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PubMedDate not supplied

Health status of newcomers.

This article presents and discusses findings on the health status of newcomers residing in Windsor, Ontario. The data are part of a larger study, which was based on the Ontario Health Survey's questionnaire. Data were collected from 548 newcomers through home visits, focus groups, mail surveys, and telephone interviews. Descriptive multivariate analyses focused on main areas in newcomers' physical and mental health status and their access to health services. The findings identified that most newcomers do not have acute, life-threatening physical problems or chronic illness. They do not experience major problems with access to health care or activity limitations. Men are happier, more satisfied with their health, and less stressed than women. This study has implications for adoption of sensitive transcultural approaches to promote newcomers' health. Special challenges lie in women's health and mental health.

Adolescent↗

PubMed1995

Staff evaluation of nursing home residents' competence.

Nursing home staff members frequently screen residents for competence, but the ability to assess competence has received limited attention. This study compared staff members' competence assessments with residents' (N = 100) mental status, measured by the Short Portable Mental Status Questionnaire (SPMSQ), and examined information used by staff to evaluate residents' competence. Staffers' evaluation of competence was significantly correlated with resident SPMSQ score. Staffers used information about orientation, alertness, and verbal function, with little consideration of decision making ability and mental status.

Aged↗

PubMed2006

A survey evaluating the training of anesthesiology residents in office-based anesthesia.

STUDY OBJECTIVE: To determine the current status and future plans of residency programs to train residents in office-based anesthesiology (OBA), which is rapidly emerging as an important specialty within the field of anesthesiology. DESIGN: Survey questionnaire. SETTING: University hospital. MEASUREMENTS: A 14-question survey was sent to the 134 listed members of the Society of Academic Anesthesia Chairs/Association of Anesthesiology Program Directors to elicit the current status of educational endeavors and clinical exposure of anesthesiology residents to this type of practice. MAIN RESULTS: There were 95 respondents (72%). Fifteen (15.8%) academic anesthesiology programs provide OBA services in the community and two (2.1%) of the academic programs provide clinical exposure to their residents. CONCLUSIONS: Residents are receiving minimal, if any, exposure to OBA during their training.

Anesthesia↗

PubMed1998

Health insurance coverage among Chinese Americans in Los Angeles County.

OBJECTIVES: This paper examines the factors associated with health insurance coverage among Chinese Americans in Los Angeles County. METHODS: Data were obtained through interviews conducted in 1993 and 1994 with Chinese Americans (aged 18 through 65 years) residing in Los Angeles County. A multistage probability sample was used to select respondents. RESULTS: The final sample consisted of 1747 respondents, which represented an 82% response rate. Thirty-nine percent of the respondents in the survey were without health insurance at the time of the survey. CONCLUSIONS: Logistic regression analysis showed that marital status, length of residence in the United States, education, employment, and household income were associated with health insurance coverage among Chinese Americans.

Adolescent↗

PubMedDate not supplied

Drug consumption in a group of elderly residents of a nursing home: relationship to cognitive impairment and disability.

OBJECTIVES: The incidence of drug interactions and adverse reactions increases exponentially with increases in the number of medications consumed. The objective of this study was to investigate drug consumption, in particular nonsteroidal anti-inflammatory drugs (NSAIDs), and to assess the relationship between drug consumption and cognitive function and disability in a group of older people residing in a nursing home. PARTICIPANTS AND SETTING: Two-hundred residents (108 women, 92 men) of a nursing home in Ankara, Turkey, mean age 77.2 +/- 8.7 years (range, 60-98), were included in the study. Data were obtained about sociodemographic variables and drug consumption, and the Mini-Mental State Examination (MMSE) and Functional Independence Measure (FIM) were used to assess the cognitive and functional status. RESULTS: The majority (94.4% of men and 80.4% of women) were prescribed at least one drug, with a mean of 3.59 prescriptions prescribed to women 2.39 to men. The mean number of self-prescribed drugs used by the elderly was higher than found in previous studies. Although there was not a statistically significant difference in regard to socioeconomic status and self-prescribed drug usage, we found a significant positive correlation between nonprescribed drug use and the scores of FIM and MMSE (P < 0.05). The drugs self-prescribed most commonly were NSAIDs, with a rate of 72.5%. CONCLUSION: This study found high drug consumption correlated with poor cognitive and functional status in elderly residents of a nursing home.

