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Health Conditions (health + condition)
Kinds of Health Conditions Selected AbstractsLiving with Your Child's Chronic Health ConditionTHE BROWN UNIVERSITY CHILD AND ADOLESCENT BEHAVIOR LETTER, Issue S8 2006Article first published online: 24 JUL 200 No abstract is available for this article. [source] Public Health Conditions and Policies in the Asia Pacific regionASIAN-PACIFIC ECONOMIC LITERATURE, Issue 2 2001Dennis A. Ahlburg Health has improved dramatically in Asia over the last 40 years. Infant mortality dropped over 60 per cent and life expectancy increased by 40 per cent. Despite these gains, health outcomes remain relatively low in many Asian countries, and vary tremendously by region, income level and demographic group. Little progress has been made, for example, in decreasing maternal mortality. Asia is experiencing an epidemiological transition from a high burden of communicable diseases to a high burden of non-communicable diseases. The pace of this transition varies across countries, and some countries will experience increasing incidence of non-communicable diseases before the level of communicable diseases has decreased. Ill-health imposes a heavy economic cost: HIV/AIDS may reduce economic growth in some countries. As incomes and expectations rise, the demand for health care also rises and one of the greatest challenges facing Asia is how to provide and finance this care. [source] Weight Change and Lower Body Disability in Older Mexican AmericansJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2005Soham Al Snih MD Objectives: To examine the association between 2-year weight change and onset of lower body disability over time in older Mexican Americans. Design: Data were from the Hispanic Established Population for the Epidemiological Study of the Elderly (1993,2001). Weight change was examined by comparing baseline weight to weight at 2-year follow-up. Incidence of lower body disability was studied from the end of this period through an additional 5 years. Setting: Five southwestern states: Texas, New Mexico, Colorado, Arizona, and California. Participants: One thousand seven hundred thirty-seven noninstitutionalized Mexican-American men and women aged 65 and older who reported no limitation in activities of daily living (ADLs) and were able to perform the walk test at 2-year follow-up. Measurements: In-home interviews assessed sociodemographic factors, self-reported physician diagnoses of medical conditions (arthritis, diabetes mellitus, heart attack, stroke, hip fracture, and cancer), self-reported ADLs, depressive symptoms, and number of hospitalizations. Cognitive function, handgrip muscle strength, and body mass index (BMI) were obtained. The outcomes were any limitation of lower body ADL (walking across a small room, bathing, transferring from a bed to a chair, and using the toilet) and limitation on the walk test over subsequent 5-year follow-up period. General Estimation Equation (GEE) was used to estimate lower body disability over time. Results: Weight change of 5% or more occurred in 42.3% of the participants; 21.7% lost weight, 20.6% gained weight, and 57.7% had stable weight. Using GEE analysis, with stable weight as the reference, weight loss of 5% or more was associated with greater risk of any lower body ADL limitation (odds ratio (OR)=1.43, 95% confidence interval (CI)=1.06,1.95) and walking limitation (OR=1.35, 95% CI=1.03,1.76) after controlling for sociodemographic variables and BMI at baseline. Weight gain of 5% or more was associated with greater risk of any lower body ADL limitation (OR=1.39, 95% CI=1.02,1.89), after controlling for sociodemographic variables and BMI at baseline. When medical conditions, handgrip muscle strength, high depressive symptomatology, cognitive function, and hospitalization were added to the equation, the relationship between 2-year weight change (>5% loss or >5% gain) and lower body disability decreased. Conclusion: Health conditions and muscle strength partially mediate the association between weight loss or gain and future loss of ability to walk and independently perform ADLs. [source] Nonparametric Identification of a Building Structure from Experimental Data Using Wavelet Neural NetworkCOMPUTER-AIDED CIVIL AND INFRASTRUCTURE ENGINEERING, Issue 5 2003Shih-Lin Hung By combining wavelet decomposition and artificial neural networks (ANN), wavelet neural networks (WNN) are used for solving chaotic signal processing. The basic operations and training method of wavelet neural networks are briefly introduced, since these networks can approximate universal functions. The feasibility of structural behavior modeling and the possibility of structural health monitoring using wavelet neural networks are investigated. The practical application of a wavelet neural network to the structural dynamic modeling of a building frame in shaking tests is considered in an example. Structural acceleration responses under various levels of the strength of the Kobe earthquake were used to train and then test the WNNs. The results reveal that the WNNs not only identify the structural dynamic model, but also can be applied to monitor the health condition of a building structure under strong external excitation. [source] Distribution and severity of damage by Cryphonectria parasitica in the chestnut stands in Guilan province, IranFOREST PATHOLOGY, Issue 5 2010E. Ghezi Summary Chestnut blight caused by Cryphonectria parasitica has recently been reported from Guilan province, the only region with natural chestnut (Castanea sativa) stands in Iran. During the past few years, chestnut stands in Iran have been seriously threatened by the fungus, incidence of the disease is increasing and vast canopies are reduced to sprouts. As yet, there is no report on the disease distribution and severity in this region. Six sites from three main growing regions of chestnut in Guilan province were selected for investigation. We report occurrence and evaluation of the damage of the disease caused by C. parasitica. To evaluate the scale of damage, the investigated trees were classified into six categories based on the degree of crown damage, the number of canker wounds and the presence of the fungus. Index of health condition was calculated for all sites. During this study, a total of 250 isolates of Cryphonectria species were obtained, of which 232 isolates were C. parasitica and 18 were Cryphonectria radicalis. Castanea parasitica was observed in all regions. Index of health condition was scored from 0 to 6 with 0 being disease free and six being the most severe infection. Index results in the investigated sites varied between 0.69,5.45 and 0.93,5.55 for years 2006 and 2007, respectively. The highest damage was found in Doran (IH = 5.55), which is located some 100 km away from Shahbalutmahalleh, the site with lowest damage (IH = 0.93). This is the first extended report on aspects of chestnut blight in Iran. [source] Prenatal drug use and the production of infant healthHEALTH ECONOMICS, Issue 4 2007Kelly Noonan Abstract We estimate the effect of illicit drug use during pregnancy on two measures of poor infant health: low birth weight and abnormal