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At least 1,729 records · Page 96Linked to original sources
PubMed1999

The health-related quality-of-life of never smokers, ex-smokers, and light, moderate, and heavy smokers.

BACKGROUND: Health related quality-of-life is recognized as an important health outcome measure; how ever, it may also have a significant application in smoking reduction and cessation programs. METHODS: Representative population data (n = 3010) was used to compare the quality-of-life status of differ ent smoking categories with never smokers. RESULTS: Statistically significant differences in mean quality-of-life scores, as measured by the SF-36 health status questionnaire, were observed between never smokers, as the reference group, ex-smokers, all smokers, and light, moderate, and heavy smokers. Heavy smokers also scored significantly lower than both other groups of smokers, scoring as low as the 29th percentile of the population on the general health dimension and lower than the 36th percentile of the population on all the mental health dimensions. CONCLUSIONS: The design of public health smoking cessation programs should consider the varying characteristics of different segments of the smoking population. The advantages of improved quality-of-life may strengthen the argument for encouraging heavier smokers to become light smokers as a precursor to total cessation.

Adolescent↗
PubMed1993

Pursuing better health care delivery at district level.

In the urban and rural districts of Tanzania's Dodoma Region a process was adopted for identifying and solving problems of health care delivery. In a single year, considerable improvements were secured in both teamwork and attitudes towards coping with managerial obstacles.

Adult↗
PubMed1975

Lessons from the Chinese experience: China's planned birth program and its transferability.

This article describes the most salient developments in the planned birth program of the People's Republic of China during the 1970s and discusses the potential for transfer of some features to other countries. Many Chinese activities are of interest because they are designed for a country with scarce resources for development and a low-income population. Some particular program features worth noting are: the encouragement of local initiative and experimentation: specific methods for the diffusion of innovation; and total integration of the health system with other development-political, administrative, economic, and social-at the grass-roots level.

Birth Rate↗
PubMed2005

A health system program to reduce work disability related to musculoskeletal disorders.

BACKGROUND: Musculoskeletal disorders (MSDs) are a frequent cause of work disability, accounting for productivity losses in industrialized societies equivalent to 1.3% of the U.S. gross national product. OBJECTIVE: To evaluate whether a population-based clinical program offered to patients with recent-onset work disability caused by MSDs is cost-effective. DESIGN: Randomized, controlled intervention study. The inclusion and follow-up periods each lasted 12 months. SETTING: Three health districts in Madrid, Spain. PATIENTS: All patients with MSD-related temporary work disability in 1998 and 1999. INTERVENTION: The control group received standard primary care management, with referral to specialized care if needed. The intervention group received a specific program, administered by rheumatologists, in which care was delivered during regular visits and included 3 main elements: education, protocol-based clinical management, and administrative duties. MEASUREMENTS: Efficacy variables were 1) days of temporary work disability and 2) number of patients with permanent work disability. All analyses were done on an intention-to-treat basis. RESULTS: 1,077 patients were included in the study, 7805 in the control group and 5272 in the intervention group, generating 16,297 episodes of MSD-related temporary work disability. These episodes were shorter in the intervention group than in the control group (mean, 26 days compared with 41 days; P < 0.001), and the groups had similar numbers of episodes per patient. Fewer patients received long-term disability compensation in the intervention group (n = 38 [0.7%]) than in the control group (n = 99 [1.3%]) (P < 0.005). Direct and indirect costs were lower in the intervention group than in the control group. To save 1 day of temporary work disability, 6.00 dollars had to be invested in the program. Each dollar invested generated a benefit of 11.00 dollars. The program's net benefit was in excess of 5 million dollars. LIMITATIONS: The study was unblinded. CONCLUSIONS: Implementation of the program, offered to the general population, improves short- and long-term work disability outcomes and is cost-effective.

Absenteeism↗
PubMed2002

An English-language clinic-based literacy program is effective for a multilingual population.

OBJECTIVE: To assess the effectiveness of a clinic-based pediatric literacy intervention on a multilingual population. BACKGROUND: Clinic-based literacy interventions are effective among English- and Spanish-speaking children. No data exist for multilingual populations. SETTING: Pediatric clinic in an urban county hospital. Design/Methods. Reading practices of 2 cross-sectional groups were assessed by standardized interview before and after the intervention. The intervention consisted of waiting-room volunteers reading to children, literacy counseling, and gift of a children's book at each well-child visit from 6 months to 5 years. Outcomes were assessed separately for primary English-speaking and primary non-English-speaking families. RESULTS: The baseline (N=85) and postintervention (N=95) groups were similar with respect to child age and sex, parental education, and length of time in the United States. Fourteen languages were represented in total, the most common being English (41%), Somali (28%), Spanish (9%), Vietnamese (7%), Oromo (3%), and Tigrinyan (3%). Compared with baseline, postintervention respondents were more likely to report reading as a favorite activity for the child (10% vs 25%) and parent (18% vs 40%), to read to their child before bed at least weekly (45% vs 71%), and to possess over 10 children's books at home (49% vs 63%). Among English-speaking families (N=30 baseline, N=40 postintervention), weekly bedtime reading increased (63% to 93%), reading as child's favorite activity increased (7% vs 30%), and reading as the parent's favorite activity to do with child increased (33% vs 58%). The proportion of English-speaking families possessing over 10 books at home and those reading with their children at least weekly showed no difference between the baseline and postintervention groups. Among non-English-speaking families (N=55 baseline, N=55 postintervention), weekly bedtime reading increased (36% vs 56%), reading as the parent's favorite activity increased (11% vs 27%), and the number of families to possess >10 children's books in the home increased (31% vs 49%). Reading as child's favorite activity (13% vs 24%) and weekly book sharing (60% vs 76%) showed nonsignificant trends between the non-English-speaking baseline and postintervention groups. CONCLUSIONS: This clinic-based literacy intervention influences home literacy behavior in this multiethnic setting, in both English-speaking and non-English-speaking families. Although efforts should be made to make such programs more appropriate for linguistic minorities, non-English-speaking families do stand to benefit from English-language-oriented programs. literacy, Reach Out and Read, pediatrics, reading, child development.