Journal Article↗

PubMedDate not supplied

Fire-related deaths among Aboriginal people in British Columbia, 1991-2001.

BACKGROUND: Fire-related mortality rates are known to be higher in Aboriginal people in BC. The purpose of this study was to describe the epidemiology and context of fire-related deaths in this population. METHODS: All death registrations attributable to fires in the province were identified by the B.C. Vital Statistics Agency (1991-2001). Age-specific death rates (ASDR) and age-standardized mortality rates (ASMR) were calculated for Status Indians and other residents. Data from Coroner's reports from the B.C. Coroners' Service (1997-2001) were used to describe the context of Aboriginal fire-related deaths. RESULTS: The overall fire-related ASMR for Status Indians and other residents were 0.66 deaths and 0.07 deaths/10,000 population respectively. Annual ASMR for both populations were constant over the study period. ASDR were higher in every age category for Status Indians; children and seniors had higher rates in both populations. Twenty-seven Aboriginal fatalities (20 fires) were identified for the contextual analysis. Key findings were: 48% of the total sample had elevated blood alcohol levels; 30% of the fires were caused by lit cigarettes (majority of decedents were intoxicated); 15% of the fires were caused by electric heating sources; at least 34% of fires occurred in homes with absent or non-functional smoke alarms. INTERPRETATION: Fire-related mortality among Aboriginal people in BC is a preventable public health concern. In this population, fire safety and prevention programs should consider improving the prevalence of functioning smoke alarms, promoting the safe use of heat sources, and decreasing smoking behaviours and the use of alcohol.

Accident Prevention↗

PubMed1998

Factors associated with overweight and obesity among Kuwaiti college women.

A random sample of 585 Kuwaiti college women was studied in 1997 for factors associated with overweight and obesity. Weight and height were measured. The index of adiposity used was the body mass index (BMI), which is the weight in kilograms divided by the height squared (W/H2). The women were classified as overweight or obese (BMI > 25 or > 30 Kg/m2). The associated factors obtained through questionnaires included age, marital status, area of residence, number of siblings, (brothers, sisters, total), suffering from a chronic disease, obesity among parents, parents' education and occupation, number of major meals eaten, eating between meals, family income, number of servants, number of people living at home, exercising, last dental and physical checkup, dieting, year of study, highest desired degree, countries prefer visiting, and socioeconomic status (SES). The results of the study revealed that 27.2 and 7.2% of the students were overweight (BMI > 25 Kg/m2) and obese (BMI > 30 Kg/m2), respectively. Factors that were found to be significantly associated with overweight and obesity among the women included number of brothers, having a chronic disease, obesity among parents, dieting and countries prefer visiting. Logistic regression analysis of significant associated factors revealed that the same factors contributed to the development of overweight and obesity except number of brothers and having a chronic disease.

Adolescent↗

PubMed1991

Public knowledge of thalassemia in Greece and current concepts of the social status of the thalassemic patients.

Current concepts with regard to the social integration of the thalassemia patient worldwide require further evaluation. In this work we have investigated the concepts of the average citizen of continental Greece and Crete about the problem of thalassemia, his awareness of the basic characteristics of the disease and his attitudes towards some 'life-style' parameters of the thalassemic sufferer. We used the method of stratified random sampling and interviewed 3500 people aged 15-65 years. We carried out multivariate statistical analysis of responses to the items on thalassemia in relation to sex, age, educational level, place of residence and marital status. The results of this survey show that education was the factor with the greatest influence on the likelihood of being aware of thalassemia and of having accurate knowledge of the basic features of the disease. There was also a general effect of age with the highest awareness and the best knowledge being found in those aged 21-44 years, while place of residence was a significant factor for two items. The features known best were that thalassemia is non-infectious, that it calls for blood transfusion, and is inherited. Education had the strongest influence on the probability that a person holds the attitude that the sufferer from thalassemia can play a normal role in society as regards working and having a family, as well as generally living a normal life and, in the case of thalassemic children, playing and going to school. The attitude that thalassemics should work instead of receiving a state benefit depended on education, age and place of residence.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1993

Trends in incidence of anal cancer in Denmark.

