Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Health Transition”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,531 records · Page 85Linked to original sources
PubMed2006

A prospective examination of high-cost health services utilization among drug using prisoners reentering the community.

The use of health services by prisoners during their incarceration and after their return to the community impacts the U.S. health care system and health care costs associated with this system. These health care costs are expected to increase over the next decade as more prisoners return to their communities. The current study prospectively examines the use of high-cost health care services-emergency room visits and hospitalizations-among 565 male drug-abusing prisoners about 1 year after prison release. A series of structural equation models were used to examine predisposing factors, including health status and drug use, and to estimate the frequency of high-cost health service utilization. As expected, health status was the most robust predictor of high-cost health services. However, the finding that drug abuse had nonsignificant relationships with high-cost health services utilization was not expected. Discussion focuses on health care service issues and health problems as prisoners' transition from prison to the community.

Adult↗
PubMed2026

Cushing's disease and autoimmune thyroid disorders in women: Impacts on fertility, pregnancy, and menopause.

Cushing's disease (CD) and autoimmune thyroid diseases (AITDs) are two distinct but interconnected endocrinopathies affecting predominantly women. A primary cause of CD is excess adrenocorticotropic hormone (ACTH) secretion, which leads to hypercortisolism and profound hormonal and immune changes. As with AITDs, Hashimoto's thyroiditis and Graves' disease are caused by a loss of immune tolerance and frequently coexist with female reproductive dysfunction. Emerging evidence suggests that chronic hypercortisolism in CD suppresses immunity as well as alters hypothalamic-pituitary-thyroid (HPT) axis activity, which may mask or exacerbate thyroid autoimmunity after disease remission. Coexisting CD and AITD has significant effects on women's reproductive health, pregnancy outcomes, and menopausal transitions, as thyroid and adrenal hormones play a crucial role in regulating ovulatory cycles, placental development, bone formation, and cardiovascular health. In this review, shared pathophysiological pathways are explored, clinical and therapeutic challenges are highlighted, and integrated management strategies are discussed. To improve early diagnosis, tailor treatment approaches, and guide future endocrine research, it is essential to understand the compounded risks of dual endocrinopathy.

Humans↗
PubMedDate not supplied

Staging the menopausal transition: data from the TREMIN Research Program on Women's Health.

The present study was conducted to test the assumptions of a staging system of reproductive aging that was proposed at the Stages of Reproductive Aging Workshop (STRAW) in 2001. Using longitudinal data provided by 100 women over a period of 3-12 years, we asked whether midlife women move in a uniform progression from pre- to peri- to postmenopause, as refuted by earlier studies but proposed by the STRAW model, or whether they differ from this assumed pattern. Participants were recruited from the TREMIN Research Program on Women's Health, the oldest ongoing study of menstruation and women's health in the world. Eligibility criteria included reaching menopause during the course of the study and not using exogenous hormones. Participants provided annual self-reports of menopausal stage based on observations of their menstrual cycles ("regular," "changing," and "menopausal"). Findings revealed a lack of uniformity as women progressed toward menopause. From 8 to over 20 different perimenopausal stage patterns were observed, depending on the analysis. While the most common pattern was to progress from regular to changing to menopause, some women experienced menstrual bleeding after a year or more of amenorrhea, others flip-flopped between stages, and still others skipped directly from regular bleeding to menopause. We conclude that there is considerable variation in women's movement across menopausal status categories and urge researchers to accommodate such findings in their model building.

Adult↗
PubMed1998

Predicting future years of healthy life for older adults.

Cost-effectiveness studies often need to compare the cost of a program to the lifetime benefits of the program, but estimates of lifetime benefits are not routinely available, especially for older adults. We used data from two large longitudinal studies of older adults (ages 65-100) to estimate transition probabilities from one health state to another, and used those probabilities to estimate the mean additional years of healthy life that an older adult of specified age, sex, and health status would experience. We found, for example, that 65-year-old women in excellent health can expect 16.8 years of healthy life in the future, compared to only 8.5 years for women in poor health. We also provide estimates of discounted years of healthy life and future life expectancy. These estimates may be used to extend the effective length of the study period in cost-effectiveness studies, to examine the impact of chronic diseases or risk factors on years of healthy life, or to investigate the relationship of years of life to years of healthy life. Several applications are described.

Aged↗
PubMed1994

University transition: major and minor life stressors, personality characteristics and mental health.

