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Adult Health (adult + health)
Selected AbstractsClinical evaluation tools for dual track adult and gerontology nurse practitioner studentsJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 12 2009Adult Health Nurse Practitioner Program, Director, FAANP Advanced Senior Lecturer, Valerie T. Cotter MSN Abstract Purpose: To describe the development of a dual track offering for the Adult Health and Gerontology Nurse Practitioner (AGNP) Programs at the University of Pennsylvania School of Nursing and share clinical evaluation tools used with nurse practitioner students in this curriculum. Data sources: Selected research and clinical articles. Conclusions: A variety of evaluation approaches are utilized in the AGNP student clinical performance evaluation. These incorporate the extended clinical practicum sequence for the dual track curriculum in addition to each individual program's objectives. Formative and summative evaluations include reflective logs, clinical documentation of patient encounters, preceptor evaluation, and faculty site visits. Self-evaluative skills of the student and quality faculty feedback are two additional integral components that facilitate learning outcomes in the cognitive, psychomotor, and affective learning domains. Implications for practice: The summary of evaluation tools presented here is an example of how the AGNP Programs at the University of Pennsylvania School of Nursing effectively measure student progress in a curriculum model for dual track enrollment. [source] Association of adolescent symptoms of depression and anxiety with daily smoking and nicotine dependence in young adulthood: findings from a 10-year longitudinal studyADDICTION, Issue 9 2010Maria McKenzie ABSTRACT Aims To examine the association of adolescent depression and anxiety symptoms with daily smoking and nicotine dependence in young adulthood. Design A prospective cohort study of adolescent and young adult health (n = 1943). Teen assessments occurred at 6-monthly intervals, with two follow-up assessments in young adulthood (wave 7, 1998; wave 8, 2001,03). Setting Victoria, Australia. Participants Students who participated at least once during the first six (adolescent) waves of the cohort study. Measurements Adolescent depression and anxiety symptoms were assessed using the Revised Clinical Interview Schedule (CIS-R). Young adult tobacco use was defined as: daily use (6 or 7 days per week) and dependent use (,4 on the Fagerstrom Test for Nicotine Dependence). Findings Among adolescent ,less than daily' smokers, those with high levels of depression and anxiety symptoms had an increased risk of reporting nicotine dependence in young adulthood [odds ratio (OR) 3.3, 95% confidence interval (CI) 1.2,9.1] compared to young adults who had low levels of adolescent depression and anxiety symptoms, after adjusting for potential confounding factors. Similarly, in the adjusted model (OR 1.9, 95% CI 1.0,3.4), among adolescent ,daily' smokers, those with high levels of depression and anxiety symptoms had an almost two-fold increase in the odds of reporting nicotine dependence in young adulthood compared to young adults with low levels of adolescent depression and anxiety symptoms. Conclusions Adolescent smokers with depression and anxiety symptoms are at increased risk for nicotine dependence into young adulthood. They warrant vigilance from primary care providers in relation to tobacco use well into adulthood. [source] Hormones as epigenetic signals in developmental programmingEXPERIMENTAL PHYSIOLOGY, Issue 6 2009Abigail L. Fowden In mammals, including man, epidemiological and experimental studies have shown that a range of environmental factors acting during critical periods of early development can alter adult phenotype. Hormones have an important role in these epigenetic modifications and can signal the type, severity and duration of the environmental cue to the developing feto-placental tissues. They affect development of these tissues both directly and indirectly by changes in placental phenotype. They act to alter gene expression, hence the protein abundance in a wide range of different tissues, which has functional consequences for many physiological systems both before and after birth. By producing an epigenome specific to the prevailing condition in utero, hormones act as epigenetic signals in developmental programming, with important implications for adult health and disease. This review examines the role of hormones as epigenetic signals by considering their responses to environmental cues, their effects on phenotypical development and the molecular mechanisms by which they programme feto-placental development, with particular emphasis on the glucocorticoids. [source] Do microfinance programs help families insure consumption against illness?HEALTH ECONOMICS, Issue 