infant health conditions. We use data from a national longitudinal study of urban parents that includes postpartum interviews with mothers, hospital medical record data on the mothers and their newborns, and information about the neighborhood in which the mother resides. We address the potential endogeneity of prenatal drug use. Depending on how prenatal drug use is measured, we find that it increases low birth weight by 4,6 percentage points and that it increases the likelihood of an abnormal infant health condition by 7,12 percentage points. Copyright © 2006 John Wiley & Sons, Ltd. [source] Internet use by end-stage renal disease patientsHEMODIALYSIS INTERNATIONAL, Issue 3 2007Emily SETO Abstract Information on the prevalence and predictors of use of the Internet by patients can be applied to the design and promotion of healthcare Internet technologies. To our knowledge, few studies on Internet use by end-stage renal disease (ESRD) patients have been reported. The objectives of this study are to ascertain the prevalence and predictors of Internet use by ESRD patients among different dialysis modalities. A questionnaire surveying Internet use was delivered in person to 199 conventional hemodialysis patients (57 returned), and mailed to 170 peritoneal dialysis (PD) patients (42 returned), and 65 nocturnal home hemodialysis (NHD) patients (43 returned). Of the respondents, most (58%) have used the Internet to find information on their health condition. The strong majority (76%) of these patients have easy access to the Internet. A higher proportion of NHD patients (86%) used the Internet compared with the PD patients (60%) (p=0.02). Internet use was found to be more prevalent with younger (p<0.001), more educated (p=0.001), and Canadian-born patients (p=0.005). The high prevalence of Internet use and easy access to the Internet by ESRD patients suggest that future Internet information and communication systems for healthcare management in ESRD will likely be well adopted by this patient population. [source] Quality of life in Chinese elderly people with depressionINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 4 2006Sally W. C. Chan Abstract Background Depression is the most prevalent functional mental disorder of later life. It is estimated that about 5% of the elderly population of Hong Kong are suffering from depression. Aim To investigate the self-rated quality of life of community-dwelling elderly people diagnosed with depression, and to examine the relationships between quality of life and mental, physical health, functional status and social support. Methods and results A cross-sectional descriptive survey was conducted in psychiatric outpatient clinics. A convenience sample of 80 Chinese elderly people with a diagnosis of depressive disorder was recruited. Perception of quality of life was measured by the Hong Kong Chinese World Health Organization Quality of Life Scale,Brief Version. Participants' mental status, functional abilities, physical health condition, and social support status were assessed. Sixty-one (76.3%) participants were female. They were least satisfied with ,meaningfulness of life', ,life enjoyment', ,concentration and thinking', ,energy' and ,work capacity'. Functional abilities had a positive association with participants' perceived quality of life, level of depression and number of physical health conditions had a negative association. Participants had low ratings of quality of life when compared with healthy persons and persons with chronic physical problems. Findings are discussed in light of the socio-cultural environment in Hong Kong. Conclusion Comprehensive treatment and better control of depression, including different modes of medical and psychosocial intervention, could help to improve participants' perception of quality of life. A longitudinal study with a larger sample with various levels of depression and socio-demographic characteristics is recommended. Copyright © 2006 John Wiley & Sons, Ltd. [source] Comparison of the prevalence and risk factors for depressive symptoms among elderly nursing home residents in Taiwan and Hong KongINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 4 2005Yun-Fang Tsai Abstract Background Depression in the elderly has become a serious health care issue worldwide. However, no studies have compared the prevalence and risk factors for depressive symptoms among institutionalized Chinese elders living in different regions. Objectives To explore and compare the prevalence and risk factors for depressive symptoms among elderly residents of nursing homes in Taiwan and Hong Kong. Methods Random sampling was used to recruit participants from eight nursing homes in each region. A total of 150 elders from Taiwan and 214 elders from Hong Kong participated. Results The prevalence of depressive symptoms was significantly higher in participants from Hong Kong (65.4%) than in Taiwan (43.3%). Logistic regression analysis indicated that gender, satisfaction with living situation, perceived health condition, and perceived income adequacy significantly predicted depressive symptoms in elderly nursing home residents in Taiwan. Significant predictors of depressive symptoms in the Hong Kong sample were satisfaction with living situation, cognitive status, and functional status. Conclusions It is important to consider risk factors specific to a target population when developing depression intervention programs. Copyright © 2005 John Wiley & Sons, Ltd. [source] Correlates of smoking among adolescents with asthmaJOURNAL OF CLINICAL NURSING, Issue 5-6 2010Su-Er Guo Aims and objective., This study examined the correlates of smoking among asthmatic adolescents to gain a better understanding of who is at particular risk. Background., Smoking is especially harmful to individuals with asthma. However, smoking is surprisingly prevalent among asthmatic individuals, with prevalence rates similar to or higher than those of the general adult or adolescent populations. Despite this notable finding, there has been little research about factors (i.e. biophysical, psychosocial and behavioural) influencing asthmatic adolescents' tobacco use patterns. Design., A Canadian provincial cross-sectional survey. Method., The study about adolescents' tobacco use and health status was conducted in secondary schools in 2004, 608 asthmatic adolescents participated. Demographic factors, biophysical (body mass index and physical health), psychosocial factors (parents' and peers' smoking, environmental tobacco smoke exposure and depression) and behavioural factors (marijuana use, alcohol use and exercise frequency) were explored. Multinomial logistic regression analyses were conducted to identify risk factors associated with tobacco use. Results and conclusions., Of the 608 asthmatic adolescents, 17·4% currently smoked and 12·0% formerly smoked. Girls, compared with boys, were more likely to smoke (OR: 3·34, 95% CI: 1·62,6·96) after adjusting for differences in the other demographic, biophysical, psychosocial and behavioural factors. Asthmatic girls who had relatively higher body mass index, were in the higher school grades, used marijuana or alcohol, had minor to severe depressive symptoms, had