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PubMedDate not supplied

Diabetes control programs: new directions.

The diabetes control programs (DCPs), which involve state and territorial health agencies working cooperatively with the Centers for Disease Control and Prevention, offer new opportunities for diabetes educators to expand their scope of practice into public health. The intervention activities of the 40 core-capacity DCPs that are proposed for the next fiscal year are summarized in this paper to provide insight into the new directions of the DCPs. These activities span a range of health-system and community-based approaches and are described by their potential impact on the audience. The interventions are aimed at a variety of intended audiences and partners, including minorities, individuals with diabetes, healthcare providers, and policymakers. As diabetes educators continue to expand their scope of practice, the DCPs offer opportunities to go beyond individual practice behaviors by participating in community development activities, disseminating practice guidelines, changing organizational practices, and advocating for health-related public policy and legislation.

Diabetes Mellitus↗
PubMed2002

A qualitative evaluation of an HIV/AIDS respite care service in Victoria, Canada.

The Victoria AIDS Respite Care Society (VARCS) has provided respite care to people living with HIV/AIDS (PLWAs) since 1991. In 1998, an evaluation of VARCS services was undertaken to gain a better understanding of the VARCS model of community-based care. The evaluation was comprised of four components including an examination of the historical evolution of VARCS, an account of the community development processes used, a description of VARCS services, and an analysis of the impact and outcomes of VARCS services. This article highlights qualitative findings from the impact and outcomes component of this study. Guided by principles of participatory action research, this project included interviews with 85 participants. Eight themes emerged from the analysis that appeared to speak to the qualitative impact and outcomes of VARCS service. Actions taken by VARCS as a result of the evaluation findings are discussed as are the study limitations.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Organic insecticides.

Organic insecticide poisoning continues to be a major health problem not only in the developing communities but also in the Western population. The insecticides commonly used are the organophosphates, organocarbamates, organochlorides and pyrethroids. Patients with organic insecticide poisoning present with a spectrum of manifestations ranging from gastrointestinal symptoms of nausea, vomiting and diarrhoea to severe neurological manifestations of fasciculations, seizures and neuromuscular weakness and paralysis or cardiac manifestations of arrhythmias and conduction disturbances. A strong clinical suspicion is necessary to make an early diagnosis of insecticide poisoning. Treatment is primarily supportive and includes decontamination, protection of airways and cardiac and respiratory monitoring. Specific therapy for organophosphates and organocarbamates includes the use of anticholinergics. The use of oximes, especially high dose, is controversial and may be associated with a higher mortality rate. Low-dose oximes given early in the course of the illness may be beneficial. This paper reviews the literature on organic insecticide poisoning worldwide.

Carbamates↗
PubMed1989

Self-poisoning in Sri Lanka: factors determining the choice of the poisoning agents.

Sri Lanka is a developing agricultural country with a high fatality rate due to self-poisoning with very toxic agrochemicals as the main poisoning agents. A prospective study of 97 consecutive admissions following self-poisoning reveals that easy availability of the agrochemicals together with the lack of knowledge regarding their lethality were the main causative factors determining the choice of poisoning agents. Developing community awareness of the lethality of these substances, educating the farmers with regards to proper storage and disposal of agrochemicals together with stricter legislation regarding their sale and distribution may reduce the incidence of self-poisoning due to these agents with a consequent reduction in mortality due to self-poisoning.

Adolescent↗
PubMed1990

The immigrant Haitian mother: transcultural nursing perspective on preventive health care for children.

Thirty immigrant Haitian mothers in Southeast Florida were interviewed regarding their beliefs and practices about preventive health care (illness prevention and health maintenance measures) for infants and preschool children (up to age 5). All mothers used preventive health care measures from both the Western biomedical and traditional Haitian ethnomedical (folk) systems. Ninety-seven percent used magico-religious measures; 47% administered home remedies; 47% gave children over-the-counter drugs; and 35% utilized a variety of measures to ensure cold air did not enter neonates and cause illness or pain. The Haitian mothers considered the preventive health care measures effective because the children remained healthy and will likely use them again. They sought consultation from a variety of individuals who formed their health management groups and child caretaker networks. Infants and toddlers were considered at higher risk than newborns for illness due to "evil harm" inflicted by other people and/or voodoo spirits. Implications for transcultural nursing practice include developing community outreach programs, implementing nursing interventions that combine biomedical and ethnomedical preventive health care measures, and functioning as part of the health management group. The authors wish to thank Maude Vincent, R.N., for her assistance in data gathering and analysis.

