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Ill Health (ill + health)
Kinds of Ill Health Selected AbstractsMental health in Europe: problems, advances and challengesACTA PSYCHIATRICA SCANDINAVICA, Issue 2001W. Rutz Objective:,To describe mental health care needs and challenges across the WHO European region of 51 nations. Method:,Based on morbidity and mortality data from HFA Statistical Database and Health21, the policy framework of WHO Europe, major trends in mental health care needs, psychiatric reform and mental health promotion are discussed. Results:,There is a mortality crisis related to mental ill health in Eastern European populations of transition. Destigmatization is required to improve early intervention and humanization of services, and national mental health audits are needed to create the basis for national mental health planning, implementation and monitoring. There are both problems and advances in service restructuring, and comprehensive mental health promotion programmes, preventive and monitoring strategies are required. Conclusion:,Partnerships between national and international organizations, especially WHO and the European Union, have to be strengthened to make progress on the way to integrated community mental health services. [source] Treatment options for hydroxyurea-refractory disease complications in myeloproliferative neoplasms: JAK2 inhibitors, radiotherapy, splenectomy and transjugular intrahepatic portosystemic shuntEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 3 2010Elena Mishchenko Abstract Clinical care of patients with polycythemia vera, essential thrombocythemia and myelofibrosis (MF) requires not only a broad understanding of general treatment principles but also familiarity with the management of hydroxyurea-refractory disease complications. The latter include progressive splenomegaly, symptomatic portal hypertension (e.g. ascites, variceal bleeding), pulmonary hypertension, bone pain, intractable pruritus, constitutional symptoms (e.g. fatigue, night sweats) and cachexia (i.e. loss of lean body mass, general ill health, poor appetite). Some of these symptoms are directly or indirectly related to extramedullary hematopoiesis (EMH) and others to proinflammatory cytokine excess. Results from recent clinical trials of JAK inhibitors suggest remarkable activity in MF-associated constitutional symptoms, cachexia, pruritus and hydroxyurea-refractory splenomegaly. Involved-field radiotherapy is best utilized in the setting of EMH-associated symptoms, including ascites, bone (extremity) pain and pulmonary hypertension. Splenectomy is indicated in the presence of drug-refractory splenomegaly and frequent red cell transfusion requirement. Transjugular intrahepatic portosystemic shunt is used to alleviate symptoms of portal hypertension. [source] Measuring the effect of husband's health on wife's labor supplyHEALTH ECONOMICS, Issue 6 2006Michele J. SiegelArticle first published online: 31 JAN 200 Abstract A sizable proportion of women remain married well into late life and an increasing proportion of them participate in the labor force. Since women tend to marry men older than themselves and men tend to experience serious illnesses at younger ages than women, women frequently witness declining health in their husbands. This is likely to affect a wife's labor,leisure trade-off in offsetting ways. Prior studies have not sought to disentangle the effect of a husband's poor health on his wife's reservation wage from the income effect of his ill health. We argue that, if we control for husband's earnings, the coefficient of husband's health in models of his wife's labor force participation (and hours of work) will reflect, in part, her preference over whether to decrease her labor supply to provide health care for her husband or whether to instead increase it to purchase this care in the market. However, husband's earnings are likely to be endogenous in these models due to unobserved characteristics common to husbands and wives. We find that the estimated effect of husband's health depends on whether we instrument for husband's earnings and on the health measure used. This is indicative of the importance of using a variety of health measures and controlling for husband's earnings, and their endogeneity, in future research on the effect of husband's health on wife's labor supply. Copyright © 2006 John Wiley & Sons, Ltd. [source] Developing a relativities approach to valuing the prevention of non-fatal work-related accidents and ill healthHEALTH ECONOMICS, Issue 11 2005Jonathan Karnon Abstract The aim of the current explorative study is to define and test a process for the valuation of the benefits associated with the prevention of non-fatal work-related accidents and ill health. A relativities approach is adopted, and monetary values for the prevention of three forms of work-related illness are estimated. The approach involves describing relevant attributes of alternative events (accidents or occurrences of ill health), their causes, the characteristics of the relevant working population, and the number of events that are avoidable, and asking respondents to make pair wise choices between alternatives options for prevention. Indirect monetary valuations are obtained against a peg event for which a reliable valuation exists (road deaths). A series of discussion groups were held to identify relevant factors affecting potential valuations and to test the presentation of