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Population health segmentation

Jasmine A Mena, Gifty G Ampadu, James O Prochaska
BACKGROUND: Tobacco use remains the leading cause of preventable disease and death. Most smokers are not motivated to quit; however, most smoking cessation interventions are designed for smokers who are ready to take action. OBJECTIVES: The aim of the present study was to describe participant engagement and satisfaction with telephonic smoking cessation coaching with a population of smokers at different stages of readiness to quit. METHODS: Qualitative description was used to capture the experiences of 62 individuals who participated in telephonic smoking cessation coaching using semistructured interviews...
October 21, 2016: Substance Use & Misuse
Edna Ruiz Magpantay-Monroe
The military and veteran populations in the U. S. state of Hawaii have a strong presence in the local communities. It was this substantial presence that provided the impetus to integrate military and veteran health into a Bachelor's of Science in Nursing (BSN) curriculum. This exploratory study investigated the relationship between the integration of military and veteran health into a psychiatric mental health BSN curriculum and nursing students' understanding of the many facets of military veterans' health...
October 6, 2016: Nurse Education Today
Sally P Weinrich, Jill E Bormann, Dale Glaser, Sally Hardin, Mary Barger, Cabiria Lizarraga, Juan Del Rio, Carolyn B Allard
Women and families are the fastest growing segment of the homeless population. Negative attitudes of nurses toward homeless women are a major barrier to homeless women seeking health care. This cross-sectional, mixed-methods pilot study, conducted primarily by nurses, tested the Mantram Repetition Program for the first time with 29 homeless women. The Mantram Repetition Program is a spiritually based skills training that teaches mantram (sacred word) repetition as a cost-effective, personalized, portable, and focused strategy for reducing stress and improving well-being...
November 2016: Holistic Nursing Practice
Carolyn M Reyes-Guzman, Ruth M Pfeiffer, Jay Lubin, Neal D Freedman, Sean D Cleary, Paul H Levine, Neil E Caporaso
BACKGROUND: Light and/or intermittent smokers have been the fastest growing segment of cigarette smokers in the U.S. over the past two decades. Defining their behavioral characteristics is a critical public health priority. MATERIALS AND METHODS: Our sample included 78,229 U.S. adults from three pooled contemporary population-based surveys: the 2012 NHIS, 2012 NSDUH, and 2011-2012 NHANES. We classified current smokers into four categories (light and intermittent [LITS], light-daily, heavier-intermittent and heavier-daily) and assessed smoking behaviors, illicit drug use, and mental health indicators using weighted analyses...
October 19, 2016: Cancer Epidemiology, Biomarkers & Prevention
Dongyan Zhang, Haifeng Ji, Hui Liu, Sixin Wang, Jing Wang, Yamin Wang
The gut microbiota plays important roles in the health and well-being of animals, and high-throughput sequencing facilitates exploration of microbial populations in the animal gut. However, previous studies have focused on fecal samples instead of the gastrointestinal tract. In this study, we compared the microbiota diversity and composition of intestinal contents of weaned piglets treated with Lactobacillus reuteri or chlortetracycline (aureomycin) using high-throughput sequencing. Nine weaned piglets were randomly divided into three groups and supplemented with L...
October 19, 2016: Applied Microbiology and Biotechnology
Ulrike Stentzel, Jens Piegsa, Daniel Fredrich, Wolfgang Hoffmann, Neeltje van den Berg
BACKGROUND: The accessibility of medical care facilities in sparsely populated rural regions is relevant especially for elderly people which often represent a large segment of the population in such regions. Elderly people have higher morbidity risks and a higher demand for medical care. Although travelling with private cars is the dominating traffic mode in rural regions, accessibility by public transport is increasingly important especially because of limited mobility of elderly people...
October 19, 2016: BMC Health Services Research
Kristi Reynolds, Alan S Go, Thomas K Leong, Denise M Boudreau, Andrea E Cassidy-Bushrow, Stephen P Fortmann, Robert J Goldberg, Jerry H Gurwitz, David J Magid, Karen L Margolis, Catherine J McNeal, Katherine M Newton, Rachel Novotny, Charles P Quesenberry, Wayne D Rosamond, David H Smith, Jeffrey J VanWormer, Suma Vupputuri, Stephen C Waring, Marc S Williams, Stephen Sidney
BACKGROUND: Monitoring trends in cardiovascular events can provide key insights into the effectiveness of prevention efforts. Leveraging data from electronic health records provides a unique opportunity to examine contemporary, community-based trends in acute myocardial infarction hospitalizations. METHODS: We examined trends in hospitalized acute myocardial infarction incidence among adults aged ≥25 years in 13 U.S. health plans in the Cardiovascular Research Network...
