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Chronic Diseases (chronic + disease)
Kinds of Chronic Diseases Terms modified by Chronic Diseases Selected AbstractsRESPONSIBILITY FOR CONTROL; ETHICS OF PATIENT PREPARATION FOR SELF-MANAGEMENT OF CHRONIC DISEASEBIOETHICS, Issue 5 2007BARBARA K. REDMAN ABSTRACT Patient self-management (SM) of chronic disease is an evolving movement, with some forms documented as yielding important outcomes. Potential benefits from proper preparation and maintenance of patient SM skills include quality care tailored to the patient's preferences and life goals, and increase in skills in problem solving, confidence and success, generalizable to other parts of the patient's life. Four central ethical issues can be identified: 1) insufficient patient/family access to preparation that will optimize their competence to SM without harm to themselves, 2) lack of acknowledgement that an ethos of patient empowerment can mask transfer of responsibility beyond patient/family competency to handle that responsibility, 3) prevailing assumptions that preparation for SM cannot result in harm and that its main purpose is to deliver physician instructions, and 4) lack of standards for patient selection, which has the potential to exclude individuals who could benefit from learning to SM. Technology assessment offers one framework through which to examine available data about efficacy of patient SM and to answer the central question of what conditions must be put in place to optimize the benefits of SM while assuring that potential harms are controlled. [source] DOES THE NUMBER OF COEXISTING CHRONIC DISEASES AFFECT THE ADVERSE ASSOCIATION BETWEEN POLYPHARMACY AND PRESCRIBING QUALITY IN OLDER ADULTS?JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2007Huai yong Cheng MD No abstract is available for this article. [source] EFFECTS OF HEALTH AND CHRONIC DISEASES ON LABOUR FORCE PARTICIPATION OF OLDER WORKING-AGE AUSTRALIANS,AUSTRALIAN ECONOMIC PAPERS, Issue 2 2009LIXIN CAI This study examines the effects of general health and chronic diseases on the labour force participation of older working-age Australians. To account for potential endogeneity of health status, a simultaneous equation model is estimated and chronic diseases are used as instrumental variables. The effects of chronic diseases on labour force participation are assessed indirectly using the parameters estimated from the simultaneous equation model. The results show that both health status and chronic diseases have significant effects on labour force participation. It also appears that the effects of chronic diseases are more accurately estimated from the simultaneous equation model than from a single equation labour force participation model. [source] Energetic Adaptation to Chronic Disease in the ElderlyNUTRITION REVIEWS, Issue 3 2000Michael J. Toth Ph.D. Several chronic diseases occur with increased prevalence in the elderly. Body weight loss is a common feature of many chronic diseases. Weight loss increases the risk for morbidity and mortality and contributes to decreased functional independence and poor quality of life. Thus, an understanding of the effect of chronic disease on energy balance has important implications for nutritional supplementation and clinical outcome. This brief review will consider recent studies that have examined the effect of several chronic diseases (i.e., Alzheimer's disease, Parkinson's disease, and congestive heart failure) on daily energy expenditure in elderly individuals. Additionally, we put forth a model to explain the energetic adaptation to chronic disease in the elderly that is based on measurements of daily energy expenditure and its components. Studies suggest that chronic disease decreases daily energy expenditure in elderly individuals due to a marked reduction in physical activity energy expenditure. Moreover, these changes in daily energy expenditure often occur in the presence of increased resting energy expenditure. Thus, the net effect of chronic disease is to decrease daily energy expenditure. These results do not favor the hypothesis that increased energy expenditure contributes to disease-related weight loss. Instead, reduced energy intake appears to be a more likely mediator of the negative energy imbalance and weight loss that frequently accompany chronic disease in the elderly. [source] Determinants of Mortality at Older Ages: The Role of Biological Markers of Chronic DiseasePOPULATION AND DEVELOPMENT REVIEW, Issue 4 2005Cassio M. Turra Researchers have had a longstanding interest in understanding the determinants of mortality. This article examines the impact of a broad array of biological markers, together with self-reports of physical and mental health status, on the probability of dying for older adults. The estimates are derived from logistic regression models based on data from a national survey in Taiwan. The analysis confirms previous studies demonstrating the effects of clinical measures related to metabolic syndrome on mortality and identifies detrimental effects of neuroendocrine and immune-system markers. The results