information. The predicted magnitude of responses for three-case study events (and road deaths) was estimated in a pilot study. These preliminary stages informed the final survey instrument that described five attributes in addition to a statement of the event and occupation, and the likely intervention effect, which was administered by post. Based on a small sample, the results show that virtually all respondents passed the inserted consistency test. The median respondent altered their choice according to the number of events avoided for all three comparisons, such that the estimated valuations appear sensible. Potential amendments are suggested, but the general relativities approach warrants further investigation for the valuation of non-fatal work-related accidents and ill health. Copyright © 2005 John Wiley & Sons, Ltd. [source] Social Changes and Welfare Reform in South Korea: In the Context of the Late-coming Welfare StateINTERNATIONAL JOURNAL OF JAPANESE SOCIOLOGY, Issue 1 2009Sung-won Kim Abstract The Korean welfare state is facing diverse pressures and challenges due to changing economic, social, and demographic circumstances: prevalence of the service economy, labor market flexibility, weakened family function and increase of untraditional families, lowest fertility rate and the most rapid ageing of the population among OECD countries, and so forth. These challenges, which indicate new types of social risks, have been stimulating a series of discussions on welfare reform in Korea. The old social risks such as retirement, ill health, poverty, and unemployment have not disappeared because of insecure or inadequate welfare, and now these risks are even intertwined with the so-called new social risks. Thereby the Korean welfare state is facing complicated reform tasks. This study attempts to analyze the structure and context of these challenges in Korea, and to explore the various driving forces that have formulated Korean welfare reform in recent decades. Through the above analyses, this study will shed light the characteristics of welfare reform in Korea as a late-coming welfare state. [source] Osteobiography of a high-status burial from the lower Río Verde Valley of Oaxaca, MexicoINTERNATIONAL JOURNAL OF OSTEOARCHAEOLOGY, Issue 6 2008A. T. Mayes Abstract This paper presents the osteobiography of an individual from an early complex society who was clearly of "special" social status but was not classified a ruling elite. Our case derives from a unique burial found at the small site of Yugüe, located in the lower Río Verde valley on the Pacific coast of Oaxaca, Mexico. Burial 14-Individual 16 (B14-I16) dates to the late Terminal Formative Period (CE 100,250), an era of regional political centralization and concomitant social inequality. B14-I16 was interred with several valuable grave offerings. A plaster-backed pyrite mirror was found below his mandible, and his left hand held an elaborately incised flute made from a deer femur. The flute is the only object of its kind known for all of Terminal Formative Mesoamerica. Drawing on the physicality of inequality, we employ osteobiography to assess the social hierarchy. Although B14-I16 was clearly an individual of unusual status in the context of Yugüe, he was not immune from the biological assaults that affected people of less distinguished social position at this time. Like his contemporaries of all social statuses, he suffered ill health in the years during which he was weaned. However, a longer weaning period and access to additional resources may have positioned him to endure later illness better than others in this population. Passing the critical transition period at age 6 ½, a time when many children died in this burial site, his adolescent health was better than that of others in this population. Although B14-I16 did have adult responsibilities, he didn't engage in the kinds of physical labour that marked the skeletons of others. The placement of Burial B14-I16 in the middle tiers of the lower Río Verde valley's ancient social hierarchy provides insight into issues of inequality and status on an individual scale. Copyright © 2008 John Wiley & Sons, Ltd. [source] Malingering, Perceptions of Illness, and Compensation Seeking in Whiplash Injury: A Comparison of Illness Beliefs Between Individuals in Simulated Compensation Scenarios and Litigation Claimants,JOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 11 2006Maggie Linnell This paper compares beliefs about whiplash injury between individuals in simulated compensation/no compensation scenarios and actual litigant claimants. Comparisons between simulators and the clinical sample revealed that chronic patients reported significantly more symptoms than all simulator groups. The beliefs of the real compensation claimants in the acute phase of the condition were similar to those in the ,injury only' simulator group. The analyses identified a trend towards beliefs in the expected timeline of the illness becoming more negative with time, whilst feelings of control over the symptoms improve. The paper discusses indicators of malingering behavior and the possible involvement of litigation and treatment processes in the transition to a chronic state of ill health. [source] Sleep in adolescence: a review of issues for nursing practiceJOURNAL OF CLINICAL NURSING, Issue 13 2009Tamara Vallido Aims and objectives., The aim of this review was to explore the literature to determine what is known about adolescent sleep, the