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At least 1,081 records · Page 60Linked to original sources

PubMed1994

Neighborhood context and residential mobility.

This paper extends the search for neighborhood contextual effects to residential mobility. We propose that neighborhood consists of subjective and objective domains, both of which are crosscut by substantive (social/physical) and temporal (current/change) dimensions. Measures of neighborhood characteristics consistent with our conceptualization are used to estimate the impact of context on mobility thoughts and on actual mobility in a sample of Nashville residents. Although individual statuses such as age and tenure remain important antecedents of mobility, subjective features of neighborhood context also play a role--albeit limited and indirect--in the decision to move or to stay.

Adolescent↗

PubMedDate not supplied

An areawide cancer reporting network.

A cancer Surveillance Program was formed in 1970 to provide a mechanism for the early identification of some 22,000 cancer cases that are diagnosed annually among the large and varied population of Los Angeles County. The program's rapid reporting procedures facilitate early access to patients for interviewing and specimen collection. Routine review of all reports of microscopically diagnosed malignancies in hospitals throughout the county and screening of all of the county's death certificates provide virtually complete data on cancer incidence in the county. Case reports include information on age, ethnic group, birthplace, residence, religion, marital status, occupation, and industry. Continuing analysis of this information has led to the development of epidemiologic studies of several factors which may have an etiological relationship to human cancer. Among these factors are genetic susceptibility, exposure to air pollutants and industrial carcinogens and possible viral transmission.

California↗

PubMed1993

[The medical care and vaccinal coverage of the children of Filipino mothers].

We present data on the access to health care services and vaccination coverage of a sample of children born to Filipino mothers in the city of Barcelona (Spain). The sample was obtained by snowball sampling from the community reference centers for the identified migrant Filipino population. Access to public health care services is much lower for this population than for the whole population, which causes use of private services to compensate for this shortcoming. The causes are related to the residence and working status of a segment of this migrant population. Vaccination coverage for two and three year olds was 68% for measles, mumps and rubella, 52% with four doses for polio, diphtheria and tetanus and 48% with four doses for pertussis. Vaccination coverage is slightly higher for four and five year olds, with a coverage of 73.9% for measles, 69.5% for mumps and rubella and 73.9% with four doses for polio, diphtheria and tetanus, and 69.5% with four doses for pertussis. Vaccination coverage of 6 to 14 year old children is much lower. It is possible that real vaccination coverage is higher, but vaccination cards or records have been lost by the families. These results are much lower than global vaccination levels for the city, but comparable to those described in the inner city district where most of these children live. The causes of this situation, their implications and how to improve them are discussed.

Adolescent↗

PubMed1993

Dynamic aspects of prescription drug use in an elderly population.

OBJECTIVE: This study explores longitudinal patterns in outpatient prescription drug use in an elderly population. DATA SOURCES/STUDY SETTING: Enrollment records and prescription drug claims were obtained for a sample of elderly Pennsylvanians (N = 27,301) who had enrolled in the Pharmaceutical Assistance Contract for the Elderly (PACE) program at any time between July 1984 and June 1987. Study Design. The study tracks monthly prescription fill rates for sampled PACE beneficiaries from their initial enrollment month through disenrollment, death, or the end of the study (whichever occurred first). We specify two-part multivariate models to assess the effect of calendar time, length of time in the PACE program, and progression to disenrollment or death both on the probability of any prescription use and on the level of use among those who filled at least one prescription claim per month. Control variables include age, gender, race, income, residence, and marital status. DATA COLLECTION/EXTRACTION METHODS: Data were extracted from administrative files maintained by the PACE program, checked for errors, and then formatted as person-month records. PRINCIPAL FINDINGS/CONCLUSIONS: We find a strong positive relationship between drug use and the length of time persons are PACE-enrolled. Persons whose death occurs within a year have much higher prescription utilization rates than do persons whose death is at least a year away, and the differential increases as death nears. Persons who fail to renew PACE coverage use significantly fewer prescription drugs in the year prior to disenrollment. Holding age and other factors constant, we find that average levels of prescription use actually declined over the study period.