OBJECTIVE: To study long term trends in incidence of anal cancer in a well monitored, unselected population. DESIGN: Descriptive epidemiological study based on data from the Danish Cancer Registry. SETTING: Denmark, 1943-87. MAIN OUTCOME MEASURES: Time related changes in anal cancer incidence according to sex, age, birth cohort, urban or rural residence, and marital status. RESULTS: The incidence of anal cancer remained fairly constant in the period 1943-57 and was similar for men and women, but it increased 1.5-fold among men and nearly tripled among women thereafter. Among men the incidence increased from 0.25 per 100,000 population (world standardised) in 1958-62 to 0.38 in 1983-7 (p = 0.01) and among women from 0.28 to 0.74 (p < 0.01). The greatest increase was among residents of the capital (Copenhagen). During 1943-87 age specific trends increased in young and middle aged men and in all age groups among women. Men with anal cancer were significantly more likely throughout the study period to be unmarried than were patients with cancer of the colon (adjusted odds ratio 2.7; 95% confidence interval 2.0 to 3.6) and stomach (2.1; 1.5 to 2.8), but no association with marital status was found among women. CONCLUSIONS: The distribution and incidence of anal cancer have changed appreciably since around 1960, especially among women, which indicates important aetiological changes. Changes in sexual behaviour may have facilitated the spread of a transmittable agent of aetiological importance. It has recently been suggested that cigarette smoking promotes anal cancer, and this finds indirect support in the synchronism between changes in anal cancer incidence and heavy smoking behaviour. Factors associated with homosexuality are likely to explain some of the cases among men.

Adult↗

PubMed2004

Factors influencing residents' decisions to pursue a career in hand surgery: a national survey.

PURPOSE: The number of programs offering hand surgery fellowships has remained approximately the same over a 6-year period while the number of fellows within these programs has decreased by 46%. This study aimed to identify factors that persuaded or dissuaded orthopedic and plastic surgery residents in choosing hand surgery as a career. METHODS: We conducted a national survey of final-year orthopedic (n = 600) and plastic surgery (n = 177) residents. We developed an internet questionnaire based on literature review and focus group discussions. A Web site link was sent via e-mail to program directors of accredited orthopedic and plastic surgery programs for distribution of this anonymous survey to the residents. Factor analysis combined items into an "intellectual issues" category and a "lifestyle issues" category. Logistic regression was used to evaluate factors that predict an outcome of entering a hand surgery fellowship. RESULTS: We achieved a 30% response rate. Respondents and nonrespondents were not significantly different in terms of gender and race. After controlling for age, gender, marital status, and specialty, residents who enjoyed the intellectual issues of the hand surgery field were more likely to pursue a hand surgery fellowship (odds ratio = 10.1; 95% confidence interval = 3.3-30.8). Although a positive attitude toward lifestyle issues of the hand surgery field tended to be associated with pursuit of a hand surgery fellowship, the relationship was much weaker (odds ratio = 2.5; 95% confidence interval = 0.8-7.3). CONCLUSIONS: Lifestyle issues associated with a career in hand surgery such as low reimbursement and long hours were not the most important factors to residents when considering a career in the field. Residents pursued hand surgery primarily because of factors such as interest in and exposure to this field. To prevent a potential shortfall of hand surgeons, both orthopedic and plastic surgery programs must strengthen residents' exposure to hand surgery education in their training.

Adult↗

PubMed2006

[Length of postpartum women hospital stay].

