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Health Efforts (health + effort)
Kinds of Health Efforts Selected AbstractsTen Dimensions of Health and Their Relationships with Overall Self-Reported Health and Survival in a Predominately Religiously Active Elderly Population: The Cache County Memory StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2006Truls Østbye MD OBJECTIVES: To document the extent of healthy aging along 10 different dimensions in a population known for its longevity. DESIGN: A cohort study with baseline measures of overall self-reported health and health along 10 specific dimensions; analyses investigated the 10 dimensions as predictors of self-reported health and 10-year mortality. SETTING: Cache County, Utah, which is among the areas with the highest conditional life expectancy at age 65 in the United States. PARTICIPANTS: Inhabitants of Cache County aged 65 and older (January 1, 1995). MEASUREMENTS: Self-reported overall health and 10 specific dimensions of healthy aging: independent living, vision, hearing, activities of daily living, instrumental activities of daily living, absence of physical illness, cognition, healthy mood, social support and participation, and religious participation and spirituality. RESULTS: This elderly population was healthy overall. With few exceptions, 80% to 90% of persons aged 65 to 75 were healthy according to each measure used. Prevalence of excellent and good self-reported health decreased with age, to approximately 60% in those aged 85 and older. Even in the oldest old, the majority of respondents were independent in activities of daily living. Although vision, hearing, and mood were significant predictors of overall self-reported health in the final models, age, sex, and cognition were significant only in the final survival models. CONCLUSION: This population has a high prevalence of most factors representing healthy aging. The predictors of overall self-reported health are distinct from the predictors of survival in this age group and, being potentially modifiable, are amenable to clinical and public health efforts. [source] Postpartum depression: what we knowJOURNAL OF CLINICAL PSYCHOLOGY, Issue 12 2009Michael W. O'Hara Abstract Postpartum depression (PPD) is a serious mental health problem. It is prevalent, and offspring are at risk for disturbances in development. Major risk factors include past depression, stressful life events, poor marital relationship, and social support. Public health efforts to detect PPD have been increasing. Standard treatments (e.g., Interpersonal Psychotherapy) and more tailored treatments have been found effective for PPD. Prevention efforts have been less consistently successful. Future research should include studies of epidemiological risk factors and prevalence, interventions aimed at the parenting of PPD mothers, specific diathesis for a subset of PPD, effectiveness trials of psychological interventions, and prevention interventions aimed at addressing mental health issues in pregnant women. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65:1,12, 2009. [source] Disparities in Alcohol-Related Problems Among White, Black, and Hispanic AmericansALCOHOLISM, Issue 4 2009Nina Mulia Background:, This study assesses racial/ethnic disparities in negative social consequences of drinking and alcohol dependence symptoms among white, black, and Hispanic Americans. We examine whether and how disparities relate to heavy alcohol consumption and pattern, and the extent to which social disadvantage (poverty, unfair treatment, and racial/ethnic stigma) accounts for observed disparities. Methods:, We analyzed data from the 2005 U.S. National Alcohol Survey, a nationally representative telephone-based survey of adults ages 18 and older (N = 6,919). Given large racial/ethnic differences in abstinence rates, core analyses were restricted to current drinkers (N = 4,080). Logistic regression was used to assess disparities in alcohol-related problems at 3 levels of heavy drinking, measured using a composite variable incorporating frequency of heavy episodic drinking, frequency of drunkenness, and maximum amount consumed in a single day. A mediational approach was used to assess the role of social disadvantage. Results:, African American and Hispanic drinkers were significantly more likely than white drinkers to report social consequences of drinking and alcohol dependence symptoms. Even after adjusting for differences in heavy drinking and demographic characteristics, disparities in problems remained. The racial/ethnic gap in alcohol problems was greatest among those reporting little or no heavy drinking, and gradually diminished to nonsignificance at the highest level of heavy drinking. Social disadvantage, particularly in the form of racial/ethnic stigma, appeared to contribute to racial/ethnic differences in problems. Conclusions:, These findings suggest that to eliminate racial/ethnic disparities in alcohol-related problems, public health efforts must do more than reduce heavy drinking. Future research should address the possibility of drink size underestimation, identify the particular types of problems that disproportionately affect racial/ethnic minorities, and investigate social and cultural determinants of such problems. [source] Existence of the School Health Coordinator in a Frontier StateJOURNAL OF SCHOOL HEALTH, Issue 9 2005Scott D. Winnail Baseline data were collected soliciting the involvement of all 48 state school districts and the state girl's school (N = 49). Thirty-seven districts responded (75.5%). Identified school health coordinators were predominantly health and physical education teachers. Most coordinators spent minimal time (less than 10% of time) each week on school health coordination activities; nearly one half identified little or no coordination of school health efforts in their school districts; few identified personal involvement in budgetary matters concerning school health; and most identified their primary teaching responsibilities as the areas where the majority of their time was spent. Data collected help create a profile of the "typical" district level-school health coordinator in this frontier state and can assist in the development of future efforts aimed at school health coordination through the work of district-level school health coordinators. (J Sch Health. 