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At least 631 records · Page 35Linked to original sources
PubMed2000

A longitudinal study of young Finnish adults' use of subsidized, private sector dental care, 1986-1997.

OBJECTIVES: Finns born after 1956 are now entitled to subsidized private sector dental care, or such persons could be enrolled in the Public Dental Service. Until 1986, eligibility was more restrictive. The purpose of this study was to investigate the use and costs of private dental care and effects of regularity of care on costs and treatment received among young Finnish adults during 1986-1997. METHODS: All 1986, 1990 and 1994 recipients of reimbursement for dental care from the Social Insurance Institution were included in the study. Five separate age cohorts were compared. Using their civil registration numbers, individuals were tracked from their first contact with a private dentist in one of the years 1986, 1990 or 1994 until the year 1997. RESULTS: While the total number of young adults who had received reimbursement for private dental care increased from about 53000 (1986) to 200000 (1994) due to extended eligibility, the number of users in the youngest group decreased from 53000 to 23000. Attending infrequently (1-2 times during the study period) was most common among the youngest adults and frequent attendance (annually) was most common among older adults. The annual mean cost was slightly lower among the frequent attenders in almost every cohort. Variation in the mean number of annual visits was directly correlated with costs. Frequent attenders most often received diagnostic and preventive measures while restorations and surgery were most common for the infrequent attenders. CONCLUSIONS: A substantial decline in the demand for private services among the 19-25-year-olds and stable demand among 26-34-year-olds was detected, indicating falling treatment needs or a preference for the Public Dental Service. All groups had a stable mean number of visits per year and almost constant costs. The mean number of dental visits per year remained steady in all cohorts indicating rigid treatment patterns.

Adult↗
PubMed2000

The role of the dental hygienist in the public health sector; an Australian perspective.

A review of the literature on dental hygienists and their utilisation in the dental workforce is presented. Dental hygienists are employed as part of a dental team in the prevention and management of the two most common and costly oral diseases; dental caries and periodontal disease. The potential scope for dental hygienists in the public health sector in Australia is examined in the light of broader issues relating to changing disease patterns, service delivery and the treatment of patients with special needs. Prevention and treatment of oral disease by the dental hygienist in schools, institutions, nursing homes, hospitals and residential facilities is discussed, with emphasis on such issues as legislation, productivity and quality assurance. Implications for the future training of dental hygienists are presented and recommendations made for increasing their utilisation in the public sector.

Australia↗
PubMed1999

Health needs of lone elderly Chinese men with heart disease during their hospitalization.

Hospitalization is a unique health-illness transition for most elderly people. Whether the patient's health-related needs are met or not often influence his or her appraisal of quality of life during hospitalization. This qualitative study explored the health needs of elderly Chinese male cardiac patients during their hospitalization. Eighteen subjects were recruited from a veterans' hospital in northern Taiwan. These men all lived alone before their hospital admission. Data were gathered using semistructured interviews and then analysed by content analysis. Ninety-four per cent of the subjects described up to three categories of needs: met needs (72%), unmet needs (78%), and expected needs (50%). Needs that participants believed were met were those for psychological support, spiritual support, tangible support and information. Unmet needs were those for participation in decision making, maintaining daily activities and resuming a preadmission lifestyle. The expected needs included those for learning self-care strategies to maintain their daily activities after discharge from the hospital. The factors that framed the participants' perceptions of different health needs were identified to be lack of family support and locus of control. Finally, a discussion of the context background of this phenomenon, as well as some suggestions for its implications, are provided from a culturally sensitive ethical aspect.

Aged↗
PubMed2000

Global health challenges: trends in public health training, research and advocacy.

As we begin the 21st century, public health is at the crossroads in trying to understand the relative importance of health determinants in risk exposures, and the collective susceptibility of our societies. Classically conditioned attitudes of investigation, instruction, and exposition in the management of acute disease breaks down, when disease surveillance becomes virtually useless as in the prevention of chronic conditions. Older populations, new lifestyle changes, environmental hazards and urbanization have converged to make social class and poverty predominant factors in the expression of morbidity and mortality. In the process, the comfort of specific disease eradication is replaced by continuous challenges in dealing with the dynamics of social change--behaviors in diet and exercise--as well as the globalization of poverty, addiction, injury and violence. The consequent dilemma to develop a base for public health intervention, a strategy for training and a platform for advocacy for health improvement shows an eclectic pattern. The traditional clinically oriented perspective has moved towards a comprehensive population-based disease management model. A second trend with a somewhat narrowed vision for public health is the one focused on cost containment limiting preventive care. As technological advances in genetics and medicine and health informatics brings more rational, evidence based management in health care, two major gaps in public health training continues to persist. One is the lack of adequate attention to social class and poverty as a major pervasive factor. The other relates to the inability to address effectively, injury, violence, and mini wars diluting the value perspectives and advocacy in public health.