Aged↗

PubMedDate not supplied

Predictors of type of vascular access in hemodialysis patients.

OBJECTIVE: Complications from vascular access account for 15% of hospital admissions among US hemodialysis patients. Complications are less frequent with arteriovenous fistulas than with synthetic grafts. We assessed clinical and nonclinical predictors of whether patients with end-stage renal disease (ESRD) starting hemodialysis receive a fistula or graft. We also investigated changes in practice between 1986-1987 and 1990. DESIGN: Cross-sectional study. SETTING: United States hemodialysis population. PATIENTS: Random, national samples of ESRD patients who started hemodialysis in 1986-1987 (n=2741) or 1990 (n=1409) from United States Renal Data System Special Studies. MAIN OUTCOME MEASURE: Type of permanent vascular access (arteriovenous fistula vs synthetic graft), analyzed using multivariate logistic regression. RESULTS: Clinical and demographic factors as well as socioeconomic status, region of residence, and year starting hemodialysis predicted the type of vascular access. Overall, 56% of patients had grafts 30 days after starting dialysis, but graft use increased from 51% in 1986-1987 to 65% in 1990 (adjusted odds ratio [AOR], 1.67 for 1990 vs 1986-1987; 95% confidence interval [CI], 1.43-1.95; P<.001). Graft use (relative to fistula) varied by region of residence (ranging from AOR, 0.20; 95% CI, 0.14-0.28; P<.001 [New England], to AOR, 2.69; 95% CI, 2.03-3.58; P<.001 [East South Central]; both relative to the national average). CONCLUSIONS: This national study documents large variations in the relative use of fistulas and grafts and a trend away from fistulas. The prevalence of comorbid conditions fails to explain these findings. Presentation and referral of patients early in the process of their ESRD, teaching surgeons to place fistulas, and training dialysis nurses to access fistulas may increase their use.

Arteriovenous Shunt, Surgical↗

PubMedDate not supplied

Anxiety and depression in adult untreated celiac subjects and in patients affected by inflammatory bowel disease: a personality "trait" or a reactive illness?

BACKGROUND/AIMS: Psychiatric illness and psychological behavioral pathologies may be present in celiac disease and in IBD patients. In these subjects anxiety and depression could be a main cause in the reduction of the compliance to the treatment. Aim of our study was to carry out a psychometric evaluation using appropriate means to determine the level of anxiety and depression and to distinguish between "state" and "trait" forms. The correction of such disturbances would improve the quality of life and the patients' compliance to treatment. MATERIAL AND METHODS: Sixteen adult celiac patients, 16 subjects affected by IBD and 16 healthy control subjects matched for sex, residence and marital status were studied by psychological assessment. All the subjects were given the State and Trait Anxiety Inventory and the Ipat Depression Scale Questionnaire. RESULTS: State anxiety was present in a higher percentage of celiac subjects and in the patients affected by IBD with respect to the healthy controls. Anxiety as a trait was present in a similar percentage in all the subjects evaluated. Depressive syndrome was present in a percentage of celiac patients statistically superior versus the healthy control group (p < 0.01). CONCLUSION: Our results shown that anxiety is present as a "reactive" form and personality trait anxiety has no effect in celiac and IBD patients. As regard depression, our data confirm a possible linkage between brain functions and malabsorption.

Adjustment Disorders↗

PubMed1996

[Nutrient and food consumption by ages and gender in school children from the Community of Madrid (CAENPE)].