October 14, 2016: American Journal of Medicine
H Malmström, P E Wändell, M J Holzmann, J Ärnlöv, I Jungner, N Hammar, G Walldius, A C Carlsson
BACKGROUND AND AIMS: Both high and low fasting glucose has been associated with an increased mortality among individuals without diabetes. This J-shaped association has also been shown for HbA1c in relation to all-cause mortality. High fructosamine is associated with increased mortality. In this study we aim to evaluate if low fructosamine is also associated with increased mortality in non-diabetic subjects. METHODS AND RESULTS: We included 215,011 subjects from the AMORIS cohort undergoing occupational health screening or primary care in Stockholm, Sweden...
September 2, 2016: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
Priti Bandi, Diana Silver, Tod Mijanovich, James Macinko
BACKGROUND: In the past 40 years, a variety of factors might have impacted motor vehicle (MV) fatality trends in the US, including public health policies, engineering innovations, trauma care improvements, etc. These factors varied in their timing across states/localities, and many were targeted at particular population subgroups. In order to identify and quantify differential rates of change over time and differences in trend patterns between population subgroups, this study employed a novel analytic method to assess temporal trends in MV fatalities between 1968 and 2010, by age group and sex...
December 2015: Injury Epidemiology
Sarah E Jackson, Clemens Kirschbaum, Andrew Steptoe
OBJECTIVE: There is increasing evidence for weight-based discrimination against persons with obesity. This study aimed to examine the physiological impact of perceived weight discrimination on cortisol in hair, an indicator of chronic stress exposure. METHODS: Data were from 563 nonsmoking individuals with obesity (body mass index, BMI ≥30 kg/m(2) ) participating in the English Longitudinal Study of Ageing. Experiences of discrimination were reported via questionnaire, and hair cortisol concentrations were determined from the scalp-nearest 2-cm hair segment...
October 14, 2016: Obesity
Albert A Okunade, Rose M Rubin, Adeyinka K Okunade
Currently, there are few studies separating the linkage of pathological obese and overweight body mass indices (BMIs) to the all-cause mortality rate in adults. Consequently, this paper, using annual Behavioral Risk Factor Surveillance System data of the 50 US states and the District of Columbia, estimates empirical regression models linking the US adult overweight (25 ≤ BMI < 30) and obesity (BMI ≥ 30) rates to the all-cause deaths rate. The biochemistry of multi-period cumulative adiposity (saturated fatty acid) from unexpended caloric intakes (net energy storage) provides the natural theoretical foundation for tracing unhealthy BMI to all-cause mortality...
2016: Frontiers in Public Health
Karen I Fredriksen-Goldsen, Sarah Jen, Amanda E B Bryan, Jayn Goldsen
Cognitive impairment, Alzheimer's disease, and other dementias are important health concerns for older adults. As a marginalized and growing segment of the older adult population, lesbian, gay, bisexual, and transgender (LGBT) older adults face distinct risk factors related to cognitive impairment and dementias, including social isolation, discrimination, barriers to health care access, limited availability of and support for caregivers, and higher rates of certain chronic illnesses. We examine cognitive impairment and dementias among LGBT older adults, describe their unique risk factors, and outline key competencies for health care and human service providers to ensure culturally relevant care for LGBT older adults experiencing cognitive impairment, Alzheimer's disease, or other dementias, as well as their caregivers, families, and communities...
October 10, 2016: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
Morgane Donadel, Gulzira Karimova, Ruslan Nabiev, Kaspar Wyss
BACKGROUND: The Government of Tajikistan is reforming its health system to make access more equitable. Nonetheless, out-of-pocket expenditures (OPE) remain a key modality for purchasing health care. Drugs remain a major driver of household expenditures for health. We conducted a household survey to investigate drug prescribing patterns at primary health care (PHC) level as well as the related OPE. METHODS: Adult patients in eight districts who had visited a PHC facility in the period March to May 2014 were interviewed at home, using a structured questionnaire...
October 6, 2016: BMC Health Services Research
Carleigh B Krubiner, Maria W Merritt
Conditional cash transfers (CCTs) present a promising approach to simultaneously tackle chronic poverty and poor health. While these programmes clearly embody beneficent aims, questions remain regarding the ethical design of CCTs. Limited guidance exists for the ethical evaluation of the defining feature of these programmes: the conditionalities. Drawing upon prominent public health ethics frameworks and social justice theories, this paper outlines five categories of morally relevant considerations that CCT programme designers should consider when assessing which behaviours or outcomes they select as conditionalities for payment: (1) likelihood of yielding desired health outcomes, (2) risks and burdens, (3) receptivity, (4) attainability and (5) indirect impacts and externalities...
