Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Healthy People Programs”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 721 records · Page 40Linked to original sources

Premiums without benefits: waste and inefficiency in the commercial health insurance industry.

The U.S. system of health insurance is wasteful and inefficient. For every dollar the commercial health insurance industry paid in claims in 1988, the industry spent 33.5 cents for administration, marketing, and other overhead expenses. Thus, not including profits, the commercial insurance industry spent 14 times as much on administration, overhead, and marketing per dollar of claims paid as did the Medicare system, and 11 times as much per dollar of claims paid as the Canadian national health system. Had an efficient public program such as Medicare or the Canadian system provided the same amount of benefits, consumers and businesses served by commercial insurers would have saved $13 billion. The sources of waste include excessive marketing costs and administrative costs bloated by discriminatory underwriting practices that segregate the profitable groups and individuals--people who are healthy, young, and in "safe" professions--from everyone else.

Canada↗

Preventing cognitive decline.

Many studies of age-related cognitive decline have failed to distinguish between usual and successful aging. Although some degree of cognitive impairment is associated with aging, when one looks at average performance, there is great variability among individuals, with many showing little or no deleterious effects of aging on intellectual abilities. Many of the risk factors for dementia and for conditions associated with cognitive impairments can be treated or controlled. Among the preventable causes of cognitive decline are the following: AIDS, Alcohol and drug abuse, Cerebrovascular disease, Exposure to organic solvents or lead, Head trauma, Overmedication, Syphilis. Other conditions that may cause cognitive decline can be controlled or treated: Atherosclerosis, Depression, Diabetes, Emphysema, High blood pressure, Obesity, Sleep disorders, Thyroid dysfunction. In addition, it may be possible to enhance the cognitive performance of even healthy elderly people through changes in diet and lifestyle. Recent data raise the possibility that improved prenatal and perinatal care and greater access to educational opportunities may result in a decreased incidence of dementia in future generations of older adults. Although they are rapidly becoming more numerous, the efficacy of cognitive training programs in preventing or slowing cognitive decline has not yet been demonstrated. Nevertheless, such programs may ameliorate cognitive impairment by reducing the psychiatric disabilities associated with anxiety and depression. The general principle underlying these strategies for limiting cognitive impairment with age is to maximize brain reserve and minimize brain damage.

Aging↗

Long-term implementation of the CATCH physical education program.

To test the effectiveness of the Child and Adolescent Trial for Cardiovascular Health (CATCH) program, a randomized trial was conducted in 96 elementary schools in four regions of the United States. Results from the original trial indicated a significant positive effect on the delivery of physical education (PE). All 56 former intervention schools (FI), 20 randomly selected former control schools (FC), and 12 newly selected unexposed control schools (UC) were assessed 5 years postintervention. Results indicate a strong secular trend of increasing moderate to vigorous physical activity (MVPA) in PE classes among both FC and UC schools. The FI schools surpassed the Healthy People 2010 goal for MVPA during PE lesson time (i.e., 50%), whereas the FC and UC schools came close to it. Barriers to implementing CATCH PE included insufficient training and lower importance of PE compared to other academic areas and indicate the need for in-service training.

Cardiovascular Diseases↗

Effect of low intensity electrical stimulation on quadriceps muscle voluntary maximal strength.

BACKGROUND: Evaluate the effect of low intensity electrical stimulation (ES) training on strength. We purposefully used a low ES stimulation intensity to have it well accepted by middle aged and low performing people. Relate strength to metabolic parameters. METHODS: Experimental design. Protocol 1: effects of 11 day low intensity ES training on quadriceps muscle maximal voluntary contraction (MVC). Protocol 2: effects of 3 day training at low intensity ES + voluntary contraction at 60% of MVC (co-contraction). VARIABLES MEASURED: maximal voluntary strength (FMAX), strength during ES (FES), strength developed during co-contraction (FES-C), oxygen consumption, heart rate. Experimental design included a basal session, a training program and controls of measured variables during and at the end of the training program. PARTICIPANTS: protocol 1: experiments were done on 13 healthy and sedentary subjects (6 males and 7 women, mean age 50.6 years). Protocol 2: experiments done on 6 healthy sedentary men (mean age 31.5 years). RESULTS: Protocol 1: FMAX increased significantly (p<0.05) to 14 and 19% at day 6 and 11, respectively. During ES, oxygen consumption increased by 20%, but no change in heart rate was observed. Protocol 2: FMAX significantly increased (about 5%) in subjects who trained with co-contraction; conversely, FMAX did not significantly increase in a control group matched for age who trained only with voluntary contractions. CONCLUSIONS: Low intensity ES in sedentary and poorly performing people increases significantly FMAX during MVC possibly via facilitatory neurogenic mechanism.