UNLABELLED: The objective of the present work was to know the consume of foodstuffs and nutrients among schoolchildren in the Madrid Autonomous Community and also the relative contribution of each group of foodstuffs to the overall intake of macronutrients. This study had a sectional observational design involving 2,608 children (51% males and 49% females) with ages ranging from 6 to 14 years who were randomly recruited from conglomerate of schools, according to socio-economic status and rural/urban residence. The inquiry on nutrients in 4 non consecutive days was analyzed (2 "24 hour-recall" and 2 "intake recall"). RESULTS: a) the consume of proteins, lipids, and carbohydrates represented 17%, 43% and 40% of the total caloric value, respectively; b) the intake of meats, sausages, sweets, tidbits, and processed products was very high. This fact is in origin of the excessive total and saturated lipid intake; c) there was a scarce intake of vegetables, cereals and potatoes among children of all ages and dairy products in children older than 12 years; d) the intake of legumes, eggs and fruits was appropriate; e) males consumed proportionally higher amounts than females of the following groups of foodstuffs: cereals, sweets and tidbits. The consume of meat, sausages, fish, eggs, potatoes, dry fruits and dairy products was similar in both sexes. Females consumed proportionally more fat foodstuffs, vegetables, fruits, legumes and processed products; f) females consumed a diet with a still higher lipid and protein content than males. These findings can serve as a basis to develop educational guidelines with a practical impact on family and school menus.

Adolescent↗

PubMed1997

The significance of selected epidemiologico-clinical factors in the prevalence of the Helicobacter pylori infection in young males.

A serological diagnosis (ELISA test) was carried out of infections by Helicobacter pylori in 1200 young males (recruits in the Polish Army) and the influence of selected epidemiologico-clinical factors (civil status, place of residence, profession, economical conditions, tobacco smoking, consumption of alcohol, diseases of the parodontonium, nutritional habits) on the prevalence of the infection was studied. Specific antibodies were detected in 228 (19%) of the persons tested. Of the eight factors analyzed, only three parodontium diseases, tobacco smoking and place of residence (of decreasing importance in that order), had a statistically significant relationship to infection by Helicobacter pylori in young males.

Adolescent↗

PubMedDate not supplied

[Social-hygienic evaluation of the prevalence of sleep disorders].

According to the data of interviews of 4000 subjects, the incidence of sleep disorders is about 30% in different regions of Russia; for the age group of 20 to 24 years it is 5%, for subjects aged over 60-40%. Fourteen percent of men and twenty-four percent of women of capable age (30-59 years) complain of insufficient sleep. The quality of sleep depends on age, sex, constitutional features (excessive or insufficient body weight), and social characteristics (frequent change of working places, change of place of residence (migrations), family status, and microclimate in a family. Health status is the main factor underlying the formation of various sleep disorders. Subjects suffering from sleep disorders earlier develop age-specific diseases, this indicating that biological age-specific processes are accelerated in this patient population.

Adult↗

PubMed1995

Preventive dentistry in Illinois.

Success in preventive dentistry requires much more than community water fluoridation, dental sealants, fluoride supplements and dental health education. The scope of preventive dentistry should include oral cancer prevention, orofacial injury control, craniofacial anomalies, malocclusion, and the early detection of systemic disease with oral manifestations. The Division of Dental Health has developed preventive programs to address a majority of these health problems. The State of Illinois can be considered in the forefront of preventive dentistry. It has more than 85% of its population served by optimally fluoridated drinking water, 75,000 children participating in fluoride mouthrinse programs, established dental sealant programs and mouthguard programs, and the availability of innovative programs that address a wide variety of oral health concerns. These programs and others being conducted by the Illinois State Dental Society and in private dental offices are providing a significant improvement in the oral health status for all residents of Illinois.

Comprehensive Dental Care↗

PubMed1976

1974 Arizona P.A.C.E. participation.

Members of the Arizona State Society for Medical Technology were contacted to ascertain their knowledge of the P.A.C.E. program as well as to obtain release of the transcripts for those who participated during 1974. Observations regarding reported credits were noted. The Analysis of Variance test with Scheffe comparison was utilized to determine if any characteristic accounted for the difference in total continuing education hours reported. It was concluded that residence location, marital status, sex, age, degree level, length of membership in ASMT, years experience, employment extent, place of employment, and number of beds at place of employment had no significant effect on the total hours reported. A significant difference in total hours reported was noted for those individuals who reported either CEU or college credits. A significant difference was also noted in the total hours reported with respect to job description.