Adult↗
PubMed2004

The lived experience of oldest-old rural adults.

The author elicited the lived experience of 19 oldest-old adults (13 women, all White, mean age 90.7 years, range 85-98 years) who lived alone in the rural Midwest to describe their everyday activities, concerns and struggles, and adaptive strategies. In-depth interviews (59 total) were audiotaped, transcribed, and analyzed in an interpretive phenomenological tradition of thematic analysis, interpretation of paradigm cases, and interpretation of exemplars. Participants described how historical, cultural, and environmental contexts shaped their everyday thoughts, activities, and what was meaningful to them. Findings can guide health care professionals to evaluate and develop community services and help significant others (family, friends, neighbors) understand what oldest-old rural adults need to remain at home.

Activities of Daily Living↗
PubMed1997

Health communication in the prevention of alcohol, tobacco, and drug use.

Research on substance abuse prevention programs indicates that effectiveness is greater when multiple intervention approaches that address the specific vocabulary, perceptions, and values of the target population are employed. The field of health communication provides unique perspectives on media that can be applied to increase the salience and effectiveness of substance abuse prevention programs. Well-designed and well-delivered health communications have the capacity for reaching remote audiences, changing health attitudes and behavior, shaping social norms, changing the way health issues are portrayed by the popular media, and influencing decisions about legislation and policies. Health communication approaches are generally employed within the broad context of health promotion programs, along with education, community development, empowerment, and social change approaches. This article describes the role of health communication in substance abuse prevention, reviews major conceptualizations of health communication, and introduces the unique features of the four articles included in this special section of Health Education & Behavior.

Adolescent↗
PubMed2001

Living conditions and health promotion strategies.

The paper assesses the empirical evidence concerning the interface between living conditions and health status provided by a number of case studies of urban regeneration in London, and Brighton and Hove. These studies were carried out in the theoretical framework provided by the Cost-effectiveness in Housing Investment programme that has been seeking since 1993 to identify and measure additional 'exported' costs to services such as health, education and policing which derive from poor living conditions. A chronological study of the 'health gain' associated with the Central Stepney Single Regeneration Budget improvement to two run-down estates indicates that a seven-fold health improvement in the rate of 'illness days' experienced has taken place over a four-year period (1996-2000). This 7:1 differential was identical to that found in the synoptic comparison of illness days, and some health and policing costs, between the Stepney area and an area of improved housing in Paddington carried out in 1996. The paper presents an exploratory attempt to list and categorise in various ways the exported costs associated with poor living conditions and offers some preliminary assessment of their measurability. Finally, a number of health promoting strategies that should be borne in mind when carrying out urban renewal programmes are discussed. It is argued that the provision of satisfactory housing is a necessary, but not sufficient, condition to promote good health. Attention must also be paid to community development, especially of 'organic' activities, the quality of services especially in relation to benefits, access to healthy food, crime reduction and, critically, the promotion of jobs and the reduction of poverty.

Cost-Benefit Analysis↗
PubMed1999

Ophthalmic care for the twenty-first century: a perspective based on a recent white paper, 'The New NHS'.

A recent white paper entitled The New NHS describes the changes that the government aims to adopt in order to deliver a new truly national health service (NHS). Priority would be given to developing community services in partnership with hospital NHS trusts. This paper describes a model that could be adopted for delivering such a service in the field of ophthalmology.

Community Health Services↗
PubMed2006

Promoting healthy people 2010 through small grants.

The Department of Health and Human Services initiated a pilot "microgrant" or small grants program in 2001 to promote Healthy People 2010 (HP 2010) implemented by the Yale-Griffin Prevention Research Center. This article describes the 103 agencies funded under this initiative and 67 control group agencies. It evaluates the HP 2010 focus areas targeted and the effectiveness of promoting HP 2010 objectives through microgrants. Forty-four percent of the grant recipients and 79% of the control group agencies indicated low levels of familiarity with HP 2010 goals. Changes in knowledge of HP 2010 goals for the microgrant group increased significantly from 5.24 +/- 3.67 to 7.83 +/- 1.86 (p < .05). The results suggest that microgrants can be a useful mechanism to plant the seeds for developing community and organizational capacity to define local health priorities, practice and test new initiatives or expand existing programs and promote knowledge about HP 2010.

Connecticut↗
PubMed2026

The need for standardization and improved open (meta)data practices in metaproteomics.

