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PubMedDate not supplied

The promotion and measurement of healthy coping.

Contemporary society is failing to meet the developmental needs of its youth. Social and cultural changes have created an urgent need for nursing interventions that promote healthy development in young people struggling with role ambiguity, the breakdown of family and social support networks, and a future that seems vague or even nonexistent. A nursing intervention that seems to be effective is peer counseling. Peer leaders with specific training and continued supervision by nurse counselors can have an impact on healthy development. In order to examine the outcome of peer counseling on coping patterns, a group of 102 adolescents who had received peer counseling was compared with two control groups (n = 134 and 104) not having received peer counseling. There were 209 young women and 131 young men in the study. Both male and female subjects were included in the study in the interest of gender-fair research (Grady, 1981). The A-COPE, a reliable and valid instrument developed by Patterson and McCubbin (1983) was administered to the 340 young people. Analysis of variance and the Scheffé test of statistical analysis of the data revealed significantly different coping patterns among the counseled and control groups.

Adaptation, Psychological↗
PubMed1997

Future treatment needs in children, adults and the elderly.

Future treatment needs for dental services are discussed in the perspective of the objective which the services are meant to fulfill. These are, broadly speaking, equal distribution of services and economic efficiency. Within the Nordic countries, the emphasis has been on equity, perhaps less on efficiency. Equity of utilization is best understood as being a situation where patients with equal needs for oral health care receive equal treatment, in terms of both the volume and the quality of the services. The justification for arguing that equality of utilization is the appropriate measure is mainly based on the externality argument: health-care consumption by one person may be the source of utility to another person. According to that view there are two beneficiaries of dental care: the patient who is sick, and the rest of society who care for the sick patient and who derive utility from seeing the patient become healthy. The public dental services for children in the Nordic countries are organized according to the principle of equity of utilization. Equity of access is best understood as being a situation where people with equal needs have equal opportunity to use dental services. It is a supply-side phenomenon; equal access is achieved when patients with the same needs face the same costs of dental-care consumption in terms of both time and money. The oral health situation among children, adults and the elderly is exemplified by national service data and recent studies.

Adolescent↗
PubMedDate not supplied

Tracking and improving influenza immunization rates in a high-risk medicare beneficiary population.

Immunization rates for end stage renal disease (ESRD) patients were well below the 80% target set by Healthy People 2000 and Centers for Medicare and Medicaid Services. The authors sought to increase documentation of immunization status, and influenza immunization rates of these patients. A survey was distributed to dialysis facilities to determine immunization practices. Facilities were provided with an immunization toolbox and spreadsheets to document the immunization status of patients. A total of 102 facilities (53%) provided data for three collection periods (1999, 2000, and 2001). Immunization rates for each influenza season increased significantly from 62.1% and 61.4% in 1998-1999 to 80.3% and 80.0% in 2000-2001 (Pennsylvania and Delaware respectively).

Aged↗
PubMed2001

The national health demonstration projects.

The White Paper Towards a Healthier Scotland pledged 15 million Pounds to support four national health demonstration projects to lead the way in achieving sustained improvement in child health, young people's sexual health, coronary heart disease and cancer. The Starting Well project aims to demonstrate that child health in Glasgow can be improved by a programme of activities which both supports families and provides them with access to enhanced community-based resources. The Healthy Respect project aims to help young people in Lothian develop a positive attitude to their own sexuality and that of others, and a healthy respect for their partners, in order to reduce unplanned teenage pregnancies and sexually transmitted infections. The Have a Heart Paisley project is targeting coronary heart disease among the population of Scotland's largest town. The Cancer Challenge project is piloting a screening programme in the North East of Scotland for the detection of colorectal cancer. Though each project has specific objectives, appropriate to its own topic, all share underlying principles. The projects will act as test beds for action and a learning resource for the rest of Scotland.

Cardiovascular Diseases↗
PubMed2000

Psychosocial and clinical risk factor profiles in managers.

