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PubMed2005

[Unintentional injuries in the home environment: home safety].

OBJECTIVE: To review the characteristics of unintentional injuries and their impact on children and adolescents. SOURCES OF DATA: Articles published between 2000 and 2005 in the MEDLINE, EBSCO, Proquest, SciELO, BVS and Google Scholar databases were selected. The authors used the keywords unintentional injuries, injuries, safe home, burns, falls, drowning, scorpions, snakes, poisoning, child, adolescent, mortality, injury control, and hospitalization. Some articles were evaluated based on the selected publications. SUMMARY OF THE FINDINGS: Unintentional injuries in the world and in Brazil are analyzed, and so are the behaviors currently adopted for injury prevention and control. The impact on mortality, on physical damage, and the economic burden of injuries are evaluated. Special emphasis is placed on home environment, approaching the effects of child development, social disparities and contextualization of home environment on children's world and vulnerabilities. The main types of events that cause physical damage to the child and adolescent in the home environment are described. CONCLUSION: The prevention of injuries in the home environment is possible. In this case, health professionals have the challenge to reduce the consequences of unintentional injuries on the morbidity and mortality of children and young people in Brazil and in the whole world.

Accident Prevention↗
PubMed1993

Prevalence of NIDDM and impaired glucose tolerance in aborigines and Malays in Malaysia and their relationship to sociodemographic, health, and nutritional factors.

OBJECTIVE: To determine the prevalence of diabetes mellitus and IGT in different ethnic groups living in the same physical environment and to find their relationship to nutritional status and dietary intake. RESEARCH DESIGN AND METHODS: The study was conducted among Malays and Orang Asli in six rural and urban locations in Malaysia. OGTTs were performed on 706 adult subjects > or = 18 yr of age. WHO criteria were used for diagnosing diabetes mellitus and IGT. RESULTS: The overall prevalence of diabetes mellitus and IGT among Orang Asli was 0.3 and 4.4% compared with 4.7 and 11.3%, respectively, among Malays. This increased prevalence of glucose intolerance among Malays was associated with higher levels of social development. Among rural Malays, the crude prevalence of diabetes in a traditional village was 2.8% and in the land scheme was 6.7%, whereas urban Malays had a prevalence of 8.2%. In contrast, the prevalence of IGT (10.5-14.8%) was higher among rural Malays, compared with 9.6% among urban Malays. Ethnic group, > or = 40 yr of age, an income > M$250, fewer daily activity, and obesity were associated with a higher prevalence of diabetes. CONCLUSIONS: Diabetes mellitus and IGT, which were more common among Malays than Orang Asli, were associated with more affluent life-styles and modernization.

Adult↗
PubMed1990

Well-being among 50-year-old people. The population study "50-year-old people in Kungsör".

Self-assessed well-being has been shown to be related to earlier medical events and to be a predictor of mortality. 50-year-old men and women (n = 314) in Kungsör were invited to an examination for traditional risk factors for cardiovascular diseases and different aspects of self-assessed well-being. The differences between men and women concerning their well-being could not explain the differences in the expected mortality between the sexes. A well-developed social network and physical exercise were the most positive determinants of well-being, while drug intake, angina pectoris, and smoking were the most negative.

Anxiety↗
PubMed2005

Gamma knife surgery for hypothalamic hamartomas accompanied by medically intractable epilepsy and precocious puberty: experience in Mexico.

OBJECT: Hypothalamic hamartoma is a nonneoplastic malformative mass of neurons and glia in the region of the hypothalamus. Because of its location, open surgery is associated with high morbidity and mortality rates. Gamma knife surgery (GKS) may be an efficient and safe treatment approach, which produces little morbidity. The authors describe the results of GKS in three patients with hypothalamic hamartomas. METHODS: All patients were male, aged 3, 12, and 15 years. The lesions were classified according to the Valdueza scale: one was Type IIb and two were Type IIa. The patients presented with gelastic seizures (15-20 per day), generalized epilepsy, behavioral abnormalities, and alterations of the sleep cycle. Precocious puberty was present in one patient. The Type IIb tumor had a volume of 1.8 cm3, and the Type IIa tumors were 597 mm3 and 530.1 mm3. The lesions received 12.5 Gy, 14 Gy, and 15 Gy, respectively, to the 50% isodose line. The patients were followed for 30 to 50 months. After 3 months, all patients showed improvement of their sleep, behavior, and epilepsy. At the present time, these patients are receiving low-dose antiepileptic agents and have achieved adequate social development and school integration. CONCLUSIONS: Gamma knife surgery appears to be a good, safe, and effective option for the treatment of selected hypothalamic hamartomas. No morbidity or mortality was associated with these three cases.

Adolescent↗
PubMed1999

Diagnosis and treatment of Klinefelter syndrome.

