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PubMed2001

Is there a consumer backlash against the diet and health message?

OBJECTIVE: Anecdotal evidence exists that the public is becoming skeptical about nutrition messages. This article examines whether there is a backlash against dietary recommendations and whether it is associated with less healthful diets. DESIGN/PARTICIPANTS: Data are from a 1997-1998 Washington State random-digit-dial survey of 1,751 adults designed to monitor attitudes and behavior related to cancer risk and prevention. STATISTICAL ANALYSES: Responses to the nutrition backlash survey were weighted to reflect the Washington State population. Linear regression was used to examine associations of nutrition backlash with fat and fruit and vegetable intake. RESULTS: This survey did not find strong evidence that nutrition backlash was widespread. However, 70% of respondents thought that Americans are obsessed with the fat in their diet and that the government should not tell people what to eat. More than a quarter agreed with the statement that eating low-fat foods takes the pleasure out of eating. Nutrition backlash was associated with less healthful diets: individuals showing high backlash had a fat-related diet habits score of 2.11 compared with a score of 1.73 among those showing low backlash (P for trend = .001), which corresponds to a difference of roughly 4 percentage points in percentage energy from fat. Individuals showing high backlash reported eating only 2.72 servings of fruits and vegetables per day, compared with 3.35 servings among those showing low backlash (P for trend = .001). APPLICATIONS/CONCLUSIONS: Nutrition professionals need to ensure that dietary recommendations are clear and positive to avoid the possibility that consumers may disregard nutrition messages entirely.

Adolescent↗
PubMed2000

Radiographic and digital imaging in periodontal practice.

This review defines terms such as accuracy, validity, and reliability, which are used to describe the quality of methods for taking x-rays and for analyzing digital images. Values for these parameters are described for techniques of taking standardized x-rays such as ear-rod fixation and fixation by use of teeth with a dental impression. In addition, values are given for linear measurements on digitized images and for quantitative image subtraction. Differences are addressed between quantitative subtraction with a reference ramp and relative subtraction using the computer-assisted densitometric image analysis (CADIA) system. The relationship between radiographic bone height and clinical attachment level is also discussed. Finally, present and future use in the periodontal office of linear radiographic measurements on digital images and digital subtraction is discussed.

Absorptiometry, Photon↗
PubMed1994

Race- and ethnicity-specific characteristics of participants lost to follow-up in a telephone cohort.

The purpose of this study was to describe race- and ethnicity-specific characteristics of subjects lost to follow-up. For a study of community-based health interventions, adult subjects from 11 US communities were initially recruited by random digit dialing and interviewed by telephone in 1988; 2 years later, they were recontacted, and the same survey was administered a second time. Associations with loss to follow-up were assessed in separate models for whites, African Americans, Hispanic Americans, and Asian Americans. After 2 years, 40.8% of the 5,851 participants were lost to follow-up; cohort attrition was highest among African Americans (51.3%) and lowest among whites (37.5%). Age, aspects of employment, education, marital status, and income were significant independent predictors of loss to follow-up for one or more of the four racial and ethnic groups. Characteristics of subjects lost to follow-up in this telephone cohort differed among various racial and ethnic groups. After adjustment for demographic, socioeconomic, and health status variables, the important behavioral predictors of loss to follow-up were current smoking for whites (p < 0.05), having a high fat diet for African Americans (p < 0.10), consuming one or more alcoholic drinks per day for Hispanic Americans (p < 0.10), and high levels of physical activity for Asian Americans (p < 0.05).

Adolescent↗
PubMed2006

Characterization and quantification of the skin radiance through new digital image analysis.

