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At least 91 records · Page 5Linked to original sources

Does leg ulcer treatment improve patients' quality of life?

OBJECTIVE: To investigate the impact of 'disease' and treatment on quality of life in patients with venous leg ulceration. METHOD: Sixty-five patients with venous leg ulcers were recruited and treated. At study entry and exit or following complete wound closure, whichever occurred first, each patient was assessed using the SF-36 quality-of-life questionnaire. Data analysis included an investigation of the study population as whole, differences between patients whose ulcers did and did not heal and between gender and age. Health domain means for all patients were compared with age equivalent norms (AENs) at both entry and exit. RESULTS: There was a significant improvement in the SF-36 domains of bodily pain, health transition, mental health and social functioning for all 65 patients. Patients whose ulcers healed also showed a statistically significant improvement in the vitality domain. Patients whose ulcers did not heal had statistically significant improved scores for bodily pain and health transition. At entry all SF-36 values, except for general health, were lower than the AENs. On exit, scores for bodily pain, general health and mental health were comparable with the AEN; values for the remaining five domains increased at exit. CONCLUSION: The results highlight that good wound management and effective compression therapy can improve quality of life in patients with venous leg ulceration, whether or not the patient's leg ulcer healed following treatment.

Aged↗

Epidemiological transitions, reproductive health, and the Flexible Response Model.

In concert with improving standards of living since the mid-19th century, chronic and non-infectious diseases replaced infectious diseases as the major causes of mortality in more developed countries. Thus, economic development has been seen as one strategy to improve women's reproductive health. However, rates of two of the major contributors to women's illness, maternal mortality and breast cancer, do not correspond well with the level of economic development. Drawing upon our longitudinal study of reproductive functioning among rural Bolivians (Project Reproduction and Ecology in Provincia Aroma (REPA)), we propose an evolutionary model to explain variation in certain aspects of women's reproductive health. Our findings suggest new avenues of inquiry into the determinants of reproductive health and have implications for improving the well-being of women worldwide.

Bolivia↗

[Global transition in health].

Global epidemiological transition reflected in changed patterns of death and diseases was first described by Omran; decreasing death and disease rates from infectious diseases, particularly in children and the young, are followed by decreased fertility rate and increased longevity, and by degenerative, and man-made diseases in ageing populations. Omran could not foresee the HIV/AIDS pandemic or the dramatic fall in longevity and fertility in, for example, Russia. But his model remains of value for health planners and politicians. We advocate for research in the interplay between diseases, populations and systems in a world in fast transition.

Adult↗

Promoting a sustainable mental health nursing workforce: an evaluation of a transition mental health nursing programme.

The recruitment and retention of the mental health nursing workforce has been identified as a major issue both nationally and internationally. Transition to practice programmes has been identified as an important strategy in addressing these issues. There is, however, a paucity of literature addressing the potential or effectiveness of transition programmes in achieving these aims. This paper reports the findings of a survey administered to registered nurses at the commencement and completion of the Transition Programme into Mental Health Nursing, in Sydney, Australia. The findings suggest a high level of satisfaction with the programme. The results are directing the ongoing development of clinical placements, clinical supports, education programmes and recruitment and retention initiatives for nurses within the Central Sydney Area Mental Health Service.

Adult↗

Israel--a health system in transition.

Israeli health reform, implemented after many failed attempts throughout the years, represents an attempt to solve problems of politicization, dissatisfaction, unclear roles of government and public organizations, and lack of financial accountability, while maintaining a high quality and universally accessible health system. Despite many favorable aspects, including high quality medical care, near universal insurance coverage, and high availability of services, the health system has attracted criticism since its earliest days. Israel's experience with health reform, based on a version of managed competition, is of interest to other countries considering similar policy decisions.

Accreditation↗

Health care transition: destinations unknown.

The movement of young adults with special health care needs from pediatric-oriented care to adult-oriented care has been a growing concern in the health care literature over the past 20 years. This article reviews the development and evaluation of health care transition policy over that period of time. These health care transition policies are discussed in light of the preliminary results from a qualitative study of the experience of health care transition. This article concludes with suggestions regarding future policy development and research efforts around health care transition.

Adolescent↗

The crisis nature of health care transitions for rural older adults.

The complex health, socioeconomic, and environmental problems experienced by many American elders often place them at high risk for disease and disability. Over time, acutely or chronically ill older persons experience numerous transitions across various health care settings. Although availability of health services is improving in rural areas, barriers such as distance, geography, and poor distribution often limit access to health care. In a longitudinal rural ethnography, the health care transition experiences of older adults, families, and health care providers were examined. A major ethnographic theme emerged from analysis data from interviews, participant observations, and photographs: the crisis nature of health care transitions experienced by rural older adults and their families and observed by rural nurses and other health care providers. Several patterns were observed including the crisis was compounded by surprise; limited knowledge of local resources exacerbated the crisis; inconsistent discharge planning disrupted transitions; changing family support necessitated admission to nursing homes; continuity of care in nursing home discharge lessened transition crisis; and rural home health care was identified as a strength. Recommendations were made for community-based interventions to improve the transition experience. Comprehensive care management services provided by public health nurses (PHNs) in the local rural community were recommended.

Aged↗

The emergence of cardiovascular disease during urbanisation of Africans.

