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At least 1,207 records · Page 67Linked to original sources
PubMed1994

[Medical and economic problems in the reform of health maintenance].

The paper summarizes the results of comprehensive studies into the management efficiency of therapeutical-and-prophylactic institutions under new economic relations in this area. Transition to public health insurance changes the relations between the system's subjects, determines the need of standardization, pricing, and quality estimation of medical services. The basic directions of the health perform are defined.

Health Care Costs↗
PubMed2000

[Health behavior of smokers--results of the TACOS (Transitions in Alcohol Consumption and Smoking) Study].

The German TACOS Project (Transitions in Alcohol Consumption and Smoking) provided an opportunity to examine the patterns of health behaviours (nutrition, physical activity, alcohol consumption) of current smokers, ex-smokers and non-smokers with special regard to different degrees of severity of nicotine dependence. Data were collected in the adult general population of Lübeck and 46 surrounding communities, resulting in a representative sample of 4075 individuals. In this sample, 37.3% were current smokers, 22.5% were ex-smokers, 25.0% of smokers were severely nicotine-dependent. As in other empirical investigations, current smokers had an unhealthy lifestyle in general. Smokers compared to ex-smokers and non-smokers consumed unhealthy foods more frequently, reported less physical activity and were more likely to consume hazardous levels of alcohol. Special attention was paid to comparing different degrees of severity of nicotine dependence. A high degree of nicotine dependence was associated with poor health behaviours. Data show that smoking, unhealthy nutrition, lack of physical activity, and hazardous levels of alcohol consumption occur in combination and that unhealthy behaviour patterns vary according to the severity of nicotine dependence. The presence of multiple unhealthy behaviours requires special secondary preventive interventions for smokers. The association of these combined health hazards must be controlled in determining the independent health risk due to one of these factors.

Adolescent↗
PubMedDate not supplied

Adolescent transitions: a nursing concern.

Adolescents with chronic conditions face unique challenges as they approach adulthood. Statistics on adults with disabilities indicate high rates of unemployment, few with college degrees, and limited options for community living. Until recently, efforts to facilitate successful transitions for adolescents with chronic conditions to adulthood have been limited. An awareness of some of the pertinent issues pertaining to adolescent transitions, especially those pertaining to health care, can assist the pediatric nurse in facilitating the transition to adult health care, career, employment, and community living.

Adaptation, Psychological↗
PubMed2001

Transition to home care after stroke: depression, physical health, and adaptive processes in support persons.

A longitudinal design was used to examine adaptation in primary support persons (PSP) of stroke survivors during the transition from hospitalization (T1) to home care (T2). The major purposes of the study were (a) to examine changes in depression, physical health, and contextual and coping factors from hospitalization of the stroke survivor through the first 6-10 weeks of home care; and (b) to identify predictors of depression. Data (N = 136) were collected on depression, physical health, background, survivor illness, and social environmental variables; appraisal of impact; social support resources; and coping skills. Reduction in mean PSP depression was significant at T2, but the change in physical health was not significant. Significant changes occurred in survivor function, family functioning, and three of six coping skills. Hierarchical multiple regression analyses were used to predict depression. T1 variables accounted for 29% of the variance in T1 PSP depression, with gender and appraisal of impact the strongest of seven predictors. T1 depression, T2 health, family functioning, and avoidance coping were the strongest of seven predictors, explaining 50% of the variance in T2 depression. Findings highlight the importance of maintaining caregiver health and preventing depression and identify variables to target for the reduction of PSP depression.

Adaptation, Psychological↗
PubMed2005

A study of midlife women's reasons for changing healthcare providers.

PURPOSE: The purpose of this study was to examine the reasons midlife women report for changing healthcare providers and to determine if there were any differences in reasons given for the change based on gender or ethnicity. DATA SOURCES: This was an analysis of data collected from a healthy community-based sample of midlife women as part of a longitudinal 5-year study of changes in health outcomes during transition to menopause. Women were queried about their experience in changing healthcare providers. CONCLUSIONS: Over 42% indicated that they had changed health providers because of dissatisfaction with care. The component accounting for the majority of the variance was related to communication issues. There were no significant differences across ethnic groups in decision to change providers or in reasons for their dissatisfaction with care. However, their reports of experiencing racism in the healthcare system were troubling. IMPLICATIONS FOR PRACTICE: The ability of the provider to communicate with women may have implications in women's choices in health care later in life.

Adult↗
PubMed1997

Transitions in nursing education: a model for designing practical/vocational nursing curriculum.