October 5, 2016: Journal of Medical Ethics
H Sadhna, R Harris, J L Miles-Chan, S Yves, M Jean-Pierre, J Noorjehan, A G Dulloo
BACKGROUND & AIMS: Global estimates of overweight and obesity prevalence are based upon the World Health Organisation (WHO) body mass index (BMI) cut-off values of 25 and 30 kg/m(2), respectively. To validate these BMI cut-offs for adiposity in the island population of Mauritius, we assessed the relationship between BMI and measured body fat mass in this population according to gender and ethnicity. METHODS: In 175 young adult Mauritians (age 20-42 years) belonging to the two main ethnic groups-Indians (South Asian descent) and Creoles (African/Malagasy descent), body weight, height and waist circumference (WC) were measured, total body fat assessed by Deuterium oxide (D2O) dilution, and trunk (abdominal) fat by segmental bioimpedance analysis...
October 4, 2016: International Journal of Obesity: Journal of the International Association for the Study of Obesity
Harshvardhan Chawla, Hassan M Ghomrawi, Jelle P van der List, Ashley A Eggman, Hendrik A Zuiderbaan, Andrew D Pearle
BACKGROUND: Improved survivorship has contributed to the increased use of unicompartmental knee arthroplasty (UKA) as an alternative to total knee arthroplasty (TKA) for unicompartmental knee osteoarthritis. However, heterogeneity among cost-effectiveness analysis studies comparing UKA to TKA has prevented the derivation of discrete implant survivorship targets. The aim of this meta-analysis was to determine the age-stratified annual revision rate (ARR) threshold for UKA to become consistently cost-effective for unicompartmental knee osteoarthritis...
August 28, 2016: Journal of Arthroplasty
Laura E Watkins, Ilan Harpaz-Rotem, Lauren M Sippel, John H Krystal, Steven M Southwick, Robert H Pietrzak
: Chronic disorders of aging are critical concerns for the U.S. veteran population, which is, on average, two decades older than the non-veteran population. Characterization of risk factors that may accelerate biological aging is important in identifying targets for prevention and intervention. In the current study, we analyzed data from a contemporary, and nationally representative sample of U.S. veterans to evaluate the relationship between a broad range of sociodemographic, military, and clinical variables, and peripheral telomere length, which is an indicator of biological age and linked to risk for aging-related disorders and mortality...
September 15, 2016: Psychoneuroendocrinology
Ricardo H M Godoi, Sérgio J Gonçalves, Célia Sayama, Gabriela Polezer, José M Reis Neto, Bálint Alföldy, René Van Grieken, Carlos A Riedi, Carlos I Yamamoto, Ana F L Godoi, László Bencs
Serpentine and amphibole asbestos occur naturally in certain geologic settings worldwide, most commonly in association with ultramafic rocks, along associated faults. Ultramafic rocks have been used in Piên County, Southern Brazil for decades for the purpose of road paving in rural and urban areas, but without the awareness of their adverse environmental and health impact. The aim of this study was the chemical characterization of aerosols re-suspended in two rural roads of Piên, paved with ultramafic rocks and to estimate the pulmonary deposition of asbestos aerosols...
September 28, 2016: Environmental Science and Pollution Research International
Jonathan Sicsic, Olivier Saint-Lary, Elisabeth Rouveix, Nathalie Pelletier-Fleury
BACKGROUND: Early diagnosis of HIV infection is a major public health issue worldwide. In 2009, the French National Authority for Health (Haute Autorité de Santé) developed specific guidelines and recommended mass screening of 15-70-year-olds across the general population. The guidelines were supported by communication directed at healthcare professionals, especially GPs. AIM: To assess the impact of the national mass screening policy on HIV testing. DESIGN AND SETTING: The study used data from the French National Health Insurance Fund database, from January 2006 to December 2013...
September 26, 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
Rainer Zbinden, Stefanie von Felten, Bastian Wein, David Tueller, David J Kurz, Ivano Reho, Soren Galatius, Hannes Alber, David Conen, Matthias Pfisterer, Christoph Kaiser, Franz R Eberli
AIMS: The British National Institute of Clinical Excellence (NICE) guidelines recommend to use DES instead of BMS only in lesions >15mm in length or in vessels < 3mm in diameter. We analysed the impact of stent length and stent diameter on ISR in the BASKET-PROVE study population and evaluated the cost-effectiveness of DES compared to BMS. METHODS/RESULTS: The BASKET-PROVE trial compared DES vs. BMS in large coronary arteries (≥3mm). We calculated incremental cost-effectiveness ratios (ICERs) and cost-effectiveness acceptability curves with regard to quality-adjusted life years (QALYs) gained and target lesion revascularisations (TLRs) avoided...
September 23, 2016: Cardiovascular Therapeutics
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