2005;75(9):329,333) [source] Sodium, blood pressure, and ethnicity: What have we learned?,AMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 5 2009Lillian Gleiberman An enormous amount of research has yielded significant knowledge about ethnic differences in sodium homeostasis and blood pressure regulation. Consistent findings such as greater sodium-sensitivity, lower potassium excretion and high higher serum sodium levels in African Americans need further exploration to define more precise physiological mechanisms. The genetic alleles associated with sodium homeostasis in relation to blood pressure have accounted for only a small proportion of the variance in blood pressure. Several allelic variants differ in frequency among ethnic groups and heat-adapted genetic variants have a high prevalence in low latitudes and hot, wet climates which lends support to the "sodium retention" hypothesis. The blood pressure disparities between African Americans and whites may, in part, be due to different allelic frequencies of genes associated with sodium homeostasis. However, with advances in genomics, environmental factors tend to be neglected in research. Better measures of environmental stress have recently been developed by anthropologists and should be included in research designs by investigators in other disciplines. Public health efforts should encourage food producers to reduce sodium content of its products, and physicians should encourage patients to reduce consumption of high sodium packaged and fast foods. Am. J. Hum. Biol., 2009. © 2009 Wiley-Liss, Inc. [source] Life course weight gain and C-reactive protein levels in young adults: Findings from a Brazilian birth cohort,AMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 2 2009Aydin Nazmi Rapid weight gain in childhood is associated with increased risk of chronic diseases in adults. C-reactive protein (CRP) is a mediator of atherosclerosis and chronically elevated levels predict cardiovascular outcomes. The effects of life course weight gain on CRP levels are not clear. The 1982 Pelotas (Brazil) birth cohort study (n = 5,914) has prospectively collected weight and health data at several follow-ups since birth. The most recent was in 2004,05, when 77.4% of the cohort was traced and CRP levels were measured in 89% of those interviewed (n = 3827). Geometric mean (SE) C-reactive protein levels were 0.89 mg/l (0.03) and 1.66 mg/l (0.04) in men and women, respectively. In analyses adjusted for confounding variables, weight gain in infancy showed a weak negative association among males, but from the second year onwards, weight gain was positively associated with CRP levels. In females, weight gain was associated with higher CRP at every period tested. The strongest associations were observed in the most recent (18,23 years) period; CRP ratios (95% CI) per z score increase in weight gain were 1.78 (1.57,2.00) and 1.52 (1.30,1.78) for men and women, respectively. Males who were stunted at 2 years and centrally obese at 23 years had the highest CRP levels (P = 0.002 for interaction). In summary, rapid weight gain throughout life predicted higher CRP levels. Public health efforts need to tackle chronic under-nutrition in infancy, together with rapid weight gain in later childhood and adolescence, especially in countries undergoing the nutritional transition. Am. J. Hum. Biol. 2009. © 2008 Wiley-Liss, Inc. [source] A review of vaccines for HIV preventionTHE JOURNAL OF GENE MEDICINE, Issue 1 2003Matilu Mwau Abstract HIV/AIDS has become the most devastating pandemic in recorded history. It has killed 40 million people in the last 20 years and the World Health Organisation estimated that at least 14 000 new infections occurred daily in 2001. There will be up to 100 million new infections in the next 10 years (for current updates, visit http://www.unaids.org/epidemic_update/). Most HIV infections occur in the developing world, and the adverse social and economic impact of the HIV/AIDS pandemic, particularly in the developing world, is unprecedented. Highly active antiretroviral therapy (HAART) has had significant effects on HIV/AIDS in the developed world. The drugs have acted to prolong survival, reduce the viral load, and to alleviate suffering. However, the incidence of side effects and resistance is high and the drugs are unaffordable and unavailable in the developing world. HAART regimens are difficult to comply with. Public health efforts to modify the behaviour, attitude and culture that accelerate the spread of HIV/AIDS have had only modest success. There is urgent need for a prophylactic and/or therapeutic HIV vaccine. This is a review of the obstacles and current trends in HIV vaccine development. Copyright © 2002 John Wiley & Sons, Ltd. [source] Higher prevalence of bipolar I disorder among Asian and Latino compared to Caucasian patients receiving treatmentASIA-PACIFIC PSYCHIATRY, Issue 3 2010Sophia H.J. Hwang MSEd Abstract Introduction: There are limited data regarding relationships between race/ethnicity and bipolar disorder. This study assessed