environmental tobacco smoke exposure in their homes and had friends who smoked or were currently more likely to smoke. The former smokers had similar risk factors including higher body mass index, environmental tobacco smoke exposure at home, friends who smoked and marijuana use. Relevance to clinical practice., Despite their health condition, asthmatic adolescents continue currently or formerly to smoke. Gender appropriate prevention and cessation interventions for asthmatic adolescents may need to address important psychosocial and environmental factors that increase the risk of these adolescents initiating and maintaining tobacco use. [source] A modified Mini Nutritional Assessment without BMI can effectively assess the nutritional status of neuropsychiatric patientsJOURNAL OF CLINICAL NURSING, Issue 13 2009Alan C Tsai Aim and objectives., To determine whether a modified version of the Mini Nutritional Assessment (MNA) without body mass index (BMI) can effectively identify individuals at risk of malnutrition among patients with neuropsychiatric disorders. Background., Neuropsychiatric patients have an additional risk of nutritional disorder due to functional impairments and drug effects. However, their nutritional status is generally neglected. It is important to find a tool that is simple, easy to use and non-invasive. Design., The study involved 105 patients in the acute phase of confirmed neuropsychiatric disorders in an area hospital. All subjects were cognitively able to have effective verbal communication. Method., The study included serum biochemical and anthropometric measurements and an on-site, in-person interview using a structured questionnaire to elicit personal data, health condition and answers to questions in the MNA. Subjects' nutritional statuses were graded with a MNA that adopted population-specific anthropometric cut-off points or one further with the BMI question removed and its assigned score redistributed to other anthropometric questions. Results., Both versions of the modified MNA effectively graded the nutritional status of neuropsychiatric patients and showed good correlations with the major nutritional indicators such as BMI, calf circumference and the length of hospital stay. Conclusions., The MNA can effectively assess the nutritional status of neuropsychiatric patients and enhance timely detection and intervention of their nutritional disorders. A modified MNA without the BMI question can maintain the full functionality of the tool. The version does not require weight and height measurements and thus will enhance the usefulness of the instrument. Relevance to clinical practice., Neuropsychiatric patients are a high-risk group of nutritional disorders. The MNA, especially the one without BMI, has the potential to improve professional efficiency of the primary care workers. [source] Self-preventive oral behavior in an Italian university student populationJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 3 2001Lia Rimondini Abstract Background, aim: The aim of this study was to assess the oral hygiene attitude and the professional preventive examination compliance in Italian university students. Method: A sample of 202 students attending the University of Bologna was randomly selected and interviewed about their preventive oral health attitude and compliance. All students reported using toothpaste and most of them (92.1%) brushed their teeth at least 2× a day using artificial, medium stiffness bristles. The toothbrush was generally (81.6%) replaced within 3 months. Few subjects (14.9%) said they used dental floss daily or utilized other devices. A majority of subjects (59.9%) had a dental examination within the year previous to the interview. Cluster analysis was performed. Results: 4 groups were identified with homogeneous oral hygiene behavior and compliance toward professional preventive examination. Only one cluster, representing 33.6% of the sample, showed consistent frequency and modalities of oral hygiene habits. The other clusters seemed to be defective with interproximal cleaning procedures and compliance toward professional preventive care. Since the sample was characterized by a young, urbanized, homogeneous group with a high educational level and frequently from an upper middle class social status, the analysis probably gives a supra-estimation of the positive behavior. Conclusion: It is rational to suppose that strategies to promote dental service utilization, patients' compliance and a professional style oriented toward prevention may be useful to improve the oral health condition in the young adult Italian population. Zusammenfassung Das Ziel dieser Studie war es bei Studenten einer italienischen Universität die Einstellung zur Mundhygiene und die Compliance mit einer professionellen Vorsorgeuntersuchung zu bestimmen. Eine Gruppe von 202 Studenten, die die Universität von Bologna besuchten wurden randomisiert ausgewählt und hinsichtlich ihrer Einstellung zur Mundhygiene und Compliance befragt. Alle Studenten berichteten, dass sie Zahnpasta gebrauchten und die meisten (92.1%) putzten ihre Zähne wenigstens 2× täglich und verwendeten eine Zahnbürste mit mittelharten Kunststoffborsten. Im Allgemeinen wurde die Zahnbürste innerhalb von 3 Monaten (81.6%) ersetzt. Wenige Personen berichteten, dass sie täglich Zahnseide benutzen oder andere Hilfsmittel verwenden. Die Mehrheit (59.9%) hatte innerhalb des zurückliegenden Jahres eine zahnärztliche Untersuchung. Es wurde eine Clusteranalyse durchgeführt. 4 Gruppen mit homogenem Mundhygieneverhalten und Compliance bezüglich professioneller präventiver Untersuchung wurden identifiziert. Nur ein Cluster, welches 33.6% der Gruppe repräsentiert zeigte eine Konsistenz in der Häufigkeit und Art der Mundhygienegewohnheiten. Die anderes Cluster schienen Defizite bei der Approximalraumreinigung und der Compliance mit professionellen Präventionsmaßnahmen zu haben. Da die Population charakterisiert war durch eine junge, städtische homogene Gruppe mit einem hohen Bildungsniveau und häufig den Sozialstatus der gehobenen Mittelklasse aufwies, gibt die Analyse wahrscheinlich eine Überbewer+tung des positiven Verhaltens wieder. Es ist vernünftig anzuhenmen, dass Strategien zur Förderung der zahnärztlichen Behandlung, der Patienten-Compliance und einer professionellen Ausrichtung hin zur Prävention nützlich sein können um in einer Population von jungen italienischen Erwachsenen den Zustand der Mundgesundheit zu verbessern. Résumé Le but de cette étude a été de vérifier l'attitude vis-à-vis de l'hygiène buccale et l'attitude vis-à-vis d'un examen préventif professionnel d'étudiants universitaires italiens. 202 étudiants de l'Université de Bologne ont été sélectionné au hasard et interviewéà propos de leur attitude préventive et leur complaisance vis-à-vis de leur santé buccale. Tous les étudiants disaient utiliser du dentifrice et la plupart d'entre eux (92%) brossaient leurs dents au moins 2× par jour avec une brosse à dents à poils artificiels de souplesse moyenne. La brosse à dents était géneralement (81.6%) remplacée tous les 3 mois. Peu d'entre eux (15%) disaient utiliser le fil dentaire tous les jours ou d'autres systèmes interdentaires. La plupart d'entre eux (60%) avaient passé une visite chez leur dentiste dans l'année précédent l'interview. L'analyse par groupe a été effectuée. 