OBJECTIVE: Finding maternal factors and hospital characteristics responsible for postpartum length of stay in hospital, as well as assessment of impact of the factors. MATERIALS AND METHODS: 28,469 maternal medical records gathered in 2001-2002 througout nationwide telematic perinatal registry. Linear Mixed Models were used for statistical analysis of two groups: vaginal deliveries and cesarean sections. The outcome variable: postpartum length of stay in hospital. As factors were used: Maternal sociodemographic variables: place of residence, education, marital status, age. Health facts: body mass, if newborn is first baby, length of pregnancy, obstetrical history, diseases before pregnancy. Facts concerning pregnancy, delivery, puerperium: diseases during pregnancy and special events in pregnancy. Hospitals were characterised by reference level. MAIN OBSERVATIONS: Postpartum length of stay depends on mode of delivery, maternal clinical profile (especially length of pregnancy), place of residence, education as well as hospital reference level. RESULTS: Postpartum length of stay for vaginal deliveries is 4,03 days, for CC 6,21 days. Length of stay for urban areas and for the first baby is greater. For delivery < 37 weeks and for complications of puerperium length of stay is greater. For vaginal deliveries under and normal weight shorten it. In CC women with underweight, university education and special events in pregnancy and delivery stay is shorter. Stay in local hospital is longer.

Adult↗

PubMed2003

Measurement of perceived health problems as a means of detecting elderly people at risk of malnutrition.

BACKGROUND: As nutritional preventative measures are more effective in elderly people assessed as non protein-energy malnourished (non-PEM) than such interventions are in those who are malnourished, early detection of those at risk of malnutrition is important. OBJECTIVE: This study tests the hypothesis that health problems measured by the Nottingham Health Profile (NHP) can predict residents at risk of malnutrition. DESIGN: Nutritional status was assessed in 261 residents newly admitted to municipal care using a combination of anthropometry and serum protein measurements. From this sample, 20 non-PEM residents, simultaneously assessed as moderately malnourished according to a subjective method, were consecutively included. Using a paired matched design, 20 other non-PEM residents, who were simultaneously subjectively assessed as well nourished, completed the pairs. RESULTS: Univariate logistic regression analyses showed that the dimensions of emotional reactions, energy, pain, physical mobility and sleep had significant power to predict residents at risk of malnutrition. In the multiple logistic regression analysis, energy had the highest explanatory power. CONCLUSION: Non-PEM residents, assessed as moderately malnourished according to the Subjective Global Assessment, perceived significantly greater health problems than non-PEM residents subjectively assessed as well nourished. Measurement of health problems adds important information to that used in early detection of residents at risk of malnutrition.

Aged↗

PubMed2006

Do people with risky behaviours participate in biomedical cohort studies?

BACKGROUND: Analysis was undertaken on data from randomly selected participants of a bio-medical cohort study to assess representativeness. The research hypotheses was that there was no difference in participation and non-participations in terms of health-related indicators (smoking, alcohol use, body mass index, physical activity, blood pressure and cholesterol readings and overall health status) and selected socio-demographics (age, sex, area of residence, education level, marital status and work status). METHODS: Randomly selected adults were recruited into a bio-medical representative cohort study based in the north western suburbs of the capital of South Australia--Adealide. Comparison data was obtained from cross-sectional surveys of randomly selected adults in the same age range and in the same region. The cohort participants were 4060 randomly selected adults (18+ years). RESULTS: There were no major differences between study participants and the comparison population in terms of current smoking status, body mass index, physical activity, overall health status and proportions with current high blood pressure and cholesterol readings. Significantly more people who reported a medium to very high alcohol risk participated in the study. There were some demographic differences with study participants more likely to be in the middle level of household income and education level. CONCLUSION: People with risky behaviours participated in this health study in the same proportions as people without these risk factors.

Adult↗

PubMed1979

Graduate education in family practice: a ten-year review.

Assessment of the progress of graduate education in family practice after ten years shows that the original goals established for residency training in this specialty are being effectively met. There are now more than 360 approved family practice residencies in the United States with over 6,000 residents in training. Student interest in these programs has remained at a high level, and attrition has been low. Graduates of these programs have favored partnership and group family practice, and are well distributed in rural, suburban, and metropolitan areas. Heavy emphasis has been placed upon quality control mechanisms for both internal and external review of family practice residency programs. This paper outlines some concerns regarding the present status of family practice residencies, and suggests some directions for future development of these programs.

Curriculum↗

PubMed1989

Nonemergency visits to hospital emergency rooms: a comparison of blacks and whites.

