Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Health Transition”

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 739 records · Page 41Linked to original sources
PubMed2002

Differences in body mass index and waist: hip ratios in North Indian rural and urban populations.

Overweight could be a major factor in determining the increasing rates of coronary heart disease in the Indian population, by its influence on blood pressure, diabetes and insulin resistance. We studied the prevalence of overweight in north Indian urban and rural population samples. The urban sample population (n = 3050) was selected using a multistage sampling with stratification for geographical zone and the type of residential colony and cluster sampling of urban blocks in each stratum. The rural sample (n = 2487) was selected by random sampling of villages stratified for population size followed by coverage of all eligible persons in the village. All participating individuals were 35-64 years of age. Women constituted 52.2% (n = 1594) and 57% (n= 1417) of urban and rural samples, respectively. The study reveals that overweight is widely prevalent in the adult urban Delhi population, whereas underweight is a significant problem in the rural population. This was noted across all the age groups in both men and women. We estimated 'comprehensive coronary risk estimates' based on the New Zealand Heart foundation guidelines and noted that the proportion of high and very high risk subjects increased in a continuous manner even within the 'normal' ranges of BMI. This difference in prevalence in the urban population could represent the demographic transition in the Indian population.

Adult↗
PubMed2006

Changes in periodontal health status are associated with bacterial community shifts as assessed by quantitative 16S cloning and sequencing.

The gingival sulcus contains a complex ecosystem that includes many uncultivated bacteria. Understanding the dynamics of this ecosystem in transitions between health and disease is important in advancing our understanding of the bacterial etiology of periodontitis. The objective of this longitudinal study was to examine the stability of bacterial colonization in the gingival crevice and to explore the relationship between shifts in microbial composition and changes in periodontal health status using a comprehensive, quantitative, culture-independent approach. Subgingival plaque samples and periodontal data were collected from 24 subjects over 2 years. Baseline and 2-year plaque samples were analyzed using quantitative ribosomal 16S cloning and sequencing. Ten subjects remained periodontally healthy over 2 years, the periodontal health of seven subjects worsened, and seven subjects showed clinical improvement. Bacterial stability was greatest among healthy, clinically stable subjects and lowest for subjects whose periodontal status worsened (P = 0.01). Higher numbers of species lost or gained were also observed for subjects whose clinical status changed (P = 0.009). This provides evidence that a change in periodontal status is accompanied by shifts within the bacterial community. Based on these data, measures of microbial stability may be useful in clinical diagnosis and prognosis. Regarding individual species, increases in levels of the uncultivated phylotype Veillonella sp. oral clone X042, a gram-negative bacterium and the most common member of the subgingival bacterial community, were associated with periodontal health (P = 0.04), suggesting that this is an important beneficial species. Filifactor alocis, a gram-positive anaerobe, was found at higher levels in subjects with disease (P = 0.01).

Adult↗
PubMedDate not supplied

[Elderly working women--late stages of employment and transition to retirement].

The employment of elderly women has become increasingly important. Changes in employment patterns have led to an increase in the number of working middle-aged women, especially among women with children and families. The later employment years of middle-aged women are characterized by problems at work and in the labour market which are caused by insufficient skills and poor health. The transition to (early) retirement does not follow any specific patterns. It is shaped by health and financial conditions and family concerns. A large percentage of retired women have difficulties adjusting to retirement conditions. An analysis of this status passage must include all scopes of action of elderly employed women.

Adaptation, Psychological↗
PubMed2004

Economic growth, longevity and the epidemiological transition.

This paper integrates investments in health to a standard growth model where physical and human capital investments are the combined engines of growth. It shows the existence of two distinct health regimes separated by an "epidemiological transition." The various patterns of this transition identified in the epidemiological literature can be mapped into the model. The model also leads to the important hypothesis that the epidemiological transition may induce an economy to switch to a modern growth regime.

Economics↗
PubMed1996

Organizational models and functions of occupational health services in countries in socioeconomic transition: present state and perspectives. Summary report on a WHO meeting, Lodz, Poland, 15-17 December 1994.

In the context of the WHO health for all policy, a meeting was convened to review the present models and functions of occupational health services in the countries of central and eastern Europe and the newly independent states of the former Soviet Union and to discuss trends in anticipated modifications to the organizational model. The participants recognized that the progress of socioeconomic transition varied widely in the 25 countries involved and that such transition substantially affects the organization, conditions of operation and needs of occupational health. To facilitate the transition process and help identify priorities, find new solutions and provide professional and information support to individuals and institutions in occupational health, the meeting proposed the establishment of a subregional WHO network of occupational health institutions in these countries.

