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At least 937 records · Page 52Linked to original sources
PubMed2004

Risk behaviors and health-related quality of life among adults with asthma: the role of mental health status.

BACKGROUND: Previous research indicates that asthma is strongly associated with depressive disorders. Depression among persons with asthma is associated with poor adherence to medication regimens, more severe asthma, and poorer disease outcomes. The objective of our study was to examine the association of frequent mental distress (FMD) [ie, > or = 14 days in the past 30 days in which respondents reported that their mental health was not good] with modifiable risk behaviors (ie, smoking, physical inactivity, and obesity) and health-related quality of life among adults with asthma. METHODS: The Behavioral Risk Factor Surveillance System is an ongoing, state-based survey that is conducted by random-digit dialing of noninstitutionalized US adults aged > or = 18 years. In 2001, all 50 states administered the asthma and risk behavior questionnaires (15,080 questionnaires). A total of 12 states administered the health-related quality-of-life questionnaire (3,226 questionnaires). We estimated prevalences, 95% confidence intervals, odds ratios, and adjusted odds ratios (AORs) using a statistical software program to account for the complex survey design. RESULTS: The prevalence of FMD among adults with asthma was 18.8%. After adjusting for sociodemographic characteristics, the overall associations between smoking and FMD (AOR, 1.9), and between physical inactivity and FMD (AOR, 1.7) were statistically significant. In addition, among those with asthma, persons with FMD were significantly more likely than those without FMD to report fair/poor general health, frequent physical distress, frequent activity limitations, frequent anxiety, and frequent sleeplessness. CONCLUSIONS: FMD is highly prevalent among persons with asthma, suggesting an apparent synergistic effect of these two conditions. The assessment of the mental health status of persons with asthma by health-care providers appears to be warranted and may prevent the emergence of risk behaviors yielding deleterious effects on the management of this disease.

Adolescent↗
PubMed2001

Screening for diabetic retinopathy in rural areas: the potential of telemedicine.

Diabetic retinopathy is a common cause of blindness, and screening can identify the disease at an earlier, more treatable stage. However, rural individuals with diabetes may have limited access to needed eye care. The objective of this project was to demonstrate the feasibility of a diabetic retinopathy screening program using a state-of-the-art nonmydriatic digital fundus imaging system. The study involved a series of patients screened in primary care and public health locations throughout seven predominantly rural counties in eastern North Carolina. Images of each fundus were obtained and sent to a retinal specialist. The retinal specialist reviewed each image, recorded image quality, diagnosed eye disease and made recommendations for subsequent care. Of 193 volunteers with a history of diabetes mellitus, 96.3 percent reported that they were very comfortable or comfortable with the camera. Eighty-five percent of images were rated as good or fair by the retinal specialist. The retinal specialist also reported being very certain or certain of the diagnosis in 84 percent of cases. Image quality correlated highly with the certainty of diagnosis (Spearman's rank order correlation coefficient = 0.79; P < 0.001). The average time since the previous examination by an eye care specialist for diabetic subjects was two years. Approximately 62 percent of diabetic patients had diagnosable eye conditions, the most common of which was diabetic retinopathy (40.9 percent). In this convenience sample, African Americans, despite similar age and disease duration, were more likely to have retinopathy. Digital imaging is a feasible screening modality in rural areas, may improve access to eye care, and may improve compliance with care guidelines for individuals with diabetes mellitus.

Adult↗
PubMed2006

Clinical and education workload measurements using personal digital assistant-based software.

OBJECTIVE: There are no accepted and practical measures of the relative clinical and educational activities of pediatricians who work in an academic health science center. Such measures are necessary for justification of existing and future human resource plans and evaluation of the activities and performance of physicians. The limited literature on the measurement of physician workload usually focuses on a specific subspecialty group and does not account for such issues as indirect patient care, such as telephone calls or e-mail consultations; variables that affect the delivery of clinical care, including patient acuity and complexity; and the presence of students during the patient care activities. After completing a pilot study that assessed the educational workload of faculty members, we adapted existing personal digital assistant technology and software to document clinical and educational activities. METHODS: Twenty full-time physicians from 4 subspecialty pediatric divisions participated in a 2-week evaluation project in May through June 2005. Clinical activities, with and without trainees, and educational activities were collected with the use of personal digital assistants. Software allowed an individualized division-specific drop-down menu. Information that was collected included clinical (location of activity, diagnosis, and time requirement) and educational activities. After completion of a 2-week data collection period, each physician was asked to complete a 5-question evaluation form. RESULTS: The project was completed successfully with capture of additional clinical and educational activities. A 5-question evaluation form was completed by 70% of the participants at the end of the 2-week data collection. Data on clinical and educational activities were analyzed qualitatively and graphed. CONCLUSIONS: This method of workload data collection added significant information in capturing activities that are not measured in traditional workload evaluations for either clinical activities, such as e-mail, telephone, and patient information review, or educational endeavors, including mentoring and educational lectures and presentations.

