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1.
Background
Multicultural families and foreign residents are rapidly increasing in Korea. Thus, the proportion of children and adolescents from minority racial/ethnic groups are also increasing, and there are concerns about adolescents who fail to adapt to school and show low academic achievement and poor health status.Objective
This study aimed to investigate influencing factors related to academic achievement among Korean multicultural adolescents.Methods
Cross-sectional data from 2234 Korean multicultural adolescent participants from the 2010–2014 Korea Youth Risk Behavior Web-based Survey were analyzed using multiple regression.Results
Perceived economic status and breakfast frequency affected academic achievement, regardless of gender. Family affluence, satisfaction with sleep time, and lifetime smoking were additional factors in males. For females, depression and frequency of physical school activities were additional factors.Conclusion
The present study suggests that diverse individual factors should be considered, including economic status, health status, and health-related behaviors, to improve multicultural adolescents’ academic achievement.2.
Background
Immunization rates for human papillomavirus (HPV) infections remain low among teenagers despite strong evidence of the effectiveness of vaccines. Physician recommendations of the vaccine are far from universal. Several states have enacted policies that mandate HPV vaccination or distribute educational materials.Objectives
To provide policy makers, physicians, and researchers information on the relative importance of physician recommendations and early state-level policies to promote HPV vaccinations among targeted age groups.Methods
We first use probit models to determine the strongest correlates of immunization in a nationally representative US sample of teenagers. We then use instrumental variable probit models to determine the direct role that physician recommendations play in vaccination using plausibly exogenous physician encounters that are likely not the result of more health-conscious parents seeking out information on the vaccine.Results
We show that children in the targeted age range who are more likely to encounter physicians for reasons other than seeking out the vaccine, such as through mandatory wellness exams or previous asthma diagnoses, are significantly more likely to get the vaccine. There is no consistent evidence that the state policies we analyze have been effective.Conclusion
Encouraging recommendations by physicians may be the most effective path toward increasing HPV vaccination. State-level mandates and policies are yet to exhibit effectiveness.3.
Background
Body dissatisfaction is common among both females and males. Dissatisfaction with the body is a risk factor both for onset of eating disorders and for abuse of anabolic androgenic steroids (AAS). Few studies have however investigated if there are other similarities in respect to self-image or psychiatric symptoms between clinical samples of eating disordered males and males in treatment for negative effects of AAS use.Aim
The aim of this study was to compare two clinical samples, one of males with ED and one of males who used AAS, regarding self-image and psychiatric symptoms.Methods
This study compared males with eating disorders (n?=?13) and males who recently stopped AAS use (n?=?29) on self-image and psychiatric symptoms, using The Structural Analysis of Social Behavior self-questionnaire and a shortened version of The Symptom Check List.Results
The eating disorder group reported significantly lower scores for Self-emancipation and Active self-love and higher scores for Self-blame and Self-hate. Both groups reported serious psychiatric symptoms. The common denominator between groups was serious psychiatric symptomatology rather than negative self-image.Conclusions
The negative self-image profile, especially self-hate, found among males with Eating Disorders may indicate that the studied groups differ in aetiology of the underlying problems. The serious psychiatric symptoms in both groups call staff to pay attention to any thoughts of suicide due to severe depressive symptoms where by specialized psychiatric treatment may be needed.4.
Objective
In recent years, the co-existence in Germany of two parallel comprehensive insurance systems—statutory health insurance (SHI) and private health insurance (PHI)—has been posited as a possible cause of a persistent unequal regional distribution of physicians. The present study investigates the effect of the proportion of privately insured patients on the density of SHI-licensed physicians, while controlling for regional variations in the average income from SHI patients.Methods
The proportion of residents in a district with private health insurance is estimated using complete administrative data from the SHI system and the German population census. Missing values are estimated using multiple imputation techniques. All models control for the estimated average income ambulatory physicians generate from treating SHI insured patients and a well-defined set of covariates on the level of districts in Germany in 2010.Results
Our results show that every percentage change in the proportion of residents with private health insurance is associated with increases of 2.1 and 1.3 % in the density of specialists and GPs respectively. Higher SHI income in rural areas does not compensate for this effect.Conclusion
From a financial perspective, it is rational for a physician to locate a new practice in a district with a high proportion of privately insured patients. From the perspective of patients in the SHI system, the incentive effects of PHI presumably contribute to a concentration of health care services in wealthy and urban areas. To date, the needs-based planning mechanism has been unable to address this imbalance.5.