Metaproteomics enables functional insight into microbial communities by identifying and quantifying proteins in complex samples. Yet, heterogeneous analytical workflows and the lack of standardization across experimental and bioinformatics stages hinder reproducibility and comparability, limiting integration with other omics data. We here present a community-developed reporting checklist tailored to the specific needs of metaproteomics. We also outline current efforts to enable structured and interoperable metadata capture, drawing on standards from proteomics and microbiome research wherever possible. By promoting transparent reporting and advancing metadata practices, our recommendations aim to align metaproteomics more closely with FAIR principles and support reproducible and interoperable research practices. Video Abstract.

Proteomics↗
PubMed1997

Practising oncology via telemedicine.

Although there are increasing numbers of telemedicine programmes in the USA, few have offered teleoncology services, so that the role of telemedicine in the practice of clinical oncology has yet to be fully defined. Telemedicine has been used successfully for direct patient care in Kansas. It is also a method of providing supportive care for the cancer patient, including assessments of pain and nutrition. In addition, televised tumour conferences and nursing education courses can help smaller communities develop a level of expertise that allows patients to be treated locally. Telemedicine may well be used in future for access to national and international cancer experts, and for participation in new cancer treatment protocols through cooperative group trials. When practising oncology via telemedicine, there are unique problems, including issues regarding technology (interactive video and radiograph review) and practice (patient/oncologist preferences and doctor-patient communication). Very little has been published in the area of tele-oncology so far, and studies concerning its efficacy, cost-effectiveness and the best organizational structure are still in progress. However, telemedicine appears to be a useful technique in the practice of oncology.

Efficiency↗
PubMed2000

Public attitudes regarding willingness to participate in medical research studies.

The recruitment of adequate numbers of people to participate in medical research studies is an ongoing problem for biomedical researchers. Although the general public has come to expect and demand that the biomedical community develop new, safe and effective approaches to the prevention and treatment of diseases, that same public is not aware of the important role that public participation plays in the development of medical advances. Much is known about willingness to participate in research studies from the perspectives of patients, survivors, and those at-risk for getting a particular disease. However, little is known about the attitudes and willingness of the general public to participate in medical research. Yet, it is this population that comprises the potential pool of participants for future treatment and prevention studies. In order to examine public attitudes toward and support for medical research, a random digit dial telephone survey was conducted with 489 persons in southwestern Pennsylvania. The survey measured the respondent's stated willingness to take part in a medical research study and the factors associated with willingness to participate. These included the respondent's health status, demographic characteristics, attitudes and beliefs about participation and their knowledge about the conduct of medical research. The results of the study indicate that 46% of those surveyed said that they would be willing to take part in a medical research study focusing on a new treatment for a specific disease that was of concern to them, 25% stated that they would not be willing and 29% stated that they were undecided regarding participation. However, under certain circumstances, such as having cancer, over half of those who were undecided said they would be willing to participate. The characteristics of those willing to participate in a medical research study differ from those not willing. Determinants of willingness include: having a relative or friend who has an illness, being middle aged (between 35-64 years old), prior experience with participation in a medical research study, having a favorable attitude toward the use of human subjects in medical research and beliefs that diverse types of persons participate in clinical trials. Those respondents who were undecided about joining a clinical trial, also have different characteristics than those who are not willing. The determinants of being undecided in contrast to not willing include: having at least a college degree, having a favorable or neutral attitude toward the use of humans in medical research and, believing that the well-being of participants is the primary concern of researchers. The findings of this study have both public policy and practice implications. From a policy perspective, medical research designed to develop new treatments for disease requires an evidenced-based approach for decision making. Such an approach can only succeed if adequate numbers of individuals are willing to participate in these studies. From a practice perspective, the current study suggests that opportunities exist to increase participation by targeting recruitment efforts not only toward the willing but also toward those who are undecided about participation in medical research studies. This would involve tailoring the content of communications to meet the specific characteristics and concerns of each of these two groups of individuals.

Adolescent↗
PubMed1998

The thrifty genotype in type 2 diabetes: an unfinished symphony moving to its finale?

The basic premise of the thrifty gene hypothesis is that certain populations may have genes that determine increased fat storage, which in times of famine represent a survival advantage, but in a modern environment result in obesity and type 2 diabetes. The concept finds support in a unique animal model (Psammomys obesus) as well as among high type 2 diabetes susceptibility populations, such as North American Indians and South Pacific islanders. However, in some developing communities (e.g., Black South Africans) the thrifty phenotype hypothesis of perinatal malnutrition causing beta-cell dysfunction seems a better explanation, but this remains a contentious issue. Several genes have already been identified as candidates for the thrifty genotype, including those encoding proteins of the insulin-signaling and leptin pathways, as well as intermediary fat metabolism. Particular interest lies in the peroxisome-proliferator activated receptors. An innovative approach might be to focus on the "mirror image" of the thrifty genotype-congenital lipoatrophic diabetes mellitus, whose molecular defect remains enigmatic. We conclude that the genetic basis of the thrifty genotype probably derives from the multiplicative effects of polymorphisms at several sites mentioned above, rather than a single regulatory abnormality.

