Future Health (future + health)

Distribution by Scientific Domains

Selected Abstracts

Will increased storm disturbance affect the biodiversity of intertidal, nonscleractinian sessile fauna on coral reefs?

Abstract Relatively little is known about how the future effects of climatic change, including increases in sea level, temperature and storm severity and frequency, will impact on patterns of biodiversity on coral reefs, with the notable exception of recent work on corals and fish in tropical reef ecosystems. Sessile invertebrates such as ascidians, sponges and bryozoans occupying intertidal rubble habitats on coral reefs contribute significantly to the overall biodiversity and ecosystem function, but there is little or no information available on the likely impacts on these species from climate change. The existing strong physical gradients in these intertidal habitats will be exacerbated under predicted climatic change. By examining the distribution and abundance of nonscleractinian, sessile invertebrate assemblages exposed to different levels of wave action and at different heights on the shore around a coral reef, we show that coral reef intertidal biodiversity is particularly sensitive to physical disturbance. As physical disturbance regimes increase due to more intense storms and wave action associated with global warming, we can expect to see a corresponding decrease in the diversity of these cryptic sessile assemblages. This could impact negatively on the future health and productivity of coral reef ecosystems, given the ecosystem services these organisms provide. [source]

Selected As the Best Paper in the 1990s: Reducing Frailty and Falls in Older Persons: An Investigation of Tai Chi and Computerized Balance Training

FAPTA, Steven L. Wolf PhD
Objectives: To evaluate the effects of two exercise approaches, tai chi (TC) and computerized balance training (BT), on specified primary outcomes (biomedical, functional, and psychosocial indicators of frailty) and secondary outcomes (occurrences of fall). Design: The Atlanta Frailty and Injuries: Cooperative Studies and Intervention Techniques, a prospective, randomized, controlled clinical trial with three arms (TC, BT, and education (ED)). Intervention length was 15 weeks, with primary outcomes measured before and after intervention and at 4-month follow-up. Falls were monitored continuously throughout the study. Setting: Persons aged 70 and older living in the community. Participants: A total of 200 participants, 162 women and 38 men; mean age was 76.2. Measurements: Biomedical (strength, flexibility, cardiovascular endurance, body composition), functional instrumental activities of daily living (IADL), and psychosocial well-being (Center for Epidemiological Studies for Depression scale, fear of falling questionnaire, self-perception of present and future health, mastery index, perceived quality of sleep, and intrusiveness) variables. Results: Grip strength declined in all groups, and lower extremity range of motion showed limited but statistically significant changes. Lowered blood pressure before and after a 12-minute walk was seen following TC participation. Fear of falling responses and intrusiveness responses were reduced after the TC intervention compared with the ED group (P=.046 and P=.058, respectively). After adjusting for fall risk factors, TC was found to reduce the risk of multiple falls by 47.5%. Conclusion: A moderate TC intervention can impact favorably on defined biomedical and psychosocial indices of frailty. This intervention can also have favorable effects upon the occurrence of falls. TC warrants further study as an exercise treatment to improve the health of older people. [source]

Diabetic persons with foot ulcers and their perceptions of hyperbaric oxygen chamber therapy

Hjelm Katarina
Aim., To elucidate how diabetic patients with limb-threatening foot lesions perceive and evaluate content and organisation of treatment in a multi-place hyperbaric oxygen chamber. Background., To our knowledge there are no patients' evaluations of diabetes care in a high-technology area like the hyperbaric oxygen chamber. The burden on persons with diabetic foot complications might be increased if adjuvant therapy with hyperbaric oxygen therapy (HBOT) within a locked airtight vessel is given. Design., Explorative study. Participants., Participants were included in the HODFU study, a prospective randomised double-blind study, designed to evaluate whether HBOT heals more chronic foot ulcers than placebo treatment with hyperbaric air. Six females and 13 males, aged 44,83 years (median 70), with diabetic foot ulcers, participated. Method., Focus-group interviews by an external evaluator. Results., Management was perceived as well-functioning with competent staff delivering quick treatment in a positive manner and in good co-operation. HBOT sessions, in groups, were described as unproblematic and pleasant, through sharing experiences with others, although time-consuming and tiring. Recognising the responsible physician and communication with other physicians in the health-care chain was perceived as problematic. Placebo treatment, when given, did not reveal any problems; many perceived HBOT as the last resort and respondents had a negative view of future health and expressed fears of new wounds and amputation. Conclusions and relevance to clinical practice., From patients' perspective HBOT in the delivered health-care model was perceived as well-functioning, taking into consideration both technical and relational aspects of care in this high-technology environment. Communication with the patient and between different care givers, with a consistent message given and information about who is responsible and to whom one should turn, wherever treated, is the most crucial aspect of the model. Future fears need to be recognised and group interaction can be encouraged to share the burden of disease. [source]