M. da Boit S. Tommasi D. Elliot A. Zinellu S. Sotgia R. Sibson J. R. Meakin R. M. Aspden C. Carru A. A. Mangoni Stuart R. Gray 《The journal of nutrition, health & aging》2018,22(4):534-540
Objectives
The current study was designed to explore the associations between L-arginine metabolites and muscle mass and function in old age, which are largely unknown.Design
The study used a randomised, double-blind, placebo-controlled design.Setting
The study was carried out in a laboratory setting.Participants
50 healthy older adults [median age 70 years (IQR 67-73); 27 males].Intervention
Participants undertook an 18-week resistance exercise program, and a nutritional intervention (fish oil vs. placebo).Measurements
Serum homoarginine, ornithine, citrulline, asymmetric dimethylarginine (ADMA), NG-monomethyl-L-arginine (L-NMMA), and symmetric dimethylarginine (SDMA), maximal voluntary contraction (MVC) and isokinetic torque of the knee extensors at 30° s-1 (MIT), muscle cross sectional area (MCSA) and quality (MQ) were measured at baseline and after the intervention.Results
No significant exercise-induced changes were observed in metabolite concentrations. There were significant sex differences in the associations between metabolites and muscle parameters. After adjusting for age, glomerular filtration rate and fish oil intervention, citrulline (P=0.002) and ornithine (P=0.022) were negatively associated with MCSA at baseline in males but not females. However, baseline citrulline was negatively correlated with exercise-induced changes in MVC (P=0.043) and MQ (P=0.026) amongst females. Furthermore, amongst males, baseline homoarginine was positively associated with exercise-induced changes in MVC (P=0.026), ADMA was negatively associated with changes in MIT (P=0.026), L-NMMA (p=0.048) and ornithine (P<0.001) were both positively associated with changes in MCSA, and ornithine was negatively associated with changes in MQ (P=0.039).Conclusion
Therefore, barring citrulline, there are significant sex differences in the associations between L-arginine metabolites and muscle mass and function in healthy older adults. These metabolites might enhance sarcopenia risk stratification, and the success of exercise programs, in old age.6.
Sandra U. Morrison Francesca Adler-Baeder Kristen L. Bub Adrienne Duke 《Child & youth care forum》2018,47(1):133-150
Background
Using data from a statewide relationship education (RE) program targeting a diverse adolescent sample, this study examined RE implementation in classroom environments.Objective
The purpose of this study was to explore (1) whether there is a beneficial RE program effect for change in individual attitudes toward sexual delay, (2) whether individual factors—student gender and sexual activity—predict change in attitudes toward sexual delay for students experiencing the intervention, and (3) whether classmate characteristics influence individual change in attitudes toward sexual delay.Methods
This study utilized multilevel modeling procedures to examine both individual- and classroom-level predictors of change in attitudes toward sexual delay.Results
At the individual level, results indicated that females demonstrated more change in attitudes toward sexual delay than males and students who were sexually active demonstrated less change toward sexual delay compared with students who were not sexually active. At the classroom level, both racial composition and the proportion of sexually active classmates influenced individual attitude change. Although students in classrooms with higher proportions of African American peers demonstrated less attitude change toward sexual delay, the proportion of sexually active peers in the classroom appeared to be a more salient aspect of classmate composition.Conclusions
Overall, this study supports the importance of considering both individual characteristics as well as social context when assessing program experience and effectiveness. Implications for future research and practice are offered.7.