BACKGROUND/AIMS: The individual perception of the radiance is difficult to define and quantify because it often includes physiological and psychological attributes. Although if they are differences in the perception of the skin radiance, dermatologists and experts in cosmetology consider that the complexion must reflect the general health of an individual. The aim of this work was to determine existing conditions of skin radiance via digital image analysis, consumer's perception and experts' evaluation, and propose a mathematical model to quantify the global radiance phenomenon. METHODS: A round table meeting was organized in order to have free discussions about skin radiance. The qualitative assessment of skin radiance was carried out using a self-assessment questionnaire constructed according to the information obtained from the round table meeting. A simplified version of this questionnaire was proposed to experts. One hundred female subjects belonging to three different age groups (20-30, 30-40, 40-50 and >50 years old) participated in the study. Facial images were taken using a video imaging with visual control system to ensure consistency of images among volunteers. From these images, algorithms based on the principle of polynomial approximation, segmentation by maximalization of the entropy and the Logarithmic Image Processing model were required to extract skin radiance parameters. Multiple regression analysis was used to establish, via consumer's perception of the skin radiance and experts' evaluation studies, the degree to which each of the independent parameters contributes to the skin radiance perception. RESULTS: All the items of the self-assessment questionnaire explained 74% of the variation of the skin radiance. Data from experts' analysis explained 87% of the variation of skin radiance. In the two cases, skin radiance appeared to be independent of age and the presence of wrinkles. From the image analysis, we observed that the skin surface parameters explained 20% of the variation of the skin radiance expressed by experts and 24% of the variation of the skin radiance expressed by volunteers. As a result, about 80% of the variation is not explained by the instrumental data. If we combine experts' analysis and instrumental data, we obtain a mathematical model that explains 92% of the variation of the skin radiance. CONCLUSION: The questionnaire constructed from this brainstorming session allowed volunteers and experts to judge their perception of skin radiance more precisely. Video imaging appears as an interesting method to quantify visual properties of the skin and to visualize what the consumer perceives of skin radiance. However, the mathematical model proposed from the skin surface parameters analysis does not totally explain the global perception of skin radiance. In the future, it will be necessary to develop new data-processing programs to quantify subjective parameters in order to validate our mathematical model.

Adult↗
PubMed1999

Assessment of public health computer readiness for 2000--United States, 1999.

Computer software, equipment, and other devices that contain embedded microchips that store and process dates may use two-digit years (e.g., 99 for 1999) to reduce data entry burden and save electronic storage space; these devices may not work properly when the year 2000 (Y2K) arrives. Many aspects of health-care delivery, public health surveillance and research, and critical infrastructure components (e.g., utilities and transportation services) depend on vulnerable computers. To ensure that critical public health functions will not be compromised because of Y2K problems, CDC assessed state public health agency readiness for Y2K. This report describes the findings of the assessment, which indicate that state health agencies that responded are substantially ready for Y2K and plan to reach full readiness in 1999.

Chronology as Topic↗
PubMed1999

Prescription drugs: issues of cost, coverage, and quality.

This Issue Brief closely examines expenditures on prescription drugs, and discusses their potential to substitute for other types of health care services. In addition, it describes employer coverage of prescription drugs, direct-to-consumer advertising of prescription drugs, and potential legislation affecting the prescription drug market. Prescription drug expenditures grew at double-digit rates during almost every year since 1980, accelerating to 14.1 percent in 1997. In contrast, total national health expenditures, hospital service expenditures, and physician service expenditures growth rates decreased from approximately 13 percent in 1980 to less than 5 percent in 1997. Private insurance payments for prescription drugs increased 17.7 percent in 1997, after growing 22.1 percent in 1995 and 18.3 percent in 1996. This growth in prescription drug payments compares with 4 percent or less overall annual growth in private insurance payments for each of those three years. From 1993 to 1997, the overwhelming majority of the increases in expenditures on prescription drugs were attributable to increased volume, mix, and availability of pharmaceutical products. In 1997, these factors accounted for more than 80 percent of the growth in prescription drug expenditures. A leading explanation for the sharp growth in drug expenditures is that prescription drugs are a substitute for other forms of health care. While it is difficult to determine the extent to which this substitution occurs, various studies have associated cost savings with the use of pharmaceutical products in treating specific diseases. Evidence suggests that more appropriate utilization of prescription drugs has the potential to lower total expenditures and improve the quality of care. Also, some studies indicate the U.S. health care system needs to improve the way patients use and physicians prescribe current medications. Prescription drug plans offered by employers are likely to undergo changes to ensure that only the most efficacious drugs are covered. Anecdotal evidence suggests that copayments for prescriptions are going to increase. Some health plans are including prescription drug costs in their capitated payments to physicians. Furthermore, prescription drug plans are expected to use formularies more aggressively. In 1996, an average 5.47 outpatient prescriptions were written for those ages 55-64, compared with more than eight for those age 65 and older. Inevitably, this translated to significantly more spending for prescription drugs by the elderly. In 1994-1995, the average elderly individual (age 65 or older) spent $558 on prescription drugs, while the average 55-64-year-old spent $355. While prescription drugs are showing sharp price increases, they are also becoming more important in the treatment of many diseases. Consequently, both employers and policymakers must carefully balance the design and cost of a drug benefit so that continual innovation is preserved and the benefit can remain affordable and effective.