reveal that biomarkers provide independent explanatory power in the presence of self-reported health measures. The associations between biomarkers and mortality found here provide new avenues for projecting future mortality and elucidating differences in longevity across populations. [source] Association of Maternal Chronic Disease and Negative Birth Outcomes in a Non-Hispanic Black-White Mississippi Birth CohortPUBLIC HEALTH NURSING, Issue 4 2007Juanita Graham ABSTRACT Objective: To investigate the impact of selected maternal chronic medical conditions, race, and age on preterm birth (PTB), low birth weight (LBW), and infant mortality among Mississippi mothers from 1999 to 2003. Design: A retrospective cohort analysis of linked birth and death certificates. Sample: The 1999,2003 Mississippi birth cohort comprising 202,931 singleton infants born to African American and White women. Measurements: The relationship between maternal chronic conditions and the dependent variables of PTB, LBW, and infant mortality were investigated using logistic regression analysis. Results: PTB, LBW, and infant mortality were more prevalent among African American women, very young women (,15 years), and women with certain chronic medical conditions. Among White mothers, maternal chronic hypertension was significantly associated with PTB and LBW, and maternal diabetes with PTB and infant mortality. Among African American mothers, maternal cardiac disease was significantly associated with PTB and LBW; maternal chronic hypertension was significantly associated with LBW and infant mortality; and maternal diabetes with PTB. Conclusions: Maternal chronic hypertension and diabetes were significantly associated with negative birth outcomes regardless of maternal race. Maternal cardiac disease was only significantly associated with PTB and LBW among African Americans. [source] Effect of Preexisting Chronic Disease on Primary Cesarean Delivery Rates by Race for Births in U.S. Military Hospitals, 1999,2002BIRTH, Issue 3 2004Andrea Linton MS This finding suggests that other maternal factors may explain the elevated rates. The purpose of this study was to examine the prevalence of specific chronic diseases identified as risk factors for complications during pregnancy, labor, and delivery, and to explore the strength of each disease to predict a cesarean outcome. Methods: United States military hospital discharge records from 1999 to 2002 for singleton births to women without a previous cesarean were used to calculate primary cesarean and chronic disease rates for diabetes, hypertension, cardiovascular disease, renal disease, anemia, asthma, sexually transmitted diseases, and substance abuse. Stepwise logistic regression was used to calculate adjusted odds ratios for dichotomized race and chronic disease indicators for five maternal age groups using the,2difference(p < 0.05) to identify significant variables for inclusion in the model. Primary cesarean delivery rates were then adjusted for the presence of chronic diseases that were significantly associated with a cesarean outcome. Results: Diabetes, genital herpes, and hypertension were significant predictors of cesarean use among all maternal age groups. Cardiovascular disease, renal disease, asthma, and anemia were predictors in some age groups. The remaining disease conditions were not significant predictors for cesarean delivery. Adjustment of cesarean rates for these chronic diseases did not significantly alter the differences in primary cesarean rates for black and Asian mothers relative to white mothers. Conclusions: The presence of certain chronic conditions before pregnancy may increase the likelihood that a woman will deliver by cesarean section. Adjustment of cesarean rates for the presence of these chronic diseases, however, does not account for the difference in cesarean rates observed for white and minority mothers in the study population. The potential for underreporting of chronic diseases complicates a true assessment of the impact of chronic disease on cesarean delivery rate variations between white and minority women. [source] Comparisons of Self-Reported and Chart-Identified Chronic Diseases in Inner-City SeniorsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2009John Leikauf BA OBJECTIVES: To examine agreement between self-report of chronic disease and medical record data for inner-city seniors, their sensitivity and specificity, and the association between patient characteristics and accuracy of self-reports. DESIGN: Cross-sectional analysis. SETTING: Two hospital-based primary care practices serving a low-income inner-city population. PARTICIPANTS: Adults aged 65 and older (n=323). MEASURES: Data on self-reported asthma, depression, diabetes mellitus, and hypertension were collected through interviewer-administered surveys (in English and Spanish) and chart abstraction. Chart-based disease was defined in two ways: physician documentation and physician documentation plus use of a medication to treat that condition. Sensitivity, specificity, and agreement were calculated. Univariate and multivariable regression analyses