Child, Preschool↗
PubMed1978

Elicited imitation in language assessment: a tool for formulating and evaluating treatment programs.

Four different clinical populations were administered an elicited imitation task before and after therapy to determine the usefulness of elicited imitation procedures for formulating and evaluating language treatment programs. Children's imitations were analyzed according to the numbers and patterns of omission errors, substitution errors, and correct responses. Results indicated that (1) patterns of responding could be identified; (2) specific patterns were associated with different clinical populations; (3) performance on pretherapy measures could be efficiently analyzed and utilized for formulating language treatment programs; and (4) changes in posttherapy performance could be readily evaluated using this procedure. The data suggest that the elicited imitation procedures can be effectively used to increase the precision of the evaluation and clinical programming of children with language disorders.

Adolescent↗
PubMedDate not supplied

[Risk behaviours and seroprevalence to HIV, HBV and HCV in patients of the AIDS information and prevention center in Valencia, Spain].

OBJECTIVE: The purpose of this study was to describe the sociodemographic and serologic profiles in a first time consultant population at the Information and AIDS Prevention Center of Valencia (Spain). In addition, the HIV infection risk factors were analyzed. METHOD: A cross-sectional study was performed on 1,573 persons who consulted during the year 1995. Sociodemographic and infection risk practices data were recorded and serologic information about HIV, HBV and HCV infection were obtained. Exact binomial method with a 95% interval confidence was used to calculate infection prevalence and the chi square test to make comparisons between qualitative variables. RESULTS: Sex distribution was 66,1% males and 31,9% females; mean age was 29,01 (SD: 9.2) years. Sexual intercourse without condom (25.2%) and parenteral drug abusers (22.6%) were the more frequent risk groups seeking consultation about HIV infection. Global HIV infection prevalence was 12.7% (95% CI= 11,2-14,5%). Among HIV seropositive patients, sexual transmission accounted for 30.8% of cases, of which 69.4% were heterosexual relations. The HIV infection prevalence for different risk groups were the following: parenteral drug abusers 36.8% (95% CI= 31,7-42%), heterosexual intercourse with an HIV-infected partner 24.1% (95% CI= 17,1-32,2%) and homosexual intercourse between men 9,5% (95% CI= 5,8-14,5%). HCV antibody prevalence for parenteral drug abusers was 81.2% (95% CI= 76,7-85,1%). Risk practices with a statistically significant association with HIV infection were: being an injecting drug abuser, as well as having an HIV infected and/or a injecting drug abuser partner. CONCLUSIONS: Drug parenteral abusers are still the target population for prevention programs. Data suggest that prevention and sexual education programs must continue. The main effort should be focused on the young population and on sexual partners of injecting drug abusers and/or HIV seropositive partners.

Adolescent↗
PubMed2000

Promoting physical activity in rural communities: walking trail access, use, and effects.

INTRODUCTION: Environmental and policy approaches to promote physical activity, such as walking trail construction and promotion, are being widely recommended, yet sparse data exist on their effectiveness. In conjunction with ongoing community-intervention projects in Missouri, walking trails are being built, promoted, and evaluated. Objectives include determining: (1) patterns and correlates of walking, (2) the availability of places to walk and perform other forms of physical activity, (3) the extent of walking trail use and possible effects on rates of physical activity, and (4) attitudes toward the trails and their uses. METHODS: In 12 rural counties in Missouri we used a cross-s ectional telephone survey to ask a population-based sample of residents aged >18 years (n=1269) some standard and specially developed questions about walking behaviors, knowledge, and attitudes. RESULTS: Only 19.5% of respondents were classified as regular walkers. About one third of respondents (36.5%) reported having access to walking trails in their area, and 50.3% reported having access to indoor facilities for exercise. Among persons with access to walking trails, 38.8% had used the trails. Groups who were more likely to have used the walking trails included women, persons with more education, those making $35,000 or more per year, and regular walkers. Among persons who had used the trails, 55.2% reported they had increased their amount of walking since they began using the trail. Women and persons with a high school education or less were more than twice as likely to have increased the amount of walking since they began using the walking trails. CONCLUSIONS: Walking trails may be beneficial in promoting physical activity among segments of the population at highest risk for inactivity, in particular women and persons in lower socioeconomic groups.

