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PubMed2005

Undergraduate dietetics programs do not support training students in smoking cessation.

Although tobacco use is the leading contributor to death and disability in the United States, allied health professionals often lack knowledge of smoking cessation techniques. The objective of this study was to identify the extent to which undergraduate dietetics programs (referred to as didactic programs in dietetics [DPD]) teach about tobacco and smoking cessation interventions and also DPD directors' opinions regarding tobacco and smoking cessation in dietetics education. All DPD directors in the United States (n=231) were sent a questionnaire to assess programs' and directors' demographics, courses that included tobacco and smoking cessation education, and directors' opinions pertaining to tobacco and smoking cessation education. The response rate was 49% (n=113). On average, DPD directors did not agree that tobacco and smoking cessation education should be a formal part of undergraduate dietetics programs and that it is not as important as other content areas required of dietetics students. Just 37% of directors believed that a dietitian's job responsibility included educating patients on smoking cessation. Only 7% of DPD directors had formal education on smoking cessation and tobacco use, but 53% had formal education on behavior modification. More than half of DPD programs (56%) did not offer any courses that provided tobacco and smoking cessation education. These results indicate that most undergraduate dietetics programs do not incorporate tobacco and smoking cessation education in their curricula. Dietetics and other allied health educators could consider including smoking cessation education in their curricula to ensure that future health professionals can contribute to Healthy People 2010 objectives related to smoking cessation.

Behavior Therapy↗
PubMed2001

Diet and drug therapy: a dynamic duo for reducing coronary heart disease risk.

A large proportion of the United States population requires aggressive low-density lipoprotein (LDL) cholesterol- lowering therapy to meet the new treatment guidelines established by the National Cholesterol Education Program Adult Treatment Panel III. This has further widened the gap between the number of people being treated compared with those who should be treated. Moreover, many people being treated do not meet their LDL cholesterol goal. Diet and healthy lifestyle practices remain the cornerstone of treatment to lower LDL cholesterol. Pharmacologic therapy has assumed an increasingly important role in reaching LDL cholesterol goals. Diet and healthy-lifestyle interventions have been shown to augment the benefits of cholesterol-lowering drugs. Together, this dynamic duo provides the most effective clinical means identified to date for maximally lowering LDL cholesterol levels.

Anticholesteremic Agents↗
PubMed2005

The role of a fitness intervention on people with serious psychiatric disabilities.

The purpose of this study was to determine the effects a health education and exercise program would have in limiting weight gain and in improving fitness and psychological parameters in adults with mood or psychotic disorders. Thirty volunteers were randomly assigned to the healthy lifestyle group (HL) or a control group. The HL group engaged in exercise for 12 weeks. Pre- and post-exercise testing was conducted to assess body fat, lipid profile, and cardiovascular fitness. Educational seminars were held weekly. The intervention group evidenced greater weight loss than the control group, although not statistically significant. Significant differences were observed in ratings of general health (p < .05) and empowerment (p < .01). Trends suggest that exercise interventions may encourage weight loss, particularly if barriers to full participation can be addressed. Additionally, such interventions may contribute to "perceived" well-being even among those with subclinical participation.

Adult↗
PubMed2001

[Wellness holidays--wholesome wish or one-sided reality].

The term wellness is widely used in European tourism. The principal observations regarding the wellness industry concern an expanding supply of and an insufficiently researched demand for wellness programs. The quality dimension of wellness services is increasingly becoming the decisive competitive factor. For this reason quality management plays an important role. Market research shows that average 3- to 5-star hotels provide fairly comprehensive wellness facilities. Wellness hotels should therefore specialize in health information, individual care and a wide range of cultural and relaxation programs. Although the same hotel can host cure and wellness guests at the same time, these two segments have to be considered separately when deciding on the marketing strategy. We therefore assume that wellness is pursued solely by 'healthy' people, the prime aim being prevention. 'Normal cure guests' aim to heal their illness.

Balneology↗
PubMed1996

The Washington Heights-Inwood Healthy Heart Program: a 6-year report from a disadvantaged urban setting.

OBJECTIVES: This report summarizes 6 years of experience in a large community-based cardiovascular disease prevention program in a predominately minority, urban setting. METHODS: The program seeks to reduce cardiovascular disease risk factors in an area of approximately 240,000 people in New York, NY; this population includes many Latino immigrants of low educational attainment and socioeconomic status. All program materials were in Spanish and English and at a low literacy level. RESULTS: Major elements that achieved high levels of reach and support were a marketing campaign promoting low-fat milk, exercise clubs, and a Spanish-language smoking cessation video. Program elements that did not meet expectations or were abandoned were school-based smoking prevention initiatives, cholesterol screening, and efforts to involve local physicians. At the end of 6 years, the program was transferred to a local community organization. CONCLUSIONS: Conclusions are that it is feasible to implement a complex cardiovascular disease prevention program in a socially disadvantaged urban community; that additional evaluation research is needed; that such programs can be transferred from an academic center to a community organization; and that such programs are unlikely to be sustained effectively without external resources.