Communicable Disease Control↗
PubMed2001

Rationalizing the dental curriculum in light of current disease prevalence and patient demand for treatment: form vs. content.

The premise of this paper is that the form and content of dental education do not reinforce each other. What results is suboptimal learning; dissatisfied students; difficulty generating excitement among the brightest to consider careers in dental education; erosion of dentists' self-identity as men and women of science; and doubts over whether dental schools can continue as the primary providers of oral health education. A need for reform exists because dental curricula must be responsive to changes in current and projected disease demographics, to advances in science and technology, and to a changing societal culture affecting patient demand for treatment. Today's dilemma is that dental schools need to continue to graduate competent practitioners to meet present clinical needs while also preparing students for a radically different kind of practice in the future. Possible approaches to resolve this dilemma include: a shift between what constitutes general practice and what constitutes specialty practice; and, the implementation of an asynchronous-distributed model of dental education. Such changes will likely be independently accompanied by changes in the role of universities in society in general that could make feasible many, now-unthinkable, alternative vehicles for providing dental education.

Credentialing↗
PubMed2000

Community Participation in Nutrition Communication: Models and Linkage Systems for Management.

New models of community participation, nutrition communication, and management linkages have been proposed. Changes in the health care sector have forced a major restructuring of facilities and a shifting of focus from traditional institution-based health care to a more community-based delivery of services, and from treatment to health promotion and disease prevention. These changes have also led to a redefinition of community clients and a review of the social processes whereby community members can participate actively in their health care. Challenges for health and nutrition professionals are to create manageable environments for meaningful dialogues, and to communicate action-oriented nutrition messages that reflect the community's values and realities. Some theories on learning and behaviour change can be applied to and aid in nutrition communication. At the same time, facilitators of and barriers to community participation in nutrition communication programs must be identified and addressed. In addition, during this time of health care transition, dietitians and nutritionists must position themselves as leaders in health and nutrition communication so that the community will act on their messages. Partnerships or linkages between organizations at the local, national, and international levels can assist in the effective delivery of nutrition information.

Journal Article↗
PubMed2005

Attachment in older adulthood: concept clarification.

AIMS: This paper is an analysis to clarify the concept of attachment by: (1) specifying the antecedents of attachment in older adulthood, (2) describing the defining or critical attributes of attachment as relevant for development beyond adulthood, including older adulthood and old age, and (3) specifying the consequences of attachment in older adulthood. BACKGROUND: Attachment is a concept that has been studied both within and outside the discipline of nursing. Most of the scholarly work on the concept has involved investigations of the concept as it applies at very early developmental phases of the lifespan. Despite this concentration of effort on the concept in childhood, theorists have consistently called for attention to the concept in adulthood and older adulthood to advance our understanding of how such close and supportive relationships relate to health. RESULTS: Antecedents of attachment behaviour include any number of fear-provoking or challenging situations, as well as interactions that involve conflict. Illnesses commonly have these characteristics and so are broadly included as antecedents. Defining attributes of attachment behaviour include three distinct behaviours: (1) proximity, or keeping to one or more 'preferred others', (2) protest following involuntary and perceived permanent separation from a preferred other and, (3) the presence of a secure base, viewed as necessary for developmental exploration and growth. Consequences include environmental interaction secure in the belief that a safe haven exists should reliable clues to danger present themselves, and the mobilization of personal and interpersonal assets called developmental resources. CONCLUSIONS: Nursing implications include the ability of nurses to intervene positively with older clients who may be experiencing age-related transitions that affect health. Knowledge about attachment will help nurses mediate the potentially negative impact of health transitions on developmental tasks and promote high-level wellness and successful ageing.

Aged↗
PubMedDate not supplied

Transition of adolescents with special health care needs: review and analysis of the literature.

A review and analysis of 43 transition studies published from 1982 through 2003 was conducted. The studies reviewed represent the diverse purposes of international researchers for examining transition issues and questions. Findings of this literature review indicate that transition research is in early stages of development. A number of limitations were associated with these studies, including the lack of theoretical frameworks, the use of valid and reliable instruments, and research designs lacking adequate controls. Future research studies are needed that overcome the design limitations of past investigations.

Adolescent↗
PubMedDate not supplied

Social marketing as a tool to improve behavioral health services for underserved populations in transition countries.