were used to determine the associations between patient characteristics and patient,chart agreement. RESULTS: Agreement between self-report and chart data was high for diabetes mellitus (kappa=0.94) intermediate for asthma (kappa=0.66), and hypertension (kappa=0.54) and low for depression (kappa=0.4). Sensitivity and specificity were high for diabetes mellitus (0.99 and 0.96, respectively) and low for depression (0.74 and 0.72, respectively). Specificity for hypertension was lowest (0.67). Age, education, health literacy, and other patient characteristics did not have clear associations across conditions. CONCLUSION: Self-reports may be most reliable for diabetes mellitus and least reliable for depression for surveys involving older, inner-city adults. Survey research with older adults should include confirmatory data when assessing presence of depression, hypertension, and asthma. [source] The Co-Occurrence of Chronic Diseases and Geriatric Syndromes: The Health and Retirement StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2009Pearl G. Lee MD OBJECTIVES: To analyze the co-occurrence, in adults aged 65 and older, of five conditions that are highly prevalent, lead to substantial morbidity, and have evidence-based guidelines for management and well-developed measures of medical care quality. DESIGN: Secondary data analysis of the 2004 wave of the Health and Retirement Study (HRS). SETTING: Nationally representative health interview survey. PARTICIPANTS: Respondents in the 2004 wave of the HRS aged 65 and older. MEASUREMENTS: Self-reported presence of five index conditions (three chronic diseases (coronary artery disease, congestive heart failure, and diabetes mellitus) and two geriatric syndromes (urinary incontinence and injurious falls)) and demographic information (age, sex, race, living situation, net worth, and education). RESULTS: Eleven thousand one hundred thirteen adults, representing 37.1 million Americans aged 65 and older, were interviewed. Forty-five percent were aged 76 and older, 58% were female, 8% were African American, and 4% resided in a nursing home. Respondents with more conditions were older and more likely to be female, single, and residing in a nursing home (all P<.001). Fifty-six percent had at least one of the five index conditions, and 23% had two or more. Of respondents with one condition, 20% to 55% (depending on the index condition) had two or more additional conditions. CONCLUSION: Five common conditions (3 chronic diseases, 2 geriatric syndromes) often co-occur in older adults, suggesting that coordinated management of comorbid conditions, both diseases and geriatric syndromes, is important. Care guidelines and quality indicators, rather than considering one condition at a time, should be developed to address comprehensive and coordinated management of co-occurring diseases and geriatric syndromes. [source] Breakfast Frequency and Quality in the Etiology of Adult Obesity and Chronic DiseasesNUTRITION REVIEWS, Issue 6 2007Maureen T. Timlin PhD The frequency of eating breakfast has declined over the past several decades, during which time the obesity epidemic has also unfolded. Therefore, there is growing scientific interest in the possible causal role of breakfast in weight control and related disease risks. We conducted a MedLine search for studies that addressed meal frequency, breakfast consumption, and chronic disease risk. Clinical studies document that regular meal consumption can potentially reduce the risk of obesity and chronic disease through mechanisms involved in energy balance and metabolism. Many observational studies have found that breakfast frequency is inversely associated with obesity and chronic disease, but this literature does have some important limitations. Only four relatively small and short-term randomized trials have examined breakfast consumption and body weight or chronic disease risk, with mixed results. Large, long-term, randomized trials are needed. [source] The Importance of Good Hydration for the Prevention of Chronic DiseasesNUTRITION REVIEWS, Issue 2005Friedrich Manz MD There is increasing evidence that mild dehydration plays a role in the development of various morbidities. In this review, the effects of hydration status on chronic diseases are categorized according to the strength of the evidence. Positive effects of maintenance of good hydration are shown for urolithiasis (category Ib evidence); constipation, exercise asthma, hypertonic dehydration in the infant, and hyperglycemia in diabetic ketoacidosis (all category IIb evidence); urinary tract infections, hypertension, fatal coronary heart disease, venous thromboembolism, and cerebral infarct (all category III evidence); and bronchopulmonary disorders (category IV evidence). For bladder and colon cancer, the evidence is inconsistent. [source] The Link Between Childhood Undernutrition and Risk of Chronic Diseases in Adulthood: A Case Study of BrazilNUTRITION REVIEWS, Issue 5 2003Ana L. Sawaya PhD Obesity, cardiovascular disease, and type 2 diabetes mellitus are now prevalent among adults living in developing countries; these chronic