Ayurveda the Science of Life
Some QoL instruments focus upon a single concept, such as emotional functioning. Other instruments regard these individual concepts as aspects or dimensions of QoL, and therefore include items relating to several concepts. Although there is disagreement about what components should be evaluated, most investigators agree that a number of the above dimensions should be included in QoL questionnaires, and that QoL is a multidimensional construct. Because there are so many potential dimensions, it is impractical to try to assess all these concepts simultaneously in one instrument. Most instruments intended for health-status assessment include at least some items that focus upon physical, emotional and social functioning. For example, if emotional functioning is accepted as being one aspect of QoL that should be investigated, then several questions could evaluate anxiety, tension, irritability, depression, and so on. Thus instruments may contain many items. Although a single global...
Jon Wool, an attorney working in public policy, explains the current status of litigation as a driving force for improving health and health care for inmates. He describes the vehicles for this litigation including constitutional entitlements through the Eighth and Fourteenth Amendments, the Americans with Disabilities Act, and the Constitutional Rights of Institutionalized Persons Act. Mr. Wool also describes the barriers to legal enforcement created by the Prisoner Litigation Reform Act. Behind bars, litigation has driven constructive change for more than 30 years, yet it has been frustrating for correctional administrators and policy makers when they are the objects of these lawsuits. The author posits the value of litigation for improving medical care in prisoners.
As the name implies, there are 36 questions addressing eight health concepts (a simpler 12-question form, the SF-12, is also available). There are two summary measures, physical health and mental health. Physical health is divided into scales for physical functioning (10 items), role-physical (4), bodily pain (2) and general health (5). Mental health comprises scales for vitality (4 items), social functioning (2), role-emotional (3) and mental health (5). In addition, there is a general health transition question, which asks Compared to one year ago, how would you rate your general health now There is also a global question about the respondent's perception of their health In general, would you say your health is (excellent, very good, good, fair, poor) Most questions refer to the past four weeks, although some relate to the present. A few questions, such as those for role-physical , take yes no responses, while some, such as the physical functioning items, have three categories...
In a 2002 article, Bandura explained the benefits for health promotion and disease prevention By managing their health habits, people can live longer, healthier, and slow the process of aging. To stay healthy, people should exercise, refrain from smoking, reduce the amount of dietary fat, keep blood pressure down, and develop effective ways of coping with stressors. Of course, most people know about the benefits of healthy lifestyle habits. Turning that knowledge into action is not always easy, though. High perceived self-efficacy helps people have the confidence to make needed changes and the determination to stick with them. One interesting line of research has looked at public health messages that are aimed at getting people to make healthy lifestyle changes. There are several possible approaches giving people factual information, instilling fear, changing people's perception of the risks involved, or enhancing people's perceived self-efficacy. Research has shown that the most...
Immunisation against hepatitis B is now recognised as a high priority in preventive medicine in all countries and strategies for immunisation are being revised. Universal vaccination of infants and adolescents is under examination as the strategy to control the transmission of this infection. More than 90 countries now offer hepatitis B vaccine to all children, including the USA, Canada, Italy, France and most western European countries. However, immunisation against hepatitis B is at present recommended in a number of countries with a low prevalence of hepatitis B only to groups that are at an increased risk of acquiring this infection. These groups include individuals requiring repeated transfusions of blood or blood products, prolonged inpatient treatment, patients who require frequent tissue penetration or need repeated circulatory access, patients with natural or acquired immune deficiency and patients with malignant diseases. Viral hepatitis is an occupational hazard among...
A review on discovery of novel products from plants should also briefly address the important role of plant extracts, which have been used in medicine since the beginning of mankind and still play an important role in modern medicine. The key issue for commercialization of herbal-based medicines is standardization and consistency of material. Adulteration or even contamination is a potential risk. However, recent successes of plant-derived products, increasing interest in Chinese and Indian medicine, and favorable regulations for commercialization have created a fast-growing market for herbal-based medicines and nutraceuticals (Table 2). In addition to most major pharmaceutical companies, several small companies are specializing in such products (a list of Internet addresses is given at the end of the reference list).
CFor example, a segment of ABC's 20 20 (broadcast on 16 January 1998) reported that this discovery would lead to the development of anti-aging drugs within 5 to 10 years, and one researcher interviewed on camera predicted healthy life spans of several hundred years. The finding itself was reported in Science magazine (54).
Public health is the art and science of preventing disease and injury, prolonging life, and promoting health through the organized efforts of society. Public health practice informs and empowers individuals and communities, and creates healthy environments through the use of evidence-based strategies and accountability mechanisms. The balance of health risks and health gains is the essential issue in considering the public health impacts of prisons (Glaser & Greifinger, 1993).
Loring, a 60-year-old white female in apparently good health, went to Dr. George with complaints of vague chest pain. Her cholesterol was slightly elevated, so Dr. George ordered a treadmill stress test with the injection of a radioactive dye that would allow the cardiologist to visualize the overall coronary blood flow. Mrs. Loring showed good coronary blood flow before exercise, some EKG abnormalities before and during exercise, and a cold spot after exercise, suggesting that blood flow to part of her heart muscle was less than it should be in response to exercise. The cardiologist recommended a cardiac catheterization, in which dye was injected directly into her coronary blood vessels so that they could be visualized. The result showed 25 blockage in one artery, not enough to explain her chest pain. The cardiologist did, however, diagnose a minor problem with Mrs. Loring's mitral valve, which he said was consistent with her symptoms.
