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At least 739 records · Page 41Linked to original sources
PubMed1993

Plasma lipid, lipoprotein cholesterol, and apoprotein distributions in selected US communities. The Atherosclerosis Risk in Communities (ARIC) Study.

The distributions of plasma lipids, lipoproteins, and apoproteins of 14,524 female and male black and white participants 45 to 64 years old in the Atherosclerosis Risk in Communities (ARIC) Study are presented. All specimens were analyzed at a central laboratory. Mean total cholesterol levels increased with increasing age across all ages from 204 to 229 mg/dL (12%) in women and from 208 to 213 mg/dL (2%) in men. Triglyceride levels increased with age in women, remained stable in men, and were higher in whites than blacks. High-density lipoprotein (HDL) cholesterol levels were higher in black and white women (range, 57 to 59 mg/dL) compared with black men (49 to 52 mg/dL) or white men (42 to 43 mg/dL). Cholesterol associated with HDL was distributed in a relatively constant proportion between HDL3 (70% to 76%) and HDL2 (24% to 30%) for all race/sex groups. Low-density lipoprotein (LDL) cholesterol levels increased with age in black (14.7%) and white (17.1%) women and in black (4.4%) and white (3.7%) men; more than 50% of all participants had LDL cholesterol levels > 130 mg/dL. Apoprotein A-I and B levels followed the same trends as HDL cholesterol and LDL cholesterol levels, respectively. Lipoprotein(a) [Lp(a)] levels were twice as high in blacks as in whites, and women's Lp(a) levels were higher than men's Lp(a) levels for each race. Menopause was associated with elevated total cholesterol, LDL cholesterol, apoprotein B, and Lp(a) levels, and hormone replacement medication use in postmenopausal subjects was associated with higher HDL cholesterol, triglyceride, and apoprotein A-I levels and lower LDL cholesterol, apoprotein B, and Lp(a) levels.

Apoproteins↗
PubMed1991

The development of reference methods in clinical chemistry. The contribution of the Community Bureau of Reference of the Commission of the European Communities.

The use of reference method procedures in clinical chemical analysis is advocated by many experts as the most reliable approach to obtaining accurate results. The performance of such procedures must, however, be rigorous. This contribution will emphasize the importance of interlaboratory studies for this purpose. Examples will be presented, taken from the work done under the BCR programme of the Commission of the European Communities. The determination of steroid hormones in serum by isotope dilution mass spectrometry and the measurement of enzyme catalytic activities, according to IFCC recommended methods, will be discussed.

Chemistry, Clinical↗
PubMed1990

[An intra-community profile of nutritional deficiency: a study of children under 5 years of age in a low-income community in Rio de Janeiro (Brazil)].

This study is part of a larger epidemiological study concerned with the health status of children under the age of five carried out in the squatter settlement of Rocinha, and focuses on the nutritional profile of a representative sample of 591 children. According to the weight-for-age criteria (Gomez's classification), 23.9% and 2.0% were, respectively, mildly and moderately malnourished. This finding is in agreement with the assessment using weight-for-height and height-for-age as anthropometric indicators: (a) absence of acute malnutrition (wasting) indicated by a pattern overlapping that of an expected normal population, and (b) growth deficiency (stunting) indicated by 7% and 15% of children exceeding the proportion normally expected to be, respectively, below the -1 and -2 standard deviate limits. So far as growth failure was concerned, the following variables remained associated even when controlling for economic status (indicated by the environmental conditions of the household): low birth weight, number of siblings equal to or above three, male gender, a history of never having breastfed and a family history of previous sibling death. Each variable is discussed separately, as well as the overall nutritional profile and the marked social intra-community stratification related to growth deficit.

Anthropometry↗
PubMed1975

Behavioral community psychology: training a community board to problem solve.

This study demonstrated the effect of training nine lower socio-economic adults participating as policy board members in a federally funded rural community project to make behaviorally defined statements to increase problem-solving behaviors in board meetings. A multiple-baseline design across subjects and skills was used to analyze the behavioral categories of: (1) stating the problem; (2) finding solutions to the problem, and (3) implementing the action to the solution. Problem-solving responses during board meetings increased for subjects following training and remained higher than baseline during follow-up.

Journal Article↗
PubMed2005

Coming home from jail: the social and health consequences of community reentry for women, male adolescents, and their families and communities.

Each year, more than 10 million people enter US jails, most returning home within a few weeks. Because jails concentrate people with infectious and chronic diseases, substance abuse, and mental health problems, and reentry policies often exacerbate these problems, the experiences of people leaving jail may contribute to health inequities in the low-income communities to which they return. Our study of the experiences in the year after release of 491 adolescent males and 476 adult women returning home from New York City jails shows that both populations have low employment rates and incomes and high rearrest rates. Few received services in jail. However, overall drug use and illegal activity declined significantly in the year after release. Postrelease employment and health insurance were associated with lower rearrest rates and drug use. Public policies on employment, drug treatment, housing, and health care often blocked successful reentry into society from jail, suggesting the need for new policies that support successful reentry into society.