diseases affect socioeconomically disadvantaged adults living in impoverished families with under-nourished children. This review summarizes data from Brazil - a developing country undergoing the nutrition transition - suggesting an association between childhood undernutrition and obesity and chronic degenerative disease. Potential mechanisms for the association include longterm effects of childhood undernutrition on energy expenditure, fat oxidation, regulation of food intake, susceptibility to the effects of high-fat diets, and altered insulin sensitivity. The combination of childhood undernutrition and adult chronic degenerative disease results in enormous social and economic burdens for developing countries. Further research is urgently needed to examine the effect of childhood undernutrition on risk of obesity and chronic degenerative diseases; one goal of such research would be to determine and provide low-cost methods for prevention and treatment. [source] Use of Nutritional Scores to Predict Clinical Outcomes in Chronic DiseasesNUTRITION REVIEWS, Issue 2 2000Stephane M. Schneider M.D. Many hospitalized patients are malnourished, and the relationship between malnutrition and patient outcome is well established. To determine which patients are at nutritional risks, clinical scores are probably more accurate than using a single nutritional parameter. Among the numerous scores published, both the Prognostic Nutritional Index and the Subjective Global Assessment were prospectively validated. One is based on objective measurements, whereas the second is based on medical history and physical examination. The Nutritional Risk lndex has been used in many studies including the "Veterans Study'. The Mini Nutritional Assessment is a promising score for evaluating malnutrition in the elderly. The development of nutritional scores for use by nurses may facilitate screening of a large number of hospitalized patients. [source] Book review: Molecular Epidemiology of Chronic DiseasesAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 2 2009Richard H. BartonArticle first published online: 6 JAN 200 No abstract is available for this article. [source] Should neurologists wait and see or see and treat RRMS?PROGRESS IN NEUROLOGY AND PSYCHIATRY, Issue 5 2009David Bates MA Early and aggressive treatment of rheumatoid arthritis (RA) is now regarded as best practice to limit irreversible joint damage. However, in the case of relapsing remitting multiple sclerosis (RRMS), current guidelines recommend that disease modifying therapy should only be initiated in patients with evidence of actively progressing disease. Here, the authors present the key findings of the Programme Identifying and Observing Novel Therapy Adoption in Chronic Diseases (PIONEER) study to examine the reasons for these different management approaches. Copyright © 2009 Wiley Interface Ltd [source] A New Frontier in Soy Bioactive Peptides that May Prevent Age-related Chronic DiseasesCOMPREHENSIVE REVIEWS IN FOOD SCIENCE AND FOOD SAFETY, Issue 4 2005Wenyi Wang ABSTRACT During gastrointestinal digestion or food processing of proteins, small peptides can be released and may act as regulatory compounds with hormone-like activities. Numerous biologically active peptides (bioactive peptides) have been identified. Most bioactive peptides are derived from milk and dairy products, with the most common being angiotensin converting enzyme inhibitory peptides. Soybean protein and soybean derived peptides also play an important role in soybean physiological activities, particularly those related to the prevention of chronic diseases. However, the bioactive potential of soybean derived bioactive peptides is yet to be fully appreciated. After a general introduction of approaches and advances in bioactive peptides from food sources, this review focuses on bioactive peptides derived from soybean proteins and their physiological properties. Technological approaches to generate bioactive peptides, their isolation, purification, characterization, and quantification, and further application in food and drug design are also presented. Safety concerns, such as potential toxicity, allergenicity, and sensory aspect of these peptides are likewise discussed. [source] Chronic disease , another challenge for the developing worldINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 9 2007Peter Stott No abstract is available for this article. [source] Strengthening Research to Improve the Practice and Management of Long-Term CareTHE MILBANK QUARTERLY, Issue 2 2003PENNY HOLLANDER FELDMAN Chronic disease and disability affect Americans of all ages, and millions rely on long-term care (LTC) services,in nursing facilities, in congregate residences, or at home,to meet their health and personal assistance needs. People who are 65 years old today have about a 40 percent chance of spending some time in a nursing home before they die (Kemper and Murtaugh 1991; Murtaugh, Kemper, and Spillman 1990). Almost three-quarters will have had some experience with home care (Stone 2000). The numbers of people, both young and old, in need of long-term care are