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PubMed1983

Utilizing tenets of inoculation theory to develop and evaluate a preventive alcohol education intervention.

With the advent of the Surgeon General's Report, Healthy People, a renewed interest in and concern for the health-risky practices of the school aged has emerged. Moreover, because the mortality rates for the 15 to 24 year age group continues to increase while the mortality rates for every other age group continues to decline, a school health education imperative has become prevention-based interventions. The experimental, prevention-based alcohol education program reported here describes one such intervention directed at 9th grade students. The program was grounded on the principles of Inoculation Theory and evaluated using a Solomon Four-Group Design. Results indicate that the formulation of preventive alcohol education programs utilizing Inoculation Theory in a school setting is both feasible and productive in achieving designated objectives. Longitudinal assessment of the subjects with regard to their alcohol-related behavior is continuing throughout their high school careers.

Adolescent↗
PubMed2006

Effect of high-intensity inspiratory muscle training on lung volumes, diaphragm thickness, and exercise capacity in subjects who are healthy.

BACKGROUND AND PURPOSE: Previous investigations have demonstrated that a regimen of high-intensity inspiratory muscle training (IMT) resulted in changes in ventilatory function and exercise capacity in patients with chronic lung disease, although the effect of high-intensity IMT in subjects who are healthy is yet to be determined. The purpose of this study, therefore, was to examine whether high-intensity IMT resulted in changes in ventilatory function and exercise capacity in subjects who were healthy. SUBJECTS: Twenty subjects were randomly assigned to 2 groups. METHODS: The training group completed an 8-week program of IMT set at 80% of maximal effort. The control group did not participate in any form of training. Baseline and posttraining measures of body composition, pulmonary function, inspiratory muscle function (including maximal and sustained maximal inspiratory pressures [MIP and SMIP]), relaxed and contracted diaphragm thickness and thickening ratio (Tdi.rel, Tdi.cont, and TR), and exercise capacity were determined. RESULTS: The training group demonstrated significant increases in MIP, SMIP, Tdi.cont, TR, VC, total lung capacity, and exercise capacity compared with the control group, which demonstrated no change from baseline measurements at 8 weeks. DISCUSSION AND CONCLUSION: The findings of this study suggest that high-intensity IMT results in increased contracted diaphragm thickness and increased lung volumes and exercise capacity in people who are healthy.

Adult↗
PubMedDate not supplied

Current federal activities in school health education.

In 1979, the Federal Government released a report, "Healthy People," that examined the major health problems and the associated preventable risks facing Americans. For the school-age population in particular, several problem areas are notable, such as violence (suicide and homicide), accidents, and drug and alcohol abuse. A number of risk factors related to personal behavior have been identified for these and other health problems facing young Americans. Comprehensive school-based health promotion programs have the potential to influence positively the health status of the school-age population. This article highlights some of the more important recent Federal activities related to school-based health education.

Adolescent↗
PubMed1994

Determination of the anaerobic threshold by gas exchange: biochemical considerations, methodology and physiological effects.

This paper explains the physiological and biochemical basis of the anaerobic threshold (AT), achieved during physical exercise. The lactate concentration is approximately the same at rest in relatively fit adults, in normal sedentary subjects in adult patients with heart disease. But during exercise, the increase of lactate is inversely related to the physical fitness of the individual. During incremental work, the lactate concentration increases initially very little until a distinct metabolic rate (VO2 AT) is reached at which lactate starts to increase steeply (anaerobic threshold/AT; VO2 AT). Above the anaerobic threshold, accelerated glycolysis increases muscle lactic acidosis. This acidosis is buffered primarily by bicarbonate. The bicarbonate-derived CO2 causes an increased alveolar CO2 output relative to O2 uptake. Oxygen uptake is increased virtually linearly with work rate in healthy subjects with a slope of approximately 10 ml O2/min/Watt. VCO2 starts to increase more steeply in the mid-work-rate range after an initial linear behavior. This steepening is caused by an increased CO2 production from the HCO3-buffering of lactic acid for the range of work rates above the AT. Below the AT, the slope of increase in VCO2 is 1 or slightly less, averaging 0.95. Above the AT, it is greater than 1. The submaximal exercise protocol for the determination of AT includes a period of 2-3 min of unloaded cycling, a ramp program with x Watt increase/minute and a recovery period of 2 min. X is the rate of work rate increase per min, so that the incremental period of the exercise test lasts 8-10 min, stressing the patient for only a short time. The anaerobic threshold can be determined during the ramp program using the following four parameters: 1) steeper increase of VCO2 as compared to VO2 (V-slope-method); 2) respiratory exchange ratio = 0.95; 3) PETO2 increase; 4) VE/VO2 increase. The V-slope-method can be successfully applied, not only in healthy volunteers, but also in patients suffering from cardiac and/or pulmonary (breathing abnormalities) diseases. The so far published data show that the anaerobic threshold in healthy people and patients is a highly reproducible, accurately measurable, securely achievable parameter for the non-invasive evaluation of the individual cardiopulmonary exercise capacity.

