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PubMed1993

Parents' perceptions of diabetes in adolescent daughters and its impact on the family.

Parent's perceptions of diabetes in adolescent daughters and its impact on the family was examined. Transitions in health and developmental state affect the experience of families and the ability to make needed adjustments. Adjustments in the parental subsystem are required at adolescence to promote increased independence. Qualitative content analysis of semistructured parent interviews showed that the daughter's diabetes was perceived to draw the whole family closer together while negatively affecting the spousal relationship. Episodes of poor diabetic control were experienced or anticipated in relation to adolescence. Suffering emotional distress was a central process related to parental concerns about diabetic control.

Adaptation, Psychological↗
PubMed1997

The World Health report 1996--fighting disease, fostering development.

This self-contained, concise and analytical publication is the second in a new series of annual reports. It provides an annual assessment of world health status and needs, and recommends relevant priorities for international health action to meet those needs, as well as reporting on WHO's contribution towards improving the world health situation. The world health report 1996 focuses on infectious diseases and gives an overview of WHO's work during 1995 (1).

Adult↗
PubMed1997

Local population differences and the needs of people with cognitive impairment.

INTRODUCTION: Variations in local population age structure have attracted less attention than national population ageing. As moderate and severe cognitive impairment is a major cause of need for long-term care, population-based estimates of the numbers and characteristics of this group were calculated, to explore the effects of local differences. METHOD: The UK Office of Population Census and Surveys (OPCS) study of disability in adults (N > 14000) was reanalysed. A group with moderate or severe cognitive impairments was identified and age-specific estimators of sociodemographic characteristics, household types, disabilities and service use were combined with population estimates for district health authorities in England and Wales. RESULTS: The proportion of the 65 plus population who are 85 plus varies from 8% to 15% across districts, equivalent to national population projections for 1986 and 2031 respectively. The estimated prevalence of the study group varies from 53 to 70 per 1000 population aged 65 plus, with 34-48% of cases aged 85 plus. Curiously, the proportion with severe disabilities varies little across districts. If national norms applied, local rates of institutionalization would vary from 18 to 27 per 1000 aged 65 plus. CONCLUSION: Local differences in population age structure age large compared to national changes over decades. Local differences have substantial effects on overall prevalence and on the proportion of the cognitively impaired who would be institutionalized if national patterns applied. Service design should be influenced by these complex variations, with estimates modified by local surveys.

Activities of Daily Living↗
PubMed1997

Establishing a link between cultural evolution and sexually transmitted diseases.

It is argued that archaic sexually transmitted diseases influenced cultural traditions by reducing multiple sexual partners within communities. In this article, the adverse consequences of current sexually transmitted diseases are surveyed: Such infections decrease fertility of women and increase infant mortality; those adverse consequences are especially potent when antibiotics are not readily available. Cultural (cross-generational transmission of learned) responses to the threat of widespread infertility and elevated infant mortality rates are hypothesized to include the implementation of expectations for restricted numbers of sexual partners. These expectations, formal or informal, have been instituted within the context of biological predispositions, the "certainty of paternity" model, already-established traditions, and the need for a social father to be aligned with the mother-child dyad. A case study of the contemporary United States is offered as a heuristic example of how and why cultural choices may be developed and sustained.

Cultural Evolution↗
PubMed1997

The World Health Report 1997--conquering suffering, enriching humanity.

This self-contained, concise and analytical publication is the third in a series of annual reports. It provides an assessment of world health status and needs, and recommends relevant priorities for international health action to meet those needs, as well as reporting on WHO's contribution towards improving the world health situation. The world health report 1997 focuses on chronic diseases and gives an overview of WHO's work during 1996 (1).

Adolescent↗
PubMedDate not supplied

Transitioning yourself into the new health care business.

This article discusses the impact of the evolving health care industry on the individual staff nurse. It identifies future trends that affect nursing's role within the acute care setting, as well as the skills and characteristics of the successful nurse of the future. Ideas and suggestions for success in this new environment are presented in a nonintimidating way. Methods to obtain information on future nursing roles are discussed, and implications for current nursing roles are presented in an informal and easily understood way. Ideas on ways for staff nurses to assess their career options, as well as plan for any potential downsizing in their existing facilities, are also discussed. The idea that each nurse must take an active role in their own career development and not wait for someone else to do it or assume they will be taken care of runs throughout the article.

Career Mobility↗
PubMed1997

The esthetics of anterior tooth aging.

As generations proceed to reinvent themselves in an effort to achieve and maintain youth, cosmetic dentistry faces one of its greatest and most persistent challenges: the restoration of an aging smile. Although the need for this restorative therapy has not yet been adequately studied, the momentum continues to build as aging teeth exhibit physical characteristics that affect their function as well as appearance. This review presents the most common factors influencing the esthetics of anterior tooth aging: coloration; wear and the effects of erosion, attrition, abrasion, and abfraction; and position of teeth relative to each other and surrounding tissues. While dental science seeks to understand how well age-specific restorative procedures can affect patients, the question of the necessity of this therapy remains. Should a healthy smile require treatment? Only time will reveal at what cost and to what extent a younger appearance plays a role in dental science.

Adult↗
PubMed1998

Hepatitis A virus: declining seroprevalence in children and adolescents in Southeast Asia.