growing. Changing demographics, a more engaged public, and growing cost pressures are increasing the demand for empirical evidence of the effectiveness and cost effectiveness of alternative LTC approaches and practices. Making the formal LTC system more effective and more efficient requires that research play a more prominent role in informing service delivery. The research agenda should both respond to and push forward the field of practice, and the definitions of appropriate topics should come from both the practitioners and the researchers. [source] Chronic disease and Indigenous healthAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2010The Hon Warren Snowdon MP No abstract is available for this article. [source] Chronic disease: when in doubt, consider accrual into a randomized controlled trial (RCT)BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue 2 2008J. M. Ritter First page of article [source] The psychosocial well-being of children with chronic disease, their parents and siblings: an overview of the research evidence baseCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 1 2006J. H. Barlow Abstract Background Chronic disease of childhood may have implications for the psychosocial well-being of children and their families. The purpose of this paper is to provide an overview of the current literature regarding the psychosocial well-being of children with chronic disease, their parents and siblings. Methods Electronic searches were conducted using AMED, CINAHL, Cochrane Database, DARE, HTA, MEDLINE, NHS EED, PsycLIT, PsycINFO and PubMED (1990 to week 24, 2004). Inclusion criteria were systematic reviews, meta-analyses and overviews based on traditional reviews of published literature. The titles of papers were reviewed, abstracts were obtained and reviewed, and full copies of selected papers were obtained. Results Six reviews of the psychosocial well-being of children were identified: three on chronic disease in general, one on asthma, one on juvenile idiopathic arthritis and one on sickle cell disease. Two reviews of psychosocial well-being among parents and two reviews of sibling psychosocial well-being were identified. Evidence from meta-analyses shows that children were at slightly elevated risk of psychosocial distress, although only a minority experience clinical symptomatology. The proportion that experience distress remains to be clarified, as do contributory risk factors. Few conclusions can be drawn from the two reviews of parents. However, a meta-analysis of siblings showed that they are at risk from a number of negative effects. Conclusion This overview has highlighted the need to extend the evidence base for psychosocial well-being of children, parents and siblings. [source] FS07.1 A survey of occupational hand eczema in DenmarkCONTACT DERMATITIS, Issue 3 2004Rikke Skoet Background:, The need for prevention to reduce the number of occupational hand eczema is high. Occupational hand eczema is the most frequently recognised work-related disease in Denmark. Previous findings have shown that almost half of all cases develop a chronic condition with persistent dermatitis, and the annual cost to society is immense. Aims:, The aim of this study was to survey the trends and development of occupational hand eczema in Denmark and thereby help to ensure future successful prevention of chronic disabling occupational hand eczema. Methods:, 758 patients with recognised occupational hand eczema were included prospectively in the period October 2001- November 2002. Data on diagnoses, disease duration, severity, absence from work and occupation was obtained from The Danish National Board of Industrial Injuries and an additional questionnaire was administered by mail. Results:, 621 patients answered the questionnaire (response rate 82%). Irritant contact dermatitis was the most frequent diagnosis and the female/male ratio was 2:1. High prevalence was found in particularly wet occupations. 19 per cent had sick leave more than 5 weeks per year and the mean disease duration was 4.8 years (median 2.1 years). 68.2% had chronic changes. Conclusion:, The results showed a marked gender difference in the pattern of diagnosis and occupation. The impact of occupational hand eczema is still high with prolonged absence from work and a high percentage of chronic disease. The results of the study give important suggestions for future preventive strategies for health authorities. [source] Managing young people with Type 1 diabetes in a ,rave' new world: metabolic complications of substance abuse in Type 1 diabetesDIABETIC MEDICINE, Issue 4 2009P. Lee Abstract The taxing transition from adolescence towards adulthood intensifies the impact of a chronic illness such as Type 1 diabetes. It is not uncommon for young people with Type 1 diabetes to use recreational drugs for emotional relief to escape the day-to-day burden of chronic disease. Despite increasing use, especially in the setting of ,rave' parties, there is professional lack of understanding of the impact of recreational drug use on glycaemia and metabolic complications. The current review describes the