Acid-Base Equilibrium↗
PubMed1997

Glucose metabolism in older adults: a study including subjects more than 80 years of age.

OBJECTIVE: This study was undertaken to understand the dynamics of glucose metabolism in healthy non-diabetic subjects older than age 80 (old-old) compared with subjects aged 61 to 79 (young-old), as well as to compare healthy older subjects with impaired glucose tolerance (IGT) with older subjects with normal glucose tolerance (NGT). DESIGN: A cross sectional, observational study. SETTING: A university hospital clinical research center. PARTICIPANTS: There were 28 community-dwelling adults, 10 older than age 80 and 18 aged 61 to 79. Thirteen of these people had NGT and 15 had IGT. Subjects were not taking any medication that interfered with glucose tolerance. MEASUREMENTS: Status of glucose tolerance was determined by an oral glucose tolerance test categorized as NGT or IGT according to WHO criteria. Insulin sensitivity (SI) and glucose effectiveness (SG) were assessed using a tolbutamide-assisted intravenous glucose tolerance test (IVGTT). The data were analyzed using the Minmod modeling program. Glucose tolerance (K(g)) and the acute insulin response to glucose (AIRg) were calculated from the IVGTT. RESULTS: There were no significant differences between the young-old and old-old in body mass index or in plasma glucose, insulin, or C-peptide levels in the fasting state or during the OGTT. Values for K(g), SI, SG, and AIRg from the IVGTT were similar in the two age groups. When the subjects were classified by glucose tolerance status, the subjects with NGT had age, gender, and body mass index similar to the subjects with IGT. Older people with IGT had a lower K(g) and tended to have higher fasting glucose and similar fasting insulin compared with people with NGT. IGT subjects had lower SI and tended to have lower SG. The AIRg in IGT subjects tended to be low rather than high when compared with older people with NGT. CONCLUSION: Otherwise healthy adults more than 80 years of age have measures of glucose metabolism similar to people aged 61 to 79. The presence of IGT in older adults is associated with insulin resistance, regardless of patient age. We hypothesize that the lack of pancreatic islet compensation for insulin resistance may contribute to impaired glucose tolerance in older adults.

Aged↗
PubMed2001

Self-reported utilization of preventive health services by retired employees age 65 and older.

OBJECTIVES: Increased utilization of preventive services among the aging has been associated with improved health status and decreased medical costs. We sought to examine the use of the Health Risk Appraisal (HRA) in benchmarking compliance and characterizing those retired employees who met preventive service guidelines. DESIGN: A retrospective cohort study of retired employees age 65 and older. SETTING: Nation-wide health promotion program offered by General Motors Corporation. PARTICIPANTS: 59,670 retired General Motors employees age 65 and older who participated in a nationwide mailed HRA health promotion program. MEASUREMENTS: Preventive health services compliance was measured using selected HRA questions. Gender, HRA participation patterns, overall health risk status, medical plan selection and disease status were examined as predictors of increased compliance. Multivariate logistic regression models were developed to test the relative contributions of participant characteristics to increased utilization. RESULTS: The self-reported HRA data indicated that compliance levels were higher than national averages. The Healthy People 2000 goals for the preventive services studied were met and exceeded (with the exception of tetanus immunization). Higher compliance was associated with being male, younger than 70 years, multiple-year HRA participation, overall low risk status and HMO insurance plan selection. CONCLUSION: The results from the HRA indicated that this population participated at a higher level than a comparable national sample exceeding goals set by Healthy People 2000.