4 groupes ont été identifiés avec un comportement homogène vis-à-vis de l'hygiène buccale et une complaisance envers l'examen préventif professionnel. Seul un groupe représentant 34% de l'échantillon montrait une fréquence constante vis-à-vis de l'hygiène buccale. Les autres groupes semblaient porter moins d'attention au processus de nttoyage interdentaire et avoir une complaisance vis-à-vis des soins de prévention professionnels. Comme l'échantillon était caractérisé par un groupe homogène de jeunes des villes avec un niveau d'éducation élevé et provenant fréquemment d'une classe sociale assez élevée, l'analyse donne probablement une surestimation du comportement positif. Il semble logique de supposer que les stratégies visant à promouvoir l'utilisation des services dentaires, la complaisance des patients et un style professionnel orienté vers la prévention peuvent être utiles pour améliorer la condition de la santé buccale des jeunes adultes de la population italienne. [source] Attributed disability: a spot of local difficultyJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 1 2006George Peat PhD MCSP Abstract There has been an exponential growth of publications relating to the development and application of health measurement instruments. Condition-specific measures have formed a large part of this trend. This article questions the rationale behind the concept of condition-specific disability, a common domain in such measures, taking musculoskeletal medicine as an example. It argues that physical functions are seldom unique to a specific condition and that measurement specificity therefore relies on attributing functional consequences to the health condition of interest. The presence of multi-morbidity (musculoskeletal and non-musculoskeletal), and the influence of personal and environmental factors, pose problems for attribution that have seldom been empirically investigated. Furthermore, attributing disability to a specific health condition of interest potentially limits insights into important interventions such as managing co-morbid interactions and targeting barriers in the physical, social, and attitudinal environment. Efforts to identify regionally relevant item content and to measure participation in daily life are a step in the right direction. Attribution is not needed for either. [source] Dietary habits and health status of African-Caribbean adultsJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 3 2010J. Earland Abstract Background:, Although African-Caribbeans in the UK are more likely to suffer from a number of diet-related health conditions, including obesity, hypertension and type II diabetes, there have been few dietary studies on this group. The present study is based on a small survey of food and nutrient intakes and traditional dietary habits of African-Caribbean adults living in Staffordshire. Methods:, A questionnaire, designed to collect demographic data and information on medical status, physical activities, dietary, cooking and food shopping habits was administered to a convenience sample of 39 adults. Detailed information on food intakes was gathered using a modified existing Food Frequency Questionnaire with 169 items. Height and weight were measured for the calculation of body mass index. Results:, The average age of the subjects was 47 years (range 19,65 years). The prevalence of obesity was 39% and one-third of subjects reported having at least one health condition. Physical activities, outside of work, were undertaken by 95% of the sample. Traditional foods were used by 92% of respondents, including fruit and vegetables purchased at markets outside of their local area. A wide variety of foods were consumed and the percentages of energy provided by fats and carbohydrates (30% and 53%, respectively) appeared to be meeting government recommendations. However, absolute energy intakes were high and salt consumption, often in the form of commercial seasonings, exceeded government recommendations. Conclusions:, The positive aspects of the diets of this population need to be encouraged. Interventions need to focus on ways of reducing total energy intakes, as well as levels of salt consumption. [source] Associations Between Adolescent Risk Behaviors and Injury: The Modifying Role of DisabilityJOURNAL OF SCHOOL HEALTH, Issue 1 2009Sudha R. Raman PT ABSTRACT BACKGROUND:, Adolescents with disabilities are at risk for poor health outcomes including injury. The objective of this study was to examine if disability status modifies the association between risk behavior and injury among adolescents. METHODS:, The cross-sectional Health Behavior in School-Aged Children Survey was administered to a representative sample of 7235 Canadian students (grades 6-10) in 2002. Students who reported at least 1 functional difficulty due to a health condition were classified as having a disability. Engagement in up to 6 individual risk behaviors and a summative multiple risk behavior score were considered the primary exposures. Primary outcomes included medically attended injury experienced during a 12-month period. RESULTS:, Sixteen percent of students reported a disability. Almost all risk behaviors and all injury outcomes were more common among students with disabilities than in those without disabilities (eg, older age group's smoking: 17.5% vs 8.9%, p = <.01; medically attended injury: 67.4% vs 51.4%, p = <.01). Clear risk gradients were observed between engagement in multiple risk behavior and all injury outcomes. The association between multiple risk behavior and injury was accentuated by disability status among older students, particularly for students with disabilities who engaged in frequent multiple risk behavior (adjusted risk ratio 1.8, 95% CI: 1.6-1.9). CONCLUSIONS:, Canadian students with disabilities who engage in risk behaviors experience higher risks for medically attended injury than their nondisabled peers who engage in those same risk behaviors. Injury prevention programs that focus on risk-taking behavior should integrate the needs of this high-risk group of adolescents in order to prevent additional disability. [source] Recommendations for assessing Patient-Reported Outcomes and Health-Related quality of life in clinical trials on allergy: a GA2LEN taskforce position paperALLERGY, Issue 3 2010I. Baiardini To cite this article: Baiardini I, Bousquet PJ, Brzoza Z, Canonica GW, Compalati E, Fiocchi A, Fokkens W, van Wijk RG, La Grutta S, Lombardi C, Maurer M, Pinto AM, Ridolo E, Senna GE, Terreehorst I, Todo Bom A, Bousquet J, Zuberbier T, Braido F. Recommendations for assessing Patient-Reported Outcomes and Health-Related quality of life in clinical trials on allergy: a GA2LEN taskforce position paper. Allergy 2010; 65: 290,295. Abstract The aim of this Global Allergy and Asthma European Network (GA2LEN) consensus report is to provide recommendations for patient-reported outcomes (PROs) evaluation in clinical trials for allergic diseases, which constitute a global health problem in terms of physical, psychological economic and social impact. During the