prevalence of substance abuse in Type 1 diabetes and the acute impact of designer drugs on its management. We propose a practical approach to improve care of young people with Type 1 diabetes using designer drugs. [source] Insights into the acute cerebral metabolic changes associated with childhood diabetesDIABETIC MEDICINE, Issue 5 2005F. J. Cameron Abstract Aims Type 1 diabetes is a prevalent chronic disease in childhood with the commonest single cause of death being cerebral oedema in the context of diabetic ketoacidosis (DKA). The nature of the alterations in cerebral metabolism that may result in vulnerability to neuronal injury remains unknown. The aim of this study was to analyse the magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) brain data from eight children with diabetes following acute presentation with hyperglycaemia with or without ketoacidosis, to determine the nature and timing of any alterations in cerebral structure and metabolism. Methods This study used MRI and MRS to investigate regional cerebral abnormalities in a small series of diabetic patients with and without DKA. Changes were compared with the clinical and biochemical features of the patients studied. Results Our small series of patients all demonstrated abnormal signal changes in the frontal region on fluid attenuated inversion recovery (FLAIR) MR imaging, suggestive of oedema, and spectroscopic abnormalities of increased taurine, myoinositol and glucose levels. The MR abnormalities varied in severity but did not correlate with any clinical or biochemical parameters. Conclusions These changes indicate that many diabetic children, particularly at presentation, may have alterations in cerebral metabolism with implications for the pathogenesis and treatment of the cerebral complications of DKA. In addition, our findings suggest that increased taurine may be one of the important differentiating factors in the response of the brain of diabetic children to DKA that may reflect an increase in their vulnerability to cerebral oedema compared with diabetic adults. [source] Outcome research in diabetes: from theory to practice.DRUG DEVELOPMENT RESEARCH, Issue 3 2006Results of the QuED study Abstract Despite the fact that several pharmacological and educational interventions have been proven to improve diabetes outcomes in the context of randomized clinical trials, the transferability of these results to clinical practice can encounter obstacles represented by physicians' knowledge and beliefs, structural and organizational constraints, and patients' clinical and socio-economical characteristics. Outcomes research represents a fundamental tool to investigate the extent to which trials results can be reproduced under routine clinical conditions, to evaluate clinical behavior in areas of uncertainty, and to ascertain which features of diabetes care are more important to improve clinical outcomes and quality of life. This report will discuss some of the results of the QuED (Quality of Care and Outcomes in Type 2 Diabetes) study, to exemplify the yield of an outcomes research approach to a complex, chronic disease. The QuED Study is a nation-wide initiative aimed at assessing the relationship between the quality of care delivered to subjects with type 2 diabetes and outcomes. The study involved 101 outpatient diabetes clinics and 103 General Practitioners (GPs) in Italy. Overall, 3,437 patients have been enrolled and followed up for 5 years at 6-month intervals. Quality of life was evaluated through questionnaires filled in by the patients at 6-month intervals for 3 years. A physicians' survey was also conducted to investigate physician's beliefs regarding metabolic control, blood pressure, and lipid control. Given the multiplicity of the sources of information, the study allowed for matching physicians' beliefs and practices with intermediate and long-term clinical and humanistic outcomes. Drug Dev. Res. 67:280,286, 2006. © 2006 Wiley-Liss, Inc. [source] Duelling timescales of host movement and disease recovery determine invasion of disease in structured populationsECOLOGY LETTERS, Issue 6 2005Paul C. Cross Abstract The epidemic potential of a disease is traditionally assessed using the basic reproductive number, R0. However, in populations with social or spatial structure a chronic disease is more likely to invade than an acute disease with the same R0, because it persists longer within each group and allows for more host movement between groups. Acute diseases ,perceive' a more structured host population, and it is more important to consider host population structure in analyses of these diseases. The probability of a pandemic does not arise independently from characteristics of either the host or disease, but rather from the interaction of host movement and disease recovery timescales. The R* statistic, a group-level equivalent of R0, is a better indicator of disease invasion in structured populations than the individual-level R0. [source] Commentary on Peretti-Watel et al. (2009): The cost of a chronic diseaseADDICTION, Issue 10 2009BERTRAND DAUTZENBERG No abstract is available for this