Europe, Eastern↗
PubMed2005

Cardiovascular diseases in Croatia and other transitional countries: comparative study of publications, clinical interventions, and burden of disease.

AIM: To determine the number of publications on cardiovascular diseases in the MEDLINE database, the rate of medical doctors and clinical interventions in cardiology, and health and socioeconomic indicators for Croatia, and to compare them with those for Slovenia, Hungary, the Czech Republic, and Austria. METHODS: PubMed was used in search for publications on cardiovascular diseases published in 1991-2004. Rates per million population and proportions of publications on cardiovascular diseases in the MEDLINE database were calculated. Gross domestic product (GDP) per capita was used as a socioeconomic indicator, whereas human resources in medicine were presented as the rate of medical doctors per million population. Standardized death rates from cardiovascular diseases and ischemic heart disease were used as indicators of cardiovascular health. Clinical interventions in cardiology, such as coronary angiograms, percutaneous transluminal coronary angioplasties (PTCA), and coronary bypass surgeries (CABG) were expressed per million population per year. RESULTS: Croatia had the lowest GDP per capita among the analyzed countries. The standardized death rate from cardiovascular diseases in Croatia was 91.7 per 100,000 population aged 0-64 in 2001, which was higher than that in Slovenia and Austria (P<0.001), similar to that in the Czech Republic, and lower than that in Hungary (P<0.001). Cardiovascular scientific output in Croatia was the lowest among investigated countries, ie, 1.1 per million population in 2003 (P<0.001). Despite a significantly lower number of medical doctors in comparison with Hungary and the Czech Republic (P<0.001), Croatia experienced a similar increment in the amount of clinical interventions in cardiology. CONCLUSION: In contrast to high cardiovascular mortality rates, cardiovascular scientific production in Croatia was significantly lower than in other investigated countries. A positive trend in cardiovascular medicine was recorded in clinical practice, but has yet to be followed by scientific production.

Adolescent↗
PubMed2002

Increasing use of prenatal care in Ladakh (India): the roles of ecological and cultural factors.

Attempts to manage the outcome of pregnancy are ubiquitous among human societies. Those practices are becoming standardized as prenatal care under a biomedically trained practitioner has come to characterize the formal management of pregnancy. However, many women do not seek biomedical surveillance of their pregnancies, and, in many contexts, particularly in 'modernizing' or rural communities, prenatal care facilities are often poorly coordinated and under-utilized for a variety of reasons. This report illustrates widespread and increasing usage of biomedical services for prenatal care and birth among women in Ladakh, India, over the course of the past 20 years. This trend is at odds with that typical of other parts of South Asia, and can be attributed to the unique ecological, cultural, and historical characteristics of this region. These include the hypoxia of this high-altitude region, which poses substantial problems for successful birth outcome, along with the socio-ecology of maternal diet and work patterns that further compromise birth outcome. These risk factors exist in the context of the absence of involvement of traditional institutions such as Tibetan medicine or traditional birth attendants (TBAs) in pregnancy and birth, and government-sponsored efforts to establish institutions of modernity in Ladakh such as biomedical facilities. Hence, the penetration of biomedical services into the domain of reproductive health has been facilitated. Idiosyncratic aspects of the obstetrics practice itself, particularly the social position and personality of the obstetrician, have also played an important role in recruiting women to make use of hospital-based prenatal care and birth. However, despite broader usage of prenatal care and hospital births by Ladakhi women, there is little indication that birth outcomes have improved significantly. Reasons for this lack of measurable success are considered.

Culture↗
PubMedDate not supplied

Changing use of hormone therapy among minority women since the Women's Health Initiative.

