Population health

Social determinants have an impact on patients' access to care and on their health at any age. Young adults are a population at risk of being affected in their health because of a lack of social protection or unavailability of healthcare system adapted to their specific needs. Primary healthcare providers need to identify that window of social vulnerability in order to avoid a discontinuation in healthcare and to prevent biopsychosocial co-morbidity leading to ongoing consequences on their health.

INTRODUCTION: In recent years, American trypanosomiasis has become an emergent public health problem in countries receiving migrant populations such as México, USA, Canada or those in Europe. OBJECTIVE: To analyze the prevalence of anti-Trypanosoma cruzi antibodies in Latin American migrants on their way to USA and Canada by means of serological techniques. MATERIAL AND METHODS: ELISA and IHA were performed to detect anti-T. cruzi antibodies...

The aim of this study was to compare health behaviours (smoking, alcohol consumption, physical activity and diet), to explore social inequality in these behaviours among cancer survivors and individuals with no history of cancer, respectively, and to study the impact of time since diagnosis on cancer survivors' health behaviours. Data from the Danish National Health Survey from 2013 were linked with data from the Danish Cancer Registry to identify all cancer diagnoses among the respondents during the period 1945-2012...

OBJECTIVES: To characterize the relationships between orthostatic blood pressure (BP) and heart rate recovery and frailty in an older population. DESIGN: Cross-sectional study. SETTING: Two health centers in the Republic of Ireland. PARTICIPANTS: The Irish Longitudinal Study on Ageing participants aged 50 and older (N=4,334). MEASUREMENTS: Continuous noninvasive BP responses during active standing were captured using digital photoplethysmography...

BACKGROUND: Over the past century, life expectancy at birth in Canada has risen substantially. However, these gains in the quantity of life say little about gains in the quality of life. DATA AND METHODS: Health-adjusted life expectancy (HALE), an indicator of quality of life, was estimated for the household and institutional populations combined every four years from 1994/1995 to 2015. Health status was measured by the Health Utilities Index Mark 3 instrument in two national population health surveys, and was used to adjust life expectancy...

Body dysmorphic disorder (BDD) is a preoccupation with a slight or imagined flaw in appearance that causes significant distress and impairment in daily functioning. The disease is more prevalent among patients who seek aesthetic procedures as compared with population standards or individuals that are not interested in aesthetic surgery. Several studies have indicated that BDD symptoms typically worsen after an aesthetic procedure because the preoccupation shifts to a different body area. This article discusses the demographic and clinical features, psychiatric comorbidity, assessment, differential diagnosis, and management of BDD...

Syria's civil conflict has created the largest humanitarian disaster of our time, causing massive population displacement, tremendous exposure to trauma, and loss. Advancing the mental health and psychosocial responses of war-affected populations both during acute humanitarian emergencies and in post-conflict transition is imperative in forging a constructive implementation agenda. This study makes an important contribution in building evidence toward effective interventions to advance the mental health and well-being of those affected by the Syrian crisis...

BACKGROUND: Individuals born extremely preterm are exposed to significant perinatal stresses that are associated with an increased risk of psychopathology. However, a paucity of longitudinal studies has prevented the empirical examination of long-term, dynamic effects of perinatal adversity on mental health. Here, internalizing and externalizing problems from adolescence through adulthood were compared in individuals born at extremely low birth weight (ELBW; <1,000 g) and normal birth weight (NBW; >2,500 g)...

BACKGROUND AND OBJECTIVES: While alcohol use disorder is prevalent in U.S. veterans, little is known about the nature and determinants of predominant trajectories of alcohol consumption in this population. The objective of the current study was to identify predominant trajectories of alcohol consumption over a 4-year period, and baseline determinants of these trajectories in veterans. METHODS: Data were analyzed from the National Health and Resilience in Veteran Study, which surveyed a nationally representative sample of 3,157 veterans (Wave 1)...

AIM: A population-based observational study design was used to describe the epidemiology of intellectual disability in cerebral palsy (CP) in terms of clinical and neuroimaging associations, and to report the impact of intellectual disability on utilization of health services and length of survival. METHOD: Population CP registry data were used to retrospectively assess the frequency of intellectual disability and strength of associations between intellectual disability and mobility, epilepsy, vision, hearing, communication, and neuroimaging patterns (n=1141)...

Caregivers of individuals with dementia are at risk for chronic stress and social isolation. These exogenous factors may lead to perceived stress and perceived loneliness-psychosocial endogenous (subjective) elements of caregiving experience. Chronic stress and perceived loneliness may disrupt neuroendocrine and neuroimmunological regulation, creating low-grade systemic inflammation, promoting proinflammatory gene expression, and expediting cellular aging (endogenous physiological factors). These disturbances may enhance caregivers' risk for chronic conditions of inflammatory pathogenesis...