Adipose Tissue↗
PubMed2004

Cardiovascular disease risk factors in post-menopausal women in West Anatolia.

Cardiovascular risk factors are important causes of morbidity and mortality in postmenopausal women. The aim of this cross-sectional study was to evaluate the cardiovascular risk factors in 207 postmenopausal Turkish women over 45 years old in a rural district of West Anatolia, Manisa Muradiye district. A questionnaire on socioeconomic and sociodemographic characteristics was conducted in the women followed by the measurement of blood pressure, fasting blood glucose, cholesterol levels, and waist-hip ratio along with an electrocardiogram (ECG). The European Cardiology Society risk index was used for cardiovascular risk evaluation. The results showed that 86% percent of the women will be carrying more than a 5% probability of developing a cardiovascular risk in the next 10 years. Moreover, the results proved 7% of the women are at high risk for a cardiovascular condition. Hypertension, hypercholesterolemia, and impaired glucose tolerance, were observed in 62%, 35.3%, and 13.5% of the women, respectively. Seven percent had smoked for at least six months. Fourteen cases had complained of exercise angina and pathologic ECG signs were diagnosed in one-third of these 14 cases. The waist-hip ratio measured 0.8 or more in 66.2% of the cases, with a range of 68-147 cm (mean; 95.6 +/- 11.55). The results indicate that the risk of a cardiovascular condition developing is extremely high in postmenopausal West Anatolian women and increases with age. Morever, the prevalance of hypertension increased with age and was very closely related with low socioeconomic levels. These hazardous cardiovascular disease risk factors should be considered as high priority health problems in rural and low socioeconomic areas of developing communities. Intervention to modify the cardiovascular risk factors should be included in routine primary health care programs.

Aged↗
PubMed2005

Metazoan parasite communities of sentinel bluegill caged in two urbanizing streams, San Antonio, Texas.

Urbanization has deleterious effects on water quality and biota in stream systems. This project used caged bluegill (Lepomis macrochirus) to assess metazoan fish parasite communities in 2 urbanizing streams of the upper San Antonio River Basin, Bexar County, Texas. Field studies on Leon and Salado creeks were conducted during late summer in 1999 and 2000. Juvenile bluegill, obtained from a local aquaculturist, were held in cages for 10-22 days at middle and lower watershed sites to expose them to in-stream conditions and to allow parasite communities to establish. After removal from cages, fish were examined for metazoan parasites. In 2000, wild Lepomis spp. also were collected at study sites for parasite assessment. In both years, physical and chemical water properties were monitored at each site. Of the 120 fish examined for parasites, 96.7% were infected by at least 1 organism from among the 11 parasitic taxa observed. For caged fish, both diversity and equitability of parasite communities tended to be lower at the more eutrophic downstream sites; accordingly, parasite diversity and equitability were inversely correlated with nitrate concentrations. Ectoparasites were more prevalent in caged fish and endoparasites were more abundant in wild fish. An Ergasilus sp. copepod and a Posthodiplostomum sp. trematode dominated the ecto- and endoparasite faunas, respectively. This study suggests that assessment of watershed health can benefit from comparative cage studies of parasite community development involving sentinel fish species.

Animals↗
PubMed1995

An outbreak of African swine fever in the southern region of Malawi.

An outbreak of African swine fever (ASF) was first detected in December 1989 in the southern region of Malawi. During 1990 the outbreak reached epidemic proportions: by August 1990, over 31,000 pigs (45%) from a population of 70,000 in the affected areas had died or been slaughtered. In affected villages this accounted for 83% of the pigs present. The outbreak probably originated in the central region of Malawi, where ASF is enzootic. Virus isolates from the southern and central region outbreaks in 1989-1990 were indistinguishable using DNA restriction fragment pattern analysis. The rapid spread of the disease and the difficulty experienced in halting this spread are discussed. Important factors included the type of pig husbandry (mainly scavenging without penning) and the fact that veterinary field staff lacked the mobility to ensure the observance of restrictions. New initiatives will be required--in particular, raising public awareness and developing community participation--if ASF is to be controlled in the future.

African Swine Fever↗