Advertising↗
PubMed2004

North Karelia regional chain of care: Finnish experiences.

Information--and communication technology is one of the most important cornerstones in more and more data and knowledge intensive health care sector. However these factors don't create financial gains and productivity benefits spontaneously. They need organisational and social innovations and new business models. The growth of productivity is connected to the process and organisational innovations and not to the number of computers and the growth of using ICT. One of the problems prohibiting health care profession to move to real e-work environment is the lack of the reliable measures and on these measures based performance measurement and strategic management. Health care can be improved by utilizing ICT and tools like performance measuring are key weapons in the arsenal of new e-work environment and measuring based new strategic management. Neither public sector nor not-for-profit hospitals look for financial rewards as their ultimate proof of success. Instead, they seek to achieve ambitious missions aimed at improving the health standards and wellbeing of the citizens. ICT- based new way of managing in the public sector is just beginning to gain a critical level of digitalization and will most likely come to its own in the coming years. Therefore, it is essential to research on how the health care sector can be moved towards new regional models and clinical workflow using intelligent standard based strategic management and performance measurement. If the breakthrough of the eight-hour working day and shortening of working time are evaluated afterwards, it can be stated that they have made the society more anthropocentric and humane. During one century the annual working time has shortened from 3000 hours to 1700 hours in the European Union countries. These foundations of a more humane society--eight-hour working day and shortening of regular working time--are however disappearing in the post-industrialized information society. There are various grounds for the eight-hour working day. These grounds relate to quality of life, occupational safety and health and productivity of work. It is worth asking if the nature of work has changed in a way that the truths of an industrialized society do not hold true or has the development of working time in health care sector become uncontrolled in some new way?

Computer Communication Networks↗
PubMed1988

Attitudinal variables related to intention, frequency and proficiency of breast self-examination in women 35 and over.

A correlational study was conducted to identify attitudinal variables specified by the Health Belief Model that were related to intent, frequency, and proficiency of breast self-examination. The probability sample consisted of 380 women age 35 and over who were contacted via random digit dialing. Data were collected during in-home interviews. Results supported the combined ability of susceptibility, seriousness, barriers, health motivation, and control to predict intent to practice breast self-examination (R = .61, p. less than or equal to .001). In addition, frequency and total proficiency for breast self-examination were predicted by health motivations, susceptibility, and barriers using discriminant analysis. Results lend support to use of the Health Belief Model variables in predicting women's intention and actual behavior of breast self-examination.

Adult↗
PubMed2005

Increasing Internet use among cardiovascular patients: new opportunities for heart health promotion.