OBJECTIVES: Over the past 10 years the IAS Foundation has performed more than 15,000 PREVENT check-ups on managers. In addition to a comprehensive clinical program of preventive examinations, the main emphasis is placed on extensive counseling. This counseling centres not only on personal behaviour patterns affecting the individual's health, but also on the psychomental capabilities of the patient within the context of the psychosocial stresses in managerial positions. METHODS: Three cross-sectional studies examined: (1) the major cardiovascular risk factors (n = 974), (2) the psychosocial structure (n = 2,800) and (3) the relationships between clinical risk factors and psychological structural features (n = 200). RESULTS: According to expectations, managers showed somewhat lower cardiovascular risk levels than did other professional groups. However, nearly 70% of them reported various unspecific, psychovegetative complaints. Managers were subdivided into four psychological types, each representing roughly one quarter of the series: Type 1: anxiety, tension (20.5%); Type 2: repression, lack of self-control (22.2%); Type 3: challenge, ambition, self-control (27.6%); Type 4: healthy living, with self-control (29.7%). Type 3 resembles most closely classic type A behaviour and is seen in a good quarter of the overall cohort. This may indicate that not only people showing type A behaviour are predestined to occupy managerial positions, but that people with a type B structure also take up managerial positions. It is, however, in particular the type B behavioural patterns that are also associated with increased psychovegetative complaints. The relationships between psychosocial structural variables and clinical risk factors such as hypercholesteremia and high blood pressure are not very strong. CONCLUSIONS: Occupational health measures in organisations should also be established for managers, as they present an important employee group within the enterprise. In addition to examining them for cardiovascular risks, counseling and coaching programmes on preventive measures and recommended behaviour at work should be a primary concern.

Administrative Personnel↗
PubMed1997

Health behaviors of an elderly Filipino group.

More than 69 million elderly people are expected to be living in the United States by the year 2050 (American Association of Retired Persons, 1991). For public health nurses, this rapidly growing, diverse population poses a challenge. P. Ebersol and P. Hess (1994) suggest that health care professionals must become skilled in understanding the health needs and practices of the diverse, heterogeneous aged if they are to help the elderly achieve more healthful, satisfying existences. According to two studies, M. Nemcek (1990) and J. Flaskerud and C. Rush (1989), health behaviors of the elderly vary among and within cultural groups. The purpose of this descriptive survey study was to examine how culture effects the health behaviors of 52 elderly Filipino women and men. The Health Behavior Survey was designed and used by the researchers in this study. Unhealthy behaviors identified were inclusion of fried foods in diet, weight gain, and little or no exercise. Because of the value placed on personal health by the participants, it appears the group would be receptive to a health promotion program which would increase their probability for a healthy life.

Aged↗
PubMed2005

Accessibility and use of touchscreens by black and ethnic minority groups in the three cities project.

OBJECTIVES: The public are being encouraged by Government, at a national level, to take a greater role in the management of their health and healthcare but information to support this is not always accessible to black and ethnic minority group members who do not speak or read English. This study looks at the feasibility of providing health-related information in a multilanguage format through a touchscreen kiosk. DESIGN: Three touchscreen kiosks were programmed with information on 10 health topics translated into five languages: Chinese, Bengali, Gujarati, Urdu and Mirpuri Punjabi. Information was provided orally and in written format. Over an 18-month period the touchscreens were rotated between settings including health centres and libraries, located in deprived areas of Leicester, Sheffield and Nottingham. Information was logged on each individual user with respect to language used, topic selected, age group and gender of user. A number of users were invited to complete a short questionnaire about their use and ease of use of the touchscreen. RESULTS: Touchscreens were accessed by 2,456 people across all ages, 53% of whom were male. Urdu and Gujarati were the most frequently accessed languages (37 and 38%, respectively) and Bengali used least (9%). There was some variation in use by setting. Most of the 508 people questioned who had used the touchscreen found it easy to use. Ease of use was related to home computer use and to being younger in age. The five most popular topics accessed by 12% or more users were stress, diabetes, blood pressure, healthy eating and exercise. Topic choice varied by language used by males but not by females. CONCLUSION: Touchscreens providing health information in ethnic minority languages can be successfully accessed by black and ethnic minority groups, particularly those living in deprived areas. Touchscreens proved acceptable to, and were used by, the targeted audience.

Adolescent↗
PubMed2006

A five-week exercise program can reduce falls and improve obstacle avoidance in the elderly.

