaluate the knowledge, attitudes, and behavior of Canadians concerning UV radiation. With this information, we hope to adapt our educational materials so that people will adopt and maintain healthy behavior choices while out in the sun.

Adolescent↗
PubMed2003

Emancipatory education versus school-based prevention in African American communities.

Schools have become strategic settings for the work of community psychologists. In a review of 177 primary prevention programs for children and adolescents, Durlak and Wells (1997) found that 129 (72.9%) were based in schools. The literature in community psychology describes many school-based prevention programs targeting problems such as substance abuse, school "maladjustment," delinquency, and violence (e.g. C. A. Mason, A. M. Cauce, L. Robinson & G. W. Harper, 1999). A large number of these programs are based in schools in African American communities and include social-cognitive, decision making, affective education, and other skills-building modules along with direct instruction. In this paper, it is argued that ideas from emancipatory education (e.g. Freire, 1998) and African-centered education (e.g. H. Madhubuti & S. Madhubuti, 1994; M. J. Shujaa, 1995) should guide school-based interventions in communities of people of African descent. There is an extensive and distinguished history of emancipatory schools and school-based programs in African American communities. Included in this history are the freedom schools during reconstruction, the SNCC Freedom Schools, the Liberation Schools of the Black Panther Party, the Malcolm X Academy in Detroit, Sankofa Shule in Lansing, the Institute for Positive Education/New Concept Development Center in Chicago, the Benjamin E. Mays Institute in Hartford, and the schools affiliated with the Council of Independent Black Institutions (CIBI) to name just a few. This paper will first provide a brief, critical review of the role of schools and social oppression. Second, primary prevention programs in communities of people of African descent will be examined, questioning some of the dominant methods and assumptions. Next, underlying assumptions about relationships between African identity, educational success, and healthy outcomes for young people will be addressed. This will be followed by a discussion of African-centered emancipatory education, focusing specifically on the role of students as agents of social change and the importance of critical reflection on African cultural resources. The Benjamin E. Mays Institute will be presented as an example of how ideas from an African-centered emancipatory approach to education have been incorporated within a school serving a community of people of African descent in Hartford, Connecticut.

Adolescent↗
PubMed2000

Examining the nutritional status of independently living elderly.

As more and more people age, the idea of quality, not just quantity, of life becomes increasingly important. Healthcare professionals and community planners need to look at programs aimed at keeping the elderly as healthy as possible for as long as possible. To accomplish this, having a profile of the needs of this population in all possible settings is important. The purpose of this study was to examine wellness behaviors and nutrition in a group of independently living elderly. Wellness behaviors and health practices were generally positive in this study. However, the author identified several areas of deficiencies including performing breast and testicular self-examinations, staying asleep, medication use, exercising and weight maintenance, and eating (dietary patterns). Healthcare professionals need to take nutrition seriously. Although poor nutrition is a risk factor for pressure ulcers, delays wound healing, and increases mortality when someone is ill, effects of poor nutrition are often overlooked when the person is healthy and active. Results of this study show that health professionals need to include nutritional assessment as an important component of any examination in community, acute care, and long-term care settings.

Activities of Daily Living↗
PubMed2004

[Health behavior and its rational in the perception of employees in medium-size and large companies].

BACKGROUND: The paper presents beliefs of employees working in Polish medium-size and large enterprises concerning the most essential aspects of healthy lifestyles and reasons for undertaking particular activities. MATERIALS AND METHODS: In the study, carried out in 2002, questionnaire-based interviews were taken in a group of 1134 employees of 250 Polish enterprises employing 100 or more workers. RESULTS: The following forms of taking care of one's own health were perceived by the respondents as the best ones: healthy nutrition (68%); physical activity and fitness (46%); adequate rest and relaxation (45%); coping with stress (35%); and regular health checkups (34%). There are various reasons why respondents undertake particular activities. Among them willingness to take care of their own good health (79%); maintaining fitness (72%); and enhancing work ability (67%) were most frequently reported. Ill health and illness were less often mentioned (57% and 43%, respectively). Taking care of health is rather motivated by the will to avoid the dependence on negatively perceived health care institutions than by fear of discomfort due to ill health or occurrence of an illness. Health enhancing activities are more often undertaken by better educated, wealthier and younger people, while in case of illness, the opposite groups become more active. CONCLUSIONS: Social differences in motivation for healthy behaviors stress the need to apply various methods in health promotion programs to be able to influence target social groups.

Adult↗
PubMedDate not supplied

California's "5 a day--for better health!" campaign: an innovative population-based effort to effect large-scale dietary change.

The annual toll of diet-related diseases in the United States is similar to that taken by tobacco, but less progress has been achieved in reaching the Public Health Service's Healthy People 2000 objectives for improving food consumption than for reducing tobacco use. In 1988, the California Department of Health Services embarked upon an innovative multi-year social marketing program to increase fruit and vegetable consumption. The 5 a Day--for Better Health! Campaign had several distinctive features, including its simple, positive, behavior-specific message to eat 5 servings of fruits and vegetables every day as part of a low-fat, high fiber diet; its use of mass media; its partnership between the state health department and the produce and supermarket industries; and its extensive use of point-of-purchase messages. Over its nearly three years of operation in California, the 5 a Day Campaign appears to have raised public awareness that fruits and vegetables help reduce cancer risk, increased fruit and vegetable consumption in major population segments, and created an ongoing partnership between public health and agribusiness that has allowed extension of the campaign to other population segments, namely children and Latino adults. In 1991 the campaign was adopted as a national initiative by the National Cancer Institute and the Produce for Better Health Foundation. By 1994, over 700 industry organizations and 48 states, territories, and the District of Columbia were licensed to participate. Preventive medicine practitioners and others involved in health promotion may build upon the 5 a Day Campaign experience in developing and implementing efforts to reach the nation's dietary goals.