3 2009Paul Gertler Abstract Families in developing countries face enormous financial risks from major illness both in terms of the cost of medical care and the loss in income associated with reduced labor supply and productivity. We test whether access to microfinancial savings and lending institutions helps Indonesian families smooth consumption after declines in adult health. In general, results support the importance of these institutions in helping families to self-insure consumption against health shocks. Copyright © 2008 John Wiley & Sons, Ltd. [source] Methodological strategies for the identification and synthesis of ,evidence' to support decision-making in relation to complex healthcare systems and practicesNURSING INQUIRY, Issue 3 2002Angus Forbes Methodological strategies for the identification and synthesis of ,evidence' to support decision-making in relation to complex healthcare systems and practices This paper addresses the limitations of current methods supporting ,evidence-based health-care' in relation to complex aspects of care, including those questions that are best supported by descriptive or non-empirical evidence. The paper identifies some new methods, which may be useful in aiding the synthesis of data in these areas. The methods detailed are broadly divided into those that facilitate the identification of evidence and those that enable the interpretation of the data retrieved. To illustrate some of the issues involved, reference is made to a multimethod review recently completed by the authors, which aimed to identify factors that promote continuity in the transition from child to adult health and social care. It is argued that as healthcare organisations are becoming increasingly preoccupied with the evidence base of practice, such methods may help ensure that aspects of care and approaches that are outside the dominant pharmaco-medical domain maintain a prominent position on the healthcare agenda while remaining open to external scrutiny. Healthcare professionals who use such approaches need to know their relative utility and benefits to inform clinical decisions, so as to ensure that best practice is observed. [source] Health and Subjective Well-Being in Later Adulthood: Different Health States,Different Needs?APPLIED PSYCHOLOGY: HEALTH AND WELL-BEING, Issue 1 2009Benjamin Schüz From midlife on, health problems become more prevalent. Health is one of the key determinants of subjective well-being (SWB), but examining the relation between health and SWB in later adulthood is complicated by the clustering of multiple illnesses. This article proposes Latent Class Analysis (LCA) for a parsimonious description of adult health. This article compares SWB in health classes and examines the relative importance of socioeconomic resources, pain and coping (flexible goal adjustment) for SWB. Data stem from a nation-wide representative sample of adults aged 40,85 (German Ageing Survey, DEAS; N = 3,084). LCA was used to examine different configurations of health. Multiple regression analyses in latent classes were conducted to examine predictors of SWB. LCA generated four distinct classes of health conditions: No disease (n = 807), cardiovascular diseases (n = 405), joint problems (n = 1,612) and multiple illnesses (n = 258). As expected, only small mean differences in SWB indicators were found, whereas discontinuous predictors of SWB were detected: Coping was more strongly associated with SWB in individuals with higher illness burden. LCA can be applied to describe health in later adulthood. Differential prediction patterns suggest distinct factors for SWB depending on individual health status. [source] Childhood Abuse and Common Complaints in PregnancyBIRTH, Issue 3 2009Mirjam Lukasse RM ABSTRACT: Background: Childhood abuse affects adult health. The objective of this study was to examine the prevalence of emotional, physical, and sexual childhood abuse within a large Norwegian cohort of pregnant women and its association with common complaints in pregnancy.Methods: This study is based on the Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health. Regression analyses were used to examine associations of childhood abuse and 16 common complaints in pregnancy.Results: Eighteen percent (10,363/55,776) of the women reported some type of childhood abuse. Of all women, 3,870 (6.9%) reported sexual abuse, 3,075 (5.5%) physical abuse, and 7,619 (13.6%) emotional abuse as a child. Of those reporting childhood abuse, 31 percent reported two or more types of abuse. All 16 common complaints in pregnancy were associated with reported childhood abuse. Women reporting three types of childhood abuse reported 5.4 common complaints in pregnancy (mean) compared with 3.7 for women without childhood abuse (p < 0.001). Women reporting childhood abuse are more likely to report seven or more common complaints in