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Selected AbstractsSense of coherence and adjustment to divorce among Muslim Arab citizens of IsraelEUROPEAN JOURNAL OF PERSONALITY, Issue 4 2003Orna Cohen This study examined the distinctiveness and causal relationships of Antonovsky's (1979) Sense of Coherence Scale and the Mental Health Index of Veit and Ware (1983) in a sample of 306 divorced Muslim Arab men and women in Israel. The findings, based on confirmatory factor analysis and latent-variable structural modelling, suggest that in the present sample sense of coherence (SOC) and mental health are two independent but correlated constructs. They also suggest that, consistent with Antonovsky's theory, SOC may be better viewed as a mediator between stress and mental health than as a concurrent outcome of stress, although the latter possibility is not ruled out. Finally, the findings indicate that the SOC of the sample was relatively low in comparison with other groups. Copyright © 2003 John Wiley & Sons, Ltd. [source] A Culturally Appropriate School Wellness Initiative: Results of a 2-Year Pilot Intervention in 2 Jewish SchoolsJOURNAL OF SCHOOL HEALTH, Issue 8 2010Maureen R. Benjamins PhD BACKGROUND: Despite the growing number of school-based interventions designed to reduce childhood obesity or otherwise promote health, no models or materials were found for Jewish schools. The current study describes an effort within a Jewish school system in Chicago to create, implement, and evaluate a school-based intervention tailored to the unique characteristics of Jewish religion, culture, and school structures. METHODS: Two schools (with approximately 600 students) were selected for the 2-year pilot study. The schools were required to form a wellness council, write a wellness policy, and implement policy changes or activities in 5 target areas (health education, physical education, school environment, family involvement, and staff wellness). Objectives were measured using pre- and postintervention surveys for students, as well as the School Health Index and other tools. RESULTS: Findings showed several significant increases in student knowledge, as well as an increase in the percentage of older students regularly meeting physical activity guidelines. Few changes in attitudes, other behaviors, or environmental factors were seen. CONCLUSIONS: Due to a strong partnership between researchers, schools, and community organizations, meaningful changes were made within the pilot schools. These changes were reflected in a limited number of improvements in student knowledge and activity levels. Future work is needed to determine how to bring about behavioral changes, how to increase the sustainability of all of the changes, and how to disseminate the model and products of this intervention to other day schools. [source] Implementation of a Coordinated School Health Program in a Rural, Low-Income CommunityJOURNAL OF SCHOOL HEALTH, Issue 9 2007BSHRM, Lisa Cornwell RN ABSTRACT Background:, Coordinated school health programs (CSHPs) bring together educational and community resources in the school environment. This method is particularly important in rural areas like Kansas, where resources and trained health professionals are in short supply. Rural Stafford County, Kansas, struggles with health professional shortages and a low-income, high-need population. Methods:, In 2001, Stafford County's Unified School District 349 began a multiyear CSHP development process, which required adaptations for implementation in a rural area. First, a CSHP team was formed of community and administrative stakeholders as well as school system representatives. Next, the CSHP team assessed school district demographics so the program framework could be targeted to health needs. During a yearlong planning phase, the CSHP team determined 4 priority areas for program development, as limited staff and funds precluded developing programs in all 8 traditional CSHP areas. Program activities were tailored to the population demographics and available resources. Results:, Program outcomes were supported by School Health Index (SHI) data. Of the 8 CSHP focus areas, the SHI found high scores in 3 of the Stafford CSHP's priority areas: Health Services; Psychological, Counseling, and Social Services; and Physical Education. The fourth Stafford CSHP priority area, Nutrition Services, scored similarly to the less prioritized areas. Conclusions:, The process by which the Stafford school district modified and implemented CSHP methods can serve as a model for CSHPs in other rural, high-need areas. [source] The School Health Portfolio System: A New Tool for Planning and Evaluating Coordinated School Health ProgramsJOURNAL OF SCHOOL HEALTH, Issue 9 2004Robert M. Weiler ABSTRACT: The School Health Portfolio System (SHPS), developed originally to evaluate the Florida Coordinated School Health Program Pilot Schools Project, offers a new and innovative system for planning and evaluating a coordinated school health program at the individual school level. The SHPS provides practitioners a detailed but easy-to-use system that enables schools to create new programs or modify existing programs across all eight components of the CSHP model, as well as administrative support critical to sustainability. The System comes packaged as a self-contained, notebook-style manual divided into 15 sections. It includes electronic templates of key documents to guide school teams in creating a customized portfolio, and a list of