Health care reform will change not only the way health care is delivered in the United States but it will bring about fundamental changes in the way health care providers will be educated and trained. Transitions in health care education are expected to occur at all levels, impacting all professional groups including doctors, pharmacists, registered nurses and licensed practical nurses. Watson's Model for the development of practical nursing curriculum is intended to help practical nurse educators design programs that will be technically futuristic, yet embedded in the traditional values of nursing. The model, which is still being tested, hopes to blend the best of two worlds: the proven effectiveness of behaviorism and the essence of humanistic caring.

Curriculum↗
PubMed2026

Stratifying the risk of transition to adult-onset psychiatric disorders in adolescents with anxiety.

BACKGROUND: Escalating mental health service demands have created a need to better identify young people most likely to require continued support from mental health services at the transition between childhood and adulthood. Anxiety is the most common adolescent mental health condition, yet its clinical significance and prognosis are not well understood. We aimed to examine the risk of young adult-onset psychiatric disorders in individuals with an adolescent anxiety disorder, and identify stratifiers of risk of subsequent psychiatric disorders in this group. METHODS: Individuals from the Norwegian Mother, Father, and Child Cohort Study (MoBa) with linked health records and aged 18 or over as of the 31st December 2023 were included. Those diagnosed with any ICD-10 anxiety disorder when aged 10-17 years were defined as having an adolescent anxiety disorder (n=2107, controls n=47,582). Polygenic scores (PGS) for psychiatric and neurodevelopmental conditions were calculated using LDpred2. Anxiety, comorbidities, and parental psychiatric history were defined through linked ICD-10 diagnoses. Sex was defined through linked records. Individuals were defined as having a young adult-onset psychiatric disorder if they first received any new psychiatric diagnosis aged 18-24. RESULTS: Adolescent anxiety diagnosis was associated with increased risk of all adult-onset psychiatric disorders (HR= 2.33-8.65). Post-traumatic stress disorder PGS, parental history of severe mental illness, and female sex were associated with increased risk of transition to a young adult-onset psychiatric disorder in people with an adolescent anxiety disorder. CONCLUSIONS: Adolescent anxiety greatly increases the risk of a psychiatric disorder during the transition to adult life. Clinicians should consider female sex and parental psychiatric history when prioritising young people with anxiety for adult mental health service support. Future research needs to further consider whether polygenic scores would aid risk stratification in clinical practice.

Norwegian Mother Father and Child Cohort Study↗
PubMed2006

Predicting the long term course of low back pain and its consequences for sickness absence and associated work disability.

BACKGROUND: Low back pain is characterised by a dynamic pattern of episodes and recovery but little is known about the long term course of back pain due to lack of cohort studies with sufficiently long follow up periods. METHODS: A cohort of 523 workers in nursing homes and homes for the elderly was followed for two years. Physical load was measured by observations at the workplace. Psychosocial factors at work, individual characteristics, and low back pain were determined by questionnaire once a year. The effect of work load on low back pain and the transition of low back pain into sickness absence was calculated with logistic regression analysis. A Markov model was used to construct a hypothetical cohort of workers with follow up of 40 years (40 cycles of 1 year) with transitional probabilities between no complaints, low back pain, and sickness due to low back pain. Permanent disability was used as end state of health. RESULTS: The transitional probability from no complaints to low back pain varied between p = 0.25 and p = 0.29, from low back pain to sickness absence between p = 0.09 and p = 0.25, and recurrence of sickness absence varied between p = 0.27 and p = 0.50, depending on the level of physical load. During a 40 year career, total sickness absence due to low back pain was approximately 140 weeks (6.6%) among workers with high physical load and about 30 weeks (1.4%) among those with low physical load. CONCLUSION: The Markov approach illustrated the potential impact of physical load on (permanent) disability due to low back pain among workers with exposure to physical load. These consequences may go unnoticed in cohort studies with follow up periods of a few years.

Adult↗
PubMed1976

Making annual indexes of health.

A discrete-state, continuous-time Markov model of health states and state transition probabilities is outlined as the basis of a health index that would reflect the annual health distribution and expected health changes of a population. The final index is an additive one, summing expected durations of the various health states over the entire population sample. The weights attached to the expected durations are derived from the instantaneous incidence rates, or intensity functions, that define the transition probabilities. A general procedure for collecting data during overlapping 6-week periods from numerous population subsamples is described.

Health Status Indicators↗
PubMedDate not supplied

Polymorphisms in the estrogen synthesis and metabolism pathways and symptoms during the menopausal transition: observations from the Seattle Midlife Women's Health Study.