The prevalence of hepatitis A virus (HAV) in a country largely reflects its standards of hygiene and socioeconomic conditions. Countries which undergo socioeconomic development show major change in HAV prevalence from high to low endemicity, and this is largely reflected in patterns of age-related seroprevalence. This paper presents age-related HAV seroprevalence patterns of SE Asian countries, and highlights how these patterns have changed over recent decades. Singapore, Thailand and Malaysia have experienced a decline in childhood and adolescent HAV seroprevalence, typical of countries which undergo socioeconomic development. By contrast, India has remained a country of high endemicity, with almost universal seroconversion in childhood. The Philippines and Vietnam show age-related seroprevalence patterns typical of high to moderate endemicity, while Indonesia shows significant regional variation in HAV seroprevalence. Populations within countries which exhibit major improvements in endemicity and age related HAV seroprevalence patterns are at risk of HAV epidemics, and a paradoxical increase in incidence tends to occur as seroconversion shifts from children to adults. The residents of these countries, a significant number of whom are at-risk, would benefit from a program of vaccination, as would non-infected individuals visiting high-risk areas.

Adolescent↗
PubMed1998

AIDS in India: recent trends in opportunistic infections.

The first case of AIDS in India was reported in 1986. Subsequently, a surveillance system was developed in 1987. The data from this surveillance activity suggest that the HIV infection has now spread to the general population and to all parts of the country, except Arunachal Pradesh in North-eastern India. With the changing scenario of the AIDS epidemic, a host of opportunistic infections add to the present endemic state of some already existing infections like tuberculosis. This report analyses the AIDS cases in India, reported to the National AIDS Control Organization over the years between 1986 to 1997. A total of 3,551 AIDS cases had been reported till 31st May 1997. Tuberculosis (pulmonary and extrapulmonary) is the major opportunistic infection affecting 62% of the cases followed by candidiasis seen in 57% of the patients. In 1997, of the 390 AIDS cases analysed, tuberculosis (pulmonary and extrapulmonary) accounted for 56.5% of the total cases whereas candidiasis was seen in 61% of the cases. An increasing trend was observed with tuberculosis from 58% in 1986-1992 to 68.5% in 1995. No trend could be established in the case of candidiasis, though, a high prevalence of 66% was seen in the cases between 1986 and 1992. An increase was also observed in cases of PCP, cerebral toxoplasmosis and Kaposi sarcoma. In the AIDS cases, chronic diarrhea (76%), weight loss (87%) and fever (85%) appeared to be the major presenting symptoms. But, of the 390 AIDS cases reported in 1997, only 47% of them were suffering from chronic diarrhea. With increase in the number of AIDS cases, India is burdened with a dual epidemic of HIV/AIDS and tuberculosis. The National AIDS Control Organization in India, is involved in training clinicians and laboratory personnel in the diagnosis and management of the AIDS cases. With better diagnosis of the opportunistic infections, especially diarrhea, in AIDS patients, a better picture will emerge regarding the opportunistic infections which would help clinicians and health planners to tackle the AIDS epidemic in a more effective manner.

AIDS-Related Opportunistic Infections↗
PubMed1998

Current patterns and future trends in the population of the United States: implications for dentistry and the dental profession in the twenty-first century.

Changes in the size, distribution and composition of the population of the United States will have significant effects on health care professionals in the coming years. For dentists and other professionals involved in health care provision, it is likely that among the effects of demographic change will be change in the characteristics of their patient base, change in the characteristics of health professionals, and potential change in the socioeconomic resources of their patients. In this article, we describe current and expected future patterns of change in the population of the United States and discuss their significance for dentistry in the twenty-first century.

Dental Health Services↗
PubMed2007

Psychological distress after employment transitions: the role of subjective financial position as a mediator.

OBJECTIVE: To explore the extent to which the mental health effects of transitions into unemployment, or other forms of non-employment, and vice versa, are mediated by financial changes. METHODS: Longitudinal analysis of the British Household Panel Survey from 1991 to 2000. There were 89,264 person-years of observation from 14,686 individuals aged > or =16 years. Main outcome measure was psychological distress measured by the 12-item General Health Questionnaire. RESULTS: Transitions to unemployment were associated with increased risk of psychological distress for men (adjusted odds ratio (OR) 3.15 (95% confidence interval (CI) 2.50 to 3.98)) and for women (OR 2.60 (95% CI 1.97 to 3.43)). Women who left work to look after the family were also more likely to experience psychological distress (OR 1.72 (95% CI 1.45 to 2.05)). A reduced risk of psychological distress was seen for transitions from unemployment to paid employment for men (OR 0.52 (95% CI 0.41 to 0.68)) and for women (OR 0.68 (95% CI 0.69 to 1.40)). Financial difficulty partially mediated these relationships: men who became unemployed and were worse off financially were more likely to experience psychological distress (OR 4.19 (95% CI 3.20 to 5.50)) than men who were not (OR 1.48 (95% CI 0.95 to 2.33)). Conversely, the beneficial health effect for people who left unemployment and became employed was confined to those who were better off financially (OR 0.34 (0.25 to 0.48) for men). CONCLUSIONS: Changes in employment status have both direct and indirect effects, through changes in financial circumstances, on subsequent psychological distress. The results support the view that the direction of causation runs from employment transitions to financial difficulties and psychological distress.

Adaptation, Psychological↗