sample goals and artifacts that confirm achievement of a goal related to the school's coordinated school health program. An evaluation rubric provides a structured method to assess a program portfolio's contents, and the extent to which the contents document achievement of program goals. The rubric produces both a qualitative assessment, such as a narrative summary of program strengths and areas for improvement, and a quantitative assessment, such as a numerical score (0,100), letter grade (A-F), or 5-star system (* - *****). The physical structure, function, and scoring of the rubric depend on the method of assessment. The SHPS enables schools to set goals based on individual school needs, and incorporate CSHP goals into school improvement plans - a critical factor in sustainability and accountability. The System also offers teams the option of coordinating their efforts with CDC's School Health Index as a companion assessment measure. This article outlines the process a team would follow in developing a portfolio, and includes a sample assessment for the area of School Health Education. (J Sch Health. 2004;74(9):359,364) [source] Nursing leadership and health sector reformNURSING INQUIRY, Issue 2 2001Chris Borthwick Nursing leadership and health sector reform The political, technological and economic changes that have occurred over the past decade are increasingly difficult to manage within the traditional framework of health-care, and the organisation of health-care is seen to need radical reform to sweep away many of the internal barriers that now divide one form of health-care, and one profession, from another. Nursing must equip itself with skills in advocacy and political action to influence the direction the system will take. Nursing currently suffers from a weakness in self-concept that goes hand in hand with a weakness in political status, and nursing leadership must build the foundations for both advocacy for others and self-advocacy for the nursing movement. The profession faces tensions between different conceptions of its role and status, its relationship to medicine, and its relationship to health. Health indices are tightly linked to status, and to trust, hope, and control of one's own life. Can nurses help empower others when they are not particularly good at empowering themselves? What will the role of the nurse be in creating the information flows that will guide people toward health? Nursing's long history of adaptation to an unsettled and negotiated status may mean that it is better fitted to make this adaptation than other more confident disciplines. [source] Influence of Semi-Rigid Connections and Local Joint Damage on Progressive Collapse of Steel FrameworksCOMPUTER-AIDED CIVIL AND INFRASTRUCTURE ENGINEERING, Issue 3 2010Yuxin Liu This article extends the threat-independent method for progressive-failure analysis of rigid frames to analysis accounting for semi-rigid connections. The influence of joint damage caused by disengagement of member(s) is also considered in the analysis, and the degree of damage is modeled by a health index. A compound element model is employed to include the contributions of nonlinear behavior of beam-to-column connections, connection and member-end damage, member inelasticity, member shear deformation, and geometrical nonlinearity to structural response. Four beam collapse modes are illustrated for the progressive collapse analysis associated with debris loading generated when disengaged structural components fall onto lower parts of the structure. The impact effect is taken into account for the quasi-static nonlinear analysis by utilizing an impact amplification factor according to GSA and DoD guidelines. Any progressive collapse occurring thereafter involves a series of collapse events associated with topological changes of the frame. The analysis procedure is illustrated for the progressive collapse behavior of two planar steel frames. The results demonstrate that the proposed method is potentially an effective tool for the progressive collapse analysis of semi-rigid steel frames under abnormal loading events. [source] The effect of health changes and long-term health on the work activity of older CanadiansHEALTH ECONOMICS, Issue 10 2005Doreen Wing Han Au Abstract Using longitudinal data from the Canadian National Population Health Survey (NPHS), we study the relationship between health and employment among older Canadians. We focus on two issues: (1) the possible problems with self-reported health, including endogeneity and measurement error, and (2) the relative importance of health changes and long-term health in the decision to work. We contrast estimates of the impact of health on employment using self-assessed health, an objective health index contained in the NPHS , the HUI3, and a ,purged' health stock measure. Our results suggest that health has an economically significant effect on employment probabilities for Canadian men and women aged 50,64, and that this effect is underestimated by simple estimates based on self-assessed health. We also corroborate recent US and UK findings that changes in health are important in the work decision. Copyright © 2005 John Wiley & Sons, Ltd. [source] ORIGINAL RESEARCH,ENDOCRINOLOGY: A Comparative Study of the Effects of Local Estrogen With or Without Local Testosterone on Vulvovaginal and Sexual Dysfunction in Postmenopausal WomenTHE JOURNAL OF SEXUAL MEDICINE, Issue 3 2010Chitra Raghunandan MD ABSTRACT Introduction., A significant number of