BACKGROUND: Information technology is revolutionizing health care delivery. Although data exist for other patient populations, awareness and use of information technology in cardiovascular patients have not been well described to date. OBJECTIVES: To assess the awareness and use of information technology in cardiovascular patients over time. METHODS: A survey of consecutive cardiovascular inpatients and outpatients attending a tertiary care, Canadian academic centre was conducted in 2001. Awareness and use of the Internet, use of the Internet for health information, attitudes toward information technology and barriers to use were studied at baseline (n=300) and at one-year follow-up (n=199). The socioeconomic correlation was also examined. RESULTS: Most respondents were aware of the Internet and e-mail. Internet use for health information was prevalent and increased over time (62 of 105 patients [59%] at baseline versus 76 of 105 patients [72%] at one-year follow-up). E-mail use was also prevalent (102 of 189 patients [54%]) but did not increase over time. Cardiovascular patients who used the Internet for health information and e-mail were employed, and were significantly younger and better educated than patients who did not use them; income status was not a significant indicator of Internet or e-mail use. Most patients (95 of 131 patients [72%]) were interested in communicating with their specialists via e-mail. CONCLUSIONS: Information technology is well accepted by cardiovascular patients in Canada. Internet use for health information was prevalent and increased over time. The present findings suggest that the 'digital divide' is evolving, with a narrowing socioeconomic divide, possibly due to the increasing public access to the Internet. This has important implications for patient education and the specialist-patient relationship.

Cardiovascular Diseases↗
PubMed1976

A seven-year follow-up of intelligence test scores of foster grandparents.

After 7 years, a group of originally nonemployed poverty-level older people (over 60) who had been employed as foster grandparents were retested with the WAIS. Four WAIS subtests - Vocabulary Similarities, Digit Span, and Block Design - were employed. Of the original group of 39, complete data were available for 28; 18 of these were still working on the project, and the other 10 had dropped out. Dropouts as a group tested lower originally and also showed more deterioration in functional health ratings over time. For the total group of 32 foster grandparents, three subtest scores showed stability over the 7 years. Only Digit Span showed a statistically significant drop. Neither age nor the initial level of health or WAIS scores was related to test-score changes over time.

Aged↗
PubMed2025

Analysis of Variants' Dynamic Using the CLIMB Database in COVID-19 Patients Admitted to Hospitals of Barts Health NHS Trust.

The COVID-19 pandemic, caused by SARS-CoV-2, has led to significant global health challenges. This study analyzes the dynamics of SARS-CoV-2 variants among patients admitted to Barts Health National Health Service (NHS) Trust hospitals using data from the CLIMB-COVID decentralized digital infrastructure allowing precise identification of SARS-CoV-2 variants. A total of 423 patients admitted between October 2020 and March 2021 were included in the study and divided into two groups: the alpha lineage group, which comprised the B.1.1.7 variant, and the other lineages group, which included all other variants. Whole-genome sequencing of SARS-CoV-2 genomes was conducted using the COVID-CLIMB pipelines. Clinical outcomes, such as mortality rates and deterioration within 28 days, were analyzed. To ensure robust findings, analyzes were adjusted for confounding factors, including age and comorbidities. Our findings revealed a significant increase in mortality with age for the alpha lineage and other lineages. The study underscores the importance of age adjustment in clinical studies to accurately assess the impact of different variants. Consistent genomic sequencing and data completeness are crucial for obtaining reliable results and guiding public health responses. These insights are vital for improving patient outcomes and providing a truthful picture of the pandemic, informing both current and future healthcare strategies.

Humans↗
PubMed1990

Some health dimensions of self-efficacy: analysis of theoretical specificity.

Based on data drawn from a random-digit-dial probability sample of adults in a major American metropolitan area, this study supports the perspective that self-efficacy is domain specific and that outcome efficacy is distinct from self-efficacy. Data were collected by telephone interviewers which were administered by telephone interviews to 525 respondents with a 64.1% completion rate. Sample demographic summary statistics closely approximated population parameters. Five orthogonal factors emerged from analysis of self-efficacy and outcome efficacy items. The five factors represented self-efficacy with regard to nutrition, medical care, exercise, and with a set of neutral control items relating to political behavior, and with the outcome efficacy items for each behavioral domain. Hypotheses relating scores for each factor with a number of behavioral indicators were tested. Only four of 125 correlations failed to support hypothesized relationships, lending evidence for the discriminant validity of the self-efficacy dimensions.

California↗
PubMed2001

Digital Libraries and Recent Medical Informatics Research. Findings from the IMIA Yearbook of Medical Informatics 2001.