INTRODUCTION: The prevalence of HIV-associated neurocognitive disorders continues to rise despite the widespread use of antiretroviral therapy. We aimed to define the risk of neurocognitive dysfunction among smokers relative to nonsmokers. METHODS: We conducted a retrospective cohort study including HIV-infected adults ages 21 to 65 years. The Mental Alternation Test (MAT) was the primary outcome. The odds of cognitive impairment were compared using random-effects logistic regression to adjust for potential confounders...

INTRODUCTION: Low level of knowledge of cardiovascular disease (CVD) risk factors is related to higher risk of death and health educational programs are of particular importance in CVD prevention. Monitoring the level of knowledge of CVD risk factors is necessary to verify the effectiveness of education and to facilitate the right choice of education methods. AIM: to compare the assessment of knowledge of CVD risk factors in the population of Małopolska Voivodeship from the two independent cross-sectional studies...

OBJECTIVE: Due to an aging population, increasing prevalence of rheumatic disease, and a growing supply and demand gap of rheumatology providers, innovative solutions are needed to meet the needs of persons with rheumatic conditions. Nurse practitioners (NPs) and physician assistants (PAs) have been identified as a group of health professionals who could help address the workforce shortage. The Executive Committee of the Association of Rheumatology Health Professionals (ARHP), a division of the American College of Rheumatology (ACR), charged a task force to facilitate the preparation of NPs/PAs to work in a rheumatology practice setting...

BACKGROUND AND PURPOSE: Tai Chi is a mind-body exercise that has been shown to improve both mental and physical health. As a result, recent literature suggests the use of Tai Chi to treat both physical and psychological disorders. However, the underlying physiological changes have not been characterized. The aim of this pilot study is to assess the changes in brain metabolites and muscle energetics after Tai Chi training in an aging population using a combined brain-muscle magnetic resonance spectroscopy (MRS) examination...

BACKGROUND: Public health nursing (PHN) is an essential component of baccalaureate nursing education. In order to build PHN competencies, universities must design and operationalize meaningful clinical activities addressing community and population health. Currently, there is a paucity of literature delineating best practices for promoting competency in PHN. AIMS: The purpose of this manuscript is to describe a PHN-student health fair program as a means for meeting undergraduate PHN curricular standards, and to report results of an evaluation conducted examining its effectiveness in improving community member's health knowledge...

BACKGROUND: Better diets, as evaluated by diet quality indices, are associated with lower rates of morbidity and mortality. Although governments and researchers alike recognise the burden that obesity incurs for increased healthcare spending, there is insufficient evidence for the role of diet quality on healthcare costs. METHODS: Diet quality was assessed by the Australian Recommended Food Score (ARFS) for 6328 women aged 50-55 years from the Australian Longitudinal Study on Women's Health...

It was suspected that aristolochic acid-induced mutations may be associated with hepatitis B virus (HBV), playing an important role in liver carcinogenesis. The purpose of this study was to investigate the association between the use of Chinese herbs containing aristolochic acid and the risk of hepatocellular carcinoma (HCC) among HBV-infected patients. We conducted a retrospective, population-based, cohort study on patients older than 18 years who had a diagnosis of HBV infection between January 1, 1997 and December 31, 2010 and had visited traditional Chinese medicine clinics before one year before the diagnosis of HCC or the censor dates...

The diagnosis, treatment, and prevention of infectious diseases in older adults in long-term care facilities (LTCFs), particularly nursing facilities, remains a challenge for all health providers who care for this population. This review provides updated information on the currently most important challenges of infectious diseases in LTCFs. With the increasing prescribing of antibiotics in older adults, particularly in LTCFs, the topic of antibiotic stewardship is presented in this review. Following this discussion, salient points on clinical relevance, clinical presentation, diagnostic approach, therapy, and prevention are discussed for skin and soft tissue infections, infectious diarrhea (Clostridium difficile and norovirus infections), bacterial pneumonia, and urinary tract infection, as well as some of the newer approaches to preventive interventions in the LTCF setting...

BACKGROUND: Falls are a major cause of disability, morbidity, institutionalization, and mortality in older adults. OBJECTIVES: The purpose of the study was to examine the risk factors for falls among Mexican older adults aged 60 years and older. METHODS: This study included 6247 participants and their spouse or partner aged 60 years and older from the Mexican Health and Aging Study, an ongoing longitudinal study (2001-2012) conducted in Mexico...