Academic Medical Centers↗
PubMed1998

Prevalence and correlates of recreational physical activity in women aged 50-64 years.

OBJECTIVE: To evaluate the prevalence of recreational physical activity in middle-aged women and to identify characteristics predisposing women to an active or sedentary lifestyle. DESIGN: In this population-based survey study of 492 women aged 50-64 years, women were interviewed between 1988 and 1993 regarding their recreational exercise habits, other health habits, and medical history. Women were selected from the general population of western Washington State through random-digit-dialing of telephones. Physical activities in a recent 2-year period were recorded, including specific types, frequency, and duration of each activity. RESULTS: Fewer than half of the women reported doing any regular physical activity and only 27% engaged in any high intensity exercise. Obesity, current cigarette smoking, low income, low education, and some dietary factors were associated with a sedentary lifestyle. CONCLUSIONS: These results suggest that only about half of middle-aged women engage in any regular recreational exercise, and that less than 25% follow the National Institutes of Health recommended guidelines for light to moderate exercise for at least 30 min per day, 6 days per week.

Age Factors↗
PubMedDate not supplied

Cognitive test performance and presence of subclinical cardiovascular disease in the cardiovascular health study.

The purpose of the present study was to investigate the relationship between performance on a comprehensive battery of neuropsychological tests and the presence of clinical, subclinical or no cardiovascular disease in an elderly community-dwelling population. The results confirm previous reports of significant associations of age, education and gender with test performance. When performance was examined controlling for these variables, significant associations of disease group were seen with five measures emphasizing speed of performance; Parts A and B of the Trail Making Test, the WAIS-R Digit Symbol and Block Design subtests and category verbal fluency. These results add to the evidence that, in addition to other health implications, cardiovascular disease is related to cognitive functioning in the elderly even at subclinical levels.

Aged↗
PubMedDate not supplied

A comparative study of prostate screening health beliefs and practices between African American and Caucasian men.

This descriptive comparative study investigated the prostate screening health beliefs and practices of men over the age of 45. A self-administered questionnaire was used prior to an informational session, which also included a question and answer period, as needed, and handout materials donated by the American Cancer Society on risk factors, screening tests and early detection of prostate cancer. The study results showed that there were no significant differences between African American and Caucasian men on age, self-reported health status and the utilization of a private physician for their health care. Both groups had similar history of blood relatives with cancer, and concern about development of illness. More Caucasian men had the digital rectal exam (DRE) done while African American males had the prostate-specific antigen (PSA) done more often; however, 26% of the entire sample indicated they had never had the screening test done. Group comparisons revealed a significant difference between the groups on the belief that faith contributes to health which was greater for the African Americans, while the Caucasian men had a greater belief that they were likely to develop prostate cancer. Results of this study indicate that there are still a significant number of men reporting never having had a PSA test done even though 75% knew that the test is recommended for early detection of prostate cancer. Continued efforts to educate and increase screening are still needed among both African American and Caucasian men.

Black or African American↗
PubMed2026

Unanticipated Effects of Parental Social Media Use: Guidance for Clinicians.

"Sharenting," the practice of parents posting photographs, videos, and information about their children on social media, has an ever-growing presence in modern society. However, researchers and the public are now recognizing the potential consequences of sharing, including creation of permanent digital footprints, strained familial relationships, and threats to children's safety. Despite this emerging evidence, no U.S. clinical or legal guidelines exist for parents on safe sharing. Visits with behavioral health providers and family physicians can serve as key points for intervention. This column aims to provide clinicians with a better understanding of sharenting and its potential effects on patients and families, guidance on discussing safe online sharing, and a tool for parents and other caregivers to use when deciding whether to post.

Humans↗
PubMedDate not supplied

Modern information technologies in environmental health surveillance. An overview and analysis.