The Yearbook of Medical Informatics is published annually by the International Medical Informatics Association (IMIA) and contains a selection of recent excellent papers on medical informatics research (http://www.med.uni-heidelberg.de/mi/yearbook/index.htm). The special topic of the just published Yearbook 2001 is "Digital Libraries and Medicine". Digital libraries have changed dramatically and will continue to change the way we work with medical knowledge. The selected papers present recent research and new results on digital libraries. As usual, the Yearbook 2001 also contains a variety of papers on other subjects relevant to medical informatics, such as Electronic Patient Records, Health Information Systems, Health and Clinical Management, Decision Support Systems, Education, as well as Image and Signal Processing. This paper will briefly introduce the contributions covering digital libraries and will show how medical informatics research contributes to this important topic.

Humans↗
PubMed2000

Is diabetes associated with cognitive impairment and cognitive decline among older women? Study of Osteoporotic Fractures Research Group.

BACKGROUND: The long-term effect of type 2 diabetes on cognitive function is uncertain. OBJECTIVE: To determine whether older women with diabetes have an increased risk of cognitive impairment and cognitive decline. DESIGN: Prospective cohort study. SETTING: Four research centers in the United States (Baltimore, Md; Portland, Ore; Minneapolis, Minn; and the Monongahela Valley, Pennsylvania). PARTICIPANTS: Community-dwelling white women 65 years and older (n = 9679). MEASUREMENTS: Physician-diagnosed diabetes and other aspects of health history were assessed by interview. Three tests of cognitive function, the Digit Symbol test, the Trails B test, and a modified version of the Mini-Mental State Examination (m-MMSE), were administered at baseline and 3 to 6 years later. Change in cognitive function was defined by the change in the score for each test. Major cognitive decline was defined as the worst 10th percentile change in the score for each test. RESULTS: Women with diabetes (n = 682 [7.0%]) had lower baseline scores than those without diabetes on all 3 tests of cognitive function (Digit Symbol and Trials B tests, P<.01; m-MMSE, P = .03) and experienced an accelerated cognitive decline as measured by the Digit Symbol test (P<.01) and m-MMSE (P = .03). Diabetes was also associated with increased odds of major cognitive decline as determined by scores on the Digit Symbol (odds ratio = 1.63; 95% confidence interval, 1.20-2.23) and Trails B (odds ratio, 1.74; 95% confidence interval, 1.27-2.39) tests when controlled for age, education, depression, stroke, visual impairment, heart disease, hypertension, physical activity, estrogen use, and smoking. Women who had diabetes for more than 15 years had a 57% to 114% greater risk of major cognitive decline than women without diabetes. CONCLUSION: Diabetes is associated with lower levels of cognitive function and greater cognitive decline among older women.

Aged↗
PubMed1993

Effects of region of interest outline variations on gray-scale frequency distributions for alveolar bone.

Normalized cumulative percentage gray-scale distributions from digitized radiographs of dry skulls can be used to evaluate alveolar bone health. With this method, manually defined regions of interest are used to identify the area of the image to be analyzed. The purpose of this study was to determine if variations in the dimensions of the regions of interest affect the gray-scale distributions. Two approaches were used. The effect of region of interest outline variations on (1) the ability to differentiate between various sized bone chips and (2) the ability to distinguish between two groups of skulls with the alveolar bone subjectively rates as normal or diseased were investigated. Four different regions of interest, which consisted of outline and area variations to a basic region, were used. Ninety-one percent of the cumulative histograms that represented chips were sufficiently separated from nonchip plots to be distinguished. Bone health was correctly assessed with a numeric classifier for 37 of 44 quadrants, for an accuracy of 84%, a specificity of 79%, and a sensitivity of 90%. Although ROI size and shape consistency in longitudinal studies are important in radiometric analyses, small variations had minimal impact in this study.

Absorptiometry, Photon↗
PubMed2006

Importance of using guarded techniques for the preparation of endometrial cytology smears in mares.