One hundred and two first-year students at an independent college in Taiwan participated in a questionnaire study. Measurements of stressors (major life events, minor daily hassles and perceived university stress), personality (locus of control, extraversion and neuroticism) and mental health (depression, anxiety and somatic symptoms) were taken. Using multivariate analyses, we found that: (1) life events predicted anxiety, while daily hassles predicted depression; (2) locus of control and extraversion correlated negatively, while neuroticism correlated positively with university stress; and (3) neuroticism had a main effect on symptom reportings across the board, while extraversion had a vulnerability effect on somatic symptoms. Relationships between life events and daily hassles, and the roles of personality in the stress process, are discussed.

Adaptation, Psychological↗
PubMed2003

Dietary risk markers that contribute to the aetiology of hypertension in black South African children: the THUSA BANA study.

Although clinical hypertension occurs less frequently in children than in adults, ample evidence supports the concept that the roots of essential hypertension extend back to childhood. Since little is available in the literature on causal dietary factors of hypertension in children, this study hypothesised that certain dietary factors can be identified as risk markers that might contribute to the aetiology of hypertension in black children. Children aged 10-15 years were randomly selected from 30 schools in the North West Province from 2000 to 2001. These children comprised 321 black males and 373 females from rural to urbanised communities, of which 40 male and 79 female subjects were identified with high-normal to hypertensive blood pressure. Blood pressure was measured with a Finapres apparatus and data were analysed with the Fast Modelflo software program to provide systolic, diastolic and mean blood pressure. A 24-h dietary recall questionnaire and weight and height measurements were taken. In a stepwise regression analysis, the following variables were significantly associated (P < or = 0.05) with blood pressure parameters of hypertensive males: biotin, folic acid, pantothenic acid, zinc and magnesium. Energy, biotin and vitamin A intakes were significantly associated with blood pressure parameters of hypertensive females. No significant dietary markers were indicated for any of the normotensive groups. Dietary intakes of all of these nutrients were well below the dietary reference intakes. In conclusion, the dietary results coupled with the cardiovascular parameters of this study identified folic acid and biotin as risk markers that could contribute to the aetiology of hypertension in black persons. The low intakes of these nutrients, among others, is a matter of serious concern, as is the increasing tendency towards urbanisation.

Adolescent↗
PubMed2000

Transactional conflict between psychobiology and culture in the etiology of postpartum depression.

In vulnerable individuals, postpartum depression may be triggered by the disruption of neuropsychological processes during pregnancy and parturition. It is proposed that in Western societies pre- and postnatal psychological and instrumental needs are poorly met and this crisis may interact with neurophysiological factors in compromising maternal psychological functioning. The influence of developmental factors and psychological and physical stressors are discussed in relation to women's neuropsychological health during the peripartal transition. It is hypothesized that the environmental milieu may support, neglect or derail the mother's psychobiological transition from pregnancy to effective postnatal parenting and resumption of family and work roles.

Conflict, Psychological↗
PubMed2000

Transactional conflict between psychobiology and culture in the etiology of postpartum depression.

In vulnerable individuals, postpartum depression may be triggered by the disruption of neuropsychological processes during pregnancy and parturition. It is proposed that in Western societies pre- and postnatal psychological and instrumental needs are poorly met and this crisis may interact with neurophysiological factors in compromising maternal psychological functioning. The influence of developmental factors and psychological and physical stressors are discussed in relation to women's neuropsychological health during the peripartal transition. It is hypothesized that the environmental milieu may support, neglect or derail the mother's psychobiological transition from pregnancy to effective postnatal parenting and resumption of family and work roles.

Conflict, Psychological↗
PubMed2001

Duration or disadvantage? Exploring nativity, ethnicity, and health in midlife.

OBJECTIVES: This study examined nativity as a risk factor for poor physical and emotional health for an ethnically diverse population making the transition into retirement. The authors addressed whether the health disadvantage observed for immigrants lessens with increased time spent in the country (supporting theories of assimilation) or increases with duration of residence (supporting theories of cumulative disadvantage). METHODS: The sample was drawn from Waves 1 and 2 of the Health and Retirement Study (HRS), an in-depth economic, social, and health database of persons in midlife and beyond. The analyses were restricted to 9,912 native-born and 1,031 foreign-born individuals. RESULTS: The data revealed that after socioeconomic factors were controlled, foreign-born individuals were at higher risk of poor emotional health than their native-born counterparts. Although aging immigrants displayed worse health than the native-born population, this disadvantage was mediated by duration of residence (young age at migration) and socioeconomic incorporation. DISCUSSION: These findings extend our understanding of nativity and duration as risk factors for poor physical and emotional health. Immigrants may overcome the nativity disadvantages found for emotional distress with increased duration of residence, but the pattern becomes more complicated with the inclusion of race and Hispanic ethnicity.