last 40 years, PROs have gained large consideration and use in the scientific community, to gain a better understanding of patients' subjective assessment with respect to elements concerning their health condition. They include all health-related reports coming from the patient, without involvement or interpretation by physician or others. PROs assessment should be performed by validated tools (disease-specific tools when available or generic ones) selected taking into account the aim of the study, the expected intervention effects and the determinant and confounding factors or patient-related factors which could influence PROs. Moreover, each tool should be used exclusively in the patient population following the authors' indications without modification and performing a cross-cultural validation if the tool must be used in a language that differs from the original. The result analysis also suggests that the relevance of PROs results in any interventional study should include a pre,post assessment providing information concerning statistical differences within or among groups, rates of response for the PROs and a minimal important difference for the population. The report underlines the importance of further investigation on some topics, such as the quality assessment of existing PROs tools, the definition of inclusion and exclusion criteria and a more extensive evaluation of the correlation between PROs, besides health-related quality of life, and clinical data. [source] Low birth weight of contemporary African Americans: An intergenerational effect of slavery?AMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 1 2009Grazyna Jasienska The average birth weight in the contemporary African-American population is about 250 g lower than the average birth weight of European Americans. Differences in genetic and socioeconomic factors present between these two groups can explain only part of birth weight variation. I propose a hypothesis that the low birth weight of contemporary African Americans not only results from the difference in present exposure to lifestyle factors known to affect fetal development but also from conditions experienced during the period of slavery. Slaves had poor nutritional status during all stages of life because of the inadequate dietary intake accompanied by high energetic costs of physical work and infectious diseases. The concept of "fetal programming" suggests that physiology and metabolism including growth and fat accumulation of the developing fetus, and, thus its birth weight, depend on intergenerational signal of environmental quality passed through generations of matrilinear ancestors. I suggest that several generations that have passed since the abolition of slavery in the United States (1865) has not been enough to obliterate the impact of slavery on the current biological and health condition of the African-American population. Am. J. Hum. Biol., 2009. © 2008 Wiley-Liss, Inc. [source] Psychosocial impact among the public of the severe acute respiratory syndrome epidemic in TaiwanPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 4 2006CHIH-HUNG KO md Abstract, During the 2003 outbreak, severe acute respiratory syndrome (SARS) spread to more than 30 countries. Not only did it cause severe health problems but it also imposed a great psychological impact on the public. SARS emerged in Taiwan during April 2003. This study investigates the psychosocial impact and the associated factors of depression of the SARS epidemic in Taiwan when the epidemic had just been controlled. A total of 1552 respondents were recruited in the study by random selection from the telephone book. Demographic data, SARS experience, self-perceived health state, neighborhood relationships, and depression were surveyed by telephone interviewing. Respondents were grouped as ,impacted group' and ,non-impacted group' according to whether they or their friends and family had been quarantined, or suspected of being infected. The psychosocial impact and associated factors were compared between the two groups. The ,impacted group' had higher depressive levels, poorer neighborhood relationships, poorer self-perceived health, and a higher economic impact than the ,non-impacted group'. The poorer self-perceived health and economic impact factors were associated with depression. The neighborhood relationship factor was negatively associated with depression for the ,impacted group', but not for the ,non-impacted group'. The ,impacted group' had experienced greater psychosocial impact possibly due to the SARS impact, the economic downturn, poor self-perceived health conditions, and decreased social support systems. An appropriate mental health intervention to improve the self-perceived health condition, to provide instrumental and psychological support for the ,impacted group', and to decrease the stigmatization and discrimination from the public could have buffered the psychological impact from this epidemic disaster. [source] A Petri Net Approach to Remote Diagnosis for Failures of Cardiac PacemakersQUALITY AND RELIABILITY ENGINEERING INTERNATIONAL, Issue 8 2004S. K. Yang Abstract This paper describes the application of Petri nets to remote diagnosis for failures of cardiac pacemakers. The operations, structures and basic control methods of the different types of cardiac pacemakers are first described. A combined synchronous pacemaker is modeled into a Petri net in this study. Twelve checkpoints are added into the modeled Petri net so as to construct a Petri net for failure diagnosis. A remote mode for failure diagnosis of implanted pacemakers is also designed by the Petri net approach. A low-power transmitter transmits a checking-code with 12 digits from the implanted pacemaker to the outside of the patient's body manually or automatically. By observing the markings of the checking code, the working status and the health condition of the pacemaker are clear at a glance. Applications of the Petri net method for failure diagnosis and control optimization are discussed. Copyright © 2004 John Wiley & Sons, Ltd. [source] Body condition does not predict immunocompetence of western pond turtles in altered versus natural habitatsANIMAL CONSERVATION, Issue 3 2010N. Polo-Cavia Abstract Many authors have addressed the relationship between body condition and ecological parameters in a wide range of studies, suggesting a better fitness in those individuals with higher values of body condition. However, body size and body condition of individuals can vary significantly at the intraspecific level between geographic locations, which is usually explained by phenotypic plasticity or local adaptation. We suggest that a higher body condition per se might not be a good indicator of physiological health status, particularly when comparing populations inhabiting places with different levels of habitat alteration. We examined two populations of the western pond turtle Emys marmorata in the northern part of California's Central Valley, and found that individuals inhabiting a water pollution control plant located on the valley floor had significantly larger body size and higher body condition than those inhabiting an unaltered natural habitat in the