OBJECTIVE: There has been a significant shift in the use of hormone therapy (HT) among nonminority women since the publication of results of the Women's Health Initiative (WHI). Little is known about how the WHI results affected minority populations. This survey measured patterns of HT use among inner city women after publication of the WHI results, identified factors involved in the decision to continue or discontinue HT, and characterized the symptom burden and the experience of women who attempted to discontinue HT. DESIGN: We conducted a cross-sectional survey of 101 English- and Spanish-speaking women in an inner city general internal medicine clinic from August 2003 to April 2004. All women had been taking HT at the time of the publication of the WHI results. The survey included questions on patient-reported experience with HT, symptoms of menopause, and use of alternative treatments. RESULTS: Overall, 101 of 142 (71%) eligible women agreed to participate. The mean age of participants was 60 years; 43% were African American and 46% were Hispanic. The mean duration of HT use was 9.6 years. Three quarters (74%) had heard about the WHI findings, and 87% had attempted to stop taking HT after their publication. The most common reason for attempting to stop HT was concern about an increased risk of cancer or a general increase in risk to health. Of those who stopped HT, the vast majority (85%) reported vasomotor symptoms, and 26% restarted HT, mostly to treat those symptoms. CONCLUSIONS: Nearly all minority women in this small sample attempted to stop HT use after the results of the WHI were published. Restarting HT for treatment of symptoms was common.

Aged↗
PubMed2006

Long-term reductions in mortality among children under age 5 in rural Haiti: effects of a comprehensive health system in an impoverished setting.

OBJECTIVES: Evidence regarding the long-term impact of health and other community development programs on under-5 mortality (the risk of death from birth until the fifth birthday) is limited. We compared mortality in a population served by health and other community development programs at the Hôpital Albert Schweitzer (HAS) with national mortality rates among children younger than 5 years for Haiti between 1958 and 1999. METHODS: We collected information on births and deaths in the HAS service area between 1995 and 1999 and assembled previously published under-5 mortality rates at HAS. Published national rates for Haiti served as a comparison. RESULTS: In the early 1970s, the under-5 mortality rate at HAS declined to a level three fourths lower than that in Haiti nationwide. More recently, HAS rates have remained at one half those for Haiti nationwide. Child survival interventions in the HAS service area were substantially higher than in Haiti nationwide although socioeconomic characteristics and levels of childhood malnutrition were similar in both areas. CONCLUSIONS: HAS's programs have been responsible for long-term sustained reduction in mortality among children aged less than 5 years. Integrated systems for health and other community development programs could be an effective strategy for achieving the United Nations Millennium Goal to reduce under-5 mortality two thirds by 2015.

Benchmarking↗
PubMedDate not supplied

Prevalence of atrial fibrillation in a primary health care centre in Fars Province, Islamic Republic of Iran.

This study determined the prevalence of atrial fibrillation at a primary health care centre in Fars province of the Islamic Republic of Iran. All ambulatory people aged > or = 50 years visiting the centre between April and October 2001 were screened for atrial fibrillation using a standard 12-lead ECG. The mean +/- SD age of participants was 64.0 +/- 8.9 years. Of 463 participants aged 50-79 years, 13 (2.8%) had atrial fibrillation (median age 74 years), significantly more women (10/230) than men (3/233). Unlike previous studies in industrialized countries, the prevalence tripled with each decade of life and increased significantly from 0.6% in the 50-59 years to 6.4% in the 70-79 years age group. With increasing longevity in some developing countries, atrial fibrillation and consequently stroke may become major health problems.

Adult↗
PubMed2002

[Promoting competition and improving quality. Accepting the intergenerational contract by stabilizing health care reform].

The challenge of demographic transition requires a health care reform which strengthens competition and quality in health care. With this, important contributions in stabilizing intergenerational relations, especially intergenerational solidarity in the public health care system, can be achieved. The reform proposal by an expert group, invited by the Friedrich-Ebert-Foundation to develop a concept of health care reform, takes these considerations into account.

Aged↗
PubMed2001

Transition of adult patients with cystic fibrosis from paediatric to adult care--the patients' perspective before and after start-up of an adult clinic.

