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PubMed1992

ABH secretor status in saliva of Calabar Municipality residents.

One hundred and seventy six healthy residents of Calabar Municipality were investigated for the presence of salivary ABH substances. Saliva and blood samples collected were analysed by haemagglutination inhibition and standard tube ABO grouping methods respectively. 86.90% and 13.10% of the subjects were ABH secretors and non-secretors respectively. A significant correlation was established between the secretor status frequency and ABO blood group phenotypes (P less than 0.001). No correlation was established with age or sex. O blood group subjects had higher titre of H-substances than A and B subjects while AB subjects had the lowest. In AB subjects, the A titre was usually higher than that of B substances. The gene frequencies for Se and se were 0.6390 and 0.3610 respectively while the phenotype prevalence rates for Se/se, Se se and se se were 40.83%, 46.15% and 13.10% respectively. It is concluded that the prevalence rate of non-secretors which has been associated with the occurrence of duodenal ulcer is low in the locality.

ABO Blood-Group System↗
PubMed2005

Does continuity of care matter in a universally insured population?

OBJECTIVE: To examine the relation between continuity of care and preventive health care and emergency department (ED) use in a universal health care system. DATA SOURCES/STUDY SETTING: Administrative data that capture health care use of the entire population of a midwestern Canadian city. STUDY DESIGN: A population-based, retrospective study of all individuals who had a least one physician contact in 1998 or 1999 (total N=536,893). METHODS: Logistic regressions were conducted to examine the relation between continuity of care, defined in terms of the proportion of total visits to family physicians (FPs) made to the same FP, and cervical cancer screening, breast cancer screening, influenza vaccination, pneumococcal vaccination, and ED visits, controlling for demographic variables, socioeconomic status (defined in terms of relative affluence of neighborhood of residence), and health status. PRINCIPAL FINDINGS: Continuity of care was related to better preventive health care and reduced ED use. A consistent socioeconomic gradient also emerged. For instance, the odds of having a mammogram was double for individuals living in the wealthiest neighborhoods, relative to those in the poorest neighborhoods (adjusted odds ratio=2.31, 99 percent CI 2.13-2.50). CONCLUSIONS: Having a long-term relationship with a single physician makes a difference even in a universal health care system. Moreover, socioeconomic disparities remain, suggesting the need to target specifically individuals from lower socioeconomic strata for preventive health care.

Adult↗
PubMed2004

Health status, lifestyle and nutrient intake of home resident elderly in Bahrain.

The elderly are more susceptible to chronic diseases which reduce functional capacity. Researches on health and nutritional status, therefore, are needed to prevent and control these chronic diseases. The objective of this study was to find out the health, lifestyle, ability to carry out daily living tasks, and intake of nutrients among home-resident Bahraini elderly. Data were based on a cross-sectional community study of 201 Bahraini elderly aged 65 years, which were selected proportionally from all geographical regions of Bahrain (88 men and 113 women). They were visited and interviewed at home by trained female workers, using a pre-tested questionnaire. There was no statistically significant difference between men and women in the history of chronic diseases. However, the proportion of chronic diseases was higher among women, except for peptic ulcer. Men were more likely to smoke (38.6%) than women (24.8%) (p = 0.0353). Dietary supplements were more common among men (19.3%) than women (12.4%). Mean nutrient intakes for energy, iron and calcium were below the USA Recommended Daily Allowances. Men had more capability to do daily activities without help than women. In conclusion, there is a need to establish a national plan of action to promote health and nutritional status among the elderly of Bahrain. This study can provide some baseline data for further in depth study of health status of Bahraini elderly.

Aged↗
PubMed2001

Nutritional status and chewing capacity in nursing home residents.

Chronically ill elderly persons sustain a high risk for protein-energy malnutrition (PEM). In this study we explored some of the complex associations between nutritional status, dental health and cognitive and physical function in 192 nursing home residents (mean age 84+/-8 years, 80% female). Nutrition-related data from the Resident Assessment Instrument (RAI) were compiled into a Nutrition Score (NuSc; 0-1 = non-PEM, 2 = risk for PEM, and 3-7 = PEM). Chewing capacity, according to number and condition of occlusal contacts, was determined by a Clinical Dental Functionality score (CDF). The Cognitive Performance Scale (CPS) and activities of daily living (ADL) were determined according to the RAI. Fifty percent of the residents had NuSc > or = 2, and 25% had NuSc > or = 3. One third did not have the dental prerequisites for chewing. i.e., < 4 occlusal contacts. Almost half of the residents had severe cognitive dysfunction, and over two thirds were severely limited in their ADL activities. Subjects with > or = 4 occlusal contacts, i.e., technical chewing capacity, had better NuSc (1.5+/-1.4) than those not able to chew (2.4+/-1.6, p=0.0005). In univariate logistic regression, the odds for NuSc > or = 2 increased with reduced ADL functions. inability to chew and poor cognition. In multivariate logistic regression, ADL and chewing capacity were significantly related to NuSc > or = 2. When NuSc > or = 3 was chosen as cut-off, only ADL was related to malnutrition. In conclusion, half of this group of nursing home residents appeared to be malnourished, or were at risk for PEM. Reduced physical function was the strongest predictor of PEM, while impaired chewing capacity was associated with risk for PEM.