postmenopausal women suffer from distressing problems because of urogenital atrophy secondary to the decline in circulating estrogen levels. Treatment with topical hormones may provide relief in such women when used judiciously. Aim., To study the effects of local estrogen with or without local testosterone on urogenital and sexual health in postmenopausal women. Methods., Seventy-five postmenopausal women symptomatic for urogenital atrophy and sexual dysfunction were randomly divided into two study groups and one control group. The women in study group 1 received local estrogen cream; study group 2 received local estrogen and testosterone cream; the control group received nonhormonal lubricant KY gel for 12 weeks. The urogenital and sexuality score, along with the vaginal health index and the vaginal maturation index (VMI), was calculated at the beginning of therapy and 12 weeks later. Main Outcome Measures., Changes in the urogenital and sexuality score along with vaginal health index and VMI. Results., After 12 weeks of therapy, there was a significant improvement in all the four study parameters, which correlated well with the improvement in symptoms of urogenital atrophy and sexual dysfunction in both the study groups as compared with the control group. Improvement in sexuality score was greatest with combined estrogen,androgen therapy. There were no adverse effects and the therapies were well accepted without any compliance issue. Conclusion., Local estrogen either alone or with androgen is highly effective in relieving symptoms of urogenital atrophy and in improving sexual function in symptomatic postmenopausal women. Raghunandan C, Agrawal S, Dubey P, Choudhury M, and Jain A. A comparative study of the effects of local estrogen with or without local testosterone on vulvovaginal and sexual dysfunction in postmenopausal women. J Sex Med 2010;7:1284,1290. [source] Quality of life in elderly men with androgen deficiencyANDROLOGIA, Issue 2 2006D. Finas Summary The partial androgen deficiency in aging male (PADAM) has been of great interest to investigators and the public in the last few years. For males, androgens are said to be essential for the maintenance of quality of life (QoL) but there are no data available with respect to QoL and PADAM yet. In order to evaluate changes of individual well-being of males older than 50 years and with subnormal levels of free testosterone (FT) (<200 pmol l,1), these men were asked to fill in a questionnaire regarding QoL. The objective of this study was to compare age-matched males with androgen deficiency (group 1; n = 24) and normoandrogenic elderly men (group 2; n = 24) with respect to QoL and somatic indicators of the endocrine status. Participants suffered from benign prostatic hyperplasia (BPH) and were hospitalized for prostate surgery. Health-related QoL was assessed by the SF-12 Health Survey, including the physical health index and the mental health index. The SF-12 was enlarged by the scales ,vitality' and ,psychological well-being' of the SF-36. Additionally, patients were asked about social and clinical items. There were no statistically significant differences between the two groups regarding social and clinical parameters. The physical health index was reduced in group 1 (P < 0.05; effect size was medium (d = 0.57)) whereas the mental health index was similar in both groups. The correlation between the two health indices was very low and not statistically significant (r = 0.05, P = 0.72). Patients of group 1 described a lower vitality compared to group 2 (P < 0.05), but no differences could be observed regarding psychological well-being. Therefore, androgen-deficient patients seem to have the impression of a reduced physical ability. Our data emphasize that the subjective description of health-related aspects of QoL is a very sensitive methodological approach to discover psychological differences between patients. For the differentiation between androgen-deficient patients and those with normal testosterone levels the physical health index seems to be more sensitive than the mental health index. A question of interest is whether this difference remains detectable if testosterone is supplemented to androgen-deficient men. Whether testosterone supplementation is beneficial to these patients has to be carefully considered. [source] The burden of coronary heart disease in M,ori: population-based estimates for 2000-02AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 4 2009Martin Tobias Abstract Objective: To estimate coronary heart disease (CHD) incidence, prevalence, survival, case fatality and mortality for M,ori, in order to support service planning and resource allocation. Methods: Incidence was defined as first occurrence of a major coronary event, i.e. the sum of first CHD hospital admissions and out-of-hospital CHD deaths in people without a hospital admission for CHD in the preceding five years. Data for the years 2000-02 were sourced from the New Zealand Health Information Service and record linkage was carried out using a unique national identifier, the national health index. Results: Compared to the non-M,ori population, M,ori had both elevated CHD incidence and higher case fatality. Median age at onset of CHD was younger for M,ori, reflecting both higher age specific risks and younger population age structure. The lifetable risk of CHD for M,ori was estimated at 37% (males) and 34% (females), only moderately higher than the corresponding estimates for the non-M,ori population, despite