Managing infant feeding practices: the competing needs of bulimic mothers and their children

Helen Stapleton
Aim., This paper seeks to explain how bulimic mothers accommodated infant feeding demands in conjunction with managing their disordered eating practices. Background., Eating disorders are chronic and disabling illnesses primarily affecting women. There are few qualitative studies describing bulimia in the context of motherhood. Design., The study employed an inductive qualitative approach. Methods., A purposive sample of childbearing women (n = 16), who self-defined as living with an eating disorder, were recruited. Data were generated from one-to-one interviews; a thematic analysis identified key issues. Results., Participants were primarily responsible for ensuring child/ren's socialisation processes, including modelling appropriate dietary behaviours and these demands often conflicted with their personal needs for food restraint. Pressures to participate in social activities with children were widely experienced as stressful especially when these events focused on food. Participants viewed early and repeated exposure to ,healthy' eating as protective against their children acquiring an eating disorder and in this respect commercial child-care facilities provided alternative environments for children to explore food-related activities. Conclusions., Participants employed a variety of strategies to ensure children's exposure to normalising influences and socialising processes. Concerns about personal competencies with respect to food preparation and storage were articulated by all participants. Relevance to clinical practice., Professionals involved with providing care to mothers and their infants are well placed to support bulimic clients and to foster confidence in their mothering skills. Early and appropriate intervention is key to effecting positive changes in bulimic patterns, with potential benefits to women's future health and well-being and that of their children. [source]

An ongoing process of inner negotiation , a Grounded Theory study of self-management among people living with chronic illness

Åsa Audulv RN
Aim., The aim of this study was to better understand the main concern of self-management processes among people with chronic illness. Background., One aspect of living with chronic illness is self-management that can reduce the illness impact on daily life and promote future health. Although factors that influence self-management have been identified in previous research, little attention has been brought to the process of making self-management decisions. In clinical settings, use of a theory could facilitate patient-empowering approaches. Method., The data collection for this Grounded Theory was mostly conducted in 2006. Data were collected by interviews with 26 adults with a variety of chronic illnesses, including rheumatoid arthritis, diabetes mellitus, inflammatory bowel syndrome, multiple sclerosis, ischaemic heart disease and chronic kidney failure. Results., Individuals are conflicted by competing preferences when taking decisions about self-management. Consequently, the decision-making process can be understood as an ongoing inner negotiation between different incompatible perspectives, e.g. social needs vs. medical needs. The process of negotiating self-management starts with the individual's considering beliefs about health and illness, which make the individual face illness threats and the need for self-management. Several aspects influence negotiating self-management namely, assessing effects of self-management; evaluating own capacity; perceiving normality or stigmatisation; and experiencing support and external resources. The process has been demonstrated in a model. Conclusions., The process of negotiating self-management is an ongoing inner debate rather than a one-time decision. This opens up new ways of understanding, and communicating with, patients. The described model also links behavioural theories and research findings in a comprehensive understanding. Relevance to clinical practice., This model could be applicable as a communication tool for health-care providers in identifying barriers to, and resources in, self-management behaviour among individuals with chronic illness. [source]

Early Adolescents Perceptions of Health and Health Literacy,

Stephen L. Brown PhD
ABSTRACT Background:, Health illiteracy is a societal issue that, if addressed successfully, may help to reduce health disparities. It has been associated with increased rates of hospital admission, health care expenditures, and poor health outcomes. Because of this, much of the research in the United States has focused on adults in the health care system. This study investigated the effect of aspects of health literacy on the motivation to practice health-enhancing behaviors among early adolescents. Methods:, Measures were generally based on 3 National Health Education Standards for grades 5-8. Data were obtained from 1178 9- to 13-year-old students visiting 11 health education centers in 7 states. Students responded via individual electronic keypads. Results:, Multivariate logistic regression revealed that, in addition to age, difficulty understanding health information and belief that kids can do little to affect their future health, decreased the likelihood for interest in and desire to follow what they were taught about health. Further, low interest independently decreased motivation to follow what was taught. Girls were more likely to turn to school, parents, and medical personnel for health information. Older students were more likely to turn to school and to the Internet. Conclusions:, Programs and curricula should be designed to increase student interest in health issues and their self-efficacy in controlling their own health destinies. Educators should also teach students to more effectively use nonconventional health information sources such as the Internet, parents, and medical professionals. [source]