Background
Suicide is a leading cause of death among youth. Suicide screening programs aim to identify mental health issues and prevent death by suicide.Objective
The present study evaluated outcomes of a multi-stage screening program implemented over 3 school years in a moderately-sized Midwestern high school.Methods
One hundred ninety-three 9th-grade students were screened in the program. Students who screened positive were referred to mental health services and followed. Suicide-related thoughts and behaviors among 9th-grade students in the school with screening were compared to those of students in a similar school without screening.Results
There was a significant increase in utilization of mental health services among students who screened positive and a decrease in rates of suicidal ideation and attempts among 9th-grade students at the school with screening.Conclusions
This multi-stage screening program shows promise in addressing suicide-related behaviors in schools. Randomized trials are needed to confirm program efficacy.8.
Tina Dorn P. Leenen R. Lindeboom M. Ceelen U. J. L. Reijnders 《Zeitschrift fur Gesundheitswissenschaften》2017,25(2):155-159
Aim
In the Netherlands, preventive child healthcare workers (PCHWs) have an important role in identifying signs of abuse, because they reach virtually all children. A closer cooperation of PCHWs and forensic physicians could improve the detection of child abuse. The aim of the study was to evaluate the use of forensic expertise by PCHWs.Subjects and methods
In November 2013, a survey was distributed among PCHWs employed by the Amsterdam Public Health Service (n?=?221).Results
Forty-nine percent of PCHWs indicated suspicions of physical abuse during the last 6 months (response rate: 43 %). In all, 89 % rated the consultation of forensic physicians as useful. In a 1-year period, only three respondents sought advice from a forensic doctor.Conclusions
Although PCHWs regularly have suspicions of physical child abuse and have a very positive attitude towards consulting a forensic physician, consultation rates are very low. More research is needed to understand barriers to consultation of forensic physicians.9.
Hanna Dauber Oliver Pogarell Ludwig Kraus Barbara Braun 《Substance abuse treatment, prevention, and policy》2018,13(1):40
Background
In western countries demographic changes are leading to an ageing society. Consequently, the number of older adults with alcohol use disorders (AUDs) will rise and the demand of treatment is likely to increase. However, thus far not many older adults with an AUD are seeking treatment and little is known about the efficacy of treatment for older adults. The present study aimed at determining the proportion of older adults with an AUD in addiction treatment, particular characteristics and treatment outcomes of this clientele.Methods
Using data of 10,860 patients with an AUD aged 60 and over that are documented within the national German addiction care system we conducted exploratory analyses with regard to prevalence, sociodemographic, disorder- and treatment-related variables.Results
Overall, we found a low proportion of older patients in treatment due to AUDs, but highly positive treatment outcomes. With regard to sociodemographic and disorder-related characteristics, older females and late-onset patients in particular constitute a unique clientele.Conclusions
The low service utilisation on the one hand but good treatment prognosis on the other emphasise the need to promote treatment seeking among older adults with AUDs. In this context, the special characteristics we found among older patients may contribute to better reach this population and to improve provisions of targeted treatment approaches.10.
Purpose
Two of the crucial components of health care service utilisation are the type of health care services received (government, private, others) and the place visited (same village, another village, another district/town, a metro city, abroad, etc.). The association between health care facilities and gender is important for understanding the disparities between males and females. Thus, the primary objective of this study was to reassess the gender differences in the type and place of health care utilisation.Methods
Data from the second round of the India Human Development Survey (2011–2012) were used for this study. Analysis was done using both bi- and multivariate techniques (multinomial logistic regression).Results
Results indicate an improvement in the female health care-seeking behaviour. We found that females have a higher tendency to visit private health care centres, whereas a higher percentage of males used government health care services for the treatment of both long- and short-term morbidities. Males and females reported visiting health care centres within the village, in another village, in another district/town and in a metro area/abroad for treatment approximately to the same extent.Conclusion
The analysis of the male and female treatment-seeking behaviour revealed a clear picture of proliferating gender neutrality. The increase in the health care-seeking behaviour of women can be considered an upshot of improved female education and increased awareness among males regarding female empowerment. Government interventions in different sectors have also improved the plight of women directly or indirectly.11.