UNLABELLED: Although most patients with cystic fibrosis (CF) survive into adulthood, many CF centres are still run by paediatricians. A transition programme from the paediatric CF unit to a newly established CF clinic at the Department of Internal Medicine was carried out for the whole group of patients > or =18 years. We aimed to evaluate our patients' opinion of the transition by analysing the results of two surveys performed before and after the transition. Nine months before the transition, we mailed an anonymous questionnaire. Statements regarding the forthcoming transition were to be answered on scales from 1 to 4, and the patients had to check a list of adjectives describing the current treatment in the paediatric CF centre as well as the presumed care in the adult unit. Fifteen months after the transition, a second survey with similar questions was carried out. RESULTS: 44 of 68 patients (65%) aged 18 to 33 years replied to the first and 56% of patients to the second questionnaire. Mean duration of treatment at the paediatric CF centre was 7.5 years (range: 1 to 22 years). Twelve patients each were classified as supporters or opponents of the transition, the remaining patients as intermediates. Older patients and those who had not required hospitalisation during the preceding year had a more positive attitude to the transition (p <0.05). There was a linear relationship between the transition attitude score and the presumed quality of care in the Internal Medicine Department (r = 0.62, p <0.001), but no relation to the quality of present paediatric care (r = -0.09, p = 0.59). In the second survey, patients rated the quality of care in the adult CF unit better than prior to the transition. CONCLUSIONS: The transition from paediatric to a newly established adult CF centre was accepted by most adult CF patients. Thorough training of all staff of the new adult unit and a close co-operation between both departments are pre-requisites to guarantee a smooth transition of all patients.

Adolescent↗
PubMed2006

Access to health care for young adults with disabling chronic conditions.

OBJECTIVE: To assess health insurance status and health care access of young adults with disabilities attributable to a chronic condition. DESIGN AND SETTING: We analyzed data from the National Health Interview Survey from 1999 to 2002. We present bivariate analysis and multiple logistic regression of reported health care access barriers in the United States stratified by health insurance status. PARTICIPANTS: The study population included 1109 survey respondents with and 22 481 without disabling chronic conditions, aged 19 to 29 years. MAIN OUTCOME MEASURES: Delayed or unmet health needs owing to cost, no contact with a health professional in the prior year, and no usual source of care. RESULTS: Thirty-five percent of respondents with and 15% without disabling chronic conditions reported an unmet health care need owing to cost (P< .001). Uninsurance rates for young adults with and without disabling chronic conditions were similar (26% vs 28%, respectively), and uninsurance was significantly associated with unmet health care needs. More than two thirds of uninsured respondents with a disabling chronic condition reported an unmet health need and 45% reported no usual source of care. After adjusting for sociodemographic factors, uninsured young adults with disabling chronic conditions had 8 times greater odds of reporting unmet health care needs and 6 times greater odds of having no usual source of care relative to insured respondents with disabling chronic conditions. CONCLUSIONS: Despite increasing attention to issues of health care transition for young adults with disabling chronic conditions, this study suggests that uninsurance is as common among these young adults as nondisabled peers and is significantly associated with health care access barriers in this population.

Adult↗
PubMed1991

From retrospective to concurrent monitoring in a university student health center: a report on the transition.

From 1984, when the quality assurance (QA) program at the Student Health Center of the New Mexico State University, Las Cruces, was initiated, to 1990, QA activities moved from purely retrospective chart reviews to concurrent monitoring. The QA plan divides center services into six units (physician medical, certified nurse practitioner [CNP] medical, nursing, clerical, laboratory, and pharmacy), for which indicators are selected by the QA committee to be evaluated each semester. Concurrent monitoring has led to improvement in areas such as laboratory specimen labeling, patient chart documentation, and patient satisfaction.

Adult↗
PubMed1997

Bore holes and the vanishing of guinea worm disease in Ghana's upper region.

Ghana's Upper Region provides an excellent example of the beneficial effects of improved water security provided by hand-pump tube wells. Following a Ghana-Canada bilateral development project that installed some 2500 pumps, protection rates against guinea worm disease may be estimated as 88% in the west, and 96% in the east. Survey comparisons between ca 1960 and 1990 show that dracunculiasis declined in 32 of a total of 38 areas. The shadow of guinea worm has been lifted from the land and, in many areas, a true "vanishing" has occurred. The few areas of disease increase are characterized by the lowest population densities, pioneer settlement for cotton farming, and an absence of bore holes. Vagaries of development have inadvertently produced disease transformations or "metamorphoses" from dracunculiasis to elephantiasis (lymphatic filariasis) in one area, and to red water disease (schistosomiasis hematobium) in other areas. Correlative associations between pump densities and guinea worm disease are weakened by the large size of areas for which disease is reported in 1990. One preliminary finding is that geographical distance to the pump is a stronger influence than demographic pressure on pumps, regarding dracunculiasis. Diminishing returns on higher pump densities in many areas support the idea of making fuller, safer use of supplementary non-pump water. Despite crises of fee payment and pump maintenance, the rural bore hole project has struck a mortal blow against guinea worm, and permanently raised the quality of life in the Upper Region.

Animals↗