causes and consequences of disturbed sleep in adolescence and the implications this has for nursing practice. Background., Sleep disorders are relatively common in young people. Disturbed sleep can be both a cause and a result of ill health and if recognised can indicate psychosocial, psychological or physical difficulties. Design., Literature review. Methods., Searching of key electronic databases. Results., Disturbed sleep in adolescents has several potential consequences, including daytime sleepiness, reduced academic performance and substance use/abuse. However, despite its significance and frequency, sleep disturbance is an area of adolescent health that is almost entirely unaddressed within the nursing literature. Conclusion., Nursing has a role to play in assisting adolescents and their families to recognise the importance of sleep to the general health and well-being of young people. Relevance to clinical practice., There is a need for nursing to develop tools to assess sleep in adolescent clients and non-pharmaceutical interventions to assist adolescents achieve optimum sleep and rest. Nurses may also contribute to educating adolescents and their families regarding the importance of good sleep hygiene. [source] Media presentation of the mental health bill and representations of mental health problemsJOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 4 2006Juliet L. H. Foster Abstract This paper discusses the findings of a study that examined the way in which the Mental Health Bill of June 2002 was presented in the British national and local media over a 3-year period. A Lexis Nexis search yielded 256 articles, which were then analysed qualitatively and quantitatively. Overall, and perhaps contrary to what might have been expected given previous studies' conclusions regarding the media's negative portrayal of mental ill health, most articles tended to present a negative view of the Bill as unnecessarily repressive, and consequently were more sympathetic towards mental heath service clients, although this was not the case for tabloid articles. However, this paper then considers the more implicit representations found within the articles. It focuses particularly on the continued linking of mental ill health and violence, and also on the way in which the mental health service user might be portrayed as passive and rather pitiful as an alternative to violent and dangerous. It is suggested that the continued use of such images may stem from the fact that mental health problems have long been constructed as ,Other', and are therefore deeply engrained in our society. The implications of this for anti-stigma campaigns are briefly discussed. Copyright © 2006 John Wiley & Sons, Ltd. [source] Life events as a risk factor for psychological problems in individuals with intellectual disabilities: a critical reviewJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 11 2008L. Hulbert-Williams Abstract Background Stressful life events such as bereavement, moving house and changing jobs have repeatedly been implicated as risk factors for mental and physical ill health. Since the 1940s, researchers have demonstrated the negative effects of stressful life events, refined methods of recording such events and investigated the relative impact of different types of event. These investigations have generally not extended to include people with intellectual disabilities. Methods We conducted a narrative review of research on life events as they occur to people with intellectual disabilities and critically assessed the evidence that life events function as a risk factor for psychological problems. Evidence was reviewed for an association between life events and a range of outcome variables, including affective disorders, challenging behaviour, psychosis and psychological problems more generally. We also critiqued the methodology behind the current evidence base and discussed a number of methodological advances that would help to strengthen it. Conclusions There is reasonable evidence that life events are associated with psychological problems, and that there is some tentative evidence that life events play a causal role, although to date, no relationship with psychosis in people with intellectual disabilities has been demonstrated. Life events are likely to be pertinent in clinical work with people with intellectual disabilities. [source] Impact of Mental Health Training for Frontline Staff Working With Children With Severe Intellectual DisabilitiesJOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 1 2008Teresa Whitehurst Abstract, The risk factors for young people with intellectual disabilities developing a mental health disorder are higher than those found in the general population, yet training is very rarely available to frontline staff. A recent study in the United Kingdom cited prevalence rates of mental ill health among adults with intellectual disabilities ranging from 35.2 to 40.9%, depending upon the sensitivity of the diagnostic tool used (Cooper et al., 2007). The ability to identify mental health problems is crucial to early intervention, but is particularly difficult when the symptoms of intellectual disability often mask emerging problems and confound differential diagnosis. The literature relating to mental health training focuses largely on changes in knowledge base and attitude, falling short of considering the primary focus of training,its impact upon practice and how this ultimately benefits