Affective Symptoms↗
PubMed2003

Age-related declines in activity level: the relationship between chronic illness and religious activities.

OBJECTIVES: When they are faced with major life transitions such as worsening health, older adults may selectively withdraw from activities. Because of the importance of religion to a large proportion of the elderly population, research is needed to determine whether levels of religious involvement are affected by serious health problems such as the onset of a chronic disease. METHODS: Multiple waves of data from the Duke Established Populations for Epidemiologic Studies of the Elderly were used to analyze the effects of five different chronic conditions on two religious activities: service attendance and religious media use. RESULTS: Findings show that broken hip, cancer, and stroke were significantly related to levels of religious attendance. Furthermore, the combined conditions also significantly predicted religious attendance, with more conditions being associated with lower attendance. Neither the individual or summed conditions were significantly related to religious media use. DISCUSSION: The study finds some evidence to support the idea that older adults withdraw from social activities such as religious involvement when faced with declining health. In contrast, levels of religious media use remain stable following the onset of one or more new chronic conditions.

Aged↗
PubMed2002

A long-term evaluation of once-daily inhaled tiotropium in chronic obstructive pulmonary disease.

Currently available inhaled bronchodilators used as therapy for chronic obstructive pulmonary disease (COPD) necessitate multiple daily dosing. The present study evaluates the long-term safety and efficacy of tiotropium, a new once-daily anticholinergic in COPD. Patients with stable COPD (age 65.2+/-8.7 yrs (mean+/-SD), n=921) were enrolled in two identical randomized double-blind placebo-controlled 1-yr studies. Patients inhaled tiotropium 18 microg or placebo (mean screening forced expiratory volume in one second (FEV1) 1.01 versus 0.99 L, 39.1 and 38.1% of the predicted value) once daily as a dry powder. The primary spirometric outcome was trough FEV1 (i.e. FEV1 prior to dosing). Changes in dyspnoea were measured using the Transition Dyspnea Index, and health status with the disease-specific St. George's Respiratory Questionnaire and the generic Short Form 36. Medication use and adverse events were recorded. Tiotropium provided significantly superior bronchodilation relative to placebo for trough FEV1 response (approximately 12% over baseline) (p<0.01) and mean response during the 3 h following dosing (approximately 22% over baseline) (p<0.001) over the 12-month period. Tiotropium recipients showed less dyspnoea (p<0.001), superior health status scores, and fewer COPD exacerbations and hospitalizations (p<0.05). Adverse events were comparable with placebo, except for dry mouth incidence (tiotropium 16.0% versus placebo 2.7%, p<0.05). Tiotropium is an effective, once-daily bronchodilator that reduces dyspnoea and chronic obstructive pulmonary disease exacerbation frequency and improves health status. This suggests that tiotropium will make an important contribution to chronic obstructive pulmonary disease therapy.

Administration, Inhalation↗
PubMed1999

Comparative cost-effectiveness of four-layer bandaging in the treatment of venous leg ulceration.

This paper reports the results of an analysis designed to estimate the expected annual cost per patient of treating venous leg ulcers, and to evaluate the relative cost-effectiveness of a systematic treatment regimen using a four-layer compression bandaging system (Profore) compared with usual care. A Markov model has been developed which simulates the transition of patients between health states (healed and unhealed) over a 52-week period. Healing rates used in the model are derived from those reported in the literature. By running the model for a cohort of 100 patients over 52 weeks it is possible to estimate expected outcomes and annual budgetary costs for alternative treatment regimens. Results suggest that, when compared with usual care, a systematic treatment regimen using Profore is unambiguously more cost-effective. Patient outcomes are improved and annual treatment costs reduced. An important implication is that failure to co-ordinate treatment policies and to use the most cost-effective treatments may result in substantial inefficiency in the use of NHS resources. This inefficiency could represent the equivalent of between 350,000 Pounds and 1.08 million Pounds annually for a typical health authority.

Bandages↗
PubMed2005

Disease-centred advice for patients with superficial transitional cell carcinoma of the bladder.