Arizona↗

PubMed2006

Oral health in Florida nursing homes.

OBJECTIVES: The purpose of this study was to measure the oral health and hygiene status among 265 South Florida nursing home residents aged between 45 and 98 years. METHODS: The oral health and hygiene status of the residents were assessed by noting the presence of calculus, caries, gingivitis, cheilitis, apthous ulcer, dry mouth and red or white lesions. RESULTS: The incidence of nursing home residents with calculus was 79.6% and the remaining 20.4% were edentulous. More than half of residents had oral problems (50.6%) the commonest was gingivitis (36.6%), followed by caries (26%) and tooth fracture (15.9%). Almost half the residents wore dentures (47.2%). Statistical analysis was conducted using analysis of variance (P-values). Ageing of the residents was statistically correlated to a worsening of oral hygiene status (P<0.0066), absence and presence of one or two dentures (P<0.0034) and a loss of teeth (P<0.0001). CONCLUSIONS: The ageing of residents is correlated to increasing oral health problems and the loss of teeth. Oral health neglect affects almost all of the nursing home residents. Care providers should receive education and training from dental hygienists to improve the standard of oral hygiene and health of the elderly.

Age Distribution↗

PubMed1988

The effect of income on selenium intake and status in Utah County, Utah.

Foodstuffs produced and/or purchased locally were analyzed for Se. The effect of income and gender on Se intake and status of Utah County residents was evaluated by measurement of the following indicators: erythrocyte (RBC) and plasma Se concentration, and activity of Se-glutathione peroxidase (Se-GSH-Px) (EC 1.11.1.9) in RBCs, platelets, and plasma. A Random Digit Dialing procedure was employed to stratify subjects according to gender and annual family income (less than +10,000, +10,000-20,000, greater than +20,000) in a 2 x 3 factorial design, seven subjects per cell. The weekly consumption of 44 foods shown to contribute over 90% of the Se intake of U.S. subjects was recorded for each study participant. The estimated minimum daily intake for this sample was 76.0 +/- 4.5 micrograms Se/day (mean +/- SEM). Available grain products are not produced locally, and their Se content is lower than average values reported by the U.S.D.A. Locally produced meat and dairy products had higher than average Se contents. In spite of lower grain Se and higher meat Se concentrations, subjects in this study derived more Se from grain and dairy products, and less from meat products than did subjects in a nationwide sample. The Se status of Utah County residents is similar to several other populations in the United States. There were no significant differences in Se status or intake due to gender or income. The results suggest that consumption of other foods produced in a "high Se" area can maintain Se intake and status in spite of reduced consumption of meat products generally viewed as more reliable sources of dietary Se.

Adult↗

PubMed2006

Predictors of antiviral therapy in a post-transfusion cohort of hepatitis C patients.

INTRODUCTION: In the past, antiviral therapy has been given to 15% to 30% of patients infected with hepatitis C virus (HCV). The efficacy of therapy has recently improved with the addition of ribavirin and pegylated interferon. The aim of the present study was to identify the clinical, socioeconomic and health-system predictors of antiviral treatment for HCV. METHODS: A retrospective analysis of compensation claims data of patients who acquired HCV through blood transfusions between 1986 and 1990 was performed. The patients consisted of 2456 Canadian HCV-positive individuals. The authors reviewed narrative comments from physicians, and constructed univariate and multivariate logistic regression models, using receipt of antiviral therapy with interferon or interferon/ribavirin as the primary outcome. RESULTS: Of the 2456 patients, approximately 30% appeared to be eligible, but only 16% received treatment. Univariate analyses suggested that the disease severity, age, HIV status and province of residence were associated with the likelihood of receiving treatment (P<0.01). The final, multivariable model indicated that in patients with HCV: intermediate disease severity (eg, fibrosis, P<0.0001); middle age (P<0.0001); HIV-negative status (P<0.0001); and province of residence (Quebec, P<0.0001; and Saskatchewan, P<0.0001) were independent predictors of treatment. Narrative comments of physicians emphasized the importance of age, HIV status and patient preferences in clinical decision-making. DISCUSSION: Given the efficacy and cost-effectiveness of current antiviral therapy, treatment rates of HCV patients may be suboptimal. Further work is required to understand barriers to treatment related to geography, organization of medical care, age, medical provider and patient preferences.