people with intellectual disabilities. This study highlights the need for training, considers a training package provided to all frontline (direct care) staff in a residential school in the United Kingdom, catering to young people between the ages of 6 and 19 with severe intellectual disabilities, and investigates the impact of training upon practice and its influence upon the organization. [source] The development of nurse-led suicide prevention training for multidisciplinary staff in a North Wales NHS TrustJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2010R. JONES rmn bsc msc Accessible summary ,,Suicide and suicidal behaviour evoke strong feelings. That is so not only for those directly affected , the individual, family and friends, but for professional staff and the community at large. ,,Assessing the risk of suicide demands staff having the ability to connect and maintain rapport with people in varying degrees of distress. ,,Multidisciplinary training groups allow staff the opportunity to share their experiences and learn from one another. ,,Suicide awareness training for non mental health staff in the UK is variable and should be more of a priority. Abstract There are 300 deaths in Wales each year as a result of suicide. Though the rate in England and Wales has fallen in recent years, it is still the second most common cause of death in men aged 15,44 behind accidental death. The majority of those who die by suicide make contact with health professionals within a relatively short time before their death. For those with mental ill health, relationships with professionals appear particularly important; indeed negative relationships have been cited as a key factor precipitating death by suicide. This paper outlines a suicide awareness programme which aims to restate the values of empathy and relationship building in everyday interaction. It acknowledges risk factors and risk assessment tools, but more than anything strives to demonstrate the value of encouraging personal expression in patients. [source] Incidence-based estimates of life expectancy of the healthy for the UK: coherence between transition probabilities and aggregate life-tablesJOURNAL OF THE ROYAL STATISTICAL SOCIETY: SERIES A (STATISTICS IN SOCIETY), Issue 1 2008Ehsan Khoman Summary., Will the UK's aging population be fit and independent, or suffer from greater chronic ill health? Life expectancy of healthy people represents the expected number of years of healthy well-being that a life-table cohort would experience if age-specific rates of mortality and disability prevailed throughout the cohort's lifetime. Robust estimation of this life expectancy is thus essential for examining whether additional years of life are spent in good health and whether life expectancy is increasing faster than the decline of rates of disability. The paper examines a means of generating estimates of life expectancy for people who are healthy and unhealthy for the UK that are consistent with exogenous population mortality data. The method takes population transition matrices and adjusts these in a statistically coherent way so as to render them consistent with aggregate life-tables. [source] Estimating life expectancy in health and ill health by using a hidden Markov modelJOURNAL OF THE ROYAL STATISTICAL SOCIETY: SERIES C (APPLIED STATISTICS), Issue 4 2009Ardo Van Den Hout Summary., Population studies with longitudinal follow-up and mortality information can be used to estimate transitions between healthy and unhealthy states before death. When health is defined with respect to cognitive ability during old age, the trajectory of performance is either static or downwards. The paper presents a hidden Markov model to describe the underlying categorized cognitive decline, where observed improvement of cognitive ability is modelled as misclassification. Maximum likelihood is used to estimate the transition intensities between the normal cognitive state, the cognitively impaired state and death. The methodology is extended to estimate total life expectancy and life expectancy with and without cognitive impairment. The paper presents estimates from the Medical Research Council cognitive function and ageing study that began in 1991 and where individuals have had up to eight interviews over the next 10 years. It is shown that the misclassification of the states is mainly caused by not detecting an impaired state. Individuals with more years of education have lower impaired life expectancies. [source] A Normativist Account of Language-Based Learning Disability1,2LEARNING DISABILITIES RESEARCH & PRACTICE, Issue 1 2006J. Bruce Tomblin Research on learning disabilities (LD) depends upon a conceptual framework that specifies what it should explain, what kinds of data are needed, and how these data are to be arranged in order to provide a meaningful explanation. An argument is made that LD are no different in this respect than any other form of human illness. In this article, a theory of LD based on weak normativism drawn from the philosophy of medicine is presented. This theory emphasizes that cultural values (norms) determine which aspects of human experience and function are instances of ill health. Thus, ill health is fundamentally normative. However, the experiences and behaviors themselves arise out of the natural world and therefore can be explained by a culturally neutral natural science. Data from a longitudinal study of specific language impairment are used to show