Acute care hospital morbidity of the Blood Indian Band was compared with that of all Albertans between April 1, 1984 and March 31, 1987. The Blood Indians had over 2.5 times as many hospital separations and 2.2 times as many patient days as the Albertans. The highest separation rare ratios by ICD-9-CM chapter for both Blood males and females were for endocrine, metabolic and nutritional disorders. Blood females had higher rate ratios for hospitalizations for all chapters except neoplasms and Blood males had higher rate ratios for all except congenital anomalies and neoplasms. For individual conditions, Blood males had the highest separation rate ratios for alcohol dependence syndrome, gastritis/duodenitis and diabetes mellitus. Bronchitis/emphysema and diabetes mellitus had the highest rate ratios for Blood females. The results are consistent with those reported in other studies of North American Indians. Their health status is more consistent with a developing country than that expected in Canada and does not appear to be improving.
This paper reviews Russia's health crisis, financing, and organization and public health reform needs.
The structure, policy, supply of services, and health status indicators of Russia's health system are examined.
Longevity is declining; mortality rates from cardiovascular diseases and trauma are high and rising; maternal and infant mortality are high. Vaccine-preventable diseases have reappeared in epidemic form. Nutrition status is problematic.
The crisis relates to Russia's economic transition, but it also goes deep into the former Soviet health system. The epidemiologic transition from a predominance of infectious to noninfectious diseases was addressed by increasing the quantity of services. The health system lacked mechanisms for epidemiologic or economic analysis and accountability to the public. Policy and funding favored hospitals over ambulatory care and individual routine checkups over community-oriented preventive approaches. Reform since 1991 has centered on national health insurance and decentralized management of services. A national health strategy to address fundamental public health problems is recommended.
Cites: World Health Stat Q. 1984;37(4):364-746441355
Cites: Am J Public Health. 1990 Feb;80(2):193-72297064
Cites: Ann Med. 1990;22(4):211-22248754
Cites: Soc Sci Med. 1990;31(8):867-772259961
Cites: BMJ. 1991 Jan 19;302(6769):170-11995141
Cites: Int J Health Serv. 1991;21(3):493-5041917209
Cites: Health Aff (Millwood). 1991 Fall;10(3):202-151748378
Cites: Health Aff (Millwood). 1991 Fall;10(3):22-381748380
Cites: Health Aff (Millwood). 1991 Fall;10(3):71-861748393
Conflicting data exist on the changes in the incidence of oesophageal (EAC) and oesophagogastric junction adenocarcinoma (EGJAC). In addition, risk factors of the disease are only partly known. The aim of the study was to evaluate the incidence of EAC and EGJAC in Finland as well as risk factors of these cancers.
The complete number of new EAC and EGJAC cases between January 1980 and December 2007 in Finland was provided by the Finnish Cancer Registry. All treated EAC and EGJAC patients in the Pirkanmaa Hospital District between January 1980 and December 2007 were included in the study.
The incidence of EAC increased significantly in Finland. Barrett's oesophagus (BE) was associated with the risk of EAC and cholecystectomy with the risk of EGJAC.
A significant increase in EAC was found in Finland over the course of nearly 30 years, indicating that the increase in EAC in Finland is existent in the long term. BE was associated with the risk of EAC and cholecystectomy with the risk of EGJAC.
Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are rare diseases with a gradual decline in physical health. Adherence to treatment is crucial in these very symptomatic and life threatening diseases.
To describe PAH and CTEPH patients experience of their self-reported medication adherence, beliefs about medicines and information about treatment.
A quantitative, descriptive, national cohort survey that included adult patients from all PAH-centres in Sweden. All patients received questionnaires by mail: The Morisky Medication Adherence Scale (MMAS-8) assesses treatment-related attitudes and behaviour problems, the Beliefs about Medicines Questionnaire-Specific scale (BMQ-S) assesses the patient's perception of drug intake and the QLQ-INFO25 multi-item scale about medical treatment information.
The response rate was 74% (n?=?325), mean age 66?±?14 years, 58% were female and 69% were diagnosed with PAH and 31% with CTEPH. Time from diagnosis was 4.7?±?4.2 years. More than half of the patients (57%) reported a high level of adherence. There was no difference in the patients' beliefs of the necessity of the medications to control their illness when comparing those with high, medium or low adherence. Despite high satisfaction with the information, concerns about potential adverse effects of taking the medication were significantly related to adherence.
Treatment adherence is relatively high but still needs improvement. The multi-disciplinary PAH team should, together with the patient, seek strategies to improve adherence and prevent concern.
Physical and sexual developments were determined in 285 schoolchildren aged 12 to 17 years from the town of Karabash, an area of ecological ill-being in the environmental levels of heavy metal salts. The atmospheric air pollution was in parallel monitored at route observational stations. It was found that 39% of the schoolchildren had disharmonic physical development; of them a fourth had lower body weight and decreased chest circumference with normal growth indices. The girls were observed to have a high frequency of a microsomatotype of harmonic physical development and disharmonic physical development mainly at the expense of underweight (52.9% of all the disharmonically developed girls) as compared with the boys. There was a preponderance of female adolescents with sexual retardation. In the population of Karabash girls, the mean age at menarche was 12 years and 9 months +/- 1.5 months.
Objective of the study were: to specify the features of clinical presentations and dynamics of anorexia nervosa (AN) developed in adolescence during the current depression; to study affective disorders preceding the onset of AN and to analyze comorbidity of these two pathologies. We examined 21 female patients, aged from 15 to 17 years old (mean age 16.7 ± 0.8 years). It was shown that depressive symptoms developed 4-11 months (mean 7.9 ± 2.5 months) before the onset of AN. The development of AN was associated with depression and might be considered as one of mechanisms of formation of eating disorders that might be termed as affective mechanism. Thus, we can specify a variant of adolescent/juvenile depression, or depression with eating disorders. The variant represents a protracted depressive state with overvalued ideas to improve body image and to restrict calories which is combined with adynamic affect associated with anxiety, melancholy and dysphoria.
The authors analyzed age-related structure of miners population in major occupational groups with connection to special work conditions in one mine of Kouzbass. The data obtained prove certain influence of work conditions on age-related structure of occupational population.
The aim of the work was to study sex-specific differences between certain risk factors of cardiovascular diseases and hemodynamic parameters in elderly subjects and their relation to age-specific diseases and genealogic history of longevity. Total cholesterol, triglyceride, glucose, fibrinogen, uric acid, urea, creatinine levels in plasma and arterial pressure (AP) were measured. Hemodynamic parameters were calculated by the formulas for the stroke volume, cardiac output, myocardial contractility, pulse pressure, total peripheral resistance (TPR), endurance factor of cardiac activity, and Kerdo index. Each new decade of life was characterized by peculiar hemodynamic patterns. Pulse AP (PAP) and TPR increased with age and was associated with sex-related metabolic changes. Elderly men presented with hypocholesterolemia and anemia. Total cholesterol, fibrinogen, and glucose levels did not correlate with age. To conclude, elevated PAP, TPR, and left ventricular hypertrophy are risk factors of cardiovascular diseases in old subjects. Combination of several risk factors in young and middle-age subjects reduces prognostic value of the longevity factor in the familial history. Aging is accompanied by the development of gender-related differences in metabolic parameters.