article. [source] The Evolution of Research in Family and Consumer Sciences: Food, Nutrition, and HealthFAMILY & CONSUMER SCIENCES RESEARCH JOURNAL, Issue 2 2001Eleanor D. SchlenkerArticle first published online: 2 JUL 200 Changing perspectives in food, nutrition, and health are bringing new research opportunities. Knowledge that nutrients and other food substances prevent chronic disease expanded the study of dietary requirements beyond merely obviating deficiency. Government policy makers mandate food guidance programs to enable consumers to choose foods that are culturally appropriate yet support health. Intervention strategies leading to suitable food behavior are needed to address the rising health costs associated with aging and chronic diseases. Functional foods carrying added health benefits have gripped the attention of food producers and consumers, yet much is to be learned regarding long term effects. FCS professionals are uniquely qualified to study not only the theoretical bases of these issues but also their impact on the physical and psychosocial well-being of families. Research methods and applications must be incorporated at all academic levels to prepare FCS professionals to meet the research opportunities and challenges ahead. [source] Impact of history or onset of chronic medical conditions on higher-level functional capacity among older community-dwelling Japanese adultsGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 2003Yoshinori Fujiwara Background: Many studies have examined the impact of chronic medical conditions on the age-related decline in basic activities of daily living (BADL) and the instrumental activities of daily living (IADL), but less is known concerning the influence of chronic disease on physical, cognitive, social, and economic aspects of higher-level functional capacity. Methods: Subjects comprised 793 and 725 persons aged 65,84 years, living in an urban and a rural Japanese community, respectively. A baseline interview established any history of chronic medical conditions. Four years later, a second interview again assessed chronic disease, and higher-level functional capacity was evaluated using the Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence. Results: Multiple logistic regression analysis revealed that declines in total score and/or any of three subscales of the TMIG Index of Competence were significantly associated with a history of chronic disease, the onset of visual impairment and the development of hearing impairment, even after controlling for the subject's age, gender, educational attainment, and baseline TMIG Index of Competence. Episodes of stroke were significantly associated with declines in IADL. Hypertension, diabetes mellitus, and heart disease were also significantly associated with a decrease in functional competence, although each affected a different subscale of the TMIG Index of Competence. Conclusions: The present results underline the importance of controlling chronic medical conditions through a physically active lifestyle and an appropriate medical regimen in order to limit the age-related decline in functional capacity. [source] Survival of neural precursor cells in growth factor-poor environment: Implications for transplantation in chronic diseaseGLIA, Issue 4 2006Ofira Einstein Abstract A key issue for therapeutic neural stem cell transplantation in chronic diseases is the long-term survival of transplanted cells in the brain. The normal adult central nervous system does not support the survival of transplanted cells. Presumably, the limited availability of trophic factors maintains the survival of resident cells but is insufficient for supporting the survival of transplanted cells. Specifically, in multiple sclerosis, a chronic relapsing disease, it would be necessary to maintain long-term survival of transplanted cells through phases of relapses and remissions. It may be beneficial to transplant cells as early as possible, in a form that will keep their survival independent of tissue support and ready for immediate mobilization upon tissue demand during disease relapse. In the present study, we examined whether, in the form of neurospheres, multipotential neural precursor cells (NPCs) survive in a growth factor-poor environment while maintaining their potential to respond to environmental cues. We found that after removal of growth factors from the culture medium of neurospheres in vitro, NPC proliferation decreased significantly, but most cells survived for a prolonged time and maintained their stem cell characteristics. After re-exposure to growth factors, neurosphere cells resumed proliferation and could differentiate along neural lineages. Furthermore, neurospheres, but not single NPCs, that were transplanted into the brain ventricles of intact animals survived within the ventricles for at least a month and responded to induction of experimental autoimmune encephalomyelitis and brain inflammation by extensive migration into the brain white matter and differentiated into glial lineage cells. © 2005 Wiley-Liss, Inc. 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