Many physicians underestimate the prevalence of Klinefelter syndrome and so fail to recognize its more obvious features. Increased awareness of its effects on physical, psychological, and social development should help to dispel persistent misconceptions about the condition and enable earlier diagnosis and more effective treatment.

Adult↗
PubMed2003

Augmentative and alternative communication.

With the help of a knowledgeable interdisciplinary team, individuals can find the best AAC system to meet their needs and enrich their quality of life. A new-found ability to communicate often significantly improves a person's overall prognosis and may prevent serious problems in the areas of behavior, learning, reading, and social development. However, because an AAC system is just one component of multimodal communication, it should not inhibit the use of speech by individuals who have some usable or functional speech. It is important to understand that AAC is a process and that an AAC system will evolve over time to meet the changing preferences, dislikes, and abilities of the user as that individual strives to accomplish communication goals.

Articulation Disorders↗
PubMed1989

Occupational therapy treatment practices with infants in early intervention.

This paper explores occupational therapy treatment practices for infants (birth to age 2 years) in early intervention programs. Generic treatment is viewed as the facilitation of the infant's independence through improved motor control, sensory modulation, adaptive coping, sensorimotor development, social-emotional development, daily living skills, and play. Treatment practices in specialized settings, that is, in a neonatal intensive care unit and in a follow-up program for high-risk infants, are outlined. The efficacy of intervention is discussed in light of recent research findings and of the comments made by critics of early intervention.

Child Development↗
PubMedDate not supplied

Diversifying the health professions: a model program.

OBJECTIVE: To describe a university-based mentoring program in the food and nutritional sciences that addresses the need for multicultural professionals in allied health fields. METHODS: The conceptual model for the program includes inputs (goals, resources), transformational process (professional development, social support and recognition) and outcomes (student participation, graduation and placement rates). Outcome data were analyzed using descriptive statistics. RESULTS: Between 1993 and 2001, 49 students completed the program, 43 (88%) graduated, 23 were placed in graduate or professional schools, and 21 obtained professional positions. CONCLUSION: This mentoring model resulted in multicultural students who successfully entered health professions.

Allied Health Occupations↗
PubMed1990

Hospitals and seniorcare: separating myth from fact.

Not every hospital should attempt to serve the senior market. For the right hospitals, it can be extremely rewarding, both professionally and financially. A hospital management team should be able to answer "yes" to most of the following questions if they want to proceed. Do 65+ persons exceed 12 to 15 percent of the population in your service area? A concentration of senior persons is required to provide a sufficient market for services. Are there organized groupings such as lifecare communities, adult communities, etc. within you service area? Marketing efforts can be targeted to these groups, including personal calls and special physician programs. Do you have physicians/groups that specialize in geriatric care? These groups provide the basis for quality care and will help promote the interest of other physicians in senior programs. Do you have strong cardiac, oncology, and orthopedic programs? These are the areas most often used by senior patients as they progress through their experiences with chronic illnesses. Do you have an aggressive and developing social work group? Social workers help locate patients in the service area, provide a basis for group activities, and outplace patients after a hospital stay. Is the volunteer group strong, populated with 50+ individuals and looking for more to do? Seniors are excellent emissaries in the community and they relate well to inpatient seniors who are often reluctant to interface with ill peers. Is your facility a low cost provider, i.e., can you break even or better on Medicare? Having a seniorcare program will obviously increase the Medicare numbers in the hospital census.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

Factors associated with differential utilization of professional care among elderly people: residents of old people's homes compared to elderly people living at home.

To investigate factors that explain differential utilization of professional care among elderly people a study was performed in Maastricht, the Netherlands. For that purpose 657 interviews with elderly people were held. In this article a comparison is made between elderly people living at home, with or without professional home care, and residents of old people's homes. Besides the functional status, as measured by limitations in household activities and activities of daily living, the composition of the household of the elderly person is recognized as a major discriminating factor between the three groups. The role of depressive complaints in care utilization is less prominent than expected from an earlier study. A bivariate analysis clearly showed the frequency of mental problems and the poorly developed social network among elderly persons using professional care. Implications for caregiving and policy planning are discussed.

Activities of Daily Living↗
PubMed1976

[International strategies in medical education: technical assistance and technical cooperation].

This article reviews the evolution of international activity for national development in general and for medical education in particular. The concepts of traditional technical aid and the new method of technical cooperation are studied. That method appeared just before the beginning of this decade as a response to needs existing at the time to coordinate development with the emerging international economic order. This article discusses the emphasis given to strategy in this new concept of international activity. Strategy, in this sense, consists of a clear definition of goals and objectives by the countries themselves, mobilization of local resources, and full participation of national personnel in all phases of the process. The projects promoted by the Pan American Health Organization in applying technical cooperation to the field of health manpower training are discussed. Such activities include: coordinating the above mentioned training, providing overall support for institutional development, training professors and administrators, developing educational technology, creating and developing a network of biomedical information, developing social sciences as applied to medicine, and encouraging medical, epidemiological, social, and operational research.