pregnancy: adjusted odds ratio (AOR) 1.7 (95% CI 1.6,1.9) for emotional abuse; AOR 2.5 (95% CI 2.0,3.1) for combined physical and sexual abuse; and AOR 3.5 (95% CI 3.0,4.0) for all three kinds of abuse. Sociodemographic characteristics and other risk factors did not explain this graded association.Conclusions: Abuse in childhood is associated with increased reporting of common complaints of pregnancy. Clinicians should consider the possible role of childhood abuse when treating women with many common complaints in pregnancy. [source] Body composition in full-term healthy infants measured with air displacement plethysmography at 1 and 12 weeks of ageACTA PAEDIATRICA, Issue 4 2010Britt Eriksson Abstract Aim:, To use Pea Pod, a device based on air displacement plethysmography, to study body composition of healthy, full-term infants born to well-nourished women with a western life-style. Methods:, Body composition was assessed in 53 girls and 55 boys at 1 week (before 10 days of age) and at 12 weeks (between 77 and 91 days of age). Results:, At 1 week girls contained 13.4 ± 3.7% body fat and boys 12.5 ± 4.0%. At 12 weeks, these figures were 26.3 ± 4.2% (girls) and 26.4 ± 5.1% (boys). Body fat (%) did not differ significantly between the genders. Body fat (%) at the two measurements was not correlated. At 1 week, the weight (r = 0.20, p = 0.044) and BMI (r = 0.26, p = 0.007) of the infants, but not their body fat (g, %) or fat free mass (g), correlated with BMI before pregnancy in their mothers. Conclusions:, Pea Pod has potential for use in studies investigating the effect of external (i.e. nutritional status) and internal (i.e. age, gender, gestational age at birth) factors on infant body composition. This may be of value when studying relationships between the nutritional situation during early life and adult health. [source] Childhood disadvantage and health inequalities: a framework for policy based on lifecourse researchCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 6 2004H. Graham Abstract Tackling health inequalities is moving up the policy agenda of richer societies like the UK, with governments looking for evidence to guide policy review and development. Observational studies of how childhood disadvantage compromises health in adulthood are an important part of the evidence base, but are largely inaccessible to the policy community. We develop a framework which captures the findings of these studies. Our framework highlights how disadvantage in childhood adversely affects both socio-economic circumstances and health in adulthood through a set of interlocking processes. Key among these are children's developmental health (their physical, cognitive and emotional development) and health behaviours, together with the associated educational and social trajectories. In breaking down the link between childhood disadvantage and adult health into its constituent elements, the framework provides a basis for understanding where and how policies can make a difference. The paper argues that the process of policy review and development needs to include both new programmes and the mainstream policies in which they are embedded. [source] Implications of childhood obesity for adult health: findings from thousand families cohort studyCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 2 2002Richard Reading First page of article [source] A mixed logit model of health care provider choice: analysis of NSS data for rural IndiaHEALTH ECONOMICS, Issue 9 2006Bijan J. Borah Abstract In order to address the persistent problems of access to and delivery of health care in rural India, a better understanding of the individual provider choice decision is required. This paper is an attempt in this direction as it investigates the determinants of outpatient health care provider choice in rural India in the mixed multinomial logit (MMNL) framework. This is the first application of the mixed logit to the modeling of health care utilization. We also use the multiple imputation technique to impute the missing prices of providers that an individual did not visit when she was ill. Using data from National Sample Survey Organization of India, we find the following: price and distance to a health facility play significant roles in health care provider choice decision; when health status is poor, distance plays a less significant role in an adult's provider choice decision; price elasticity of demand for outpatient care varies with income, with low-income groups being more price-sensitive than high-income ones. Furthermore, outpatient care for children is more price-elastic than that for adults, which reflects the socio-economic structure of a typical household in rural India where an adult's health is more important than that of a child for the household's economic sustenance. Copyright © 2006 John Wiley & Sons, Ltd. [source] | ||||||||||