that academic achievement is culturally evaluated, that low achievement is disvalued, and that therefore actions are taken to help the poor achiever. Spoken language abilities in kindergarten are associated with judgments of the adequacy of fourth grade academic achievement and are mediated by reading prior to fourth grade and also via a path that is independent of reading. It is argued that poor academic achievement may be viewed as a disvalued state consistent with an illness, whereas language and reading skills can be viewed as basic causal systems that can explain the child's learning performance. Properties of this causal system are value free, except that they can inherit disvalue by their association with poor achievement. It remains to be determined whether the notion of LD is to be equated with poor achievement and therefore serve as a type of illness or whether it is to be viewed as a particular cause of poor achievement and thus functions as a type of disease associated with poor achievement. The conceptual framework lays out the alternative meanings for LD and the choice between these alternatives will ultimately depend on how it is used in the LD research community. [source] Infant feeding in the neonatal unitMATERNAL & CHILD NUTRITION, Issue 4 2010Rhona J. McInnes Abstract Infants admitted to a neonatal unit (NNU) are frequently unable to feed by breast or bottle because of ill health or prematurity. These infants require nutritional support until they can start oral feeding. Breastfeeding is advocated for these infants, and mothers are frequently encouraged to express breast milk to be fed via the enteral tube. However, by discharge, breastfeeding rates tend to be low. Oral feeding requires careful management, and although practices may vary because of clinical need, some may be informed by unit norms. There is limited evidence for effective breastfeeding support in this environment and little exploration of the effect of routine feeding decisions. This study aimed to explore feeding decisions and considered how these might affect outcomes. The staff in the two large urban NNUs who participated in the feeding decisions were interviewed and the data were analysed using a theoretical framework. Feeding decisions were made mainly by the unit staff, with limited parental involvement. Subsequent management varied, with differences being related to staff experience and beliefs, unit norms, parent's expectations and physical constraints within the unit. The staff were overtly supportive of breastfeeding, but the need to monitor and quantify milk intake may undermine breastfeeding. Furthermore, feeding breastfed infants during the mothers' absence was controversial and provoked debate. There is a need for clear guidelines and increased parental involvement in feeding decisions. Routine practices within the system may discourage mothers from initiating and persisting with breastfeeding. A change in unit culture is required to fully support the parent's feeding choices. [source] The assessment of poorly performing doctors: the development of the assessment programmes for the General Medical Council's Performance ProceduresMEDICAL EDUCATION, Issue 2001Lesley Southgate Background Modernization of medical regulation has included the introduction of the Professional Performance Procedures by the UK General Medical Council in 1995. The Council now has the power to assess any registered practitioner whose performance may be seriously deficient, thus calling registration (licensure) into question. Problems arising from ill health or conduct are dealt with under separate programmes. Methods This paper describes the development of the assessment programmes within the overall policy framework determined by the Council. Peer review of performance in the workplace (Phase 1) is followed by tests of competence (Phase 2) to reflect the relationship between clinical competence and performance. The theoretical and research basis for the approach are presented, and the relationship between the qualitative methods in Phase 1 and the quantitative methods in Phase 2 explored. Conclusions The approach is feasible, has been implemented and has stood legal challenge. The assessors judge and report all the evidence they collect and may not select from it. All their judgements are included and the voice of the lay assessor is preserved. Taken together, the output from both phases forms an important basis for remediation and training should it be required. [source] Epidemiologic research on man-made disasters: Strategies and implications of cohort definition for World Trade Center worker and volunteer surveillance programMOUNT SINAI JOURNAL OF MEDICINE: A JOURNAL OF PERSONALIZED AND TRANSLATIONAL MEDICINE, Issue 2 2008David A. Savitz PhD Abstract Studies of long-term health consequences of disasters face unique methodologic challenges. The authors focused on studies of the health of cleanup and recovery workers, who are often poorly enumerated at the outset and difficult to follow over time. Comparison of the experience at the World Trade Center disaster with 4 past incidents of chemical and radiation releases at Seveso, Italy; Bhopal, India; Chernobyl, Ukraine; and Three Mile Island, USA, provided useful contrasts. Each event had methodologic advantages and disadvantages that depended on the nature of the disaster and the availability of records on area residents, and the emergency-response and cleanup protocol. The World Trade Center