Changing Patterns Of Health Research Articles

Motivational Influences on Health, Well-Being, and Lifestyle: Validation of the Spanish Version of the Treatment Self-Regulation Questionnaire in Four Health Domains.

Motivation is a central concept in self-determination theory (SDT). The Treatment Self-Regulation Questionnaire (TSRQ), which assesses motivation (autonomous, controlled, etc.), has been widely used. However, less is known about its applicability to samples such as college students, who may be at risk of having unhealthy behavior in many areas (including smoking, poor dietary habits, alcohol, or tobacco consumption). As this population is transitioning to adulthood, research is needed to understand motivation and changing health patterns. In addition, the lack of instruments for this population in Spain has made the measurement validation process a priority. The purpose of this psychometric study was to adapt the TSRQ to Spanish college students and to examine its structural and validity across four health domains. Two samples of Spanish college students (n = 347 and n = 244) agreed to participate in the study. Participants completed a booklet containing measures of motivation, well-being, general health, anxiety, depression, and lifestyle. CFA supported a five-dimensional structure in each domain. Reliability values were also adequate for each questionnaire. Regarding other sources of validity, statistically significant relationships between self-determination, health, and well-being were clearly confirmed, and autonomy was a significant predictor of lifestyle. The Spanish version of the TSRQ showed adequate psychometric properties (dimensionality and internal structure, reliability, and validity evidence regarding its relationships with other constructs) in college students. The Spanish TSRQ will provide future research aimed to understand the motivational role in college students' health behavior and well-being.

Pattern And Prevalence Of Psychiatry Morbidity Among Subjects Attended Psychiatric Outpatient Department In A Tertiary Care Hospital In Northern Telangana

Abstract Background: Mental health problem is a major public health issue all over the world including India. In India, mental disorders are the leading contributors to significant morbidity and disability amongst those affected. With changing health patterns among Indians, mental behavior and substance use disorders are coming to the forefront in health care delivery systems. Objective: This study was aimed to assess the diagnostic pattern of psychiatric morbidity among the patients attending psychiatric outpatient department in a private medical college. Methodology: This cross-sectional study was carried out in the Department of Psychiatry in Prathima Institute of Medical Sciences located at Karimnagar, Telangana, India. For this study, a total of 442 new subjects attending Psychiatry Outpatient Department (OPD) from August 2020 to July 2021 were taken. All the information including longitudinal histories of patients was recorded in files and the diagnosis was made following Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM 5). Socio-demographic parameters and family history of mental illness were collected from the record file of the individual patient. Results: In the present study, among the different age groups, the majority (28.05%) of the study subjects were of the age ranging from 21-30 years. The distribution according to gender was (62.89%) males and (37.10%) females. The majority of the study subjects belonged to the rural background (69.45%), educated up to 10th standard (28.73%), self-employed (29.86%), married (67.42%), belonged to Hindu religion (85.74%), and with a monthly family income of 5,000 to 10,000 (38.68%). The majority of the study subjects were diagnosed with Major depressive Disorders (28.05%), followed by anxiety disorders (17.87%) and Substance-Related and Addictive Disorders (16.96%). Conclusion: This study provides information about the prevalence of psychiatric morbidity among patients attending outpatient department in a private medical hospital in Northern Telangana. It helps in assessing the pattern of psychiatric problems and taking necessary steps to plan for better management of mental health care in the near future.

The place of population change in explaining geographical inequalities in health in New Zealand