Activities of Daily Living↗
PubMed2005

Using the FoodEx-LTC to assess institutional food service practices through nursing home residents' perspectives on nutrition care.

Background. Undernutrition occurs in approximately 2 of every 5 nursing home residents, negatively influencing their health and quality of life. The purposes of this study were to collect data about institutional meal preparation and food service practices that promote or retard adequate nutritional intake and to evaluate residents' food and food service satisfaction. Methods. The FoodEx-LTC, a simple, 44-item, 5-subscale questionnaire that measures food and food service satisfaction, was administered to 61 residents. Serum albumin and body mass index gauged the nutritional status of each resident. SPSS for Windows, version 10, was used for analyses. Results. Overall, 89% of residents were satisfied or somewhat satisfied with the food service. Of those who ate in the dining room, 44% had to wait to go back to their rooms, presenting a quality of life issue. Fifty-two percent received food they hated, 56% often received the same food, and 59% received food always cooked the same way. Most residents (75%) felt comfortable refusing food they did not like, but 65% did not complain. Most (79%) wanted to choose what to eat, but only 54% believed that choosing when to eat was important. Conclusions. The FoodEx-LTC, used to monitor nutrition care in nursing homes, incorporates residents' views into service delivery and responds to the Health Care Finance Administration's Nutritional and Hydration Awareness Campaign, part of the federal Nursing Home Initiative. Using the FoodEx-LTC to identify residents' perspectives may promote resident satisfaction and dietary intake through adaptation of nursing home food and food service practices.

Aged↗
PubMed2001

Functional disability at nursing home admission: a comparison of urban and rural admission cohorts.

This study's objective was to examine the relationships between rural residence and availability of nursing home and home health care to functional disability at the time of nursing home admission. Secondary data were obtained from the Minimum Data Set (MDS) 2.0 for Nebraska for 3,443 rural and 1,296 urban older people admitted to nursing facilities. Data from the MDS were merged with county-level data on home health agencies and nursing homes in Nebraska. The relationship of rurality of nursing home residents' prior residence and availability of nursing home and home health care to functional status at admission, controlling for demographic and health characteristics of older people, was estimated using multiple linear regression with robust variance estimates. After taking account of demographic and health status characteristics, rural residence and availability of home health and nursing home care had nonsignificant effects on functional status at admission. The findings indicate that functional disability at admission is associated with specific diseases and medical conditions, cognitive status, gender, living arrangements and marital arrangements. Rural older people are not at higher risk of admission at lower levels of functional disability compared to their urban counterparts.

Activities of Daily Living↗
PubMed1990

An examination of total charges in the long-term health care industry.

A significant amount of work relating to long-term health care costs has appeared in the literature. Although shortcomings exist, there is at least some understanding of the relationships underlying costs. The subject of charges for long-term health care, however, has essentially been ignored in the literature to date. The purpose of this study was to gain an initial understanding of those factors underlying differences in charges per resident. The study used descriptive data from the 1977 National Nursing Home Survey and regression analysis to examine the relative effects of three sets of characteristics on charges per resident: characteristics of the facility, characteristics relating to the resident's medical needs, and characteristics relating to the socioeconomic status of the resident.

Activities of Daily Living↗
PubMed1994

Residency training in graduate medical education (nine-year view).

Assessment of the progress of residency training in graduate education after 9 years shows that the original goals established for various specialties are being effectively met. There are now 7 approved residency programmes for diplomas and 10 approved residency programmes for fellowships with 324 residents trained and in training, out of whom (32%) were females, and 222 (68%) were male residents. Student interest in these programmes has remained at a high level. Only 15 candidates (4.64%) had withdrawn from the residency training programmes. Heavy emphasis has been placed upon curriculum design, selection criteria of students and quality control mechanisms through residency committees in specialty departments and the residency board embracing residency coordinators. This paper outlines some concerns regarding the present status of various residencies and suggests some recommendations for future development of these programmes.

Curriculum↗
PubMed1997

Epidemiological health study of a town exposed to chemicals.