California↗
PubMed1996

Assessing mammography rates for Medicaid recipients age 50 to 65 years using claims data from a southeastern state.

A retrospective Medicaid claims data analysis for physician-submitted mammography procedure codes was performed for all continuously eligible female Louisiana Medicaid recipients in 1994. The study measured mammography screening and diagnostic radiology procedures, using CPT coding logic. The study population consisted of 19,688 female Medicaid recipients, age 50 to 65, comprising 55% of the total female Medicaid recipients within Louisiana. In this cohort, 18.3% received a mammogram, with approximately 50% being diagnostic mammography procedures. No significant racial difference in utilization of mammography was found for this population. This claims data analysis suggests that Louisiana's Medicaid population appears to be underserved with respect to mammography screening. The authors conclude that community, physician, and public health resources would be well served to place more emphasis on educational and other outreach programs. Louisiana has to increase its rates for Medicaid recipients by 50% to meet the goal of screening 60% of eligible women every 2 years as set forth in Healthy people 2000, by the United States Public Health Service.

Aged↗
PubMed1997

A successful tobacco cessation program led by primary care nurses in a managed care setting.

We conducted a descriptive study of a tobacco cessation program sponsored by a health maintenance organization (HMO) and led by primary care nurses. The tobacco cessation program was conducted at 20 primary care clinics in northeastern and central Pennsylvania. We gauged the successfulness of the program by the patients' self-reported quit rates at 1 year. We also examined the association between quit rates and compliance with scheduled counseling visits, the impact of the availability of an HMO pharmacy benefit that supported the costs of nicotine replacement therapy, and the quit rates among patients with HMO insurance versus those with insurance other than managed care. Of 1,695 patients enrolled in the program from July 1993 to March 1996, 1,140 completed 1 year of follow-up. Of these, 348 (30.5%) reported they had quit using tobacco. Among the 810 HMO enrollees who participated in the program, the quit rate was 280 (34.6%); among the 330 non-HMO participants, the quit rate was 69 (20.9%), a statistically significant difference (P < 0.001). For all patients, keeping more than four visits with the program nurse was associated with a significantly higher likelihood of quitting (317/751 [42.2%] versus 32/389 [8.2%]; P < 0.001). Non-HMO patients were less likely than HMO enrollees to keep four or more visits (165 [50%] versus 586 [72.3%]; P < 0.001). We were unable to detect a difference in quit rates among those with and those without a pharmacy benefit (196/577 [34%] versus 84/233 [36.1%]). These data are limited by their descriptive nature and the lack of information about other factors important in determining the quit rate among program participants. Nevertheless, they suggest that HMOs can successfully sponsor nurse-led tobacco cessation programs in multiple primary care settings and achieve 1-year quit rates significantly higher than the 15% quit rate reported in the medical literature. In addition, successfully quitting tobacco use appeared to be associated with use of counseling visits but not with use of a pharmacy benefit to pay for nicotine replacement therapy. Even though tobacco cessation programs have the best chance of benefitting HMO enrollees, patients not enrolled in managed care plans also appear to benefit significantly. This finding has important implications for developing future strategies--including the role of managed care organizations, the need to defray the costs of nicotine replacement therapy, and the best approach to provide counseling to patients--to meet the Healthy People 2000 goal of reducing tobacco smoking.

Administration, Cutaneous↗
PubMedDate not supplied

Healthy People 2010: implications for orthopaedic nurses.

Healthy People 2010 is the latest publication developed by the United States Public Health Service (USDHSS, 2000) to identify the most significant and preventable threats to health and to establish national goals to reduce these threats. This document contains two major goals, 467 objectives, 28 focus areas, and 10 leading indicators. Orthopaedic nurses are in ideal positions to assume leadership roles in promoting healthier behaviors in neighborhoods and communities as individuals, groups, and organizations begin to incorporate Healthy People 2010 into health promotion planning. Healthy People 2010 is designed to be a valuable resource for participating most effectively in improving the nation's health. By using this document to plan health promotion and disease prevention programs, orthopaedic nurses, regardless of practice setting, can impact the health of future generations of Americans.

Health Policy↗
PubMed1995

[Activity of superoxide dismutase in erythrocytes and leukocytes and levels of zinc and copper in blood of patients with diabetes. Effect of diabetic treatment on examined parameters].

UNLABELLED: The purpose of the present work was to assess the relationship of leukocyte and erythrocyte superoxide dismutase activity to its cofactors concentrations i.e. zinc and copper in plasma and erythrocyte in diabetic patients and treatment variability. 104 patients were included in the study. 23 persons were in the control group. All patients were divided into 2 groups (NIDDM and IDDM). Patients with NIDDM were divided into 3 subgroups depending on treatment (insulin, gliclazide, dietary treated). In all groups, there were assessed following parameters: the leucocyte and erythrocyte SOD activity according to the method of Misra and Fridovich, and zinc and copper concentrations in plasma and erythrocyte, which were measured by flame absorption spectrophotometry. Statistical analysis was performed using the CRISP program. CONCLUSION: 1. The leukocyte and erythrocyte superoxide dismutase activity is significantly lowered in diabetes mellitus. 2. In diabetic patients both in type I and type II as in the healthy people, there is a close correlation between SOD activity and its cofactors i.e. zinc and copper erythrocyte concentrations. 3. Insulin and gliclazide treatment increases SOD activity and delays late diabetic complications.

Adolescent↗