We appreciate Harper’s comments on the role of population change in explaining rising geographical inequalities in health in New Zealand. 1 As we note in our original paper, we agree that selective migration patterns may well be an important explanation as to why regional health status in New Zealand has become more geographically polarized during the 1980s and 1990s. 2 Selective patterns of migration between the regions of New Zealand and the high levels of immigration into the country, and emigration from it, are likely to lead to a high level of population sorting between areas and to have strengthened the widening life expectancy gap during the 1980s and 1990s. Given that New Zealand experiences almost the highest rate of combined immigration and emigration (population turnover) in the world, a if selective migration were to have an explanatory role anywhere it would be in helping to understand changing health patterns within this country. Although we agree that selective migration is likely to be an important factor in explaining our results, there are five areas of interpretation where we disagree with Harper. First, Harper contends that growing geographical inequalities in health observed using the Slope Index of Inequality (SII) may be due to differential levels of population growth between regions of the country (i.e. if areas with the highest or lowest life expectancies grow at a faster rate then the gap will increase even if the life expectancy in those areas remains the same). Harper gives an example of where he thinks the problem lies: ‘‘Given the near-linear relationship between socioeconomic rank and life expectancy among health districts, even if regional life expectancies had stayed exactly the same, but over this time there was more rapid population growth among areas of higher and lower life expectancy, the SII would register an increase.’’ (Harper, 2006, p. 604) It is not hard to see how Harper came to assume this—it is an easy error to make and perhaps we could have explained the SII more fully—but it is important that researchers recognize that the results are not an artefact of using the SII as Harper suggests. Rather, an increase in the index means that inequality amongst people measured between areas has risen. Suppose you were measuring educational attainment and over time a greater number of people failed to gain any qualifications and more gained degrees—inequality would have increased between people in terms of educational attainment. It is not that the population sizes of these groups had simply altered. Places are not entities of themselves—they are collections of people. 3 The SII is the slope of the regression line from the hypothetically poorest individual to the hypothetically richest individual derived from the relative poverty ranks of life expectancy for each geographic area, weighted for population size. The SII takes into account all measures for all areas and not, say, simply the worst-off and best-off 10th or 5th of areas. The index is most effective as a summary measure when the two measures are linearly related, as is the case with the data we analysed. The index has a further advantage that it is, by definition, unaffected by general increases or decreases in life expectancy over time (in this case the constant—that is the intercept—changes but not the slope). The SII is the slope coefficient in a simple regression analysis of life expectancy in years against a ranking of each area, where ranking is expressed as the cumulative proportions of the total population. An example of use of the SII in comparisons of life expectancy over time between continents shows that in 1950–55 the hypothetical worst-off person in Africa had a

Global systems biology, personalized medicine and molecular epidemiology

Mol Syst Biol. 2: 52 One of the great challenges for 21st century medicine is to deliver effective therapies that are tailored to the exact biology or biological state of an individual to enable so‐called ‘personalized healthcare solutions’. Ideally, this would involve a system of patient evaluation that would tell clinicians the correct drug, dose or intervention for any individual before the start of therapy. A practical approach to this evaluation is the concept of patient stratification in which individuals are biologically subclassified (classically according to some genetic features) and biofeatures modelled in relation to outcome. In principle, such stratification for personalized therapy can be applied to drug safety and efficacy modelling and to more general healthcare paradigms involving optimized nutrition and lifestyle management. Of course, truly personalized treatments, even if they can be developed and applied widely, will lamentably always be a luxury of the worlds' richest citizens and nations. So in some respects, personalized healthcare might appear to be at the opposite end of the medical spectrum to the subject of epidemiology in which disease risk factors and disease incidence are studied in populations rich and poor alike. Systems biology provides us with a common language for both describing and modelling the integrated action of regulatory networks at many levels of biological organization from the subcellular through cell, tissue and organ right up to the whole organism. The relatively new science of molecular epidemiology concerns the measurement of the fundamental biochemical factors that underlie population disease demography and understanding ‘the health of nations’ and this subject naturally lends it to systems biology approaches. Hence, systems biology is certain to have in future a major role in both the development of personalized medicine and in molecular epidemiological studies. Populations are, of course, made up of individuals and, in …

As Patients and Healers: The History of Women and Medicine

The history of women and medicine in the United States over two centuries is not easily contained in a brief essay. To cover the years from the late eighteenth to the late twentieth century, we have selected three case studies from three different points in time that illustrate the broad outlines of the story of women and medicine: Mar tha Ballard, a rural midwife who practiced from 1785 to 1812; Elizabeth Blackwell, who, in 1849, became the first American woman to graduate from a regular medical college; and the Boston Women's Health Book Collective, publishers in 1973 of Our Bodies, Ourselves, the popular medical guide for women. These and other stories from the history of women and medicine are often used to explore changing pat terns of health and illness or developments in American health care professions; for teachers of general U.S. survey courses, however, these stories may at first appear far removed from the broad themes of American social and political history usu ally addressed in these courses. Here, we want to connect the history of women and medicine to some of those themes?the growing authority of experts; the chang ing role of the state; the significance of race and class; and, of course, the Ufe ex periences of women and the extension of women's sphere.

Trajectories of health for older adults over time: accounting fully for death.

The process of healthy aging can best be described by plotting the trajectory of health-related variables over time. Unfortunately, graphs including data only from survivors may be misleading because they may confuse patterns of mortality with patterns of change in health. Two approaches for creating graphs that account for death in such situations are 1) to incorporate a category or value for death into the longitudinal health variable and 2) to measure time in years before death or some other event. The first approach has been applied to self-rated health (excellent to poor) and the 36-Item Short-Form Health Survey (SF-36). It allows for flexible and interpretable analyses and may be appropriate for other variables as well. The second approach also accounts fully for death, but the questions it can address are limited. Both approaches are useful and should be used at a minimum for supporting analyses in longitudinal studies in which persons die during observation.