Material for endometrial cytology can be collected by veterinarians using guarded or unguarded swabs, or digitally with a gloved hand, and is an important diagnostic tool in establishing the endometrial health of mares prior to breeding. The aim of this study was to determine whether the use of unguarded endometrial samples is a reliable indicator of the presence of neutrophils in the uterus. Duplicate endometrial smears were collected from 41 genitally normal, non-pregnant fertile mares by both double-guarded swabs (DGS) and in an unguarded manner by digital scraping (DS) of the endometrium. In 17 of the 41 mares, smears were also collected from the cranial vagina by DS. Cytological samples were collected from a further seven non-pregnant mares at different reproductive stages, and tissues (vestibule, vagina and cervix) from four reproductively normal mares were examined histologically after slaughter to detect the presence of neutrophils. Only 3/41 (7.3%) of the DGS endometrial smears had neutrophils present compared to 36/41 (87.8%) of the DS endometrial smears. The percentage of neutrophils in DGS endometrial smears ranged from 0 to 6% (mean = 0.41%), whereas those in the DS smears ranged from 2 to 90% (mean = 22.02%). Neutrophils were present in all vaginal smears (17/17, range=3-56% (mean = 22.18%)). There was a significant positive correlation (r = 0.84; P < 0.001) between the percentage of neutrophils in the vagina and in the DS endometrial smears. More neutrophils were found in the cervix, vagina and vestibule than in endometrial smears during the cycle (P<0.05). Neutrophils were also observed in tissue collected from the cervix, vagina and vestibule from reproductively normal mares at post-mortem. In conclusion, endometrial smears collected using unguarded techniques are very likely to be contaminated with neutrophils transferred from the vagina potentially leading to incorrect diagnosis of endometritis. When collecting samples for endometrial cytology it is important to use guarded techniques to ensure that only the endometrium is sampled to avoid contamination with cells carried over from other areas of the reproductive tract.

Animals↗
PubMed2006

Influenza vaccine effectiveness among 50-64-year-old persons during a season of poor antigenic match between vaccine and circulating influenza virus strains: Colorado, United States, 2003-2004.

During the 2003-2004 influenza season, we conducted a case-control study of influenza vaccine effectiveness (VE) among Colorado residents aged 50-64 years. Cases (n=330) were identified from laboratory-confirmed influenza reports to the Colorado Department of Public Health and Environment (CDPHE). Controls (n=1055) were recruited by random-digit dial telephone survey. VE was 60% (43-72%) and 48% (21-66%) among those without and with high-risk medical conditions, respectively. VE was 90% (68-97%) and 36% (0-63%) against influenza-related hospitalization for persons without and with high-risk conditions, respectively.

Antigenic Variation↗
PubMedDate not supplied

A client/server system for Internet access to biomedical text/image databanks.

Internet access to mixed text/image databanks is finding application in the medical world. An example is a database of medical X-rays and associated data consisting of demographic, socioeconomic, physician's exam, medical laboratory and other information collected as part of a nationwide health survey conducted by the government. Another example is a collection of digitized cryosection images, CT and MR taken of cadavers as part of the National Library of Medicine's Visible Human Project. In both cases, the challenge is to provide access to both the image and the associated text for a wide end user community to create atlases, conduct epidemiological studies, to develop image-specific algorithms for compression, enhancement and other types of image processing, among many other applications. The databanks mentioned above are being created in prototype form. This paper describes the prototype system developed for the archiving of the data and the client software to enable a broad range of end users to access the archive, retrieve text and image data, display the data and manipulate the images. System design considerations include; data organization in a relational database management system with object-oriented extensions; a hierarchical organization of the image data by different resolution levels for different user classes; client design based on common hardware and software platforms incorporating SQL search capability, X Window, Motif and TAE (a development environment supporting rapid prototyping and management of graphic-oriented user interfaces); potential to include ultra high resolution display monitors as a user option; intuitive user interface paradigm for building complex queries; and contrast enhancement, magnification and mensuration tools for better viewing by the user.

Anatomy, Cross-Sectional↗