foothills. However, turtles from the water pollution control plant did not show a better health status, estimated by comparisons between two immune system variables: T-cell-mediated immune response and heterophil/lymphocyte ratio. Parameters such as body size and body condition might be misleading indicators of health condition, particularly when they are used to estimate health status of populations from habitats with different levels of alteration. We emphasize the importance of using physiological methods in assessing the conservation state of wildlife populations, rather than relying on biometric indices that might miss important effects of alteration. [source] Analysis of consumers' preferences and behavior with regard to horse meat using a structured survey questionnaireANIMAL SCIENCE JOURNAL, Issue 6 2009Woon Yong OH ABSTRACT In this study, a structured survey questionnaire was used to determine consumers' preferences and behavior with regard to horse meat at a horse meat restaurant located in Jeju, Korea, from October 1 to December 24, 2005. The questionnaire employed in this study consisted of 20 questions designed to characterize six general attributes: horse meat sensory property, physical appearance, health condition, origin, price, and other attributes. Of the 1370 questionnaires distributed, 1126 completed questionnaires were retained based on the completeness of the answers, representing an 82.2% response rate. Two issues were investigated that might facilitate the search for ways to improve horse meat production and marketing programs in Korea. The first step was to determine certain important factors, called principal components, which enabled the researchers to understand the needs of horse meat consumers via principal component analysis. The second step was to define consumer segments with regard to their preferences for horse meat, which was accomplished via cluster analysis. The results of the current study showed that health condition, price, origin, and leanness were the most critical physical attributes affecting the preferences of horse meat consumers. Four segments of consumers, with different demands for horse meat attributes, were identified: origin-sensitive consumers, price-sensitive consumers, quality and safety-sensitive consumers, and non-specific consumers. Significant differences existed among segments of consumers in terms of age, nature of work, frequency of consumption, and general level of acceptability of horse meat. [source] Fund allocation within Australian dental care: an innovative approach to output based fundingAUSTRALIAN DENTAL JOURNAL, Issue 4 2005M. Tennant Abstract Background: Over the last 15 years in Australia the process of funding government health care has changed significantly. The development of dental funding models that transparently meet both the service delivery needs for data at the treatment level and policy makers' need for health condition data is critical to the continued integration of dentistry into the wider health system. Methods: This paper presents a model of fund allocation that provides a communication construct that addresses the needs of both policy makers and service providers. Results: In this model, dental treatments (dental item numbers) have been grouped into eight broad dental health conditions. Within each dental health condition, a weighted average price is determined using the Department of Veterans Affairs' (DVA) fee schedule as the benchmark, adjusted for the mix of care. The model also adjusts for the efficiency differences between sectors providing government funded dental care. In summary, the price to be applied to a dental health condition category is determined by the weighted average DVA price adjusted by the sector efficiency. Conclusions: This model allows governments and dental service providers to develop funding agreements that both quantify and justify the treatment to be provided. Such a process facilitates the continued integration of dental care into the wider health system. [source] Prevalence of Breastfeeding and Acculturation in Hispanics: Results from NHANES 1999,2000 StudyBIRTH, Issue 2 2005Maria V. Gibson MD The study objective was to describe current national estimates of the prevalence of breastfeeding and evaluate differences in reasons not to breastfeed by acculturation status. Methods: Secondary data analysis of the National Health and Nutrition Examination Survey (NHANES) 1999,2000 was performed on a nationally representative sample of non-Hispanic white women born in the U.S. and Hispanic women with at least one live birth. Acculturation status among Hispanics was assessed using a validated language scale, and prevalence of breastfeeding was based on maternal self-report. Results: Prevalence of breastfeeding was higher in less acculturated Hispanic women (59.2%) than high acculturated Hispanic women (33.1%) and white women (45.1%). Less acculturated Hispanic women were more likely to cite their child's physical/medical condition as a reason not to breastfeed (53.1%), whereas whites and more acculturated Hispanics were more likely to cite their child preferred the bottle (57.5% and 49.8%, respectively). A logistic regression analysis revealed no significant differences in likelihood to breastfeed between non-Hispanic whites and Hispanics after controlling for education, age, and income. Higher acculturated women were less likely to breastfeed their children than low acculturated women (95% CI: 0.14,0.40) even after education, age, and income were taken into account. Conclusions: Acculturation differences in prevalence of breastfeeding and reasons not to breastfeed may be the result of attitudinal changes that occur due to acculturation. Further research into the acculturation process and its impact on breastfeeding may help to prevent the decline in breastfeeding that occurs as mothers become more acculturated. Meanwhile, patient education that addresses women's perceptions of the child's health condition and benefits of breastfeeding would be helpful. (BIRTH 32:2 June 2005) [source] Parent-proxy report of their children's health-related quality of life: an analysis of 13 878 parents' reliability and validity across age subgroups using the PedsQL 4.0 Generic Core ScalesCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 5 2007Richard Reading Parent-proxy report of their children's health-related quality of life: an analysis of 13 878 parents' reliability and validity across age subgroups using the PedsQL 4.0 Generic Core Scales . VarniJ. W., LimbersC. A. & BurwinkleT. M. ( 2007 ) Health and Quality of Life Outcomes , 5 , 2 . DOI:10.1186/1477-7525-5-2. Background, Health-related quality of life (HRQOL) measurement has emerged as an important health outcome in clinical trials, clinical practice improvement strategies, and healthcare services research and evaluation. While paediatric patient self-report should be considered the standard for measuring perceived HRQOL, there are circumstances when children are too young, too cognitively impaired, too ill or fatigued to complete an HRQOL instrument, and reliable and valid parent-proxy report instruments are needed in such cases. Further, it is typically