In recent years we have witnessed the massive introduction of new information technologies that are drastically changing the face of our society. These technologies are being implemented en masse in developed countries, but also in some pockets of developing nations as well. They rely on the convergence of several technologies such as powerful and affordable computers, real-time electronic measurement and monitoring devices, massive production of digital information in different formats, and faster, wireless communication media. Such technologies are having significant impacts on every domain of application, including environmental health surveillance. The current paper provides an overview of those technologies that are having or will likely have the most significant impacts on environmental health. They include World Wide Web-based systems and applications, Database Management Systems and Universal Servers, and GIS and related technologies. The usefulness of these technologies as well as the desire to use them further in the future in the context of environmental health are discussed. Expanding the development and use of these technologies to obtain support for global environmental health will require major efforts in the areas of data access, training and support.

Decision Support Systems, Management↗
PubMed2004

A demographic approach to monitoring the health of coral reefs.

Inshore coral reefs adjacent to the wet tropics in North Queensland, Australia, are regularly exposed to flood plumes from coastal river systems. Changes in the nature of these plumes have been linked to the declining health of coral reefs in the region. The effect of flood plumes on the health of inshore corals was investigated by quantifying aspects of the demography of populations of corymbose and digitate Acropora at three groups of Island reefs along a gradient of exposure and decreasing water quality (High Island >Frankland's >Fitzroy). The size-structures of colonies, the rates of sexual recruitment, and the growth and survival of juveniles, all varied among the Island reefs. Juvenile and adult sized colonies were far more abundant at the Fitzroy Island reefs, than at the High or Frankland Island reefs that were more exposed to flood plumes. Additionally, there were up to eight times as many sexual recruits at the Fitzroy Island reefs, compared with the High Island reefs. However, the rates of growth and survival of the juvenile sized corals at the Fitzroy Island reefs were lower than at the more exposed reefs. The comparatively low abundance of adult corals at the exposed reefs is most likely due to their histories of disturbance from crown-of-thorns and coral bleaching, but the lack of subsequent recovery due to their low levels of larval recruitment. If a stock-recruitment relationship is typical for these groups of reefs, then the low rates of recruitment may be linked to the low density of adult colonies. Alternately, direct or indirect effects of chronic exposure to poor water quality may have resulted in less suitable substrata for larval settlement. We discuss these results and provide examples of how information about population structure and dynamics can be used in simple matrix models to quantify the current and future health of populations of corals under various scenarios.

Animals↗
PubMed2003

Treatment of displaced bicondylar tibial plateau fractures (OTA-41C2&3) in patients older than 60 years of age.

OBJECTIVE: To investigate the outcome (clinical, radiographic, and general health status) of the surgical treatment of displaced bicondylar tibial plateau fractures (OTA-41C) in patients >60 years old. DESIGN: Prospective cohort study. SETTING: Limb reconstruction service, university teaching hospital. PATIENTS: Eleven consecutive patients >60 years old with a mean age of 72 years (range 60 to 90 years). The indications for surgery were displaced bicondylar tibial fractures, open fractures, and fractures with severe soft tissue injury. INTERVENTION: All patients were treated according to a standard protocol, which involved limited articular reconstruction and percutaneous intrafragmentary screw fixation, followed by neutralization with a stable beam-loading external fixator and early mobilization. MAIN OUTCOME MEASUREMENTS: The clinical outcome was assessed using Rasmussen's system and the Iowa knee score. For general health assessment, the anglicized SF-36 was used. Radiographic assessment was performed for redisplacement and angulation on digitized radiographs. RESULTS: After a mean follow-up of 38 months (range 18 to 51 months), bony union was achieved in all patients. Seven of 11 patients started full weight bearing 2 to 6 weeks postoperatively. According to Rasmussen's system, 9 of 11 (82%) scored satisfactory results. Radiographic redisplacement was found in three severely comminuted cases resulting in >/=10 degrees of valgus malunion. One patient received a corrective osteotomy while still in the fixator. Another needed TKA. Limited knee flexion was found in three patients with cross knee fixation. Superficial pin site infection occurred in five patients, but there were no cases of deep infections or septic arthritis. CONCLUSIONS: All-ring external fixation, as a beam-loading system applied in a neutralizing mode, is a safe, stable, and reliable technique for the treatment of displaced bicondylar tibial plateau fractures in elderly patients.

Aged↗