Modern statistics: the myth and the magic

David J. Hand
Summary., The paper is a personal exploration of the puzzling contradiction between the fundamental excitement of statistics and its poor public image. It begins with the historical foundations and proceeds through the role of applications and the dramatic impact of the computer in shaping the discipline. The mismatch between the reality of statistics and its public perception arises from a number of dichotomies, some of which are explored. In particular, although statistics is perhaps typically seen as an impersonal discipline, in some sense it is very personal, and many of its applications are aimed at providing unique benefit to individuals. This benefit depends on the creation of detailed data sets describing individuals, but the contrary view is that this represents an invasion of privacy. Some observations on statistical education are made, and issues which will affect the future health of the discipline are examined. [source]

A critical analysis of UK public health policies in relation to diet and nutrition in low-income households

Pamela Attree phd
Abstract Diet and nutrition, particularly among low-income groups, is a key public health concern in the UK. Low levels of fruit and vegetable consumption, and obesity, especially among children, have potentially severe consequences for the future health of the nation. From a public health perspective, the UK government's role is to help poorer families make informed choices within healthy frameworks for living. However, the question is , to what extent are such policies in accordance with lay experiences of managing diet and nutrition on a low-income? This paper critically examines contemporary public health policies aimed at improving diet and nutrition, identifying the underlying theories about the influences on healthy eating in poor families, and exploring the extent to which these assumptions are based on experiential accounts. It draws on two qualitative systematic reviews , one prioritizing low-income mothers' accounts of ,managing' in poverty; and the other focusing on children's perspectives. The paper finds some common ground between policies and lay experiences, but also key divergencies. Arguably, the emphasis of public health policy on individual behaviour, coupled with an ethos of empowered consumerism, underplays material limitations on ,healthy eating' for low-income mothers and children. Health policies fail to take into account the full impact of structural influences on food choices, or recognize the social and emotional factors that influence diet and nutrition. In conclusion, it is argued that while health promotion campaigns to improve low-income families' diets do have advantages, these are insufficient to outweigh the negative effects of poverty on nutrition. [source]

Excessive longitudinal FEV1 decline and risks to future health: A case,control study,

Mei Lin Wang MD
Abstract Background Accelerated loss of forced expiratory volume in 1,s (FEV1) in an individual is considered an indicator of developing lung disease. Methods We investigated longitudinal FEV1 slopes, calculated by simple linear regression, and adverse health outcomes after 10,30 years, among 1,428 chemical plant workers. Cases were defined by FEV1 slopes below 5th percentile values for the cohort. Cases were matched with controls (107 pairs) for race, gender, smoking status, year of birth, age, height, and calendar year at first test. Matched pair statistics were used for comparisons. Results Cases had a higher proportion, compared to controls, of diagnosis of COPD or emphysema (17.8% vs. 1.9%, P,=,0.0002), medication use for respiratory diseases (24.3% vs. 4.7%, P,<,0.0001), dyspnea (15% vs. 3.7%, P,=,0.0042), and wheezing or rhonchi on examination (10.3% vs. 1.9%, P,=,0.0225). Conclusions Chemical plant workers who experienced accelerated FEV1 declines experienced four to nine times as many adverse health conditions over 10,30 years. Am. J. Ind. Med. 52:909,915, 2009. © 2009 Wiley-Liss, Inc. [source]

Understanding the developmental and psychological needs of young people with diabetes

Implications for providing engaging, effective services
Abstract Throughout adolescence, young people are going through a period of rapid biopsychosocial change when the developmental demands (,tasks') of childhood (e.g. sustaining friendships and achieving academic success) are continuing, tasks of adolescence (e.g. developing the sense of self and acquiring autonomy) are central and certain tasks of adulthood (e.g. focusing on career, intimate relationships and future health) are emerging. Young people with diabetes are also coping with the demands of their condition, managing the change from paediatric to adult services and may have additional psychological difficulties associated with diabetes. In addition, ongoing life-events and daily hassles continue during this period. The developmental tasks of adolescence and young adulthood are described. A brief overview of recent research into the impact of diabetes upon adolescent development and the specific psychological difficulties associated with diabetes is provided. It is suggested that young people with diabetes experience a sense of difference and constancy to do with their condition. An increased prevalence of ,sub-clinical' eating problems and likelihood of depression could also be apparent in this population. Young people's suggestions for providing developmentally-appropriate services are outlined and implications for service delivery are discussed. Copyright © 2005 John Wiley & Sons, Ltd. [source]