Electric Stimulation↗

Nutrition education for the healthy elderly population: isn't it time?

In the United States, people are living longer, healthier lives. A major goal of our public health system is to maintain health among successful agers and prevent or delay chronic disease morbidity. Major strides are being made in identifying the dietary needs of elderly people that are different from those of younger adults. However, nutrition education programs to promote those dietary needs have lagged behind. This report reviews dietary needs, demographic information, and recent nutrition policies for older adults as a basis for nutrition education programs. This report suggests that it is time to keep pace with recent findings and develop national and state-sponsored programs that will provide nutrition education and information transference to older people in the communities.

Aged↗

Medical training in community medicine: a comprehensive, academic, service-based curriculum.

The University of Pennsylvania's Family Practice Residency includes a significant community medicine component in order to accomplish the goals of addressing the health-related needs of the university's neighbors; exposing residents to the knowledge, skills and attitudes necessary to address the health needs of a community; and encouraging health careers with a community focus. It is my belief that these goals further the agenda of the National Institute of Medicine and Healthy People 2000 and 2010. Longitudinal and block community medicine experiences were established to accomplish these goals. This article describes and discusses three measurable outcomes of this curriculum: (1) individual resident projects, (2) resident class projects and (3) significant career foci in community medicine among resident graduates. I believe that our community medicine program exemplifies medical training in a community setting and furthers the national health agenda.

Community Health Services↗

Epidemiology in health promotion: a Canadian perspective.

During the second half of this century, Canada has made major organizational advances in providing universal hospital and medical care programs. Although these advances have largely overshadowed public health issues, the focus is now shifting back to public health with an emphasis on health promotion as a guiding philosophy. Epidemiology has played a key role in these developments. However, as we seek to address matters such as "enhancing people's capacity to cope," "healthy public policy," and "self-care," we find ourselves with a limited data base. So it is now necessary for epidemiology to integrate concepts that have their origins in the social and behavioral sciences, and also to deal with new measures of functional and self-assessed health status. A scientific approach to all this is essential, especially in developing and evaluating health promotion initiatives. In addition, national health goals and objectives are needed to help allocate resources rationally and hold health promotion activities accountable for their own performance.

Canada↗

Asthma: in plain language.

The Community Asthma Program was designed to increase awareness of asthma among urban residents and to bring more people into available care. Educational sessions with patients indicated that many adults struggle with the complicated demands of managing a chronic disease. At the same time, however, a good deal of the written materials meant to provide information and assistance instead make inappropriate demands on the average adult reader. The project team members developed a glossary of asthma terms to improve communication between patients and providers and to help patients understand the materials commonly used in neighborhood health centers. We report on the development of the glossary and describe formative research activities, initial dissemination efforts, and an interim evaluation. Health literacy, included in the goals and objectives for Healthy People 2010, can be improved when health materials are written in plain language and designed for the existing skills of the average U.S. adult reader.

Adolescent↗

[Health promotion--as a change of social systems].

Most prevention concepts are principally based on the goal to change people's behavior, yet consider structural changes as important. Often measures concerning structural changes are planned and realized over people's heads. The concept of health promotion according to the Ottawa Charta postulates the planning and realization of structural changes with the participation of the persons affected by it. Methodical hints and concrete examples of such participative changes of social systems (communities, districts, schools, hospitals, firms etc.) are rare in literature. This article outlines how, with the model of the "Public-Health-Action Cycle", changes in social systems can be participatively planned and realized, with the aim of developing or maintaining healthy social systems. Social systems can only be changed together with the people affected (participation), if these systems are comprehensible. In this way, participative structural changes become a practicable goal in health promotion.

Community Participation↗

Trends in perinatal regionalization and the role of managed care.

OBJECTIVE: To describe trends in regionalization of perinatal care and identify factors that predict the extent of regionalization. METHODS: Data were drawn for four states for every year between 1989 and 1998. Panel data models estimated the effect of managed care enrollment on site of delivery for low, very low, and extremely low birth weight neonates. RESULTS: Strong evidence for regionalization over time was observed for North Carolina and Illinois, with little change in site of delivery in Washington. A shift from level III to level II hospitals was observed for low and very low birth weight neonates in California. Although managed care enrollment increased substantially in all four states, managed care had no effect on site of delivery; that is, the effect of managed care was near zero and not statistically significant in any state. CONCLUSION: Evidence supports the delivery of high-risk neonates at tertiary care centers. Despite changes in site of delivery, the percentages of very low birth weight neonates delivered at level III hospitals were substantially lower than the goal of 90% set by Healthy People 2010. Financial pressures introduced by managed care cannot be blamed for the failure to meet this goal. LEVEL OF EVIDENCE: II-2.