BACKGROUND: Falls in the elderly are a major health problem. Although exercise programs have been shown to reduce the risk of falls, the optimal exercise components, as well as the working mechanisms that underlie the effectiveness of these programs, have not yet been established. OBJECTIVE: To test whether the Nijmegen Falls Prevention Program was effective in reducing falls and improving standing balance, balance confidence, and obstacle avoidance performance in community-dwelling elderly people. METHODS: A total of 113 elderly with a history of falls participated in this study (exercise group, n = 79; control group, n = 28; dropouts before randomization, n = 6). Exercise sessions were held twice weekly for 5 weeks. Pre- and post-intervention fall monitoring and quantitative motor control assessments were performed. The outcome measures were the number of falls, standing balance and obstacle avoidance performance, and balance confidence scores. RESULTS: The number of falls in the exercise group decreased by 46% (incidence rate ratio (IRR) 0.54, 95% confidence interval (CI) 0.36-0.79) compared to the number of falls during the baseline period and by 46% (IRR 0.54, 95% CI 0.34-0.86) compared to the control group. Obstacle avoidance success rates improved significantly more in the exercise group (on average 12%) compared to the control group (on average 6%). Quiet stance and weight-shifting measures did not show significant effects of exercise. The exercise group also had a 6% increase of balance confidence scores. CONCLUSION: The Nijmegen Falls Prevention Program was effective in reducing the incidence of falls in otherwise healthy elderly. There was no evidence of improved control of posture as a mechanism underlying this result. In contrast, an obstacle avoidance task indicated that subjects improved their performance. Laboratory obstacle avoidance tests may therefore be better instruments to evaluate future fall prevention studies than posturographic balance assessments.

Accidental Falls↗
PubMed2006

Mapping your future--a proactive approach to aging.

As the number of older adults who live healthy and extended lives increases, people will need to envision the ways in which they choose to live. More emphasis will be given to the potential and strengths that older adults maintain in to later years rather than anticipating the consequences of decline. This paper describes the development of a tool to be used by older adults in planning their futures. It provides an individualized portfolio that encourages older adults to contemplate their future needs and resources. It includes the domains of health, work/leisure, finances, housing, and relationship/support systems. It is a means of encouraging conversations about life choices and maintaining a sense of empowerment and well-being.

Advance Care Planning↗
PubMed2002

Reawakening your passion for work.

All of us struggle from time to time with the question of personal meaning: "Am I living the way I want to live?" For millions of people, the attacks of September 11 put the issue front and center, but most of us periodically take stock of our lives under far less dramatic circumstances. This type of questioning is healthy; business leaders need to go through it every few years to replenish their energy, creativity, and commitment--and their passion for work. In this article, the authors describe the signals that it's time to reevaluate your choices and illuminate strategies for responding to those signals. Such wake-up calls come in various forms. Some people feel trapped or bored and may realize that they have adjusted to the frustrations of their work to such an extent that they barely recognize themselves. For others, the signal comes when they are faced with an ethical challenge or suddenly discover their true calling. Once you have realized that it's time to take stock of your life, there are strategies to help you consider where you are, where you're headed, and where you want to be. Many people find that calling a time-out--either in the form of an intense, soul-searching exercise or a break from corporate life--is the best way to reconnect with their dreams. Other strategies include working with a coach, participating in an executive development program, scheduling regular time for self-reflection, and making small changes so that your work better reflects your values. People no longer expect their leaders to have all the answers, but they do expect them to try to keep their own passion alive and to support employees through that process.

Adaptation, Psychological↗
PubMed1998

The pediatrician's role in the twenty-first century.

The world's children comprise: (i) those in wealthy, industrialized countries; (ii) those from rapidly industrializing countries; (iii) minority groups including recently arrived immigrants in otherwise affluent and healthy societies; (iv) previously traditional people in rapid transition to urbanized, Western lifestyles; and (v) many millions living in grinding poverty in overcrowded, unhygienic conditions where child mortality is high and often due to malnutrition and infections. Industrialization, affluence, better housing, hygiene and nutrition, better clinical care and disease prevention have helped enhance child health in many countries over the past century. However, this is being offset by obesity, smoking, alcohol and drug abuse and social disruption, mental disease and high rates of violence including homicide and suicide. These 'new morbidities' are worse among minorities and in populations undergoing rapid social change. Social pressures including unemployment, depression and family dysfunction are important. Pediatricians must become active in decisions about the use of public resources in disease prevention, health education and more rational and equitable use of high technology. They should also be active advocates for children and their rights and advise governments about all issues that affect child health, protection and well-being. This is particularly so in the poorest and developing countries. There is a need for better international collaboration, training and exchange programs involving the International Pediatric Association, United Nations International Children's Emergency Fund, World Health Organization and other local, national and regional organizations to help overcome these problems as the next century draws near.

Adolescent↗
PubMed2001

The economic impact of breastfeeding.