Adolescent↗

PubMed1999

Rural health status: what do statistics show that we don't already know?

Arguably the policies and programs designed to bring about improvements in the health status of rural and remote residents have been limited by the absence of systematic statistical data about health status and its relationship with place of residence. The Australian Institute of Health and Welfare addresses this problem in the recent report Health in rural and remote Australia. The report compares the health status, health risk factors and preventative measures, and health resources for rural, remote and urban areas. The data highlights that people in rural and remote areas of Australia have poorer health status than their metropolitan counterparts on several counts. While further work is required, the report provides a useful and important basis for identifying and monitoring the pattern of health status and resource availability in rural and remote Australia.

Australia↗

PubMed1994

The vaccination status of aboriginal children in the North Coast Health Region of New South Wales.

OBJECTIVE: To determine the vaccination status of Aboriginal children resident in the North Coast Health Region of NSW. DESIGN: Cross-sectional descriptive study. SETTING AND PARTICIPANTS: The vaccination status of Aboriginal children aged 4 months to 11 years and resident in selected villages/isolated communities, small and large towns in the North Coast Health Region of NSW was determined by review of vaccination records. Data were obtained from general practitioners, the Aboriginal Health Service, Community Health Centres and Local Government Councils. MAIN OUTCOME MEASURES: Vaccination status according to the childhood immunisation schedule recommended by the National Health and Medical Research Council, defined as fully or partially documented, with a generous lag time. RESULTS: The study population comprised 1179 children--55% of the estimated Aboriginal population under 12 years of age in the North Coast Health Region. Data collection on Sabin vaccine was incomplete and was not included in the analysis. Of 1094 children whose records were analysed, 9% had fully documented and 27% fully or partially documented evidence of up-to-date vaccinations. For measles vaccination, 28% of children aged 18 months or more had fully documented and 35% fully or partially documented evidence of vaccination. There was no fully documented evidence of any vaccinations for 52% of children. CONCLUSION: The vaccination status of Aboriginal children in the North Coast Health Region is poor. The 1989-1990 National Health Survey showed overall vaccination rates for NSW and Australia to be more than twice those found for this population.

Child↗

PubMed2006

Examining the physician's role with assisted living residents.

In response to the rapid growth of the assisted living (AL) residents, this article considers the resulting range of roles, opportunities, and challenges physicians may face as increasing numbers of their older adult patients choose residence in AL facilities. The problem is framed by providing an overview of the AL industry and reviewing AL resident demographics and health status characteristics. The discussion section examines the pervasive involvement of physicians with AL residents, reviews professional position statements on health care in AL, and reviews the emerging AL-focused clinical literature. In conclusion, the paper proposes key elements of a research agenda including establishing baseline physician-AL activity levels, physician collaboration with mid-level practitioners, and exploring physician involvement in chronic care and health promotion in AL.

Activities of Daily Living↗

PubMed1978

Is nonmetropolitan America being repopulated? The evidence from Pennsylvania's minor civil divisions.

We analyze population change and net migration, by age and sex, from 1940 to 1970, for 1,834 Nonmetropolitan Pennsylvania Minor Civil Divisions (MCD's) classified by residence, population potential, socioeconomic status, and distance from metropolitan centers. Our analysis indicates, as expected, reconcentration of residents from both urban and remoter nonmetropolitan localities into exurban peripheries 25 to 35 miles for metropolitan centers. Since 1960, however, a "turnaround" appears in many truly rural tracts, which have been experiencing an influx or retention of persons 35 years of age and older. Statistical explanations are strongest for males in poor, isolated places, weakest for more accessible, socioeconomically advanced places and their female inhabitants. Throughout the study period and area, nonurban MCD's register more positively than the rural.

Adolescent↗