Background
The introduction of vaccination against human papillomavirus (HPV) has increased physicians’ and women’s awareness about the prevention of cervical cancer.Methods
To gain further knowledge about prevention measures against cervical cancer and HPV vaccination in daily practice, 112 physicians were interviewed by means of a standardized questionnaire in an outpatient setting in Mecklenburg–Western Pomerania, Germany.Results
Regardless of specialisation area, the physicians regarded HPV vaccination positively. They expect not only a reduction in human suffering caused by cervical cancer and its prestages but also, because of less need for therapy and monitoring, a reduction in costs. In addition, they expect increasing awareness of cervical cancer prevention and more regular attendance at cervical cancer screening.Conclusions
The majority of interviewed physicians showed a positive attitude toward HPV vaccination and do not expect a trade-off between screening and vaccination.12.
13.
Background
Many adults in Germany do not receive immunizations as recommended. False assumptions about vaccinations and the risk of infectious diseases are important reasons why people fail to receive recommended immunizations.Aim
Our aim was to provide new possibilities to improve vaccination rates among adults. We directed special attention to some newsworthy infectious diseases (e.g. measles, pertussis).Results
Owing to their special range of responsibilities and their numerous medical attendances, occupational health physicians are in a position to improve the immunization rates of adults as well as to collect epidemiologic data of this broad age group.Conclusions
The use of a mobile cart vaccination program in the workplace might increase vaccination rates.14.
Francieli Cembranel Carla de Oliveira Bernardo Silvia Gisele Ibarra Ozcariz David Alejandro González-Chica Eleonora d’Orsi 《Zeitschrift fur Gesundheitswissenschaften》2018,26(3):331-338
Objective
The objective of this study was to estimate the prevalence of indicators of healthy food consumption among older adults with diabetes and/or hypertension and whether or not they occur more frequently than in healthy older adults.Methods
Cross-sectional study with 1656 older adults who participated in the first wave of a longitudinal, population-based study held in Florianopolis, Southern Brazil, EpiFloripa Idoso 2009/2010, using the self-reported diagnosis of diabetes and/or hypertension as exposure variable and indicators of healthy food consumption as outcomes.Results
Only 22.7% (95% CI: 20.1–25.3) of females and 29.6% (95% CI:25.8–33.4) of males eat fruit ≥ 3 times/day and vegetables ≥ 2 times/day. More than one third of the sample had frequent consumption (> 2 times/week) of fats from meat/chicken, fried foods and whole milk.Conclusion
We found that the indicators of healthy food consumption do not differ among older adults with and without diabetes and/or hypertension, indicating no adopting of the secondary prevention measures in the treatment of these diseases.15.
Eman Sameh Mohammed Mostafa Ehab Salah Eshak Amany Edward Seedhom Eman Ramadan Ghazawy 《Zeitschrift fur Gesundheitswissenschaften》2018,26(6):625-630
Aim
Body dissatisfaction is an important component of a variety of prevalent health problems. This study aimed to assess the media influences on body dissatisfaction among female college students.Subjects and methods
This study included a sample of 408 adolescent females who were chosen randomly from Minia University and completed a survey using the the Sociocultural Attitudes Towards Appearance Scale (SATAQ-4) and Body Shape Questionnaire (BSQ) in the period from 1 March to 1 April 2017. In addition, their body mass index (BMI) was measured.Results
It was found that adolescents who showed marked concern with body shape had higher SATAQ-4 scores. The independent variables (BMI, SATAQ total score and its subscales) explained 58% of the variance in body shape dissatisfaction. The most significant predictors of body dissatisfaction were BMI and subjective feelings of media pressure to have an ideal appearance (β?=?0.38 and 0.31, respectively).Conclusion
There was a relation between media influence and body dissatisfaction in this sample of Egyptian female students. Media literacy training could represent a promising approach to eating and body disturbance prevention.16.