Is Capitalism A Disease? The Crisis of US Public Health

Readers will note that this article is nearly twice the length of the normal MR piece, but because of the importance of the subject we are publishing it in its entirety. The text is based on a talk given by the author at the Brecht Forum in New York. -Eds. The scientific tradition of the "West," of Europe and North America, has had its greatest success when it has dealt with what we have come to think of as the central questions of scientific inquiry: "What is this made of?" and "How does this work?" Over the centuries, we have developed more and more sophisticated ways of answering these questions. We can cut things open, slice them thin, stain them, and answer what they are made of. We have made great achievements in these relatively simple areas, but have had dramatic failures in attempts to deal with more complex systems. We see this especially when we ask questions about health. When we look at the changing patterns of health over the last century or so, we have both cause for celebration and for dismay. Human life expectancy has increased by perhaps thirty years since the beginning of the twentieth century and the incidence of some of the classical deadly diseases has declined and almost disappeared. Smallpox presumably has been eradicated; leprosy is very rare; and polio has nearly vanished from most regions of the world. Scientific technologies have advanced to the point where we can give very sophisticated diagnoses, distinguishing between kinds of germs that are very similar to each other.This article can also be found at the Monthly Review website, where most recent articles are published in full.Click here to purchase a PDF version of this article at the Monthly Review website.

Toward an ecosocial view of health.

The changing patterns of health in the United States justify both celebration and dismay. We can celebrate declining mortality rates, increased life expectancy, and improvements in diagnostic and therapeutic technologies. But public health was caught by surprise by the return of infectious disease; the gap in health outcomes between rich and poor and between whites and blacks increases; there is a growing discrepancy between what is technically possible and the actual health status; and despite its greater expenditures on health, the United States lags behind the other developed countries in health outcomes. The authors examine four reasons for this: we do not buy more health care, only pay more for it; we receive more health care, but much of it inappropriate, ineffective, or harmful; only some of us get more health care; and we have created a way of life that makes us sick, then spend more to repair the damage. Major failures arise when problems are understood too narrowly. An ecosocial perspective attempts to look at the whole. It rejects as false the dichotomies social/biological, physical/psychological, genetic/environmental, lifestyle/environment, examining their interrelations rather than assigning them relative weights. In addition to looking at average differences among populations, the authors examine patterns of variability in health outcomes.

Are we going in the right direction? A survey of the undergraduate medical education in Canada, Australia and the United Kingdom from a general practice perspective

This study looks at the changing patterns of medical education in 45 medical schools in Canada, Australia and the United Kingdom. It examines the extent to which the undergraduate curricula in the above three countries have changed, and the direction of that change. It looks at the teaching and assessment methods used, and the development of teacher training. Finally it gathers innovative teaching ideas from the various participating family medicine departments. The results show, that in response to changing patterns of health and social trends, medical education is gradually moving to a more learner-centred, community-orientated format.There is a move towards problem- and system-based teaching, horizontal and vertical integration in many new curricula. General practice is gaining a higher profile in undergraduate teaching, but it is often still under-resourced. Many of the family medicine departments provide high quality faculty training and stimulating programs for students, based in the community.

Captive care: changes in prison nursing.

Nursing in prisons is a new growth area. This article highlights how the major developments in mental health provision and changing health patterns in inmate populations have influenced the evolution of specialist nursing services for prisoners. Many issues concerning the role, training and salaries of nurses who work in prisons remain unresolved, however, and the complex ethical and legal conflicts remain ever-present in the prison environment.

The Ok Tedi Health and Nutrition Project, Papua New Guinea: physique, growth and nutritional status of the Wopkaimin of the Star Mountains.

A survey was carried out to establish baseline anthropometric and health data in the Wopkaimin, a small group of Mountain Ok-speaking hunter-horticulturalists who live in a remote and isolated part of the Highland fringe of Papua New Guinea, where a major gold and copper mine is being developed. Malaria is hyperendemic in the region and infant mortality has been estimated at approximately 230 per thousand. A 79% sample of the population was examined and the results of the anthropometric survey are reported. Wopkaimin childrens' heights and weights are well below the 50th percentile of British standards throughout growth; at maturity boys' weights and girls' heights and weights are at or below the 3rd percentile, and boys' weights are just above the 10th percentile. Wopkaimin children lag far behind British children in percentage of adult height achieved at all ages, and appear to attain maturity at least four years later. This relatively slow growth and short adult stature may represent an adaptive response to chronic nutritional deprivation, for which there is evidence from skinfold thickness and arm circumference measurements. Younger adults are significntly taller, heavier, fatter and more muscular than older adults; possible explanations for this are discussed. Within the sample, individuals living in villages less than a day's walk from the mine town are significantly taller, heavier and fatter than those living further away, and there are also similar significant anthropometric differences between employed and unemployed men. Ready food availability which has come with the mine development appears to be the most likely explanation for these differences. A continuing study of changing patterns of health and nutrition in the area has been initiated.