OBJECTIVE: The purpose of this study was to determine whether polymorphisms in the estrogen synthesis and metabolism pathways are associated with women's vasomotor symptom experiences during the menopausal transition. DESIGN: In 2002, a subset of women enrolled in the Seattle Midlife Women's Health Study since 1990 (N = 174) provided a buccal smear for genotyping. Women were recruited by complete ascertainment of selected multiethnic neighborhoods in 1990. Participants were midlife women with a mean age of 53 years in 2005, well educated, employed, married, and represented a multiethnic population. Genotyping was done for the following polymorphisms: CYP1A1m2; CYP1B1*2 and CYP1B1*3; CYP17 5'UTR; CYP19 3'UTR; CYP19 (TTTA)n; including CYP19 7r and CYP19 7(r-3); CYP19 8r and CYP19 11r; and ESR1PvuII and ESR1XbaI. Women rated their vasomotor symptom severity in diaries on days 5, 6, and 7 of the menstrual cycle or on a constant date each month for women skipping periods. Menopausal transition stage was determined from daily menstrual calendars. First voided urine specimens provided several times each year were assayed for estrone glucuronide. RESULTS: Women with the CYP19 11r polymorphism reported more severe and frequent hot flashes during the middle and late menopausal transition stages and postmenopause and higher E1G levels during middle and late stages. None of the other polymorphisms studied were related to hot flashes or to estrone glucuronide levels. CONCLUSIONS: These findings suggest a possible role for CYP19 polymorphisms in estrogen levels and in vasomotor symptoms during the menopausal transition that warrants further study in larger and more diverse populations of women.

Alleles↗
PubMed2003

[Alcohol drinking in the time of political transition in Poland. Report of the National Health Programme ].

The National Health Programme was adopted in Poland in the mid-1990s. It consists of 18 targets including target 4 that calls for diminishing alcohol consumption and changing its structure as well as limiting health harms associated with alcohol. The programme is being monitored on bi-annual basis. The monitoring covers a level of alcohol consumption and associated harm including trends in mortality and morbidity as well as in road accidents in 1990-2001 period. During the period in point, particularly in the beginning of the transition alcohol consumption increased at least by one third reaching 10-11 litres of pure ethanol per capita, mostly due to sudden disruption of the alcohol control system and high tide of unrecorded supply. Currently, the consumption is estimated to be 9.5-10.0 litres with 30% share of the unrecorded. During last decade recorded morbidity due to mental disorders associated with alcohol increased by 80% and 60% respectively in out- and in-patient system while mortality rates almost doubled. Male mortality due to liver diseases increased by 50% while that of women remained relatively flat. In last few years, alcohol related mortality tended to decline slightly parallel to consumption trends. Significant improvement has been achieved in prevention of drunken diving. The number of deaths in alcohol related road accidents decreased two fold while a rate of drunken crashes per 1000 vehicles dropped three times.

Adaptation, Psychological↗
PubMed2005

Self-rated health within the Canadian immigrant population: risk and the healthy immigrant effect.

Set within the determinants of health framework and drawing upon Statistics Canada's longitudinal National Population Health Survey, this paper explores the self-assessed health of Canada's immigrant population. Using both descriptive and multivariate techniques, including logistic regression and survival analysis, the intent is to identify differences in self-assessed health between the immigrant and native-born populations, the factors that contribute to immigrant self-assessed health, and the factors associated with declining self-assessed health status. In each case, the key questions are whether differences in health status exist between the native- and foreign-born. Results indicate mixed support for the Healthy Immigrant Effect, with the native- and foreign-born neither more nor less likely to rank their health as fair or poor. However, results from the proportional hazards model indicated that the native-born were at lower risk to transition to poor health.

Adult↗
PubMed1998

Oral microbiota in smokers and non-smokers in natural and experimentally-induced gingivitis.