Adolescent↗
PubMed1993

Diffusion of new technologies in the treatment of the Medicare population. Implications for patient access and program expenditures.

Patterns of diffusion were analyzed for three pairs of technologies: one of each pair represents a very recent innovation, and the other is more established. Tremendous growth in utilization from 1985-89 was documented, primarily due to more patients obtaining access to the technologies. Nevertheless, disturbing differences in levels of use remain between black and white patients.

Adult↗
PubMed2002

Outcome of a latex avoidance program in a high-risk population for latex allergy - a five-year follow-up study.

BACKGROUND: Children with a shunted hydrocephalus are at highest risk for developing an immediate type allergy to latex. Limited data are available for preventive or therapeutical approaches. OBJECTIVE: To evaluate the effectiveness of latex avoidance, with special regard to status of sensitization and compliance. METHODS: In 1995, 131 children with a shunted hydrocephalus were screened for sensitization to latex by skin prick test and determination of specific IgE. Patients and parents were instructed on latex-avoiding strategies. Hospital physicians, family doctors and dentists were advised to perform further surgical and other medical interventions under latex-free conditions. In 2000, 100 of these 131 patients were re-evaluated according to the same testing procedures. Special attention was directed at the extent prophylaxis had been performed. RESULTS: In 1995, 30/100 patients re-evaluable in 2000 proved sensitized to latex, 70 had negative testing results. In 2000, 64/70 patients were still negative, six had meanwhile developed latex-specific IgE. Seven out of thirty subjects with former positive testing had changes within the same RAST-class, 20 showed a decline of at least one RAST-class, whereas in three cases an increase of latex-specific IgE was found. However, only 34 patients, mainly those being already sensitized, had thoroughly followed both medical and private prophylaxis. Within this group, 16 subjects (47.1%) had improved and another nine (26.5%) were still negative. Only three (8.8%) already previously sensitized patients presented with a further increase of latex-specific IgE. Medical prevention contributed more to the outcome than home prevention. No statistically significant correlation with latex-avoidance was observed, however, in previously unsensitized subjects. Underlying disease, atopy, number of operations, and age did not prove as significant variables. CONCLUSION: Secondary prevention results in a decrease of specific IgE in latex-sensitized patients with hydrocephalus. This is due to medical more than home prophylaxis. Sensitization obviously occurs mainly in early childhood, thus primary prevention remains to be the main target.

Adolescent↗
PubMed2006

[Mammography screening in Germany: how, when and why?].

It is well-known from several large randomized trials that regular mammography screening can reduce breast cancer mortality. While in many countries mammography screening programs have been in existence for quite some time, an organized population-based screening program is only now being implemented in Germany. In this review article, the different elements of a mammography screening program and their effect on the cost-benefit ratio are discussed and the planned German screening program is compared to the international programs.

Breast Neoplasms↗
PubMedDate not supplied

African Americans and obesity: implications for clinical nurse specialist practice.

PURPOSE/OBJECTIVE: The purpose of this article is to examine the connection between genes, culture, and environment in the development of obesity and its impact on the health of African Americans. This information will be utilized to facilitate the design of weight management programs for African Americans. RATIONALE: Literature review of the connection between the above variables revealed a disproportionate amount of health risks associated with excess weight in African Americans. Several nonfatal consequences of obesity were noted to impact quality of life but improved significantly with small reductions in body weight. However, factors that affect weight in a culturally relevant context were seldom addressed and few intervention programs were specifically designed to treat minorities with obesity issues. DESCRIPTION: This article describes the role that genetic, cultural, and environmental factors play in energy regulation. Factors that impact lifestyle changes, self-esteem, public awareness, participation, and community involvement are highlighted. OUTCOME: Providing healing environments that are culturally acceptable can empower individuals to commit to goals as well as influence others who are resistant to change. Public awareness tools designed by clinical nurse specialists (CNSs) that appeal to ethnic values can facilitate cooperation and enhance successful outcomes. CONCLUSION: Despite genetic susceptibility to obesity, research on the African diaspora emphasized that obesity tends to be expressed in environmental conditions that are markedly different from ancestral origin. (Kruger A, Kruger HS, MacIntyre U, et al. S Afr J Sci. 2000;96:505-513. Available at: www.nrf.ac.za/sajs/absepooj.stm. Accessed April 11, 2004.) Black adults therefore have much to gain from weight management strategies that address the complexity of the disorder and are sensitive to cultural issues. IMPLICATIONS FOR NURSING PRACTICE: CNSs with advanced knowledge of the impact of obesity on health and wellness are in a unique position to utilize research-based data in the design of weight management programs for diverse populations. In practice, cultural variables that significantly impact the complex issues of weight control should be addressed in the study and treatment of obesity in black populations. By researching what is available to the community, CNSs can evaluate programs that may require adaptation to encourage greater participation.

Black or African American↗