Worker Monitoring Program has well-defined eligibility criteria but lacks information on the universe of eligible workers to characterize response proportions or the potential for distortion of reported health effects. Nonparticipation may result from lack of interest, lack of awareness of the program, availability of another source of medical care, medical conditions precluding participation, inability to take time off from work, moving out of the area, death, or shift from initially ineligible to eligible status. Some of these considerations suggest selective participation by the sickest individuals, whereas others favor participation by the healthiest. The greatest concern with the validity of inferences regarding elevated health risks relative to external populations is the potential for selective enrollment among those who are affected. If there were a large pool of nonparticipating workers and those who suffered ill health were most motivated to enroll, the rates of disease among participants would be substantially higher than among all those eligible for the program. Future disaster follow-up studies would benefit substantially by having access to accurate estimates of the number of workers and information on the individuals who contributed to the cleanup and recovery effort. Mt Sinai J Med 75:77,87, 2008© 2008 Mount Sinai School of Medicine [source] Differences in perceived barriers to volunteering to formal organizations: Lack of time versus lack of interestNONPROFIT MANAGEMENT & LEADERSHIP, Issue 3 2007Richard A. Sundeen This article reports the findings of a study of perceived barriers to volunteering to formal organizations by nonvolunteers. We examine the types of barriers, their frequencies, and their relationships with individual-level sociodemographic characteristics of nonvolunteers. Data from a 2001,2002 national survey conducted by the U.S. Bureau of Labor Statistics are analyzed using multiple regression techniques. Contrary to general expectations, only three barriers,lack of time, lack of interest, and ill health,are fairly common. Furthermore, as expected, different social class groups identify different types of barriers. The article concludes with a discussion of the theoretical implications of the findings (for example, how indicators of social and cultural capital affect access to volunteer opportunities) and practical implications concerning recruitment of volunteers. [source] Developing and setting up a patient and relatives intensive care support groupNURSING IN CRITICAL CARE, Issue 1 2009Maureen Peskett Abstract Aim:, The purpose of this article was to highlight the need to provide support for patients and relatives following critical illness and discharge from hospital and how this can be improved through the establishment of user support groups. Background:, Critical illness predisposes patients to extended physical and psychological ill health with the potential for a reduced quality of life. The authors' personal experience, patient feedback and current literature suggested that there was a need for further support during their recovery. Methods:, Building on an existing formal follow-up service, Intensive Care Unit (ICU) Support Team for Ex-Patients established a patient-centred forum, where patients and relatives could share experiences with others who had also been through critical illness by holding drop-in sessions. Feedback from those attending these flexible and informal sessions indicates that support was needed and that patients and families have found benefit in sharing experiences with others who can empathise, having been through critical illness themselves. Conclusions:, Our experience has shown there is a need that can be met simply with minimal investment of time and funding but that addresses a gap in patient support that otherwise goes unmet. Although this was a service development in one local area, it could be adapted to ICU patients and relatives more widely. [source] The burden of overweight and obesity-related ill health in the UKOBESITY REVIEWS, Issue 5 2007S. Allender Summary This paper reviews previous cost studies of overweight and obesity in the UK. It proposes a method for estimating the economic and health costs of overweight and obesity in the UK which could also be used in other countries. Costs of obesity studies were identified via a systematic search of electronic databases. Information from the WHO Burden of Disease Project was used to calculate the mortality and morbidity cost of overweight and obesity. Population attributable fractions for diseases attributable to overweight and obesity were applied to National Health Service (NHS) cost data to estimate direct financial costs. We estimate the direct cost of overweight and obesity to the NHS at £3.2 billion. Other estimates of the cost of obesity range between £480 million in 1998 and £1.1 billion in 2004 [Correction added after online publication 11 June 2007: ,of the cost of obesity' added after ,Other estimates']. There is wide variation in methods and estimates for the cost of overweight and obesity to the health systems of developed countries. The method presented here could be used to calculate the costs of overweight and obesity in other countries. Public health initiatives are required to address the increasing prevalence of overweight and obesity and reduce associated healthcare costs. [source] Growth patterns in adverse environmentsAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 