higher M,ori CHD incidence. This reflects the offsetting effect of the higher ,other cause' mortality experienced by M,ori. Median duration of survival with CHD was similar to that of the non-M,ori population for M,ori males but longer for M,ori females, which is most likely related to the earlier age of onset. Conclusions: This study has generated consistent estimates of CHD incidence, prevalence, survival, case fatality and mortality for M,ori in 2000-02. The inequality identified in CHD incidence calls for a renewed effort in primary prevention. The inequality in CHD case fatality calls for improvement in access for M,ori to secondary care services. [source] Adult Right-Lobe Living Liver Donors: Quality of Life, Attitudes and Predictors of Donor OutcomesAMERICAN JOURNAL OF TRANSPLANTATION, Issue 5 2009D. A. DuBay To refine selection criteria for adult living liver donors and improve donor quality of care, risk factors for poor postdonation health-related quality of life (HRQOL) must be identified. This cross-sectional study examined donors who underwent a right hepatectomy at the University of Toronto between 2000 and 2007 (n = 143), and investigated predictors of (1) physical and mental health postdonation, as well as (2) willingness to participate in the donor process again. Participants completed a standardized HRQOL measure (SF-36) and measures of the pre- and postdonation process. Donor scores on the SF-36 physical and mental health indices were equivalent to, or greater than, population norms. Greater predonation concerns, a psychiatric diagnosis and a graduate degree were associated with lower mental health postdonation whereas older donors reported better mental health. The majority of donors (80%) stated they would donate again but those who perceived that their recipient engaged in risky health behaviors were more hesitant. Prospective donors with risk factors for lower postdonation satisfaction and mental health may require more extensive predonation counseling and postdonation psychosocial follow-up. Risk factors identified in this study should be prospectively evaluated in future research. [source] Quality of life in elderly men with androgen deficiencyANDROLOGIA, Issue 2 2006D. Finas Summary The partial androgen deficiency in aging male (PADAM) has been of great interest to investigators and the public in the last few years. For males, androgens are said to be essential for the maintenance of quality of life (QoL) but there are no data available with respect to QoL and PADAM yet. In order to evaluate changes of individual well-being of males older than 50 years and with subnormal levels of free testosterone (FT) (<200 pmol l,1), these men were asked to fill in a questionnaire regarding QoL. The objective of this study was to compare age-matched males with androgen deficiency (group 1; n = 24) and normoandrogenic elderly men (group 2; n = 24) with respect to QoL and somatic indicators of the endocrine status. Participants suffered from benign prostatic hyperplasia (BPH) and were hospitalized for prostate surgery. Health-related QoL was assessed by the SF-12 Health Survey, including the physical health index and the mental health index. The SF-12 was enlarged by the scales ,vitality' and ,psychological well-being' of the SF-36. Additionally, patients were asked about social and clinical items. There were no statistically significant differences between the two groups regarding social and clinical parameters. The physical health index was reduced in group 1 (P < 0.05; effect size was medium (d = 0.57)) whereas the mental health index was similar in both groups. The correlation between the two health indices was very low and not statistically significant (r = 0.05, P = 0.72). Patients of group 1 described a lower vitality compared to group 2 (P < 0.05), but no differences could be observed regarding psychological well-being. Therefore, androgen-deficient patients seem to have the impression of a reduced physical ability. Our data emphasize that the subjective description of health-related aspects of QoL is a very sensitive methodological approach to discover psychological differences between patients. For the differentiation between androgen-deficient patients and those with normal testosterone levels the physical health index seems to be more sensitive than the mental health index. A question of interest is whether this difference remains detectable if testosterone is supplemented to androgen-deficient men. Whether testosterone supplementation is beneficial to these patients has to be carefully considered. [source] Volunteering and health among older people: a reviewAUSTRALASIAN JOURNAL ON AGEING, Issue 2 2003Jenny Onyx This paper presents a review of the available literature on the relationship between volunteering and health among older people. There is consistent evidence that morbidity rates, functional health indices, self reported health and life satisfaction are affected by formal and informal volunteering. Some studies suggest that the benefits of volunteering are reciprocal, in that both those who give and those who receive assistance benefit. The evidence is consistent with the proposal that social capital is generated through volunteering. It is likely that the presence of high levels of social capital supports and maintains the health of older persons, provides informal support in times of sickness and stress and thus enhances quality of life as well as reducing or delaying the onset of illness and death. [source] |