INTRODUCTION: Urologists tend to regard superficial tumours (e.g. pTa or pT1 transitional cell carcinoma of the bladder) as being of low pathogenicity. There is a clearly established link between cigarette smoking and bladder cancer, with incidence, recurrence and mortality being positively associated with duration of smoking and number of cigarettes smoked. PATIENTS AND METHODS: A questionnaire-based audit was undertaken to determine the amount of information being provided by urologists for patients who had been diagnosed with pTa or pT1 transitional cell carcinoma of the bladder about both their disease, its aetiology and appropriate advice regarding life-style change. RESULTS: A total of 78 patients adequately completed the questionnaire. Of these, 55 (71%) had been smokers at some time, and 24 (31%) continued to smoke at the time of follow-up. Only 26 of these 55 (47%) were aware of their underlying diagnosis. This level of knowledge was similar in non-smokers, of whom only 12 (52%) were aware of their disease. Of the ever-smokers, only 12 (22%) were aware that smoking was a risk factor for the development of bladder cancer, and 7 (13%) were aware that continued smoking could worsen the prognosis. Only 18 (33%) of the 55 smoking patients had been told to stop smoking, for any reason, by their general medical practitioner, and only 4 (7%) had been told to stop by a urologist. CONCLUSION: In the urology department in which the audit was performed, patients with bladder cancer were not being provided with adequate information about their disease.

Carcinoma, Transitional Cell↗
PubMed2026

AML, Myelodysplasia-Related: Beyond Classification-Toward Precision Decision-Making.

Acute myeloid leukemia, myelodysplasia-related (AML-MR), represents a genetically defined and clinically heterogeneous entity characterized by myelodysplasia-related gene (MRG) mutations, specific cytogenetic abnormalities, and frequently a previous history of myelodysplastic syndromes (MDS) or MDS/myeloproliferative neoplasm (MDS-MPN). The transition from the World Health Organization (WHO) 2016 classification to the 2022 WHO and International Consensus Classification (ICC) systems reflects a paradigm shift from morphology-based definitions toward genomics-driven disease entities. However, while diagnostic precision has improved, translation of these classifications into clinically actionable strategies remains incomplete. This review critically examines the biological and prognostic implications of MRG mutations, their interaction with key molecular subgroups such as NPM1- and FLT3-mutated AML, and their impact on therapeutic decision-making. We highlight unresolved issues, including the context-dependent prognostic value of MRG mutations, limitations of static risk stratification, and the need to integrate measurable residual disease (MRD), genomics, and patient fitness into therapeutic algorithms. At the clinical level, many studies have explored the sensitivity of AML-MR to various induction treatments in both younger and older AML patients, with significant improvements in survival. The main objective of these different induction therapy strategies is to achieve a complete remission with minimal toxicity, particularly in older patients, allowing patients to proceed to allogeneic hematopoietic stem cell transplantation, the only curative option so far.

AML MDS-related↗
PubMed2005

Youth experiences of living with mental health problems: emergence, loss, adaptation and recovery (ELAR).

Current understanding of youth aged 15-24 experiencing mental health problems is limited. Through a qualitative analysis of the subjective experiences of 7 male and 6 female youths, 4 core categories emerged as stages that described the participants' process of mental illness: emergence, loss, adaptation, and recovery. Results showed that youth experiencing mental health problems felt stigmatized and labelled, and experienced multiple losses of identity, family, career choices, and educational and social standing. Participants reported that having mental health problems disrupted their transition from adolescence to young adulthood; however, these data reveal how youth adapt and recover. Implications of the findings in this study will be useful in identifying youth-focused interventions that may help professionals assist youth more effectively in their recovery process.

Adaptation, Psychological↗
PubMed1999

Use of host nation facilities as medical force multipliers at the Operation Joint Guard intermediate staging base, March to October 1997.

In March 1997, a transition occurred in the health service support of the intermediate staging base of Operation Joint Guard in Taszar, Hungary, by which a level III, 32-bed Deployable Medical Systems facility staffed by 178 personnel was replaced by a level II+ clinic staffed by 48 personnel with no organic surgical or blood transfusion capabilities. This was achieved by the use of local host nation facilities for surgery, sophisticated diagnostics, and medical specialty hospitalization. In the ensuing 7 months, 34 American patients were admitted to Hungarian hospitals for a total of 100 inpatient days, and 8 of them underwent surgery. This successful use of host nation facilities as medical force multipliers allowed great savings in cost and personnel and should be considered in future operations other than war that involve low-intensity conflict.

Cost Savings↗