School Health Examinations

School health examinations were begun years ago because parents, educators, and physicians all realized that healthy children learned more effectively than children with health problems. Earlier in this century, many children in the United States entered school without having had a health evaluation. Most children in this country today receive health care during their preschool years. Therefore, reevaluation of the concept of routine health exammations is now indicated because of changing health patterns in the United States and children's different health needs. PHYSICAL EXAMINATION Ideally, every school child should have a complete physical examination and health evaluation every one to two years from his or her personal physician or source of ongoing medical care. Several things should be accomplished during this examination: (1) interval health history; (2) head-to-toe health appraisal; (3) assessment of growth, development, and school progress; (4) mental health evaluation of the child and family; (5) assessment of immunization status; (6) health education and counseling for both parent and child; (7) evaluation for participation in athletics; (8) recommendations about the child's health needs. Physicians may not be available for comprehensive health supervision in some rural and urban areas. Therefore, the Committee makes the following recommendations for health examinations required by schools. 1. Schools should require a complete physical examination for all children at least every three years. 2. Ideally, this physical examination should be done by the child's pediatrician or primary care physician. A school nurse, with physician backup, if trained in physical assessment skills, can do an assessment if no physician is available to conduct the examinations.

Part one: Patterns of health and disease among the Waorani Indians of Eastern Ecuador

Abstract The Waorani Indians, who live south of the Rio Napo in eastern Ecuador, are beginning to experience the effects of contact with the outside world. Synthesis of biomedical information with an understanding of cultural practices related to health provides insight into changing patterns of health and disease during the process of acculturation. The perspective gained from these multidisciplinary studies will aid in providing health care in the future and will increase appreciation of the ecology of health of these Amerindians in the past.

Part two: Changing patterns of health and sickness among the Cree‐Ojibwa of northwestern Ontario

T. Kue Young, M. D.INTRODUCTIONNorthwestern Ontario is a sparsely populated region offorests, lakes and rivers in the Canadian Shield. About 20percent of the region's population are native Indians belong-ing to two culturally related groups—the Northern Ojibwaand the Swampy Cree, the majority of whom still live inisolated and scattered communities.Traditionally a hunting and fishing culture, the Indians ofthe region have been in contact with the advancing Euro-Canadian society since the late seventeenth century. Theearly explorers and fur traders were followed by mission-aries, government officials, and loggers and miners. Theprocess of acculturation has proceeded at varying pacewithin the region, but rapid social changes since the SecondWorld War have fundamentally altered the lifestyle of thepeople (Dunning 1959, Bishop 1974).Organized health services for the region's Indians, aresponsibility of the Canadian federal government, are ofrelatively recent vintage. Prior to the Second World War, theonly modern health services came in the form of the annualvisit by a physician attached to the government Treaty party.In the southern fringes of the region, the services ofphysicians in private practice in the predominantly whitetowns were accessible to Indians in nearby reserves. In 1949Downloaded by [University of Toronto Libraries] at 09:17 26 April 2013

Medical Nemesis and Economic Health, or Economic Nemesis and Medical Health: The Modern Dilemma

Modern analyses of health trends recognize the importance of ‘life style’ or behavioural variables in health. But this has the effect of taking the emphasis off the real socioeconomic determinants of life style in modern society. In the present paper changing health patterns in Australia are examined and some explanations of these changes are considered. It is concluded that ‘life style’ explanations of modern ‘societal’ illness are a ‘cop‐out‘. They ignore the deeper economic and social causes of life styles and in particular the dynamic relationship between these and a rapidly expanding growth economy. The question of whether medical health demands economic nemesis under a continuation of the growth system is considered in this light.

Group theory implications for changing health patterns.

Group theory implications for changing health patterns. R F Stewart, and J A IrvingCopyRight https://doi.org/10.2105/AJPH.59.10.1894 Published Online: August 29, 2011

Changing Morbidity of Schoolboys, 1900 to 1965

A unique compilation of morbidity data uniformly recorded daily over a 65-year period (1900 to 1965) at St. Mark's School, Southboro, Mass, has been analyzed in order to determine the changing patterns of health and disease in this schoolboy population since 1900. Morbidity findings remained relatively stable and at appreciably higher levels from 1900 through World War II than during the past 20 years. Since 1945, a progressive decline to about 20% to 25% of the former values was recorded. These data are similar to data collected by the US Navy and Marine Corps. Factors influencing the post World War II decline in morbidity include antibiotic therapy and decline in communicable diseases.