Age Factors↗
PubMed1991

AIDS risk and prevention among adolescents.

Although relatively few teenagers have been diagnosed with AIDS and the extent of asymptomatic human immunodeficiency virus (HIV) infection among adolescents remains largely unknown, there is cause for concern about teens' risk of contracting HIV disease The incubation period (the time from initial infection to the development of full-blown AIDS) is estimated to average eight years, and therefore it is probable that most of the individuals in their twenties who have AIDS (20% of all the people with AIDS) contracted HIV during their teenage years. The sexual and drug use activities of many teenagers place them at increased risk for HIV transmission. Sexually transmitted diseases (STDs) are pervasive and a major cause of morbidity among sexually active adolescents. The rates of STDs have continued to rise even during the 'age of AIDS'. These rates are of concern since the behaviors associated with the acquisition and transmission of STDs are also the behaviors associated with HIV transmission. In addition, the presence of STDs may increase the likelihood of HIV transmission. Although condoms reduce the risk of HIV transmission, their use remains low among sexually active teenagers. Reducing or eliminating high risk behaviors is the only way to limit further spread of HIV. Effective prevention programs should be based on models and theories of risk behavior so that the programs can be designed to change those factors which lead to the undesirable risky behaviors. The AIDS Risk Reduction Model (ARRM) is presented as an example of such a social-physiological model. The ARRM model characterizes why people persist in engaging in high risk activities or make efforts to alter those activities. The three stages theorized to be necessary to reduce risky sexual activities are: (1) recognizing that one's activities make oneself vulnerable to contracting HIV; (2) making the decision to alter risky sexual behaviors and committing to that decision; (3) overcoming barriers to enacting the decision, including problems in sexual communication and seeking help when necessary to learn strategies to reduce risky behaviors. Each stage includes a number of constructs identified in prior research as important for engaging in 'healthy' or low risk behaviors. Innovative strategies must be developed and implemented to reach all adolescents, ranging from teenagers who attend school and live with their families to those teens who are runaways, live in detention facilities or are otherwise 'disenfranchised'. To be most effective, HIV prevention programs must utilize strategies which combine cognitive and behavioral skills training.(ABSTRACT TRUNCATED AT 400 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Ensuring quality preventive care: the Texas Department of Health's Put Prevention into Practice initiative.

In the current public health arena, assurance of quality clinical preventive services to all populations will be possible only if collaborations are nurtured between public health and the private sector health care delivery systems. This article explores key preventive health programs that serve as the historical context for the evolution of the Texas Department of Health-Put Prevention Into Practice (TDH-PPIP) initiative, outlines documented barriers to implementation of preventive services in primary care, and reviews national public health programs launched to reduce these barriers. Lastly, a discussion regarding the joint responsibilities of the public health and the private sector professionals in assuring quality preventive services to all populations is initiated. Collaborative efforts, such as the TDH-PPIP, initiative improve the availability and quality of clinical preventive services and, thus, result in significant advances in the public health goal of ensuring conditions in which people can be healthy.

Delivery of Health Care↗
PubMed1996

African American and white differences in nutritional status among low-income women attending public health clinics.

Information concerning nutritional status and factors influencing dietary intakes among underserved populations is scarce. To obtain this information, data on nutritional status in a group of 726 white and African American women of low education and low income who were inner-city dwellers were analyzed. Dietary habits in all subjects were characterized by high intakes of fat, saturated fat, cholesterol, and salt and low intakes of fiber and folate. A comparison of dietary intake patterns of low-income white and African American women showed a trend toward poorer dietary habits among the white women. It is suggested that differences between African Americans and whites in most nutrient intakes were due to factors such as low levels of education and income rather than racial background alone. Results imply that disease prevention and health promotion programs should include efforts to increase awareness and practice of healthy diet habits among all low-income women.