The present study primarily aimed at investigating the oral microbiota in smokers and non-smokers with established gingivitis and monitoring its composition during experimental gingivitis. Secondly, it aimed at examining whether the composition of the microbiota is associated with different levels of gingival inflammation during this experimental gingivitis trial. For this purpose, 25 non-dental university students with gingivitis were recruited. 11 subjects were smokers and 14 were non-smokers. After achieving gingival health, they entered a 14-day experimental gingivitis trial. Plaque and bleeding were assessed before entering into the study (intake), at day 0, day 5 and at day 14 of the experiment. Microbiological samples from mucosal sites and dental plaque (taken at intake, day 0, and day 14) were analysed for the presence of Actinomyces species, Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Campylobacter rectus, Fusobacterium nucleatum, Peptostreptococcus micros, Porphyromonas gingivalis, Prevotella intermedia and Streptococcus species. At day 14 of the experimental period, the level of plaque formation was not different between smokers and non-smokers, but bleeding scores were lower in smokers than in non-smokers (15% and 30% respectively, p=0.01). The change from natural gingivitis to a state of gingival health and a subsequent change from gingival health to experimentally induced gingivitis was accompanied by quantitative alterations in the cultivable microbiota in both groups. Changes were most prominent in the transition from gingival health to experimental gingivitis and were found in dental plaque for Actinomyces species, C. rectus, F. nucleatum, and P. intermedia. Within the group of non-smokers, a distinction was made between subjects with a 'weak' or 'strong' inflammatory response. No relationship with a single bacterial species could be established which would likely explain the differences in levels of inflammation. It is concluded that differences in response to experimental gingivitis are not caused by major differences in the composition of the oral microbiota.

Actinomyces↗
PubMed2002

Diet and health changes at the end of the Chinese neolithic: the Yangshao/Longshan transition in Shaanxi province.

In this paper we discuss diet and health changes of millet agriculturists in Northern China, Shaanxi province, during the period 7,000-4,000 BP. An episode of intensive climatic oscillations that preceded the onset of colder climate circa the fifth millennium BP divides the period (Shi et al. [1993] Global Planet. Change 7:219-233). The onset of the cooler climate marks the decline of the egalitarian society of Yangshao and the rise of the chiefdom-like society of Longshan. Skeletal materials from the two sites of Beiliu and Jiangzhai are from the earlier phases of Yangshao culture (7,000-6,000 BP), while remains from the Shijia site were excavated from the terminal phase of Yangshao culture (6,000-5,000 BP), a phase that would be expected to show adjustments to strong climatic fluctuations. Human remains from the Longshan culture (5,000-4,000, BP) were found at the Kangjia site. In order to investigate whether the trajectory of diet and health changes persisted beyond the Longshan, a skeletal sample from the Xicun site of the Western Zhao Dynastic period (3,800-2,200 BP) is included in our analyses. All Yangshao sites in our study are characterized by low frequencies of anemia and carious lesions. Some subsistence changes probably occurred during the later phase of Yangshao culture that resulted in elevated masticatory stress and occlusal macrowear among the Shijia people. However, deterioration of community health did not begin until the Longshan, when increased occurrence of porotic hyperostosis and caries is accompanied by decreased adult stature. The transition to softer, more extensively processed food during Longshan is evident in decreased rates of occlusal wear. Increased population density and diminished food values were most likely responsible for these changes. Poor health persisted into the subsequent Dynastic period of Western Zhao.

Adult↗
PubMed1998

Moving from science to public health programs: lessons from vitamin A.

The transition from research to the applications of its results is a difficult one. Several stages must be passed through before a discovery can be put to practical use. The development of the current standards for vitamin A is a good example of both a successful and a difficult transition. The importance of the public media and of international organizations, especially the World Health Organization, in any transition is noted. Movement from research to practical applications requires that scientists take an active, sensible leadership role, that mechanisms for disseminating information and for bringing about scientific consensus are used effectively, and that international funding and support agencies take a role.

Animals↗
PubMedDate not supplied

Physical activity is associated with better health and psychological well-being during transition to university life.

The authors investigated vigorous physical activity, psychological well-being, and self-reported illness during transition to first-year university life in a sample of 175 Canadian undergraduates. At the completion of their first year of university study, participants completed retrospective measures assessing vigorous physical activity, upper respiratory infectious illness (URI), doctor visits, as well as measures of psychological well-being. Based on nationally recommended (US Department of Health and Human Services) standards, 61% of students reported engaging in adequate levels of vigorous activity during their first year at university. The authors found no differences in URIs between sufficiently and insufficiently active students. However, insufficiently active students scored lower on psychological well-being and were twice as likely to have consulted a physician regarding an illness compared with sufficiently active students.

Adolescent↗
PubMed1994

A case study: using members' values to increase plan awareness.

Consumer awareness of a health plan is the direct result of name recognition and overall health plan identity. After many name changes and transitioning ownerships, Greater Atlantic Health Service found that its membership was waning, and a lack of consumer awareness of the HMO was a substantial part of the problem.

Consumer Behavior↗