OBJECTIVE: To review the available data on risk factors for cardiovascular disease (CVD), the influence of urbanisation of Africans on these risk factors, and to examine why stroke emerges as a higher risk than ischaemic heart disease (IHD) in the health transition of black South Africans. DESIGN: A review of published data on mortality from and risk factors of CVD in South Africans. SETTING: South Africa. SUBJECTS: South African population groups and communities. METHODS: The available data on the contribution of stroke and IHD to CVD mortality in South Africa are briefly reviewed, followed by a comparison of published data on the prevalence and/or levels of CVD risk factors in the different South African population groups. The impact of urbanisation of black South Africans on these risk factors is assessed by comparing rural and urban Africans who participated in the Transition and Health during Urbanisation of South Africans (THUSA) study. RESULTS AND CONCLUSIONS: The mortality rates from CVD confirmed that stroke is a major public health problem amongst black South Africans, possibly because of an increase in hypertension, obesity, smoking habit and hyperfibrinogenaemia during various stages of urbanisation. The available data further suggest that black South Africans may be protected against IHD because of favourable serum lipid profiles (low cholesterol and high ratios of high-density lipoprotein cholesterol) and low homocysteine values. However, increases in total fat and animal protein intake of affluent black South Africans, who can afford Western diets, are associated with increases in body mass indices of men and women and in total serum cholesterol. These exposures may increase IHD risk in the future.

Black or African American↗

Health care transition: youth, family, and provider perspectives.

OBJECTIVE: This study examined the process of health care transition (HCT) posing the following questions: What are the transition experiences of youths and young adults with disabilities and special health care needs, family members, and health care providers? What are promising practices that facilitate successful HCT? What are obstacles that inhibit HCT? METHODS: A qualitative approach was used to investigate these questions. Focus group interviews were conducted. Content and narrative analyses of interview transcripts were completed using ATLAS.ti. RESULTS: Thirty-four focus groups and interviews were conducted with 143 young adults with disabilities and special health care needs, family members, and health care providers. Content analysis yielded 3 content domains: transition services, which presents a chronological understanding of the transition process; health care systems, which presents differences between pediatric and adult-oriented medicine and how these differences inhibit transition; and transition narratives, which discusses transition experience in the broader context of relationships between patients and health care providers. CONCLUSION: This study demonstrated the presence of important reciprocal relationships that are based on mutual trust between providers and families and are developed as part of the care of chronically ill children. Evidence supports the need for appropriate termination of pediatric relationships as part of the transition process. Evidence further supports the idea that pediatric and adult-oriented medicines represent 2 different medical subcultures. Young adults' and family members' lack of preparation for successful participation in the adult health care system contributes to problems with HCT.

Adolescent↗

[Organization of health care and health protection in the transitional phase of health care reform and under new legal regulations].

In Federation of Bosnia and Hercegovina, Health Reform is brought up, dictated after newly created post-war policy; fundamental laws in health are brought up, and changes in constitutional sense, brought the country in the phase of transition. Organization of health protection and health business had many disadvantages, what impacted its realisation in direction of satisfying needs and requirement of the population. This paper-work tries to connect existing situation and practice in organization of health care and health business, by using relevant rules which were not adequately and completely realised, and were without possibility of evaluation. The paper tries, by using new Law regulations in Health and Reform to come, to offer organizational solutions which could be more acceptable and realisable in this transitional period.

Bosnia and Herzegovina↗

Work transitions and health in later life.

OBJECTIVES: The goal of the analysis was to examine the association between health status and work behavior among men aged 55-69. We specifically examined the conditions under which health is most strongly associated with labor force exit and reentry. METHODS: The association between health and labor force transitions was examined using logistic regression analyses, based on data from the 1984 and 1985 panels of the Survey of Income and Program Participation. RESULTS: We found that for men aged 55-69 in the mid-1980s, poor health was positively associated with labor force exit, and negatively associated with returns to work. Although these main effects are very strong, we found that health was particularly important among individuals for whom retirement was least attractive. Health had its most substantial association with work transitions among men with working wives, as well as among men who were younger, or who had limited nonwork financial resources. Health also had a particularly strong association with work transitions among Black men, but only with reference to reentry decisions. DISCUSSION: Our results suggest that continued work may have limited appeal for men who are prepared for retirement, even when they are in excellent health.

Black or African American↗

The impact of successful assisted reproduction treatment on female and male mental health during transition to parenthood: a prospective controlled study.

BACKGROUND: The dynamics of mental health during the transition to parenthood have not been a focus of research. Our prospective longitudinal study was designed to reveal whether there are differences in mental health during the transition to parenthood between parents undergoing treatment with assisted reproduction techniques (ART) and those who conceive spontaneously. METHODS STUDY GROUP: 367 couples with a singleton ART pregnancy using their own gametes. CONTROL GROUP: 379 couples with a spontaneous singleton pregnancy. Men and women separately filled in questionnaires including the General Health Questionnaire: at the 18th-20th week of pregnancy, 2 months postpartum and 1 year postpartum (T3). The effect of social and child-related factors on mental health was examined. RESULTS: ART women had fewer depressive symptoms during pregnancy than controls, but at T3 their depressive symptoms were at the same level as seen in controls. Anxiety symptoms increased among control but not among ART women across the transition. ART men reported generally fewer mental health symptoms than their controls. Social and child-related stressors had negative impacts on mental health changes among control couples, whereas no impact was found among ART couples. CONCLUSIONS: Successful ART did not predict mental health problems during the transition to parenthood. Moreover, ART couples' mental health was remarkably resistant to social and child-related stress during the transition to parenthood.

Adult↗