Both blacks and whites go to hospital emergency rooms for nonemergency health problems. Age, marital status, and health conditions are significant sociodemographic determinants for blacks' visits on these occasions, while those for whites include sex, age, education, insurance, employment status, region of residence, and health conditions. Despite the significant differences in determinants, similar influences bear on the two groups' decision to utilize medical services generally. Discrete analyses are still needed of cultural and interracial variation affecting the use of health facilities, together with intensive assessment of community characteristics in which the facilities are located, especially among black populations.

Adolescent↗

PubMed2005

Position of the American Dietetic Association: Liberalization of the diet prescription improves quality of life for older adults in long-term care.

It is the position of the American Dietetic Association (ADA) that the quality of life and nutritional status of older residents in long-term care facilities may be enhanced by liberalization of the diet prescription. The Association advocates the use of qualified dietetics professionals to assess and evaluate the need for medical nutrition therapy according to each person's individual medical condition, needs, desires, and rights. In 2003, ADA designated aging as its second "emerging" area. Nutrition care in long-term settings must meet two goals: maintenance of health and promotion of quality of life. The Nutrition Care Process includes assessment of nutritional status through development of an individualized nutrition intervention plan. Medical nutrition therapy must balance medical needs and individual desires and maintain quality of life. The recent paradigm shift from restrictive institutions to vibrant communities for older adults requires dietetics professionals to be open-minded when assessing risks vs benefits of therapeutic diets, especially for frail older adults. Food is an essential component of quality of life; an unacceptable or unpalatable diet can lead to poor food and fluid intake, resulting in weight loss and undernutrition and a spiral of negative health effects. Facilities are adopting new attitudes toward providing care. "Person-centered" or "resident-centered care" involves residents in decisions about schedules, menus, and dining locations. Allowing residents to participate in diet-related decisions can provide nutrient needs, allow alterations contingent on medical conditions, and simultaneously increase the desire to eat and enjoyment of food, thus decreasing the risks of weight loss, undernutrition, and other potential negative effects of poor nutrition and hydration.

Aged↗

PubMed1989

A survey of the human T-cell lymphotropic virus type I (HTLV-I) in south-western Colombia.

To evaluate altitude of birthplace and residence as factors associated with geographic clustering of HTLV-I infection in Colombia, we sampled a total of 670 current residents of the South Pacific coastal lowland and of upland regions (Cali and environs) of the Valle and Cauca Provinces, located at an altitude of 3,100 ft. Among the 255 lowland study subjects, 4.3% had antibody against HTLV-I, compared to 0.9% of the 415 upland study subjects. A hypothesis emerging from this study is that the lower socio-economic status of lowland residents and associated diseases, particularly untreated syphilis and other sexually transmitted diseases, may explain the increased HTLV-I seropositivity rates in this population.

Adult↗

PubMed2007

Low-carbon energy policy and ambient air pollution in Shanghai, China: a health-based economic assessment.

Energy and related health issues are of growing concern worldwide today. To investigate the potential public health and economic impact of ambient air pollution under various low-carbon energy scenarios in Shanghai, we estimated the exposure level of Shanghai residents to air pollution under various planned scenarios, and assessed the public health impact using concentration-response functions derived from available epidemiologic studies. We then estimated the corresponding economic values of the health effects based on unit values for each health outcome. Our results show that ambient air pollution in relation to low-carbon energy scenarios could have a significant impact on the future health status of Shanghai residents, both in physical and monetary terms. Compared with the base case scenario, implementation of various low-carbon energy scenarios could prevent 2804-8249 and 9870-23,100 PM10-related avoidable deaths (mid-value) in 2010 and 2020, respectively. It could also decrease incidence of several relevant diseases. The corresponding economic benefits could reach 507.31-1492.33 and 2642.45-6192.11 million U.S. dollars (mid-value) in 2010 and 2020, respectively. These findings illustrate that a low-carbon energy policy will not only decrease the emission of greenhouse gases, but also play an active role in the reduction of air pollutant emissions, improvement of air quality, and promotion of public health. Our estimates can provide useful information to local decision-makers for further cost-benefit analysis.

Air Pollutants↗