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Health promotion in motion: improving quality of life for persons with neurogenic bladder and bowel using assistive technology.

The neurogenic bladder and bowel lead to many complications in individuals with spinal cord injury (SCI). Management of these neurological complications is a multidimensional challenge for persons with SCI and their caregivers, and can affect the person medically, economically, socially, and personally. This may result in social isolation, poor self-image, and overall decreased quality of life (QOL). When facing this challenge, nurses working with persons with SCI must expand their practice to include more than traditional preventive care. A newly available technique for promoting health with a neurogenic bladder and bowel is the VOCARE Bladder and Bowel Control System. Sixteen persons with SCI who received this system were interviewed by telephone and asked for their recollections of health and QOL pre-operatively in relation to bladder and bowel care and to rate changes in their QOL post-implant. Post-operatively, the recipients reported improved health, a decrease in costs of management of their neurogenic bladder and bowel, increased independence leading to less social isolation, increased sense of control, increased feelings of self-worth, and overall improvement in QOL. These outcomes illustrate the global impact that can be made on the lives of persons with SCI by health services that go beyond prevention of complications and into the realm of health promotion.

Defecation↗

Promoting health among perimenopausal women through diet and exercise.

PURPOSE: To review the literature related to health promotion during the perimenopausal years and suggest methods for integrating those changes into the lifestyles of women in primary care. DATA SOURCES: Selected scientific literature and guidelines for exercise programs. CONCLUSIONS: The transition into perimenopause presents an opportunity for addressing health promotion issues, such as diet and exercise. As a woman senses perimenopausal changes, health awareness emerges. Such personal insight motivates the woman to implement lifestyle changes. IMPLICATIONS FOR PRACTICE: Considering the average women will spend approximately one third of her life past menopause, a concerted effort is needed to ensure her well-being. Diet and exercise represent two modifiable areas of concern for perimenopausal women. Dietary selections of phytoestrogens, calcium, fiber and fat along with exercises plans are relatively simple interventions to begin the process of change.

Cardiovascular Diseases↗

Promoting health: intervention strategies from social and behavioral research.

This report, released by the Division of Health Promotion and Disease Prevention within the Institute of Medicine at the National Academy of Sciences, asserts that behavioral and social interventions such as health promotion and disease prevention offer great promise to reduce disease morbidity and mortality in the United States, but as yet their potential has not been recognized or tapped by the federal government. Two overarching recommendations are the need to address generic social and behavioral determinants of health rather than the clinical causes of disease and death, and the need to intervene at multiple levels of influence including the individual, interpersonal, institutional, community, and policy levels. Seven recommendations for intervention strategies, nine recommendations for research, and three recommendations for funding are offered.

Behavioral Sciences↗

The case for health promotion programs containing health care costs: a review of the literature.

A review is conducted of major studies dealing with the impact of work site health promotion programs on health care costs. Inconsistent results were produced due to measurement, design, and sampling problems. A study of Blue Cross-Blue Shield of Indiana employees provided the best evidence of program-related health care cost reductions. Suggestions are made which, if implemented, should enable researchers to more confidently attribute cost reductions to health promotion program activities.

Adult↗

Health risks and health promotion for older women: utility of a health promotion diary.

Elderly women require health screening and health promotion services from nurses and other health care providers. Nurses serving this population require knowledge of age-specific health screening and health promotion services. A case study from a geriatric nurse practitioner's practice demonstrates the complexity of these activities. A diary of such services can help nurses focus on elderly women's needs for health promotion interventions.

Aged↗

Promoting health among teenagers.

The need for health promotion programmes geared to adolescents has never been more acute. Today's youth lives in a "throw away society" characterized by an impermanence of both objects and human relations--which works counter to traditional health values and practices. The result has been a rise in teenage drug-addiction, suicide, abortion, delinquency and alcoholism. How can we make nurses and health services more accessible to adolescents? Below, Angela Gillis describes a model for adolescent health promotion and provides some practical suggestions for dealing more effectively with this age group.

Adolescent↗

Promoting health in the construction industry?

The construction industry has long been regarded as a high-risk industry in relation to health and safety issues. The purpose of this research was to investigate the extent of occupational health and safety provision within the residential development sector of the construction industry in Britain. An additional aim was to gauge the sectors' attitudes toward health promotion. Data were collected using a self-completed questionnaire that was sent to 200 residential developers; a 46% response rate was achieved. The results revealed a high level of knowledge of health and safety legislation; occupational health provision in the sector is low, but a strong appreciation was demonstrated of the value of such services. There was a low level of health promotion policy development in relation to the areas of alcohol, smoking, and skin cancer.

Accidents, Occupational↗

Health promotion strategies for spousal caregivers of chronically ill elders.