Assessment of organochlorine pesticides and metals in ring-tailed lemurs (Lemur catta) at Beza Mahafaly Special Reserve, Madagascar

Thomas R. Rainwater
Abstract Like most of Madagascar's endemic primates, ring-tailed lemurs (Lemur catta) face a number of threats to their survival. Although habitat loss is of greatest concern, other anthropogenic factors including environmental contamination may also affect lemur health and survival. In this study, we examined ring-tailed lemurs from the Beza Mahafaly Special Reserve (BMSR), southern Madagascar for exposure to organochlorine (OC) pesticides and metals and examined differences in contaminant concentrations between sexes and among age groups, troops, and habitats. A total of 14 pesticides and 13 metals was detected in lemur blood (24 individuals) and hair (65 individuals) samples, respectively. p,p,-DDT, heptachlor, aldrin, heptachlor epoxide, endrin aldehyde, and endrin were among the most prevalent pesticides detected. Surprisingly, the persistent metabolite of p,p,-DDT, p,p,-DDE, was not detected. The most commonly detected metals were aluminum, zinc, boron, phosphorus, silicon, and copper, whereas metals considered more hazardous to wildlife (e.g. arsenic, cadmium, lead, selenium, vanadium) were not found above detection limits. Overall, concentrations of OC pesticides and metals were low and similar to those considered to be background concentrations in other studies examining the ecotoxicology of wild mammals. Few inter-sex, -age, -troop, and -habitat differences in contaminant concentrations were observed, suggesting a uniform distribution of contaminants within the reserve. Several statistically significant relationships between lemur body size and contaminant concentrations were observed, but owing to the lack of supportive data regarding contaminant exposure in wild primates, the biological significance of these findings remains uncertain. Results of this study document exposure of ring-tailed lemurs at BMSR to multiple OC pesticides and metals and provide essential baseline data for future health and toxicological evaluations of lemurs and other wild primates, especially those in regions with expanding agricultural and mining operations. Am. J. Primatol. 71:998,1010, 2009. © 2009 Wiley-Liss, Inc. [source]

Where Is the Future in Public Health?

Context: Today's societies have far-reaching impacts on future conditions for health. Against this backdrop, this article explores how the future is represented in contemporary public health, examining both its conceptual base and influential approaches through which evidence is generated for policy. Methods: Mission statements and official reviews provide insight into how the future is represented in public health's conceptual and ethical foundations. For its research practices, the article takes examples from epidemiological, intervention, and economic research, selecting risk-factor epidemiology, randomized controlled trials, and economic evaluation as exemplars. Findings: Concepts and ethics suggest that public health research and policy will be concerned with protecting both today's and tomorrow's populations from conditions that threaten their health. But rather than facilitating sustained engagement with future conditions and future health, exemplary approaches to gathering evidence focus on today's population. Thus, risk-factor epidemiology pinpoints risks in temporal proximity to the individual; controlled trials track short-term effects of interventions on the participants' health; and economic evaluations weigh policies according to their value to the current population. While their orientation to the present and near future aligns well with the compressed timescales for policy delivery on which democratic governments tend to work, it makes it difficult for the public health community to direct attention to conditions for future health. Conclusions: This article points to the need for research perspectives and practices that, consistent with public health's conceptual and ethical foundations, represent the interests of both tomorrow's and today's populations. [source]

Occupational therapy, a central role in the future health and wellbeing of an ageing Australia

Hal Kendig
No abstract is available for this article. [source]

Parents' views of their child's health and family function in paediatric inflammatory bowel disease

H Lindfred
Abstract Aim:, The aim of this study was to explore parents' views and agreement of their child's current and future health, as well as the family's functioning in daily life with inflammatory bowel disease (IBD). Methods:, In this study, 119 parents (65 mothers and 54 fathers) of 66 adolescents (11,16 years) with IBD completed a questionnaire regarding their views of their child's IBD and health-related behaviour. Results:, The majority of the parents held a positive view of their child's current health status. However, the parents voiced a range of worries about their children's future health and life situation such as fear about the side effects of medication, concerns for future schooling, social life and employment options. Within the families, the parental pairs had more similar views about their child's current health status than about their future health. Factors that affected the parents' views consisted of cohabitation status, i.e. parents not living together, and severe disease course, both correlated with a more negative view of the child's current health and family functioning. Conclusion:, The majority of the parents in this study had a largely positive view of their child's current health status, but they expressed concerns about their child's future health. Knowledge about parents' thoughts may be of importance for healthcare teams supporting families with IBD. [source]