parents' perceptions of their children's HRQOL that influences healthcare utilization. Data from the PedsQL DatabaseSM were utilized to test the reliability and validity of parent-proxy report at the individual age subgroup level for ages 2,16 years as recommended by recent Food and Drug Administration (FDA) guidelines. Methods, The sample analysed represents parent-proxy report age data on 13 878 children ages 2,16 years from the PedsQL 4.0 Generic Core Scales DatabaseSM. Parents were recruited from general paediatric clinics, sub-specialty clinics and hospitals in which their children were being seen for well-child checks, mild acute illness or chronic illness care (n = 3,718, 26.8%), and from a State Children's Health Insurance Program in California (n = 10 160, 73.2%). Results, The percentage of missing item responses for the parent-proxy report sample as a whole was 2.1%, supporting feasibility. The majority of the parent-proxy report scales across the age subgroups exceeded the minimum internal consistency reliability standard of 0.70 required for group comparisons, while the total scale scores across the age subgroups approached or exceeded the reliability criterion of 0.90 recommended for analysing individual patient scale scores. Construct validity was demonstrated utilizing the known groups approach. For each PedsQL scale and summary score, across age subgroups, healthy children demonstrated a statistically significant difference in HRQOL (better HRQOL) than children with a known chronic health condition, with most effect sizes in the medium-to-large effect size range. Conclusion, The results demonstrate the feasibility, reliability and validity of parent-proxy report at the individual age subgroup for ages 2,16 years. These analyses are consistent with recent FDA guidelines which require instrument development and validation testing for children and adolescents within fairly narrow age groupings and which determine the lower age limit at which reliable and valid responses across age categories are achievable. Even as paediatric patient self-report is advocated, there remains a fundamental role for parent-proxy report in paediatric clinical trials and health services research. [source] Integrated care of childhood disease in Brazil: Mothers' response to the recommendations of health workersACTA PAEDIATRICA, Issue 8 2005Antonio JL Alves da Cunha Abstract Aim: To describe the process of follow-up in primary care facilities where the Integrated Management of Childhood Illness (IMCI) strategy was implemented. IMCI was developed by WHO and UNICEF as an integrated approach to manage sick children under 5 y of age and aims to reduce mortality and morbidity. Methods: From August 2001 to February 2002, 229 sick children who had a health condition included in the IMCI case management guidelines were seen in six family healthcare facilities in Brazil. We analysed the care provided to 153 children who were recommended for a 2- or 5-d follow-up visit. Children who did not return were visited and assessed at home. Results: Only 87 children (56.9%) timely returned for follow-up: 70 had improved, eight presented the same health conditions, five were worse and four had a new problem. The main reasons given for not returning for follow-up were: the child had improved (35.1%) and other family priorities (47.4%). Home visits showed that, although most children had improved (n=49), some had a new health problem and one child was sick enough to be referred. Prescription of antibiotics was associated with increased probability of returning for a follow-up visit (RR =1.64 [1.22,2.20], p=0.001). Conclusion: Adherence to follow-up was just over 50%, mostly because the condition had already resolved, but some children were still sick and needed intervention. Training on counselling on the recognition of danger signs and when to return for a follow-up visit must be reinforced. [source] Self-reported and clinically determined oral health status predictors for quality of life in dentate older migrant adultsCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 1 2008R. Mariño Abstract,,, Objective:, This paper reports the impact of oral health on the quality of life (QOL) of Southern European, dentate older adults, living independently in Melbourne, Australia. Participants were recruited through ethnic social clubs and interviewed about oral health, general health, socio-demographics, and QOL using the Medical Outcomes Study Short-Form 12 (SF-12). The SF-12's physical and mental health component summary scores (PCS and MCS, respectively) were computed. The Oral Health Impact Profile (OHIP-14) assessed the specific impact of oral health on QOL. Participants were also given a clinical oral examination. Results:, A total of 603 eligible older adults volunteered; 308 were from Greek background and 295 were from Italian background. Mean age was 67.7 years (SD 6.2), with 63.7% being female. The PCS score had a mean value of 45.8 (SD 11.8), and MCS had a mean of 47.8 (SD 5.7). PCS was associated with, periodontal status, chronic health condition, self-perceived oral health needs, self-assessed oral health status, oral health impact score and the interaction between gender and level of education [F(11 552) = 10.57; P < 0.0001]. These independent variables accounted for 16% of the variance in PCS. The multivariate model predicting MCS had only one significant variable (self-reported gingival bleeding), explaining 1.5% of the variance. The OHIP-14 ranged from 0 to 48 with a mean score of 5.6 (SD 9.3). The model predicting OHIP-14 contained four significant variables: perceived oral health treatment needs, number of missing natural teeth, reports of having to sip liquid to help swallow food, and gender [F(4576) = 33.39; P < 0.0001], and explained 18% of the variance. The results demonstrated a negative association between oral health indicators and both the oral health-related QOL and the physical component of the SF-12. Conclusion:, The present findings support a growing recognition of the importance of oral health as a mediator of QOL. However, the self-selected sample and modest predictive power of the multivariate models suggest that further research is needed to expand this explanatory model. [source] Forest Stand Dynamics and Livestock Grazing in Historical ContextCONSERVATION BIOLOGY, Issue 5 2005MICHAEL M. BORMAN clima; incendio forestal; pastoreo histórico; pino ponderosa; supresión de fuego Abstract:,Livestock grazing has been implicated as a cause of the unhealthy condition of ponderosa pine forest stands in the western United States. An evaluation of livestock grazing impacts on natural resources requires an understanding of the context in which grazing occurred. Context should include timing of grazing, duration of grazing, intensity of grazing, and species of grazing animal. Historical context, when and under what circumstances grazing occurred, is also an important consideration. Many of the dense ponderosa pine forests and less-than-desirable forest health conditions of today originated in the early 1900s. Contributing to that condition was a convergence of fire, climate, and grazing factors that were unique to that time. During that time