Aim
The objective of this study was to assess and compare the prevalence of self-reported unmet healthcare needs (UHN) among Canadian indigenous groups using the 2006 and 2012 Aboriginal Peoples Surveys (APS).Subject and methods
Frequency distributions and cross tabulations were produced to estimate the proportion of indigenous people who reported UHN in 2006 and 2012 and for sub-populations, based on indigenous identity, gender, age, geographic region and urban/rural area. Additionally, frequency distributions were produced for reasons for UHN and types of care needed. Standard errors and confidence intervals were calculated and took into account bootstrap weights.Results
In 2006, 11.65% (CI: 11.04, 12.26) of indigenous people reported UHN, and this proportion significantly increased to 13.74% (CI: 12.88, 14.60) in 2012. UHN varied among indigenous identities; however, only Inuit had a significant difference in UHN between 2006 (10.19%, CI: 9.05, 11.33) and 2012 (14.58%, CI: 12.57, 16.59). Individuals aged 18–34 years, females, and those in the Prairies and Territories and in urban areas had significant differences in UHN. The most common reasons for UHN were related to availability, and the majority of respondents reported needing care for physical health problems.Conclusions
Further research is warranted that examines the association between general factors related to UHN and indigenous-specific factors. Additionally, assessing how chronic disease impacts UHN will provide information on reasons for UHN (e.g., healthcare system-related versus personal circumstances).17.
Aim
A beneficial classroom climate is vital for school achievements, health, well-being, and school satisfaction. However, there is little knowledge as to how the classmate characteristics and class composition are related to the level of a perceived messy and disorderly classroom climate and whether the estimated relationships vary between different groups of children. The aim of the study was to explore the relationship between classmate characteristics as well as class composition and children’s perceived classroom climate.Method
Data from a cross-sectional survey administrated in 71 classes including 1,247 children in a mid-sized Swedish city were used. The analyses were conducted using multilevel models.Results
A class with a higher proportion of girls was associated with a lower likelihood of perceiving the classroom climate as messy and disorderly. Moreover, a higher proportion of immigrant children in a class was associated with a perception of a messier and disorderly classroom climate among non-immigrant children, but not among immigrant children themselves.Conclusion
Classmate characteristics and class composition deserve more research attention and can be important considerations when aiming to improve the classroom climate and children’s well-being in general.18.
Caterina Tsiata Vassilis Tsekouras Antonis Karokis John Starakis Harry P. Bassaris Mihalis Maragoudakis Athanasios T. Skoutelis 《Disease Management & Health Outcomes》2001,9(1):23-32
Objective
To compare various strategies for antibacterial administration in terms of patient outcomes, overall costs and quality of care provided.Design
Prospective, nonblind, randomized, clinical study.Setting
Tertiary care hospital in Greece from November 1995 to June 1996.Patients and participants
458 patients admitted to the internal medicine department who received antibacterial therapy for infectious diseases.Methods
Patients were randomized into 4 different antibacterial administration policies defined by various levels of restriction control. Efficacy and resource use data were obtained from clinical study case report forms, the hospital financial database and physician expert opinion. Outcomes included complete infection control, disease improvement, unchanged patient condition, infection needing surgical treatment, and death. Direct medical costs were estimated. The perspective adopted was that of the healthcare system (hospital budget; third-party payor). Cost-minimisation analysis was based on cost per patient treated.Results
382 eligible patient records examined showed no significant difference in clinical outcomes among patient groups. Baseline analysis showed the strict antibacterial control policy to produce statistically significant differences (p < 0.05) in various resource parameters. Accordingly, compared with all other patient groups, total cost per patient for that strategy was reduced by 26 to 30%. Also, patients in that group received fewer drug doses and underwent fewer treatment days, and antibacterial treatment was modified in fewer cases for these patients.Conclusion
Strict control of antibacterial administration in this hospital setting achieved lower direct medical costs with no harmful effect on patient outcomes or quality of care provided. Such a policy appears to be a useful option for both physicians and administrators.19.