Attitude of Health Personnel↗
PubMed2006

Epidemiological studies on Bartonella quintana infections among homeless people in Tokyo, Japan.

In an epidemiological investigation of trench fever in Japan, we compared the seroprevalence of Bartonella quintana in homeless people and in the general population. In homeless rescue outreach programs held in Tokyo from May 2001 to March 2003, 151 blood samples were taken from non-hospitalized homeless people. The prevalence of IgM and IgG antibodies against B. quintana in these people was compared with that in 200 healthy blood donors using a commercially available indirect fluorescent antibody test. Although IgG titers of > or = 1:128 were found in 57% (86/151) of homeless people and 51% (101/200) of blood donors, high titers of > or = to 1:1,024 were encountered only in homeless people (11%, 16/151). Attempts to isolate B. quintana from the blood of homeless people were unsuccessful, but polymerase chain reaction based detection, using Bartonella genus specific primers, demonstrated the presence of B. quintana DNA in the blood of 10 homeless people. Our data suggest that urban trench fever is endemic among the Japanese homeless population.

Adult↗
PubMed2003

Comprehensive health care for women in Georgia.

In summary, comprehensive health care for women begins first with a paradigm shift that acknowledges women's health is more than reproductive health. Second, it requires viewing women's health issues from an across the lifespan perspective. This perspective includes addressing women's health beginning with the formative years, through reproductive health and sexuality to the frail elderly. The OWH has launched a statewide effort, with input from the leadership of Georgia, including an eleven-member advisory council attached to the office to develop a comprehensive women's health plan. The OWH will partner with public and private organizations, academic institutions and other government agencies to devise a course of action that addresses the health needs of all women, of all ages, including racial and ethnic backgrounds, and socioeconomic and education levels. This plan will serve as a guide for those organizations whose interest is meeting Healthy People 2010 broad objective of increasing the quality and years of healthy life for women.

Comprehensive Health Care↗
PubMed2006

Change for Life/Cambia tu vida: A health promotion program based on the stages of change model for African descendent and Latino adults in New Hampshire.

Studies have shown that diabetes and cardiovascular disease can be controlled and prevented through the modification of behavioral risk factors. The transtheoretical model of behavior change, also known as the stages of change model, offers promise for designing behavior change interventions. However, this model has rarely been applied in group settings with minority communities. To address racial and ethnic disparities related to the risk for diabetes and cardiovascular disease, the New Hampshire REACH 2010 Initiative has designed and implemented Change for Life/Cambia tu vida, a health promotion program based on the stages of change model for African descendent and Latino residents of southern New Hampshire. The program guides participants through the five stages of change and provides resources to support healthy behavior change. We also sponsor periodic class reunions that help program graduates to maintain these healthy habits. This article describes curriculum development, participant feedback, and early pretest and posttest evaluation results from a standardized assessment.

Black People↗
PubMed2001

Weight loss attempts and attitudes toward body size, eating, and physical activity in American Indian children: relationship to weight status and gender.

OBJECTIVE: This study examined dieting, weight perceptions, and self-efficacy to eat healthy foods and engage in physical activity and their relationships to weight status and gender among American Indian elementary schoolchildren. RESEARCH METHODS AND PROCEDURES: Data for this study were collected as part of the baseline examination for the Pathways study. Participants were 1441 second- through third-grade American Indian children in 41 schools representing seven tribes in Arizona, New Mexico, and South Dakota who filled out a questionnaire and had heights and weights taken. RESULTS: Forty-two percent of the children were overweight or obese. No differences were found between overweight/obese and normal weight children for healthy food intentions or self-efficacy. Heavier children (especially those with body mass index > 95th percentile) were more likely to have tried to lose weight or were currently trying to lose weight. No gender differences were found. Normal weight children chose a slightly heavier body size as most healthy compared with overweight/obese children. DISCUSSION: The results indicate that children are concerned about their weight and that weight modification efforts are common among overweight American Indian children. School, community, and family-based programs are needed to help young people adopt lifelong healthful eating and physical activity practices.

Arizona↗
PubMed2000

What are the special needs of chronically ill young people?