Human development efforts continue to change the world and improve quality of life for humans. Without the struggle and drive to contemplate new ideas to improve society, the global community would be in a constant state of oppression. Although cultures and norms change as international boundaries are crossed, the universal goal is to improve standards of living to include behavioral health services for underserved populations. In recent times, pioneers and community groups have used social marketing as an instrument to change public perceptions and behaviors within societies. These efforts have transformed nations in the acceptance and understanding of community health and rehabilitation, education, service, and human rights. This article examines the justification for utilization of the concepts and tools of social marketing to bring about proactive behavior modification among segments of underserved populations. A section of this article provides an overview of the basics of social marketing for the benefit of makers of health policy in transition countries. Finally, the case of 2 underserved population segments in the Republic of Slovakia, a new member of the European Union (former socialist block member), is examined for possible implementation.

Developing Countries↗
PubMed1998

Cost effectiveness of screening for subclinical hypothyroidism in the elderly. A decision-analytical model.

OBJECTIVE: The value of early detection of subclinical hypothyroidism is the object of a long lasting debate. In this study, we assessed the cost effectiveness of a policy based upon screening for this condition through thyroid-stimulating hormone (TSH), triiodothyronine (T3) and thyroxine (T4) serum level measurements in the elderly. DESIGN: A Markov model was developed where hypothetical elderly patients (i.e. > or = 60 years of age), who attend general practitioner (GP) clinics for periodic health examinations in a primary-care setting in Italy, made transitions between health states at annual interval for 15 years, thus allowing an estimation of the average cost and of the expected average number of quality-adjusted life-years (QALY). In this model, patients were assumed to be seen at annual intervals by GPs for clinical examination and serum cholesterol level measurement, to which a TSH, T3 and T4 serum measurement was added. In the base-case analysis, TSH was measured every 5 years and, if abnormal, T3 and T4 serum levels were also determined. Costs were analysed from the perspective of the Italian National Health Service (NHS) and reflected 1996 values. MAIN OUTCOME MEASURES AND RESULTS: In the base-case analysis, the additional benefit estimated from testing a female population for subclinical hypothyroidism every 5 years was 0.36 QALY, with a cost per QALY gained of 668,298 lire (L). The expected gain in QALY for men was 0.20 and the cost per QALY gained was L270,322. In general, the best cost-effectiveness profile was seen with testing every 3 years. Results were sensitive to variations in the prevalence of disease among the target population, both in men and women. CONCLUSIONS: Our study indicates that a screening policy for subclinical hypothyroidism in the elderly population could be worthwhile. However, as the costs could be significant when applied at the population level, this policy deserves further assessment through well-designed primary research.

Aged↗
PubMed2004

The transition from good to poor health: an econometric study of the older population.

This is a study of the influence of socioeconomic factors on the state of health of older Canadians. Three years of panel data from the Survey of Labour and Income Dynamics are used to model the transition probabilities between good and poor health. Care is taken to avoid the problem of endogeneity of income in modelling its effects, and to adjust reported income to free it from its strong association with age at the time of the survey. Of particular note are the significant effects found for income, in spite of universal public health care coverage. Significant effects are found also for age, education, and other variables.

Age Factors↗
PubMedDate not supplied

[The transition from 'international' to 'global' public health and the World Health Organization].

Within the context of international public health, 'global health' seems to be emerging as a recognized term of preference. This article presents a critical analysis of the meaning and importance of 'global health' and situates its growing popularity within a historical context. A specific focus of this work is the role of the World Health Organization - WHO in both 'international' and 'global' health, and as na agent of transition from one to the other. Between 1948 and 1998, the WHO went through a period of hardship as it came up against an organizational crisis, budget cuts and a diminished status, especially when confronted with the growing influence of new, power players like the World Bank. We suggest that the WHO has responded to this changing international context by inititating its own process of restructuring and repositioning as an agent for coordinating, strategically planning and leading 'global health' initiatives.

Global Health↗
PubMed2002

Transition: a future promise for children and adolescents with special health care needs and disabilities.

Transitions are a part of everyone's life experience. Most young people with special health care needs and disabilities (SHCN/D) become independent partners in adult society, but some need deliberate guidance and support. This latter group is growing in number. Through a new consensus statement from the American Academy of Pediatrics and the U.S. Federal Government (Healthy People 2010), society is recognizing the need to assist young people with SHCN/D in attaining their potential in adulthood. This article discusses the growing number of young people with SHCN/D, their desires for their transition, the definition and areas of transition that should be addressed, and the key elements of successful transition programs. The article ends with a suggested list of actions a health care professional can undertake to foster a successful transition and a selected list of helpful resources for health professionals, families, and young people with SHCN/D.

Activities of Daily Living↗