Delivery, Obstetric↗

Developing practice for healthy ageing.

The Foundation of Nursing Studies together with Pfizer Ltd has set aside susbtantial funds to reinforce the role of nursing in health promotion for older people. This article describes the work of the four teams selected from across Enlgand to take part in the Developing Practice for Healthy Ageing Programme.

Aged↗

Segmentation of fat and muscle from MR images of the thigh by a possibilistic clustering algorithm.

Physical training is proved to induce changes in physical capacity and body composition. We propose in this article a fast, unsupervised and fully three-dimensional automatic method to extract muscle and fat volumes from magnetic resonance images of thighs in order to assess these changes. The technique relies on the use of a fuzzy clustering algorithm and post-processings to accurately process the body composition of thighs. Results are compared on 11 healthy voluntary elderly people with those provided on the same data by a validated method already published, and its reliability is assessed on repeated measures on three subjects. The two methods statistically agree when computing muscle and fat volumes, and clinical implications of this fully automatic method are important for medicine, physical conditioning, weight-loss programs and predictions of optimal body weight.

Algorithms↗

Providers and consumers of prenatal genetic testing services: what do the national data tell us?

Prenatal genetic services are currently available in all but a few states. The Council of Regional Networks for Genetic Services (CORN) has developed and implemented a data collection project to collect a minimum data set (MDS) on genetic services, including prenatal services, throughout the US. More than 400 reporting units were solicited for data in 1989, and approximately 240 (60%) responded. The CORN MDS Report for 1989 shows that more than 124,000 prenatal patients received services in the reporting centers. These individuals received almost 303,000 individual prenatal clinical services and accounted for more than 481,000 laboratory tests. Advanced maternal age was the primary indication for service in the vast majority of patients (62%). Based on data from the two major proficiency testing programs for laboratories performing screening tests for maternal serum alpha-fetoprotein (MSAFP), it is estimated that 50% of the pregnancies in the US are screened for MSAFP. The CORN database provides the only data available for the rapidly expanding area of genetic services. Therefore, it provides a unique resource for evaluating progress toward the Healthy People 2000 objectives regarding genetic services.

Adult↗

Current status of infection-related gastrointestinal and hepatobiliary diseases in Thailand.

The objective of this overview is to assess the present situation with regards to gastrointestinal and hepatobiliary diseases prevailing in Thailand. In that context, special emphasis has been put on those forms of viral hepatitis prevalent in the region, namely, hepatitis A the frequency of which has undergone a change from hyper- to hypoendemic with a resulting decline in naturally acquired immunity; hepatitis B with its tendency to cause chronic liver disease mainly due to asymptomatic infections during early childhood and the impact of mass vaccination programs on its endemicity; hepatitis C which can also lead to chronicity; hepatitis D solely found as a coinfection with hepatitis B; hepatitis E acute cases of which can sporadically be found; hepatitis G encountered in healthy subjects at a prevalence similar to that seen in patients with chronic liver disease and rather more prevalent among people at risk for contracting blood borne agents; finally the novel hepatitis TT virus with a distribution comparable to that of hepatitis G virus and a similarly unclear role as to the etiology of serious liver disease. Particularly in connection with hepatitis B we have examined the situation regarding hepatocellular carcinoma which represents one of the most common malignancies among the Thai population. Cholangiocarcinoma caused by the liver fluke Opisthorchis viverrini is the most common form of liver cancer in the northeastern part of Thailand where an estimated 70% of the population are infested with the parasite. Peptic ulcer caused by Helicobacter pylori constitutes another common gastrointestinal affliction with the overall prevalence of antibodies to the agent amounting to 63 to 74% in patients exhibiting gastroduodenal symptoms. The final part of the paper deals with HIV-related gastrointestinal and liver disease and with amebic and pyogenic liver abscesses.

Biliary Tract Diseases↗

[Preaching to the converted: deficits and surpluses in preventative pain therapy in German back care programs].