Adaptation, Psychological↗
PubMed2006

Promoting physical activity in a low-income multiethnic district: effects of a community intervention study to reduce risk factors for type 2 diabetes and cardiovascular disease: a community intervention reducing inactivity.

OBJECTIVE: The aim was to assess the net effects on risk factors for type 2 diabetes and cardiovascular disease of a community-based 3-year intervention to increase physical activity. RESEARCH DESIGN AND METHODS: A pseudo-experimental cohort design was used to compare changes in risk factors from an intervention and a control district with similar socioeconomic status in Oslo, Norway, using a baseline investigation of 2,950 30- to 67-year-old participants and a follow-up investigation of 1,776 (67% of those eligible, 56% women, 18% non-Western immigrants) participants. A set of theory-based activities to promote physical activity were implemented and tailored toward groups with different psychosocial readiness for change. All results reported are net changes (the difference between changes in the intervention and control districts). At both surveys, the nonfasting serum levels of lipids and glucose were adjusted for time since last meal. RESULTS: The increase in physical activity measured by two self-reported questionnaires was 9.5% (P = 0.008) and 8.1% (P = 0.02), respectively. The proportion who increased their body mass was 14.2% lower in the intervention district (P < 0.001), implying a 50% relative reduction compared with the control district, and was lower across subgroups. Beneficial effects were seen for triglyceride levels (0.16 mmol/l [95% CI 0.06-0.25], P = 0.002), cholesterol-to-HDL cholesterol ratio (0.12 [0.03-0.20], P = 0.007), systolic blood pressure (3.6 mmHg [2.2-4.8], P < 0.001), and for men also in glucose levels (0.35 mmol/l [0.03-0.67], P = 0.03). The net proportion who were quitting smoking was 2.9% (0.1-5.7, P = 0.043). CONCLUSIONS: Through a theory-driven, low-cost, population-based intervention program, we observed an increase in physical activity levels, reduced weight gain, and beneficial changes in other risk factors for type 2 diabetes and cardiovascular disease.

Adult↗
PubMed2003

Evaluation of a community-based program for breast self-examination offered by the community health nurse practitioners in Korea.

BACKGROUND: Breast cancer is the most common form of cancer among Korean women. Only 14% of urban women and 10% of rural women in Korea, however, participated in breast cancer screening behavior in 1998 (Korean Ministry of Health & Welfare, 1999). PURPOSE: The aim of this study was to evaluate the effect of community-based breast self-examination (BSE) education programs in Korea. METHODS: First, breast cancer risk appraisals were done with 1,977 rural women. Of the 1,977 women, nearly 30% (n= 494) had a higher or equal to borderline risk of developing breast cancer. This quasi-experimental study was conducted to target these women with a high or equal to borderline risk of breast cancer. The risk appraisal feedback and breast self-examination education were used as an intervention for breast cancer prevention and early detection. RESULTS: After a 3-month follow-up, 30.5% of the women in the intervention group performed regular BSE compared to 10.2% of women in the control group. The mean knowledge score related to breast cancer and BSE was significantly higher for the women in the intervention group than that in the control group.

Journal Article↗
PubMedDate not supplied

Health promoting community design: a new paradigm to promote healthy and active communities.

Richard Killingsworth explains that we have engineered routine forms of physical activity out of our daily lives, and that this is an important contributor to the obesity epidemic which claims at least 200,000 lives each year in the United States alone. A new field of study is emerging to address this problem, and the American Journal of Health Promotion has launched a new editorial section called "Health Promoting Community Design" to provide a forum to disseminate research in this new area.

Adult↗
PubMed2001

Community and connectivity: summary of a community based monitoring program set up to assess the movement of nutrients and sediments into the Great Barrier Reef during high flow events.

The Great Barrier Reef (GBR) system encompasses the largest system of corals and related life forms anywhere in the world. The health of this extensive system, particularly the inshore area, is dependent on the relationship between the GBR and adjacent coastal catchments. The major impact of agricultural practices on the GBR is the degradation of water quality in receiving (rivers) waters, caused by increased inputs of nutrients, suspended sediments and other pollutants. For the past three years, the Great Barrier Reef Marine Park Authority (GBRMPA) has been involved with the co-ordination of a river-monitoring program, specifically targeting the sampling of rivers during flood events. Representative sites were set up along two North Queensland rivers, the Russell-Mulgrave and Barron Rivers. This monitoring program is run in conjunction with the Queensland Department of Natural Resources' Waterwatch program. The program involves intensive sampling of first flush, extreme flow and post flood conditions over the two rivers. Extreme flow conditions are sampled over a limited time span (48 hours) with trained volunteers at 4-hour intervals. Concentrations measured in the flood events are dependent on land use characteristic, and extent of flow. Concentrations of dissolved and particulate nutrients are higher if the extreme flow event is part of the first flush cycle. Concentrations of DIN and DIP measured before, during and after a major flood event suggest that there is a large storage of inorganic material within the Barron and Russell-Mulgrave agricultural subcatchments that move over a period of days, and perhaps weeks. This program created a forum in which GBRMPA liased with the Barron and Russell-Mulgrave community about the connectivity existing between the river and the Great Barrier Reef lagoon.