Although breastfeeding is well accepted as the optimal method of infant feeding, the US failed to reach the goals set for the year 2000. Support from employers, health insurers, health providers, and society are required to reach the goals set forth in Healthy People 2010-75% of mothers initiate breastfeeding, 50% of infants still receive breast milk at 6 months, and 25% of infants are still breastfed at 1 year of age. In today's era of cost accountability and economic competition, these groups likely will desire information regarding the financial effects of breastfeeding and breastfeeding promotion from their perspectives. Although much research still is needed in this area, evidence suggests that a significant return on investment is likely with breastfeeding promotion. Also, the finances of health care must be viewed within the concept of value. In health care, value can be thought of as the cost required to achieve a specified outcome. In lay terms, this can be thought of as "how much bang we get for our buck." Breastfeeding clearly improves the health of infants and mothers and seems to result in cost savings for parents, insurers, employers, and society, which means that the medical and economic value of breastfeeding is high. To reap the health and economic benefits associated with breastfeeding, society must support breastfeeding promotion, which most likely will necessitate a coordinated US breastfeeding program. The US government is in a unique position to accomplish this goal as it views the associated costs from the joint perspectives of employer, health insurer, medical provider, and society. Through support of such a program, the US government likely will benefit significantly by improving the health of children and its financial bottom line.

Breast Feeding↗
PubMed2005

Health fair in a mosque: putting policy into practice.

BACKGROUND: Towards the end of 2001, the Scottish Executive Health Department published a unique report, 'Fair for All', on the issue of addressing the health needs of ethnic minorities. One of the recommendations contained within the report was that different groups and organizations within communities should work together to provide services to minority groups. This descriptive paper is an illustration of how a settled community, in this case a Muslim community, was encouraged to become involved in its own health care by holding a health fair at its mosque. PLANNING: The health fair was organized by the Minority Ethnic Health Inclusion Project, in collaboration with the Local Health Care Co-operative, and in co-operation with Edinburgh Central Mosque. The health fair was held over two consecutive Fridays in May 2003 and focused primarily on diabetes, high blood pressure, healthy eating and oral hygiene, as well as providing information on cancer and local community services. OUTCOMES: The health fair was well received on both days, with around 200 men and 120 women participating. In total, there were 99 recorded blood pressure measurements and 81 blood glucose checks, and the community dental service was very well received. EVALUATION: Strong participation by the community shows that people from ethnic minorities are interested in their health and will participate in health-related activities arranged for them. The success of this health fair shows that, as proposed by the Scottish Executive, different groups and organizations within the community can work together to provide services to minority ethnic groups.

Attitude to Health↗
PubMed2001

Age specificity of the relationship between serum cholesterol and mood in obese women.

Despite increasing evidence of an association between lower cholesterol levels and negative mood, no study has specifically investigated this relationship in obese people, a population at high risk for both dyslipidaemia and depression. Data on serum cholesterol and mood were collected in a group of 73 healthy women, aged 16 to 76 years, with different degrees of obesity and widely varying total cholesterol concentrations. Mood was assessed using three self-rated scales: the Toronto Alexithymia Scale (TAS-20), the State-Trait Anger Scale (STAS), and the Beck Depression Inventory (BDI). The association between lower total cholesterol levels and negative mood was age-dependent. No significant association was found in the younger age group (<50 years). In contrast, in the subgroup of older women, serum cholesterol was negatively and significantly correlated with the TAS-20 and the STAS. The negative correlation between serum cholesterol and the BDI was nearly statistically significant. Restricting analysis to the subjects in the highest quartile of the age distribution (>60 years) yielded stronger correlations between cholesterol and mood. In this sample of obese women, the relationship between lower cholesterol levels and negative mood was age-specific and limited to the older age group. The results of this study suggest that preventive programs or drug treatments for reducing cholesterol levels in elderly obese women should include a careful evaluation of mood state.

Adolescent↗
PubMed2005

Statistical methodology of the National Immunization Survey, 1994-2002.