Although there is a growing body of literature on family member caregivers of chronically ill elders, there is no systematic body of knowledge for promoting health in this vulnerable population. Spousal caregivers are especially vulnerable because of the relentless demands of caregiving combined with the grief process associated with changes in role expectations. To date, nursing interventions have focused more on a crisis orientation. This article focuses on the state of the science of spousal caregiving, identifies gaps in our current knowledge, and suggests possible health promotion strategies for further exploration.

Aged↗

Using franking machine messages to promote health.

Over a 12-month period, the Oxfordshire Health Unit experimented with the addition of four different health promotion messages to all franked mail leaving the unit. Each message was evaluated by enclosing a return questionnaire in a sample of the mail. More than half the respondents read the messages (before seeing the questionnaire). Of all those who read the messages, 40 per cent said they would take some action as a result. Four out of five people thought the idea a good one. Using the evaluation results--including observed differences between the messages--some guidelines were created on the use of this relatively cost-effective form of health promotion.

Acquired Immunodeficiency Syndrome↗

Health promotion in acute care settings.

Promoting health in a hospital setting is a realistic goal for the acute-care nurse. Nursing strategies such as lifestyle assessment, health teaching, and effective communication can be used to make decisions about health practices. Nurses should be alert to lifestyle-induced diseases and risk factors that precede these diseases. Hospitals have an important role in providing individuals with health information. Nurses can play integral parts in helping the hospitalized patients achieve better health by incorporating health promotion strategies in everyday clinical practice.

Behavior Therapy↗

Small taxes on soft drinks and snack foods to promote health.

Health officials often wish to sponsor nutrition and other health promotion programs but are hampered by lack of funding. One source of funding is suggested by the fact that 18 states and 1 major city levy special taxes on soft drinks, candy, chewing gum, or snack foods. The tax rates may be too small to affect sales, but in some jurisdictions, the revenues generated are substantial. Nationally, about $1 billion is raised annually from these taxes. The authors propose that state and local governments levy taxes on foods of low nutritional value and use the revenues to fund health promotion programs.

Candy↗

The adolescents training and learning to avoid steroids program: preventing drug use and promoting health behaviors.

BACKGROUND: Use of alcohol and other illicit drugs by adolescent male athletes is a significant problem. Participation in sports may encourage use of drugs that enhance athletic performance, especially anabolic steroids (AS). Because, to our knowledge, no other intervention has successfully altered substance abuse by athletes, we developed and assessed the efficacy of a team-centered, sex-specific education program designed to reduce adolescent athletes' intentions to use and use of AS and alcohol and other illicit drugs. METHODS: We studied 31 high school football teams that comprised 3207 athletes in 3 successive annual cohorts (1994-1996). The intervention included interactive classroom and exercise training sessions given by peer educators and facilitated by coaches and strength trainers. Program content included discussion of sports nutrition, exercise alternatives to AS and sport supplements, and the effects of substance abuse in sports, drug refusal role-playing, and the creation of health promotion messages. Questionnaires assessing AS, the use of sport supplements and alcohol and other illicit drugs, and potential risk and protective factors were administered before and after the intervention (before and after the football season) and up to 1 year after the program. RESULTS: At season's end, intentions to use (P<.05) and actual AS use (P<.04) were significantly lower among students who participated in the study. Although AS reduction did not achieve significance at 1 year (P<.08), intentions to use AS remained lower (P = .02). Illicit drug use (marijuana, amphetamines, and narcotics) was reduced at 1 year, whether alcohol was included (P = .04) or excluded (P = .02) from the index. Other long-term effects included fewer students reporting drinking and driving (P = .004), less sport supplement use (P = .009), and improved nutrition behaviors (P<.02). CONCLUSIONS: Use of alcohol and other illicit drugs and associated harmful activities can be prevented with a sex-specific, team-centered education. School athletic teams provide an optimal environment in which to provide drug prevention and health promotion education.

Adolescent↗

General practitioner and health promotion: what patients think.

Although there has been growing interest in general practitioners' participation in promoting health, little is known about the attitudes of their patients. Thus we sent a copy of a self administered questionnaire (the Health Survey Questionnaire) to 3452 patients aged 17-70 who were registered with two practices in north west London. Questions about attitudes to and perceptions of general practitioners' interest in weight, smoking, drinking, and fitness problems were included. The patients were also asked whether they thought that they had a problem in any of these areas. The response rate was 72%. Of those who responded, the proportions who thought that their general practitioners should be interested ranged from 72% in the case of fitness to 83% for weight, but only 38% thought that general practitioners had in fact been interested in fitness and only 48% thought so about weight. Forty one per cent of the respondents thought that they had a fitness problem, 42% a weight problem, and 59% of the smokers thought that they had a smoking problem. Four per cent of respondents stated that they had a drinking problem. Of those patients who said that they had a problem, the proportions who thought that their general practitioners had seemed interested ranged from 43% for fitness to 69% for smoking. The findings of this study suggest that greater participation by general practitioners in health promotion would be well received by most patients and that currently there may be considerable discrepancies between patients' expectations and their perception of their general practitioner's interest in these areas of preventive medicine.