Agriculture↗
PubMed2000

The community in the classroom: designing a distance education community health course for nurses in Solomon Islands.

In 1994 in order to improve educational opportunities for nurses in the Solomon Islands and to try the distance learning model as an educational method, the Distance Education Programme of the Ministry of Health implemented five post basic nursing certificate courses for health workers. This paper focuses on issues and experiences in the development of the Community Health course which in some ways as the most difficult of the courses to prepare. As in many Pacific Island countries, the geographic context of Solomon Islands creates isolated working situations for rural health practitioners, with difficult and limited communications. Each module in the course consists of a study guide with glossary and in-text questions, hand-outs, and an assignment. Videos are available to accompany several units and practical teaching aides are also given. Audiotapes for teaching sessions are currently being developed. The benefits of the distance education model offered in this course are discussed in detail and attention is drawn to some of the difficulties encountered. Overall, the outcome of the trial of this method has been highly successful.

Education, Distance↗
PubMed2004

Observations on the teaching and learning occurring in offices of community-based family and community medicine clerkship preceptors.

BACKGROUND AND OBJECTIVES: Previous reports have defined the time that community preceptors spend teaching students, but much remains to be learned about the process and content of office-based teaching. Our objective was to understand better the teaching process and content by documenting how often preceptors used the microskills described in the Five-step "Microskills" Model of Clinical Teaching and how often they discussed tasks described in the Task-oriented Processes in Care (TOPIC) teaching model when working with their students. METHODS: Using a checklist combining these two models, two independent observers documented the teaching and learning that occurred between 12 preceptors and their students. RESULTS: Inter-rater concordance was 96.2%. Preceptors frequently used two of the teaching microskills, "probe for supporting evidence" and "teach general rules." Preceptors and students frequently discussed many information-processing and management tasks in the TOPIC model. CONCLUSIONS: Despite the lack of training in using either model, preceptors frequently used some teaching microskills and discussed many TOPIC model tasks. This finding supports both models as relevant teaching models but further observational study of preceptors trained in using both models is needed. For the TOPIC model, preceptor development may help preceptors to more explicitly refer to TOPIC tasks when teaching clinical content to students.

Clinical Clerkship↗
PubMed2004

The impact of the introduction of treated water on aspects of community health in a rural community in Kwazulu-Natal, South Africa.

A project was designed by Umgeni Water (funded by the Water Research Commission of South Africa) to monitor the implementation of water reticulation in Vulindlela and evaluate the Water Supply Scheme from a community and environmental health perspective. The findings would hopefully contribute toward the development of criteria for Health Impact Assessment on Water Reticulation Projects. One objective of this study was to evaluate the usefulness of diarrhoeal disease as opposed to other health indicators for water-associated diseases. The innovative methodology followed in the study, a "stepped wedge design", compared four discrete areas of water reticulation implementation in Vulindlela over a 15-month period. Five surveys, including a baseline and four follow-ups at each household, were carried out. Analysis (microbiological, chemical) was carried out of samples from the household drinking water and from the source of the water. Each survey included health questionnaires, the respondent being the head of the household in each case. Overall, there was no direct correlation proved between water quality and diarrhoea per se. However, there was a marked decrease in diarrhoea with the introduction of the new water supply. There was definite correlation between hygiene behaviours and diarrhoea. Diarrhoea would seem to be the health impact associated with water, of choice.

Diarrhea↗
PubMed2004

[A community-based case-control study on risk factors of hyperuricemia among residents in the community].

OBJECTIVE: To investigate the risk factors of hyperuricemia among residents aged >/= 20 years. METHODS: A community based case-control study was conducted in 286 patients with 858 controls without hyperuricemia. Available data were analyzed by mono-factorial and multi-factorial logistic regression methods using SPSS 10.0 software. RESULTS: 17 factors related to exposure were identified for hyperuricemia the mono-factorial analysis when; five factors were selected through multiple factoral logistic regression model at P = 0.05 level. The risk factors on hyperuricemia were: hypertriglyceridemia (OR = 3.069), alcohol consumption (OR = 2.032), obesity (OR = 1.802), taste of spicy food (OR = 1.877) and hyperglycemia (OR = 1.622). CONCLUSION: Hyperuricemia is a disease associated with environment and style-life. Changing lifestyle, such as decreasing alcohol consumption and adopting proper structure of diet may prevent or decrease the chance of getting hyperuricemia and gout.