period, substantially fewer low-intensity ground fires (those that thinned dense stands of younger trees) were the result of reduced fine fuels (grazing), a substantial reduction in fires initiated by Native Americans, and effective fire-suppression programs. Especially favorable climate years for tree reproduction occurred during the early 1900s. Exceptionally heavy, unregulated, unmanaged grazing by very large numbers of horses, cattle, and sheep during the late nineteenth and early twentieth centuries occurred in most of the U.S. West and beginning earlier in portions of the Southwest. Today, livestock numbers on public lands are substantially lower than they were during this time and grazing is generally managed. Grazing then and grazing now are not the same. Resumen:,El pastoreo de ganado ha sido implicado como una causa de la mala salud de los bosques de pino ponderosa en el occidente de Estados Unidos. La evaluación de los impactos del pastoreo sobre los recursos naturales requiere de conocimiento del contexto en que ocurrió el pastoreo. El contexto debe incluir al período de ocurrencia, la duración y la intensidad del pastoreo, así como la especie de animal que pastoreó. El contexto histórico, cuando y bajo que circunstancias ocurrió el pastoreo, también es una consideración importante. Muchos de los bosques densos de pino ponderosa y de las condiciones, menos que deseables, de salud de los bosques actuales se originaron al principio del siglo pasado. Contribuyó a esa condición una convergencia de factores, fuego, clima y pastoreo, que fueron únicos en ese tiempo. Durante ese período, hubo sustancialmente menos incendios superficiales de baja intensidad (que afectaron a grupos densos de árboles más jóvenes) como resultado de la reducción de combustibles finos (pastoreo), una reducción sustancial en los incendios iniciados por Americanos Nativos y programas efectivos de supresión de incendios. Al inicio del siglo pasado hubo años con clima especialmente favorable para la reproducción de árboles. Al final del siglo diecinueve y comienzo del veinte hubo pastoreo no regulado ni manejado, excepcionalmente intensivo, por una gran cantidad de caballos, reses y ovejas en la mayor parte del oeste de E.U.A. y aun antes en porciones del suroeste. En la actualidad, el número de semovientes en terrenos públicos es sustancialmente menor al de ese tiempo, y el pastoreo generalmente es manejado. El pastoreo entonces y el pastoreo ahora no son lo mismo. [source] The Illness/Injury Sensitivity Index: an examination of construct validityDEPRESSION AND ANXIETY, Issue 6 2006R. Nicholas Carleton M.A. Abstract The 11-item Illness/Injury Sensitivity Index [ISI; Taylor, 1993: J Behav Ther Exp Psychiatry 24:289,299] measures fears of injury and illness and has the potential to delineate some mechanisms underlying anxiety-associated chronic health conditions. In a principal components analysis in 2005, Carleton et al. [2005a: J Psychopathol Behav Assess 27:235,241] indicated that a two-factor solution (Fear of Injury and Fear of Illness) best explained the structure of the ISI. The primary purpose of this study was to examine the structural and construct validity of the ISI. Results supported a two-factor solution after removal of two overinclusive items. Although the measure demonstrated good factorial validity, convergent and discriminant validity require further evaluation. In addition, a substantial correlation with fear of pain suggests a shift in our perspective on what constitutes a fundamental fear. Future research implications are discussed. Depression and Anxiety 23:340,346, 2006. © 2006 Wiley-Liss, Inc. [source] PROCEED: Prospective Obesity Cohort of Economic Evaluation and Determinants: baseline health and healthcare utilization of the US sample,DIABETES OBESITY & METABOLISM, Issue 12 2008A. M. Wolf Aim:, To summarize baseline characteristics, health conditions, resource utilization and resource cost for the US population for the 90-day period preceding enrolment, stratified by body mass index (BMI) and the presence of abdominal obesity (AO). Methods:, PROCEED (Prospective Obesity Cohort of Economic Evaluation and Determinants) is a multinational, prospective cohort of control (BMI 20,24.0 kg/m2), overweight (BMI 25,29.9 kg/m2) and obese (BMI , 30 kg/m2) subjects with AO and without AO [non-abdominal obesity (NAO)], defined by waist circumference (WC) >102 and 88 cm for males and females, respectively. Subjects were recruited from an Internet consumer panel. Outcomes were self-reported online. Self-reported anthropometric data were validated. Prevalence of conditions and utilization is presented by BMI class and AO within BMI class. Differences in prevalence and means were evaluated. Results:, A total of 1067 overweight [n = 474 (NAO: n = 254 and AO: n = 220)] and obese [n = 493 (NAO: n = 39 and AO: n = 454)] subjects and 100 controls were recruited. Self-reported weight (r = 0.92) and WC (r = 0.87) were correlated with measured assessments. Prevalence of symptoms was significantly higher in groups with higher BMI, as were hypertension (p < 0.0001), diabetes (p < 0.0001) and sleep apnoea (p < 0.0001). Metabolic risk factors increased with the BMI class. Among the overweight class, subjects with AO had significantly more reported respiratory, heart, nervous, skin and reproductive system symptoms. Overweight subjects with AO reported a significantly higher prevalence of diabetes (13%) compared with overweight subjects with NAO (7%, p = 0.04). Mean healthcare cost was significantly higher in the higher BMI classes [control ($456 ± 937) vs. overweight ($1084 ± 3531) and obese ($1186 ± 2808) (p < 0.0001)]. Conclusion:, An increasing gradient of symptoms, medical conditions, metabolic risk factors and healthcare utilization among those with a greater degree of obesity was observed. The independent effect of AO on health and healthcare utilization deserves further study with a larger sample size. [source] Community Resilience and Volcano Hazard: The Eruption of Tungurahua and Evacuation of the Faldas in EcuadorDISASTERS, Issue 1 2002Graham A. Tobin Official response to explosive volcano hazards usually involves evacuation of local inhabitants to safe shelters. Enforcement is often difficult and problems can be exacerbated when major eruptions do not ensue. Families are deprived of livelihoods and pressure to return to hazardous areas builds. Concomitantly, prevailing socioeconomic and political conditions limit activities and can influence vulnerability. This paper addresses these issues, examining an ongoing volcano hazard (Tungurahua) in Ecuador where contextual realities significantly constrain responses. Fieldwork involved interviewing government officials, selecting focus groups and conducting surveys of evacuees in four locations: a temporary shelter, a permanent resettlement, with returnees and with a control group. Differences in perceptions of risk and health conditions, and in the potential for economic recovery were found among groups with different evacuation experiences. The long-term goal is to develop a model of community resilience in long-term stress environments. [source] | ||||||||||||||||||||||||||||||||||||||||||||||