Although significant advances have been made in the treatment of serious disease, there remains much scope for assisting young people in adjusting to life with a chronic medical condition. Commonly, chronically ill young people experience lower emotional well being than their healthy peers. Conventional approaches to promoting emotional well being have involved referring young people and their families to an appropriate public mental health service or psychologist/psychiatrist in private practice. However, there is increasing interest in the use of peer support programs. Support groups such as the ChIPS program aim to promote positive adjustment to chronic illness by bring together young people facing similar circumstances. It is maintained that by increasing connections between chronically ill young people, emotional well being can be enhanced.

Adolescent↗
PubMed1978

[Adaptive physiopathology of advanced age].

We have considered the so-called "teleological" aspects in many senile diseases that is a kind of effort to compensate alterations due to the aging process, where that process takes place with biological trouble (which happens for most subjects since aging without biological trouble is a prerogative of a minority of privileged people who will have a longevous and healthy life). These "teleological" aspects represent the foundation of the phisiopathology of adaptation in advanced age and the key for a correct interpretation of it and therefore for a correct preventive and curative program.

Adaptation, Physiological↗
PubMed1995

Setting and monitoring health objectives for the nation.

Healthy People 2000 is a national effort to focus and coordinate a wide variety of efforts to improve the health and longevity of the American people. By establishing specific objectives, each with measurable targets for the year 2000, the success of programs to improve health and prevent disease can be assessed. The cancer objectives concentrate on the leading sites that account for more than half of all cancer deaths. They include risk reduction objectives to modify individuals' behaviors towards more healthful practices, and services and protection objectives to enhance counselling and early detection efforts. National surveys conducted by the National Center for Health Statistics are in place to monitor the progress towards accomplishment of these objectives and to guide policies for effective actions.

Adolescent↗
PubMed1997

[Television and eating disorders. Study of adolescent eating behavior].

BACKGROUND: The media, mainly TV, play a significant social and cultural role and may affect the prevalence and incidence of eating disorders such as bulimia and anorexia nervosa. Their influence acts mainly by favoring a tall and thin body as the only fashionable for female adolescents: your social success depends primarily and totally by your physical appearance and you can, (and must), shape your body as you like better. Our research aims t analyze the attitude of adolescent people toward the TV and to investigate on: 1) time spent watching TV programs; 2) the influence of TV on the personal choices of goods to buy; 3) the ideal body images; 4) choice of TV programs. METHODS: Sixty-seven healthy adolescents (36 F-31 M) were included in our study as controls together with 24 female adolescents with eating disorders (DCA) diagnosed according to the DSM-IV and EAT/26 criteria. RESULTS: Our results show a psychological dependence of DCA adolescents from the TV (longer period of time spent watching TV programs, buying attitudes more influenced by TV advertising). The thin and tall body image is preferred by the DCA girls as well as by the controls; however the body appearance and proportions have a predominant and utmost importance only for the eating disorder females. The masculine subjects instead have a preference for a female and masculine opulent body appearance. CONCLUSIONS: To prevent the observed increase in prevalence and incidence of eating disorders among adolescents, it is appropriate to control the messages, myths and false hood propagated by media, TV in particular.

Adolescent↗
PubMed1999

Quality of life after cerebrovascular stroke: a systematic study of patients' preferences for different functional outcomes.

OBJECTIVES: To elicit valid quality of life estimates and the highest acceptable treatment risk of different outcomes after stroke. This is a prerequisite for rational medical decision-making, especially when considering treatments like thrombolysis. SUBJECTS: Healthy people, non-stroke medical patients and stroke survivors aged 20-84 years (n = 158) INTERVENTIONS: Subjects were interviewed by a physician using three different methods ('standard gamble', 'time trade-off' and 'direct scaling') supported by an interactive computer program. MAIN OUTCOME MEASURES: We measured utility, a numerical value ranging from 0.00 (death) to 1.00 (perfect health), representing the strength of the patient's preference for an outcome. When using the standard gamble method, risk is also introduced into the measurement. RESULTS: People's preferences for stroke outcomes varied widely, and the estimates were influenced by assessment method. We found that previous stroke, marital status and age were the only independent variables influencing the utility given. Subjects in our population over the age of 45 were very comparable to the real population at risk for acute stroke regarding these three variables, and they assigned a median utility of 0.91 (10th percentile, 0.65; 90th percentile, 0.99) to a minor stroke and 0.61 (10th percentile, 0.08; 90th percentile, 0.95) to a major stroke using the standard gamble method. CONCLUSIONS: Most people do not feel that suffering from stroke is an overwhelming catastrophe and they do not accept treatment options with very high risks.

Adult↗
PubMed2000

Asymmetric vestibular function in the elderly might be a significant contributor to hip fractures.