Adolescent↗
PubMed1990

[Community viral pneumonia in the adult population: a prospective multicenter study of 62 cases. The Pneumonia Study Group of the Community of Valencia].

The present work prospectively analyzes, in a multicentric study, viral pneumonias acquired in the community during one year. Were studied 510 patients diagnosed of pneumonia in hospital, or whom 62 (12.1%) had a viral origin. Influenza virus A and B were the most common causative agents (47.6% and 20.6% respectively). Smoking habit was present in 44% of patients, previous OCFA in 45% and other previous pathology in 64.4%. The greatest number of registered cases was during December. The most frequent radiologic finding was alveolar pattern. Evolution in general, was favourable with a low mortality rate (one case).

Adult↗
PubMed1990

[Community-based epidemiological study on hypertension and diabetes--community-based preventive medicine by Yang-Ming Crusade in 1989].

A community-based preventive medicine project was carried out by the Yang-Ming Crusade, organized by more than 180 students of National Yang-Ming Medical College, in July 1989. All of the registered residents over 40 years old of 13 villages (from 8 towns) were chosen for the study population. Their blood pressure, urine sugar, urine protein, high and weight were taken by the crusaders through door by door interviews. The screening positive cases were referred to the local Group Practice Center for confirm diagnosis and follow-up treatment. Among 7598 study population. 5088 (67%) were interviewed including male 48.9% and female 51.0%. About one third of the interviewee were in 50-59 age group. 762 hypertensive cases out of 3462 interviewee with blood pressure taken were found. The prevalence of hypertension was 21.0%. 334 diabetes cases out of 4713 interviewee with urine sugar taken were found. The prevalence of diabetes was 7.1%. Among 762 hypertensive cases, 560 (77.1%) were self-recognized and treated with the following methods: modern medicine 79.2%, traditional medicine 8.7%, drug stores 6.4%, and herbs 2.8%. Among 334 diabetes cases, 203 (60.8%) were self-recognized and only 171 (51.2%) were treated with the following methods: modern medicine 79.5%, traditional medicine 8.2%, drug stores 3.5%, and herbs 4.1%. Univariate analysis on hypertension showed that age, ethnicity, obesity, diabetes, hypertension history of mother, and hypertension history of siblings were significant variables. All of the above 6 variables were significant in multiple logistic regression analysis. Univariate analysis on diabetes showed that age, ethnicity, obesity, hypertension, diabetes history of father, diabetes history of mother, and diabetes history of siblings were significant variables. However only 4 variables, age, hypertension, diabetes history of mother, and diabetes history of siblings, were significant in multiple logistic regression analysis.

Aged↗
PubMed1990

[Hemoglobin, sedimentation and community health legislation. Frequency of tests and fees at the Vaga community health center during 1983-87].

On the basis of laboratory records and doctors' list of appointments, we analyzed the number of hemoglobin tests and sedimentation rates performed at Vågå community health centre during the period 1983-87. In 1983 the doctors worked on a "fee for service" basis. Since 1984 they have been paid a fixed salary. Individual doctors showed little variation in their use of tests, but there were considerable differences between doctors. The average number of tests per patient was stable and seemed independent of how the doctors were reimbursed.

Ambulatory Care Facilities↗
PubMed1986

Control of deaths from diarrheal disease in rural communities: II. Motivating and monitoring the community.

In 1980 the Ministry of Health of Egypt undertook a short term investigation into means and methods to reduce the annually excessive number of preschool child deaths from Diarrheal Disease. This investigation sought to identify ways to overcome constraints related to logistics, supplies, and community participation. The unifying theme of this study was to examine the feasibility of stressing Oral Rehydration Therapy (ORT) instead of the then conventional parenteral treatment and heavy use of antibiotics. Study cells were arranged to test feasibility of placing responsibility for the intervention primarily with rural mothers, secondly with itinerant nurses. Appropriate health education programs, revised supervision and data collection systems were developed and implemented. Results limited to mortality indicators demonstrating that mothers could affect a significant decrease in the diarrhea-specific death rate were reported in an earlier paper. In this paper a more comprehensive presentation of various survey data associated with the investigation are presented. These data show that mothers were indeed able to recognize diarrheal disease and institute early and effective treatment, and that they developed remarkable skills of preparing safe oral rehydration fluids from home supplies of sugar and salt. In addition, the data show that health service staff increasingly gained confidence in ORT as demonstrated by increasing rates of utilization of the method, and as mothers indicated ORT to be the preferred method of treatment of diarrheal disease.

Child, Preschool↗