OBJECTIVES: Since 1994 the National Immunization Survey (NIS) has monitored progress toward the Healthy People 2000 and 2010 vaccination goals. The NIS collects data in two phases: first, a random-digit-dialing (RDD) telephone survey to identify households with children 19-35 months old and, second, a mail survey to vaccination providers to obtain vaccination histories used to estimate vaccination coverage rates. This report reviews the methodologies used in the 1994-2002 NIS to obtain official estimates of vaccination coverage and describes the methodology used for the first three topical modules of the NIS. METHODS: From 1994 to 1997 the NIS used a variation of a two-phase estimator to compensate for missing provider-reported vaccination histories. Between 1998 and 2001 a weighting-class estimator was used. In 2002 and thereafter the weighting-class approach was refined to account for households that do not have telephones and for unvaccinated children. To collect data on immunization-related topics, the NIS sample was randomized among three topical modules: health insurance and ability to pay for vaccinations (HIM); parental knowledge and experiences about vaccinations (PKM); and daycare attendance, breastfeeding practices, and participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (DCM). RESULTS: In 2001 among children with completed RDD interviews, 0.3 percent were entirely unvaccinated. Together, the new nontelephone adjustment and the refinement for unvaccinated children yielded revised estimates that were within 1.5 percentage points of the original estimates obtained using the 1998-2001 methodology. Over the six quarters during which the first three topical modules were fielded (from mid-2001 through 2002), 21,163 children were randomized to the HIM, 3576 to the PKM, and 3511 to the DCM.

Adolescent↗
PubMed1995

Sex differences in pharmacokinetics of oral propranolol in healthy Chinese volunteers.

AIM: To determine if the gender-based dimorphism of the distribution and metabolism of oral propranolol (Pro) exists in the healthy Chinese volunteers. METHODS: Twelve subjects (6 M and 6 F) were given an 80 mg single oral dose of Pro. Plasma Pro levels were determined by HPLC with fluorescence detector and the pharmacokinetic parameters were calculated by using the MCPKP program. RESULTS: AUC and Cmax in females were about 74% and 99% higher than those in males (P < 0.05), whereas oral clearance and apparent distribution volume were 109% and 120% lower in females than in males (P < 0.05), respectively. The T1/2 tended to be longer in females (P > 0.05). No differences in any other kinetic parameters were found between the sexes. CONCLUSION: The higher oral bioavailability (AUC and Cmax) of Pro in Chinese women is in part caused by their lower oral clearance and volume of distribution.

Administration, Oral↗
PubMed2005

Evolution of Quit & Win program carried through 2002 year in FB&H.

UNLABELLED: World Health Organization (WHO) in cooperation with National Public Health Institute of Finland carried through Quit & Win program 2002. People from all over the world try to abstain from smoking or using tobacco products for a four-week period, from 2-29 May. FB&H took part in this campaign. Quit & Win-2002 program was an optional contest for health professionals. The purpose of this paper is to present the participant's characteristic towards age, gender, education, tobacco consumption and previous attempts to quit. RESULTS: the research encompassed 81 health professionals. Among them 71% were women. The highest participation rates on average where found in the 45-54 year group (29.7%). The most of participants were health professionals with middle school education (81%). Only 5% of the participants were physicians. The great number of health professionals (47.5%) smoked between 1-9 years. Research shows that 61% of participants were passionate smokers who smoked more than 14 cigarettes a day. Out of 81 participants 42 medical workers has never tried to stop smoking. Research shows that smoking habit is very spread among medical workers and it follows the general state in population. It's surprising because we expect that health worker must be role model of the healthy life.

Adolescent↗
PubMed2006

Immunity to poliovirus among children and the elderly in north-east Italy.

INTRODUCTION: Italy and Europe were declared polio-free in June 2002, but increasing migration, even from undeveloped countries where polio still exists, may lead to a come-back of circulating poliovirus (PV) and infection in previously polio-free areas. It is consequently advisable to continue to monitor the immunity of the population in polio-free areas. The aim of this study was to assess the current prevalence of neutralizing antibodies in recently-immunized children and in elderly people who were never vaccinated. METHODS: Sera from 511 healthy subjects resident in the Veneto Region were examined to assay their antibody titer for PV 1, 2 and 3, using the microneutralization test. Data were analyzed by chi-squared test, Student's t-test and linear regression analysis, using EPI-Info 2000 supplied by the Centers for Disease Control and Prevention (Atlanta, GA, USA). RESULTS: Neutralizing antibodies in group A (231 subjects aged 1-17 years) showed significantly higher geometric mean titers (GMTs) than in group B (280 subjects aged 65-100 years) for all three PV serotypes (P < 0.001). Nobody simultaneously lacked neutralizing antibodies for all three serotypes. There were no difference between the two groups in terms of male/female GMTs for the three PV Antibodies decreased with time since vaccination, but the difference was only significant for PV 3. GMTs were lower in the elderly, with no significant difference among the three PV. DISCUSSION: The population examined showed a good level of protection against the three PV strains: both groups A (vaccinated) and B (naturally immunized) revealed a valid immunity to poliovirus. CONCLUSION: Immunization programs and immunity status population screening are still advisable until polio has been world-wide eradicated.

Adolescent↗