The purpose of this survey was to assess the health status of community residents exposed to a 16-day release of Catacarb from a nearby refinery and to document the prevalence rates of symptoms and illnesses of this town. The health status of the exposed residents was compared to that of unexposed residents of a demographically similar control town. An epidemiologic study design was used and questionnaires were mailed to all households in both towns. Response rate was 43%. Household cluster effects, gender, education, and race were controlled in the analysis. Questionnaire health data reveal increased reporting of symptoms in the exposed, specifically headaches, respiratory, visual, gastrointestinal, and dermatologic with odds ratios ranging between 1.3 and 3. Exposure relationships with increased symptoms and worsening of illnesses was found.

Adolescent↗
PubMed1999

Acute health problems among the people engaged in the cleanup of the Nakhodka oil spill.

To determine if the Nakhodka oil spill and subsequent cleanup efforts had any health effects on the residents along the oil-contaminated coast, we investigated the health status of Anto residents who resided nearest to the coast where the bow ran aground. Two hundred eighty-two men and women involved in the cleanup activities between January 7 and January 20 were interviewed and examined by public health nurses to determine whether they suffered physical symptoms after exposure to the oil spill. Urine examinations for hydrocarbon toxicological markers were performed on 97 residents. The average number of days worked on cleanup activities was 4.7 days for men and 4.3 for women. Seventeen percent of the subjects had worked on cleanup activities for more than 10 days. Protective equipment was used against direct exposure to oil during the cleanup jobs and consisted of gloves used by almost 100% of the subjects and masks used by 87.1% of women and by only 35.4% of men. Glasses were worn by less than 30% of the subjects. Many symptoms emerged after the beginning of cleanup activities. The principal symptoms included low back pain and leg pain, headache, and symptoms of eyes and throat. Among the subjects undergoing urine tests, only three people showed a higher level of hippuric acid, although they returned to normal in the second examination. Accordingly, the exposure to the oil and the subsequent cleanup efforts were suggested to inflict acute health problems on local residents.

Acute Disease↗
PubMed1996

The status of pediatric surgical rotations by residents in pediatrics.

A variety of forces are reshaping the traditional relationship between physicians and their patients. One consequence of this reform movement will be increased responsibility of the pediatrician to evaluate children with surgical diseases. Pediatricians also will be encouraged to do more of the minor surgical procedures themselves. It is not clear how academic pediatric surgeons should adapt to these changes to assure that the general pediatrician is equipped with the skills to handle this increased responsibility. One obvious solution would be to have the pediatrician in training rotate on the pediatric surgery service. The authors have considered these issues at their institution, and thus became interested in learning the status of pediatric surgical rotations by pediatric house staff in this country. A survey was distributed to the 221 accredited pediatric training programs in this country, and 143 individuals responded. Only thirty-five of these programs require a rotation on pediatric surgery. Eighty-six programs offer it as an elective, but only a minority of house staff takes it. The most disturbing aspect of the survey was the 28 of the programs had required a pediatric surgical rotation in the past but had eliminated it. The most common reasons given for this action were the poor educational content of the rotation and the labor requirements of the pediatric service. Based on the survey, the authors believe that it is unlikely that mandatory rotations on pediatric surgery will be begun in pediatric training curriculums. If pediatric surgeons wish to be involved in training pediatricians, they will need to address the educational content of their electives to meet the changing educational needs of the pediatricians.

Data Collection↗
PubMed2004

Meals in nursing homes.

Undernutrition is present among 33% of nursing home residents in Denmark. Hence, it is relevant to examine the meal situation at nursing homes to single out factors that may increase or reduce the residents' food intake. In the ongoing Danish nursing home debate it is claimed that a new type of nursing home improves the residents' meal situation with a positive effect on nutrition. The aim of this work is to test the general hypothesis that (i) residents appreciate the meal situation in these nursing homes and (ii) nutritional status of the residents is improved in this type of nursing home. This study was carried out in four Danish nursing homes at various locations in Denmark. The methods used are qualitative interviews and observations at four nursing homes in combination with measurement of body mass index (BMI) at two of the four nursing homes. Undernutrition is defined as a BMI below 20. The study could not confirm the general hypothesis, as a consistent improvement in the meal situation was not found in the nursing homes studied. But an indication of improved nutritional status was found in two of the nursing homes where the degree of undernutrition was lower than generally found in Denmark. Furthermore, the study indicated that the staff and the residents conceived the nursing homes differently.

Aged↗
PubMed1989

Maintaining health and independence of elderly women.

1. There is a paucity of research specific to elderly women in the nursing literature. Research is needed in this area because older women have different patterns of aging than men. 2. Since older women are the most rapidly growing segment of American society, there is a need to maintain their health and independence while minimizing the effects of chronic illness. 3. Elderly women with a reported health status of excellent or good indicated they had a greater degree of social support than respondents reporting a fair or poor health status. 4. Women residing in private housing reported having an excellent or good health status and a greater degree of social support more frequently than women in public housing.