5 2007Noël Cameron The triple-logistic pattern of human growth in linear dimensions is probably one of the most recognizable models within human biology. The fact that postnatal somatic growth occurs in three phases (infancy, childhood, adolescence) creates opportunities for the individual expression of this genetically directed, but environmentally modified, phenomenon. The impact of the environment works to alter the duration and intensity of critical stages within the total process resulting in individual patterns that can differ radically from the general pattern. However, the constancy of the general pattern is so fixed that its presence in children is taken as a reflection of good health. Departures from that pattern are recognized as reflecting ill health. While the cessation of growth in response to an acute attack is uniformly dramatic, the gradual response to chronic adverse stimuli is less easily predicted and interpreted. For example, in chronic scenarios the loss of centile position that precedes the eventual establishment of normal increments can be viewed as either a poor or a good growth response, as either maladaptive or adaptive, as either poor health or good health. This article reviews such growth patterns in urban South African children exploring the relationship between environment and growth outcome. Am. J. Hum. Biol., 2007. © 2007 Wiley-Liss, Inc. [source] Sensitization to wheat flour and enzymes and associated respiratory symptoms in British bakersAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 2 2009Joanne Harris-Roberts PhD Abstract Rationale Current literature suggests that flour exposed workers continue to be at risk of allergic sensitization to flour dust and respiratory ill health. Objectives A cross-sectional study of 225 workers currently potentially exposed to flour dust in British bakeries was performed to identify predictors of sensitization to wheat flour and enzymes. Results Work-related nasal irritation was the most commonly reported symptom (28.9%) followed by eye irritation (13.3%) and work-related cough or chest tightness (both 10.2%). Work-related chest tightness was significantly associated (OR 7.9, 1.3,46.0) with co-sensitization to wheat flour and any added enzyme. Working at a bakery with inadequate control measures was not a risk factor for reporting work-related respiratory symptoms (OR 1.3, 0.4,3.7). Fifty-one workers were atopic and 23 (14%) were sensitized to workplace allergens. Atopy was the strongest predictive factor (OR 18.4, 5.3,64.3) determining sensitization. Current versus never smoking (OR 4.7, 1.1,20.8) was a significant risk factor for sensitization to wheat flour or enzymes in atopic workers only, corrected for current level and duration of exposure. This effect was not seen in non-atopic workers (OR 1.9, 0.2,17.9). Evidence of sensitization to less commonly encountered allergens was also seen to Aspergillus niger derived cellulase, hemicellulase and xylanase mix, in addition to glucose oxidase and amyloglucosidase mix. Conclusions The combination of health surveillance and exposure control in this population has been insufficient to prevent clinically significant workplace sensitization. Smoking may pose an additional risk factor for sensitization in atopic workers. Am. J. Ind. Med. 52:133,140, 2009. © 2008 Crown copyright. [source] The Retirement-Consumption Puzzle and Involuntary Early Retirement: Evidence from the British Household Panel Survey,THE ECONOMIC JOURNAL, Issue 510 2006Sarah Smith This article uses data from the British Household Panel Survey (BHPS) to shed further light on the fall in consumption at retirement (the ,retirement-consumption puzzle'). Comparing food spending of men retiring involuntarily early (through ill health or redundancy) with spending of men who retire voluntarily, it finds a significant fall in spending only for those who retire involuntarily. This is consistent with the observed fall in spending being linked to a negative wealth shock for some retirees. [source] Endocrine Aspects of Female Sexual DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 1 2004Susan R. Davis MD ABSTRACT Introduction., Various endogenous hormones, including estrogen, testosterone, progesterone and prolactin, may influence female sexual function. Aim., To provide recommendations for the diagnosis and treatment of women with endocrinologic sexual difficulties. Methods., The Endocrine Aspects of Female Sexual Dysfunction Committee was part of a multidisciplinary International Consultation. It included four experts from two countries and several peer reviewers. Main Outcome Measure., Expert opinion was based on committee discussion, a comprehensive literature review and evidence-based grading of available publications. Results., The impact of hormones on female sexual function and their etiological roles in dysfunction is complex. Research data are limited as studies have been hampered by lack of precise hormonal assays and validated measures of sexual function in women. Sex steroid insufficiency is associated with urogenital atrophy and may also adversely affect central sexual thought processes. Systemic estrogen/estrogen progestin therapy alleviates climacteric symptoms but there is no evidence that this therapy specifically improves hypoactive sexual desire disorder (HSDD) in premenopausal or postmenopausal women. Exogenous testosterone has been shown in small randomized controlled trials (RCT) to improve sexual desire, arousal