Education, Medical↗
PubMed1995

Identifying depressive symptoms among elderly Medicare HMO enrollees.

Increasing attention has been devoted to the urgent need for identifying depressive symptomatology at the primary care point of contact for older individuals to prevent more serious disease and potential negative behavioral outcomes. Delivering medical care services in a system that is sensitive to the symptoms of depression may lead to greater cost-effectiveness and improved quality of life. This paper examines the correlates of depression in a random sample of 1800 Medicare beneficiaries enrolled in a risk-sharing HMO. Ten percent of the total sample reported a high degree of depressive symptoms, as measured by the CES-D score. The prevalence of depressive symptoms was significantly higher for those who were not married, reported less well-developed social support networks, had low perceived ability to control future health, or had poorer health status. Depressive symptoms were also associated with a greater number of physician office visits and higher ambulatory charges, although no significant relationship was found for inpatient use or total charges. Practical approaches to monitoring depressive symptomatology at the primary care level in an HMO are suggested.

Aged↗
PubMed1999

The prevalence of Gilles de la Tourette's syndrome in children and adolescents with autism.

Thirty-seven pupils attending a special school for children and adolescents with autism were observed for the presence of motor and vocal tics. Subsequent family interviews confirmed the diagnosis of comorbid Gilles de la Tourette's Syndrome (GTS) in three children with autism, giving a minimum prevalence rate of 8.1 %. Family history data also suggested this was heritable. The presence of GTS was not associated with superior intellectual, language, or social development. Results suggest that the rate of GTS in autism may exceed that expected by chance. The limited sample size constrains this conclusion. A large-scale epidemiological study testing this association study would appear merited.

Adolescent↗
PubMed1999

[A case of neonatal 49,XXXXY syndrome].

The authors present the case of 49,XXXXY syndrome diagnosed in neonatal age. During the investigation of ambiguous genitalia was identified sex chromosome anomaly. The authors deal with possible pathogenesis of the syndrome and its clinical symptoms in details. They emphasize the importance of both testosterone substitution with pubertal timing, and early intellectual and social development.

Abnormalities, Multiple↗
PubMed1999

Qualitative case study of physical therapist students' attitudes, motivations, and affective behaviors.

The purposes of this study were 1) to describe and document the attitudes, motivations, and affective behaviors of senior physical therapist students at a single university, and 2) to determine how data gathered from this work might assist with curriculum changes designed to promote professional behavior and self-directed learning. Student attitudes, behaviors, and motivations were identified using a qualitative case-study method. Phase one of the study examined clinical experiences using four focus groups, one conducted with six clinical instructors and three with 21 senior physical therapist students. Five follow-up interviews were conducted with students. During phase two, the same 21 students were queried about their classroom experiences using three focus groups and five follow-up interviews. Five major themes were identified: 1) mismatch of expectations between students and instructors, 2) preferred learning environment, 3) student-instructor relationship, 4) vocational expectations, and 5) stress. These themes parallel Chickering's theory of social development in college students. The authors encourage curriculum changes that directly address issues of professionalism, create an active learning environment, promote collaboration, and provide students with strategies for stress management.

Communication↗
PubMed1999

Medical libraries, bioinformatics, and networked information: a coming convergence?

Libraries will be changed by technological and social developments that are fueled by information technology, bioinformatics, and networked information. Libraries in highly focused settings such as the health sciences are at a pivotal point in their development as the synthesis of historically diverse and independent information sources transforms health care institutions. Boundaries are breaking down between published literature and research data, between research databases and clinical patient data, and between consumer health information and professional literature. This paper focuses on the dynamics that are occurring with networked information sources and the roles that libraries will need to play in the world of medical informatics in the early twenty-first century.

Databases, Factual↗
PubMed1999

Opportunities, problems and perspectives for malaria control in sub-Saharan Africa.

Environments conducive to high malaria transmission and widespread poverty are at the roots of the 'malaria giant', which affects 46 countries in Africa. The recent interest in and momentum of work on malaria, in endemic countries and the international community, is unprecedented and opens new perspectives for controlling the disease. Significant steps included: (i) the allocation of US$20 million by WHO for accelerated implementation of malaria control in 34 African countries in 1997-98; (ii) the Declaration on Malaria by the Heads of States of the Organization of African Unity and the establishment of the African Initiative for Malaria Control in 1997; (iii) the concomitant mobilisation of the research community in the Multilateral Initiative on Malaria; (iv) the G8 Summit in 1998 in Birmingham asking for higher commitment to malaria control, particularly in Africa; and (v) the Roll Back Malaria initiative set as a WHO priority project in 1998. However, experiences have proved the alarming 'resilience' of the malaria system in Africa, showing devastating consequences when malaria returns to the original levels after intensive control is interrupted. Effective malaria control in Africa requires long-term action, firmly rooted in the social development of the country.

Africa South of the Sahara↗