Adolescent↗

Evaluation of the total health promotion plan in Japan, as related to health promotion effects and the prevention of lifestyle-related diseases.

The present study was undertaken to investigate whether health-promoting activities in Japan are useful for preventing the development of lifestyle-related diseases and for promoting health. One thousand, one hundred and sixty-seven Japanese workers were given a medical health check and had their maximum oxygen uptake measured according to the total health promotion plan (THP) protocol, which the Japanese Ministry of Health, Labor and Welfare is actively planning. Correlations between the maximum oxygen uptake and performance on health check items were statistically evaluated. The maximum oxygen uptake was positively correlated with the duration of a worker's ability to stand on one leg, and on the frequency with which they performed upper body weight lifting. In addition, the maximum oxygen uptake was negatively correlated with age, body weight, thickness of subcutaneous fat in the upper arms and shoulders, body fat ratios, body mass index (BMI), maximum and minimum blood pressures, resting heart rates, and total cholesterol levels. Moreover, the maximum oxygen uptake tended to be significantly higher in both male and female subjects who exercised regularly. It is suggested that maximum oxygen uptake and regular exercising play important roles in the inhibition of risk factors for ischemic heart diseases. Therefore, we believe the THP can play an important role in the primary prevention of lifestyle-related diseases. The purpose of the THP in Japan is to promote the achievement of healthy lifestyles in individual subjects, both from mental and physical perspectives. These results suggest that such efforts may help prevent the development of lifestyle-related diseases.

Adult↗

A strategy for health promotion among unemployed people in Japan.

OBJECTIVE: To describe the unemployment situations in Japan and to propose a strategy for promoting health among unemployed persons. METHODS: The published government reports and the actual circumstances were analyzed to make an action program on the basis of social and occupational situations in Japan. RESULTS: The unemployment rate was low as compared to that of other countries because of two major reasons. One was that the workers were absorbed in minor or family corporation despite unsatisfactory job. The other was based on the financial support system for adjusting employment by the government. In an action program for promoting health of the unemployed persons, the same health care system as workers should be applied to the unemployed in the regional center of occupational health.

Health Promotion↗

Survey of health promotion organisational arrangements and levels of service for health promotion.

This study was promoted by the Executive Committee of the Association of Directors of Public Health when faced with the need to examine the organisation of and quantify health promotion arrangements in the Health Districts of England and Wales, resulting from the concerns of many of the members of the Association. These concerns were based on the views that health promotion is a key purchasing function of the District Health Authorities and must be appropriately and effectively structured and adequately resourced if the requirements of The Health of The Nation are to be fulfilled. There are many aspects to health promotion work and the delivery of health promotion services which will need addressing in the new commissioning environment of the NHS. A need was recognised for up-to-date data about health promotion services to inform a necessary debate about future arrangements, since it appeared that organisational change was being driven by influences unconnected with the possibly most appropriate structure of health promotion departments and which relate to a contemporary view of health promotion. Reducing the size and cutting the cost of commissioning authorities was perceived as one of the most important influences. A postal questionnaire survey to all Health District and Regional Health Authorities in England and Wales was conducted covering questions about the present organisational arrangements and levels of service, and soliciting the opinions of those canvassed. A total of 185 District and Regional Health Authorities, effectively reduced to 171 because of mergers, was sent questionnaires, of which 141 were completed and returned, giving a response rate of 82.5%.(ABSTRACT TRUNCATED AT 250 WORDS)

Contract Services↗

The new woman: health-promoting and health-damaging behaviors.

Compared with their mothers, contemporary women are better educated, live alone more of their adult lives, and participate in the labor force more consistently throughout their lives. Most studies of the New Woman have focused on the effects of the configuration of her roles on her health and health-related behavior. Few have considered both the influence of women's roles and the broader context of their lives on their health. Moreover, investigators have devoted little attention to the health behavior patterns of the New Woman, despite the demonstrable impact of health-related behaviors on mortality and morbidity. The present study was designed to test models relating women's roles, gender role norms, social demands and resources, and health-promoting and -damaging behaviors. Women who resided in middle-income and racially mixed neighborhoods (N = 659) were interviewed in their homes. The women were a mean age of 32.7 years and had an educational level of 14.2 years. Approximately 57% were married or partnered, and 76% reported some level of employment outside the home. Women who had fewer life stressors and were better educated performed more health-promoting behaviors. Women who experienced more stressors, were less well educated, had more contemporary attitudes toward women, were not partnered, or experienced depressed mood engaged in more health-damaging behaviors. These results underscore the importance of considering women's social context in health promotion efforts and as a deterrent to health-damaging behaviors.

Adolescent↗