The aim of this study was to assess postural control, vestibular symmetry and health status in otherwise healthy hip fracture subjects and compare these factors with controls. The fracture subjects were recruited from 113 consecutive patients operated 12-33 months earlier. Nineteen of those were otherwise healthy and fulfilled the inclusion criteria. They were assessed and compared with 28 age- and sex-matched controls. Nystagmus after head shake was checked for by video-nystagmoscopy (charged couple device cameras). Vibration sensation was tested with a tuning fork, medical history and posturography of vibration-induced sway were studied. The subjects had a significantly higher frequency of head shake nystagmus (p = 0.03), indicating a vestibular asymmetry and a history of previous fractures (p = 0.002). Nine out of 12 subjects had fallen and sustained the hip fracture towards the slow phase of the nystagmus, which is expected in a vestibular related fall. Losing balance during testing was more frequent among the subjects than among the controls (p = 0.002). The subjects with head shake nystagmus swayed more than those without, especially in the sagittal plane during neck vibration with eyes closed (p < 0.001). Vibration perception was significantly poorer in the operated legs than in the healthy legs (p = 0.021) and in the legs of the controls (p = 0.001). The findings suggest that vestibular asymmetries may contribute to falls and fractures in elderly people. As such asymmetries can be compensated to a certain degree by specific training programs, these might be advisable for elderly people, especially those with a history of falls or fractures or where a vestibular asymmetry is suspected.

Aged↗
PubMed2002

Immunization for seniors.

Vaccine-preventable diseases remain a significant health problem for adults in the United States. Far more adults die from the complications of vaccine-preventable diseases than do children in this country. Available vaccines that are effective in preventing morbidity and mortality from these conditions are underutilized, and significant racial and ethnic disparities in rates of utilization of adult vaccines persist. A variety of important vaccine-preventable diseases affect seniors. However, influenza and pneumococcal infections stand out as being responsible for more cases and more deaths each year among seniors than all other vaccine-preventable diseases in the United States combined. Current vaccination rates for these two diseases are far short of the Healthy People 2010 target rates of 90% immunization of the population of adults aged 65 years or over. Despite state efforts to improve vaccination rates of seniors, efforts that have included regulatory and educational approaches, significant challenges remain in designing immunization programs for seniors that are universally effective.

Black or African American↗
PubMed2006

[Integrative medicine in health science education].

Integrative Medicine (IM) is a concern of many people. We consider IM to be very important in Health Science, especially Clinical Laboratory Science. We will start a new program named "Introduction to Integrative Health Science", which covers the relationship of Health Science and IM, in addition to "Introduction to Healthy Food and Supplement". These programs will bring a new angle to the education of Clinical Laboratory Science as Health Science. We have held various community health education sessions about IM, which have helped to explain Clinical Laboratory Science as well as the scientific evaluation of IM. We hope that Clinical Laboratory Science Education will develop further in the future.

Complementary Therapies↗
PubMed2003

Strength training vs. aerobic training: cardiovascular tolerance in elderly adults.

The aim of the present study was to evaluate cardiovascular tolerance to two different types of exercise (strength training vs. aerobic training) in healthy elderly subjects. Nineteen healthy elderly subjects aged 65-81 were studied. All the subjects participated in a 6-month combined physical activity program of gymnastics (2 times/week; 50 min.) and strength training (2 times/week; 40-50 min.). The gymnastics sessions consisted of general physical activity that is usually offered to elderly people and included warm-up, aerobic exercises, strength training, some balance and coordination exercises, recreational games and cool-down. The strength training consisted of two sets of 10 to 12 repetitions at 70% of one repetition maximum (1 RM) for "women's double chest"; "leg extension"; "overhead press; "seated leg curl"; "lateral raise"; "leg press" and "abdominal machine". Cardiovascular tolerance was evaluated both by measuring heart rate (HR) continuously (Polar Vantage NV) during the sessions and by measuring systolic (SBP) and diastolic blood pressure (DBP) with an electronic sphygmomanometer at five different times (baseline, after warm-up, 15-20 min., 30-40 min. and after cool-down). Moreover, in order to measure the response according to the type of exercise, in strength training sessions, SBP and DBP were also evaluated in different machines (legs vs. arms). Comparison between the two different types of exercise (gymnastics vs. strength training) and between different machines was performed by an unpaired Student's t test. The level of significance was set at p < 0.05. The results showed no significant differences in HR, SBP and DBP values between the two training types. Both sessions were performed at appropriate intensity without exaggerated cardiovascular response. In strength training, exercises that involved the legs presented higher rises in SBP and DBP values than those performed with the arms. These data suggest that, if appropriate techniques are used, strength training as well as gymnastics can be performed by healthy older subjects so long as basic rules for exercise in this population are followed. Furthermore, the data indicate a greater cardiovascular hemodynamic response after strength exercises with the legs than with the arms.

Age Factors↗