such relationships in patients receiving treatment in a university clinic. Methods: Demographic, illness characteristics, symptom severity, treatment, and care utilization data were collected from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) Affective Disorders Evaluation, Mini-International Neuropsychiatric Interview, and the STEP-BD Clinician Rated Packet. Data were compared among 51 Asian, 35 Latino, and 86 Caucasian patients in treatment at the Stanford University Bipolar Disorders Clinic. ,2 tests and analyses of variance were used to assess between-group differences. Results: Asian and Latino compared to Caucasian patients had significantly higher prevalence of bipolar I disorder (58.8% and 60.0% versus 37.2%, respectively). Asian and Latino patients also had a higher prevalence of history of psychosis, but this was related to the excess of bipolar I disorder, becoming non-significant after controlling for bipolar subtype. The racial/ethnic difference in bipolar subtype prevalence did not appear to be secondary to demographic or socioeconomic differences. Discussion: The higher prevalence of bipolar I disorder and thus lower prevalence of bipolar II disorder and bipolar disorder not otherwise specified in Asian and Latino patients may be related to under-diagnosis, misdiagnosis, or care underutilization of patients with milder forms of bipolar disorders. Additional research and public health efforts are warranted to further understand the effects of race and ethnicity on the management of bipolar disorders and to enhance timely and accurate diagnosis, culturally sensitive treatment, and optimal care utilization. [source] National rates of birth defects among hospitalized newborns,,§BIRTH DEFECTS RESEARCH, Issue 11 2006T.M. Bird Abstract BACKGROUND: The Healthcare Cost and Utilization Project (HCUP) family of hospital discharge databases offer an unprecedented opportunity to generate national estimates of newborn infants with birth defects. This report estimates national hospital admissions for newborn infants diagnosed with birth defects computed from HCUP and compares them to pooled prevalence figures computed from state birth defect surveillance systems. METHODS: HCUP-derived rates of 36 birth defects from 1997 through 2001 were compared to rates derived from pooled data reported by 26 state-based surveillance systems stratified by inclusion of elective terminations in case definitions. Rate ratios (RRs) were calculated for each birth defect by dividing the rate derived from HCUP by the rate derived from the relevant surveillance systems. RESULTS: HCUP newborn hospitalization rates for birth defects closely approximate pooled birth defect rates for surveillance systems that do not include elective terminations. HCUP rates were not significantly different for 35 of 36 defects. Overall, 20 HCUP rates were within 10% of state rates, 11 more were within 20% of state rates, and only 1 differed by more than 50%. HCUP rates compared most closely to state rates for cardiovascular (VSD RR = 0.98, ASD = 0.96, pulmonary valve atresia and stenosis = 0.92), orofacial (cleft palate RR = 1.10, cleft lip = 1.06), and genitourinary defects (obstructive genitourinary RR = 1.01, bladder exstrophy = 0.97). HCUP rates compared less favorably to rates derived from surveillance systems that included elective terminations. CONCLUSIONS: HCUP data approximate state-based surveillance system data for defects that are easily recognized in the newborn period and infrequently a cause for elective termination. HCUP data can be used to examine the impact of public health efforts on the number of infants born with birth defects as well as the cost and consequences of variations in the hospital management of birth defects. Birth Defects Research (Part A), 2006. © 2006 Wiley,Liss, Inc. [source] Termination of pregnancy according to immigration status: a population-based registry linkage studyBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 10 2008S Vangen Objective, Frequency of termination of pregnancy (TOP) and associated risk factors according to immigration status were studied. Design, Population-based registry study linking hospital data with information from the Central Population Registry of Norway. Setting, Oslo, Norway. Population, All women 15,49 years undergoing TOP and resident in Oslo, Norway from 1 January 2000 to 31 July 2003. Methods, TOP rates per 1000 women/year were calculated. The association of socio-economic variables such as maternal age, marital status, number of children and education level within the study groups were estimated as odds ratios and using logistic regression. Main outcome measure, Termination of pregnancy. Results, Refugees (30.2, 95% CI = 28.5,31.8) and labour migrants (19.9, 95% CI = 18.7,21.3) had significantly higher TOP rates than nonmigrants (16.7, 95% CI = 16.3,17.1). Except in women less than 25 years, labour migrants had higher TOP rates than nonmigrants. Refugees had the highest rates in all age groups. Being unmarried was associated with a substantially increased risk of TOP among the nonmigrants; such effect was not observed among labour migrants and refugees. Two or more children were associated with increased risk among nonmigrants and refugees compared with four or more among the labour migrants. Generally, higher education showed a protective effect that was most pronounced among nonmigrants. Compared with nonmigrants, adjusted risk of TOP was 1.37 (95% CI = 1.25,1.50) for labour migrants and 1.94 (95% CI = 1.79,2.11) for refugees. Conclusion, Public health efforts to increase the use of contraceptives among refugees and labour migrants above 25 years should be encouraged. [source] | |||||||||||||