BACKGROUND: In response to the growing incidence of back pain, increasing emphasis is being placed on individualized preventive measures. The purpose of the present study was to investigate representative data for back pain, participation rates of back care programs, and their correlates in the German general population. METHODS: The first National Health Survey was carried out in the Federal Republic of Germany in the period from October 1997 to March 1999. It comprised a representative, cross-sectional study of the population with a total sample of 6235 participants between the ages of 18 and 79. RESULTS: The 7-day prevalence for back pain in Germany was found to be 36%, and 7% of all Germans had participated in a back care program within the past year. The 1-year participation rate was significantly lower in persons with higher risk for back pain (men, full-time workers, unmarried people, and those with an unhealthy lifestyle). CONCLUSIONS: The user profile for back care programs indicates that genuine needs are not being met and the target group is not being reached. A "preaching to the converted" phenomenon is evident, as indicated by the fact that the user group is made up of individuals who already have a healthy lifestyle and few risks while the population group most likely to develop back pain is significantly less likely to participate in preventive back care programs.

Adult↗

Differences in food intake and exercise by smoking status in adolescents.

BACKGROUND: Smoking, diet, and lack of exercise are the top preventable causes of death in the United States. Some 23% of high school students currently smoke and many teens do not meet Healthy People 2010 standards for healthy eating or physical activity. This study examined the relationship between smoking and the consumption of fruit, vegetables, milk/dairy products and the frequency of exercise in 10,635 Virginia youth. METHODS: Survey data were collected from middle school (MS; n = 8022) and high school (HS; n = 2613) adolescents participating in youth tobacco prevention/cessation programs. Data were analyzed using chi-square bivariate tests and multivariate regression models. RESULTS: Smokers were significantly less likely than nonsmokers to exercise > or = 3x week and to consume > or = 1 serving/day of vegetables or milk/dairy products. This was more evident in high school than middle school students and in females compared to males. In both HS and MS, a dose-response relationship was detected with higher level smoking associated with lower frequency of eating specified food and exercise. CONCLUSIONS: Smoking is associated with compromised intake of healthy food and exercise. To decrease incident cases of chronic disease later in life, new tailored, innovative interventions are needed that address multiple health behaviors in youth.

Adolescent↗

Hepatitis B virus infection: epidemiology and vaccination.

Worldwide, two billion people have been infected with hepatitis B virus (HBV), 360 million have chronic infection, and 600,000 die each year from HBV-related liver disease or hepatocellular carcinoma. This comprehensive review of hepatitis B epidemiology and vaccines focuses on definitive and influential studies and highlights current trends, policies, and directions. HBV can be transmitted vertically, through sexual or household contact, or by unsafe injections, but chronic infections acquired during infancy or childhood account for a disproportionately large share of worldwide morbidity and mortality. Vaccination against HBV infection can be started at birth and provides long-term protection against infection in more than 90% of healthy people. In the 1990s, many industrialized countries and a few less-developed countries implemented universal hepatitis B immunization and experienced measurable reductions in HBV-related disease. For example, in Taiwan, the prevalence of chronic infection in children declined by more than 90%. Many resource-poor nations have recently initiated universal hepatitis B immunization programs with assistance from the Global Alliance for Vaccines and Immunization. Further progress towards the elimination of HBV transmission will require sustainable vaccination programs with improved vaccination coverage, practical methods of measuring the impact of vaccination programs, and targeted vaccination efforts for communities at high risk of infection.

Child Health Services↗

The immigrant Haitian mother: transcultural nursing perspective on preventive health care for children.

Thirty immigrant Haitian mothers in Southeast Florida were interviewed regarding their beliefs and practices about preventive health care (illness prevention and health maintenance measures) for infants and preschool children (up to age 5). All mothers used preventive health care measures from both the Western biomedical and traditional Haitian ethnomedical (folk) systems. Ninety-seven percent used magico-religious measures; 47% administered home remedies; 47% gave children over-the-counter drugs; and 35% utilized a variety of measures to ensure cold air did not enter neonates and cause illness or pain. The Haitian mothers considered the preventive health care measures effective because the children remained healthy and will likely use them again. They sought consultation from a variety of individuals who formed their health management groups and child caretaker networks. Infants and toddlers were considered at higher risk than newborns for illness due to "evil harm" inflicted by other people and/or voodoo spirits. Implications for transcultural nursing practice include developing community outreach programs, implementing nursing interventions that combine biomedical and ethnomedical preventive health care measures, and functioning as part of the health management group. The authors wish to thank Maude Vincent, R.N., for her assistance in data gathering and analysis.

Adult↗