Adult↗
PubMed2002

Position of the American Dietetic Association: total diet approach to communicating food and nutrition information.

It is the position of the American Dietetic Association that all foods can fit into a healthful eating style. The ADA strives to communicate healthful eating messages to the public that emphasize the total diet, or overall pattern of food eaten, rather than any one food or meal. If consumed in moderation with appropriate portion size and combined with regular physical activity, all foods can fit into a healthful diet. Public policies that support the total diet approach include Reference Dietary Intakes, Food Guide Pyramid, Dietary Guidelines for Americans, Nutrition Labeling and Healthy People 2010. The value of a food should be determined within the context of the total diet because classifying foods as "good" or "bad" may foster unhealthy eating behaviors. Eating practices are influenced by taste and food preferences, concerns about nutrition and weight control, physiology, lifestyle, environment, and food product safety. To increase the effectiveness of nutrition education in promoting sensible food choices, dietetics professionals plan communications and educational programs that utilize theories and models related to human behavior. Communication campaigns/programs should implement an active, behaviorally focused approach within the larger context of food choices. Nutrition confusion can be reduced by emphasizing moderation, appropriate portion size, balance and adequacy of the total diet over time, the importance of obtaining nutrients from foods, and physical activity.

Advertising↗
PubMed1990

Efficacies of US Food and Drug Administration-licensed HIV-1-screening enzyme immunoassays for detecting antibodies to HIV-2.

To determine the efficacy of enzyme immunoassays (EIAs) for antibodies against HIV-1 in detecting HIV-2-infected blood, we tested 55 HIV-2-positive sera with seven Food and Drug Administration-licensed EIA kits. The percentage detection of HIV-2 sera giving positive reactions with these kits varied between the various manufacturers from 60 to 91%. Observations based on a small number of sera (n = 13), suggest that HIV-2-positive blood collected from apparently healthy people (blood donors, prenatal clinics) are detected with a greater frequency (means = 89%) than blood from AIDS patients or patients (n = 32) hospitalized with other infectious diseases (means = 72%). Based on these results and the low incidence of HIV-2 infection observed in the USA, it was concluded that screening with HIV-2-specific tests would not significantly increase the number of HIV-2-positive people detected by current screening programs. However, due to the poor sensitivity of certain HIV-1 assays for HIV-2 antibodies, HIV-2 sera without cross-reacting antibodies will escape detection. Surveillance for HIV-2 might then be improved by the availability of HIV-1 and HIV-2 combination assays.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Lessons learned from employee fitness programs at the Marshfield Clinic.

PURPOSE: To describe and evaluate employee fitness programs at the Marshfield Clinic. METHODS: A 16-week program was offered to employees from April-July 2004, and a 12-week program was offered from August-November, 2004. Weekly e-mails included suggestions to increase physical activity and eat a healthy diet. Incentives were offered for meeting program goals. RESULTS: A total of 1129 employees signed up for the first program (approximately 18% of all employees) and 610 for the second program. More than 95% of the participants in both programs were female. The activity program goal was met by 231 (20.5%) participants in the first program and 31% (n = 190) of participants in the second program. There was a significant increase in the percent of people with good or excellent fitness levels from baseline (46.4%, 95% CL = 40.5, 52.3) to follow-up (70.7%, 95% CL = 65.3, 76.0) in the first program. In the second program, there was a significant association between the number of program goals met and self-report of having increased energy, better weight control, and feeling better overall and about body image. CONCLUSION: Emphasis in future programs should be placed on increasing employee participation. Program evaluation could be expanded to include health care costs and employee absenteeism.

Adult↗
PubMed2006

Comprehensive statewide approach to improve youth outcomes: experience of the New York State Youth Development Team.