and sexual satisfaction in both premenopausal and postmenopausal women. However, as there is no biochemical measure that clearly identifies who to treat, use of exogenous testosterone should be considered only after other causes of HSDD have been excluded, such as depression, relationship problems and ill health. The clinical assessment of HSDD should include detailed medical, gynecologic, sexual and psychosocial history and physical examination including the external/internal genitalia. Hormonal therapy should be individualized and risks/benefits fully discussed, and all treated women should be carefully followed up and monitored for therapeutic side effects. Conclusions., There is a need for prospective, multi-institutional clinical trials to define safe and effective endocrine treatments for female sexual dysfunction. [source] Parents' experiences of pain and discomfort in people with learning disabilitiesBRITISH JOURNAL OF LEARNING DISABILITIES, Issue 2 2008Zara Jane Clarke Accessible summary ,,Eight parents of adults with learning disabilities were interviewed about their,,experience of managing their son or daughter's pain. ,,Parents developed trial and error methods of identifying pain and managing this. ,,Parents reported having mixed experiences of the services their sons/daughters,,had received. ,,Parental carers play a crucial role in the pain management of adults with learning,,disabilities. ,,This research matters to people with learning disabilities because it,,informs professionals of the importance of listening to parental carers' views and,,experiences in the successful management of ill health and pain in situations,,where the sufferer has limited verbal communication. Good practice statement, The results of this study have already been presented to health professionals who work with people with learning disabilities, within the first author's organization, as well as at a conference about pain in people with learning disabilities. Further work is intended to publicize the findings to people with learning disabilities and their carers. Summary There are few measures of pain for people with limited ability to communicate. Eight parents of adults with a known learning disability and associated physical health complaint were interviewed to explore their experience of identifying and managing the pain felt by their children. The parents did not often perceive their son or daughter to be in pain or discomfort, which was an unexpected finding given the sampling strategy. They described, however, specific ways of recognizing pain and would use a trial and error process to determine the cause. Parents had strategies for dealing with pain and reported mixed experiences of service interactions. The emerging themes can be related back to the pain literature and psychological theory. They emphasize the importance of involving parents in pain assessment and represent the first stage of research into a previously unexplored area. [source] Intellectual disability and ill health: a review of the evidenceACTA NEUROPSYCHIATRICA, Issue 5 2010Julian Trollor No abstract is available for this article. [source] Perceptions of child labour among working children in Ibadan, NigeriaCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 3 2006F. O. Omokhodion Abstract Background The adverse effects of child labour on the children's psychological development continue to raise concerns about this public health problem worldwide. Several views have been presented by child health authorities, non-governmental organizations (NGOs) and international agencies. Few studies have focused on the children themselves. This study sought to determine working children's perspective of child labour, its benefits and disadvantages and the working children's perceptions of themselves, and their aspirations for the future. Methods A cross-sectional study was carried out among working children in a large market in Ibadan, south-west Nigeria. Questionnaires were administered to all consenting children. Results A total of 225 children, 132 females and 93 males, participated in the survey. Their age range was 8,17 years. A total of 103 respondents (46%) were currently in school while 117 (52%) were out of school. Five respondents (2%) had never attended school. A total of 104 (46%) thought that children should not work. However, when asked about the benefits of working, 81 working children (36%) felt that work provided a source of income for them, 52 (23%) indicated that it was a way of helping their parents and 39 (17%) thought it was part of their training to be responsible adults. Bad company, ill health and road traffic accidents were the perceived ill effects of child labour. The majority of the children interviewed were aspiring towards artisan trades and very few towards professional or office jobs. A total of 106 (47%) children perceived themselves as less fortunate than their peers. Fifty-five children (24%) thought that child labour was a sign of deprivation. The perception that child labour is a sign of deprivation was more prevalent among child workers whose highest educational attainment was primary school, child workers who had worked for more than 6 months and those whose earnings were small. Conclusion We recommend that school education for children should be a priority even when the harsh economic realities in their families force parents to send them to work outside the home. [source] | |||||||||||||||||||||||||||||||||||||