Activities of Daily Living↗
PubMed2005

Are there associations between socio-economic status and known diabetes in an elderly Finnish population?

The aim of the study was to describe the associations between socio-economic status and type 2 diabetes in a non-institutionalised population aged 70 years or over. Diabetes was assessed on the basis of self-reports and additionally 2-h oral glucose tolerance test for the subjects on diet treatment. Socio-economic status was assessed by questions on marital status, number of residents in household, basic education, self-rated income and economic status. In the population of 379 subjects (141 men), 14% (n = 19) of men and 19% (n = 46) of women had known diabetes. Known diabetes was less common among married compared to unmarried, widowed or divorced subjects. Diabetes was also more common among men with higher compared to lower level of basic education, while a reverse trend was seen among women. Women, who had been engaged in manual labour, had diabetes more often compared to those engaged in administrative work. Diabetes was more common among men who rated their income as good, but the opposite was true of women. Higher income among men and lower income among women were the most powerful variables associated with known diabetes. Known diabetes was more common in elderly women with lower socio-economic status, whereas the opposite was true of men. This finding suggests that the impact of the socio-economic changes that have taken place in Finland in the 20th century on the risk factors for diabetes has been greater among men with higher and women with lower socio-economic status.

Aged↗
PubMed2005

[The influence of socioeconomic factors on female fertility].

OBJECTIVE: To define causes of female infertility and socioeconomic factors affecting fertility. MATERIAL AND METHODS: The study group consisted of 438 patients, aged 21-46 (average 29.7), treated because of primary or secondary infertility between January 1999 and March 2003 at Gynecological Endocrinology Department of Medical University of Warsaw. All of them were residents of mazovian province. The following factors were analyzed: age, marital status, place of residence, education and the type of job performed in regard to their influence on fertility. The socioeconomic characteristics and the distribution of infertility in each age group were presented. RESULTS: Fifty women were aged over 35 (11.4%). Most of the examined patients were city residents--339 (80%). 182 (43.5%) women had university education, 189 (45.2%)--secondary education. 76 (18.5%) women were physical workers. The factors affecting fertility were: age, education and the type of work performed. CONCLUSION: Age over 35 years and intensive physical work are the factors affecting fertility.

Adolescent↗
PubMed1986

Socio-environmental factors and lung function.

The literature was reviewed to assess whether the evidence implicating socio-environmental (SE) factors as determinants of adult lung function was sufficient to require that they be taken into account in epidemiological studies, together with other factors, such as age and smoking. In six studies involving 11,000 adults resident in the USA, France and Denmark forced expiratory volume in 1 second was related to social class and/or one of a number of other factors including education, area of residence and housing status. Trends in three other studies involving approximately 15,000 children resident in the UK and the USA were similar. The consistency of the findings makes it difficult to escape the conclusion that SE factors should be taken into account in comparisons of lung function between populations when the purpose is to assess the role of other environmental factors such as occupational exposure.

Adolescent↗
PubMed2003

Selenium status of low-selenium area residents: Polish experience.

The concentration of selenium (Se) in human organism varies widely between geographical areas depending on its content in soil and plants, dietary Se intake, bioavailability and retention, mineral interactions and other factors. The study includes healthy inhabitants of different regions of Poland; pregnant women, lactating women, children from 0 to 15 years of age and adults. Systematic determinations allow us to observe changes of the concentration of Se in time, which may be significant for developing preventive action. The results obtained confirm our thesis that Se concentration in the blood of the inhabitants of Poland depends on the region of the country. In recent years, in a considerable number of Polish inhabitants, the concentration of Se in blood plasma has been relatively low-about 50-55 microg/l, and the calculated daily dietary intake about 30-40 microg/day. The low levels of the element in the blood and urine are probably due to its deficiency in the diet.

Adolescent↗
PubMedDate not supplied

Community residential care: comparison of cognitively impaired and noncognitively impaired residents.

Community residential care (CRC) is growing, with cognitive impairment the most common reason for CRC placement. We enrolled cognitively impaired and noncognitively impaired residents, informal caregivers, and providers in 219 CRC facilities for this study. Residents with cognitive impairment were older (p < .001), needed more activities of daily living (ADL) assistance (p < .001), and had a higher frequency of behavior problems (p < .001) than noncognitively impaired residents. Cognitively impaired and noncognitively impaired residents did not significantly differ in the facility-related factors they perceived as important or in the amount of control they felt they had over the decision to move. Including residents with cognitive impairment in future research and separately analyzing residents by cognitive status will give a more accurate picture of the needs of CRC residents.

Activities of Daily Living↗