Best practice research indicates a need for a policy shift toward positive youth development (YD) principles and strategies. The New York State Youth Development Team (YDT) is a public-private partnership of leading agencies whose holistic vision, "families, schools and communities partner to support the development of healthy, capable and caring youth," requires key stakeholders at all levels to address adverse youth health outcomes through effective partnerships. To transform the YDT vision into statewide practice requires committed actions (policy, funding, and training) at the state and community levels. Key lessons learned and experience-based recommendations that guide YD efforts in New York State can help state and local agencies move more to a positive YD approach that helps young people become healthy, caring, competent, and contributing adults, fully prepared to be parents, workers, leaders, entrepreneurs, and citizens of the future.

Adolescent↗
PubMedDate not supplied

Making a difference: immunizing infants and children.

Childhood immunizations, particularly for those under the age of two, is a major health issue. Since the measles epidemic in 1989-1991, the American Nurses Association/Foundation has collaborated with Every Child By Two (ECBT) to protect the nation's youngest from the ravages of vaccine preventable disease. Immunizations are the first line of prevention for infants and children. Healthy People 2000, together with the Presidential Administration's Childhood Immunization Initiative has mandated a goal of 90% immunizations for children under the age of two by the year 2000. As a nation, we are very close to meeting that goal.

Adolescent↗
PubMed2001

Primary care-based physical activity programs: effectiveness in sedentary older patients with osteoarthritis symptoms.

OBJECTIVE: This study examined, in a group of older patients, (a) the effectiveness of an invitation to participate in a program providing individualized physical activity advice in a primary care setting and (b) the changes in self-reported physical activity and symptoms in patients with osteoarthritis (OA). METHODS: Healthy, sedentary community-dwelling men and women aged 60 years or more were invited to participate. Following random allocation, the intervention group received individualized physical activity advice at baseline and at 3, 6, and 12 months followup. RESULTS: Of the 299 people who satisfied the study's inclusion criteria, a subgroup of 69 people reported pain and stiffness of the hip or knee at baseline. These patients reported increases in frequency and time of walking and vigorous exercise (all P < 0.001), with no change to OA symptom scores (pain and stiffness), and a small decline in physical functioning was reported at 12 months followup in the control group only (P = 0.027). At the 12-month followup more intervention participants than control participants (P = 0.013) reported a greater intention to exercise. CONCLUSIONS: An offer of primary care-based physical activity advice, with an emphasis on the benefits for general health (rather than "treatment" for OA), will attract individuals with OA symptoms. Although the present study was unable to demonstrate intervention-control group differences for the majority of outcomes, intention to exercise did appear to be positively influenced.

Age Factors↗
PubMed1997

Lung cancer.

The primary prevention of lung cancer is to avoid and decrease the use of tobacco. Further research could include studying the effects of culture, ethnicity, and geographic location on smoking. Education needs to start early in the educational systems. At present there are programs for primary grades on drug and alcohol abuse and how to say "no." Education also needs to include the family when the parents are smokers, as their children are exposed to second-hand smoke and are led by example. Certain religious groups believe it is their duty to keep healthy and, therefore, do not smoke. These groups may be able to provide some answers as to how to prevent people from smoking. Prevention--it is our real hope.

Aged↗
PubMed1993

Philippines: pilot project on HIV and AIDS education and prevention.

The project set up by Christian Children's Fund-Philippines and STOP Trafficking of Filipinos aims to identify cultural practices of young people which may have bearings on their sexual practices and information on how they think and feel about HIV and AIDS. The baseline study found that a number of young adults shared common misconceptions about boy-girl relationships and sex; therefore, there is a need to clarify these concepts and develop self-awareness in order to promote sound and healthy attitudes toward interpersonal relationships and sexual behaviors. The study also found the need for young people to undergo training as a strategy for information dissemination and acquisition of right information and/or expand knowledge to deal effectively with current realities including HIV/AIDS and human sexuality. This baseline information is used to design intervention and communication packages composed of training modules, posters, and other materials that can be used for an educational program for youth. This project was supported by the National AIDS Prevention and Control Program of the Department of Health in the Philippines.

Acquired Immunodeficiency Syndrome↗