Tactile nurturance, consisting of secure holding and hugging, is essential for the formation of a healthy body image (Gupta et al., 1995), including cutaneous body image. When there is neglect and or abuse in early life, the infant does not experience healthy tactile nurturance and may be predisposed to developing body image problems in later life. It has been observed that a perceived lack of adequate tactile nurturance is associated with body image problems (Gupta et al., 1995). A patient with a significant history of trauma or neglect may therefore present with dissatisfaction with their body image including cutaneous body image.
Healthy living guidelines Before discharge, signs and symptoms of rejection, adverse reactions to medications, recommended routine screening, vaccine recommendation, exercise, and healthy living guidelines are reviewed. Tables 6.1 and 6.2 outline a formal, posttransplant medication teaching plan for a renal transplant recipient. Additional reinforcement or new teaching methods can be instituted to avoid complications. Outpatient clinic visits present an excellent opportunity to assess the patient for changing needs. As the patient recovers, new information may be introduced.
The first clinical microsystem research was completed by Julie Mohr and Molla Donaldson in 2000 (Donaldson & Mohr, 2000). In this research the success characteristics of high-performing microsystems were first identified. The significance of the microsystem for improving the U.S. health system was called out by Berwick in the chain of effect for improving health care (Figure 1.1, in Chapter One), and this thinking lies behind the Institute of Medicine (IOM) report Crossing The Quality Chasm (Institute of Medicine U.S. , Committee on Quality of Health Care in America, 2001).
Estimated average requirement3 (EAR) the average daily nutrient intake level estimated to meet the requirement of half the healthy individuals in a particular life stage and gender group Estimated energy requirement (EER) the EER is defined as the average dietary energy intake that is predicted to maintain energy balance in a healthy adult of a defined age, gender, weight, height, and level of physical activity consistent with good health. In children and pregnant and lactating women, the EER is taken to include the needs associated with the deposition of tissues or the secretion of milk at rates consistent with good health
It is clear that it is never going to be possible to argue that a genetically modified plant is safe any more than to argue that a plant produced by conventional plant breeding is safe. The very concept can be addressed only in the context of a history of safe use as a human food. Clearly, the overwhelming evidence supports the view that health benefits arise as a consequence of the regular consumption of a variety of fruits and vegetables, few if any of which have any close compositional relationship to the wild types from which they were bred. Similarly, their production, storage, and distribution have depended on the use of a wide range of chemical fertilizers and pesticides. These chemicals are extensively tested for safety before approval is given for their marketing and use, but this has not removed the widely held view among consumers that organic products are better for your health. There is no evidence to support this view, and any adverse health effects that there might be...
Different educational HIV prevention efforts have measured their successes with different outcomes. Though the bottom line outcome is not getting infected, there are a myriad of other outcomes that indirectly impact HIV incidence. Outcomes that should be considered for evaluation of programs include condom use and use of sterile injection equipment both inside and after release. The next level of outcomes among those who are released include decreased alcohol drug use with sexual activity, and if available, use of needle exchange programs, substance abuse and mental health treatment. Finally, with many prisoners not connected with community services, working with community case managers (including parole probation) to access services and stay out of the criminal justice system should be considered as outcome measures. For someone with HIV, success would also include access and utilization of community health services. A successful community reintegration would also include housing,...
In the case of more than two categories, there are many situations when they can be ordered in some way. For example, the SF-36 question 1 asks In general, would you say your health is Excellent, Very good, Good, Fair, Poor In this case there are five ordered categories ranging from Excellent to Poor. The proportion or percentage of subjects falling into these five categories can be calculated, and in some situations these categories may be given a corresponding ranking 1, 2, 3, 4 and 5 which may then be used for analysis purposes. An example is the test-for-trend as alluded to in Table 8.2 (see below). However, although numerical values are assigned to each response, one cannot always treat them as though they had a strict numerical interpretation, as the magnitude of the differences between, for example, Excellent (Rank 1) and Very good (2) may not necessarily be the same as between Fair (3) and Poor (4). Stiggelbout et al. (1997) posed three questions assessing fear of recurrence...
Finally, the Health in Prisons Project (HIPP) was started in Europe in 1995 by the WHO with the goal of improving health in prisons in order to improve public health (Gatherer et al., 2005). Member countries (there are currently 28) have pledged the resources necessary to build a public health infrastructure in prisons and participate actively in the collaboration (Whitehead, 2006).
Prisons typically house people sentenced to more than a year and include individuals who will never be released from the facility. Longer lengths of stay and a more secure and stable environment sometimes enable prisons to have more opportunities for planned health activities and to have the intensity and duration of contact needed to achieve health goals. On the other hand, prisons have more limited interactions with families and communities, reducing their potential to have an impact on population health (Austin & Hardyman, 2004).
While to our knowledge no correctional system has yet implemented a comprehensive and integrated health promotion initiative, in fact all elements of such a program have been implemented in some correctional facilities. Moreover, the evaluation of many such interventions shows that some have been shown to be effective or promising in achieving health outcomes or demonstrating feasibility.
Another dimension of the correctional environment that has been inadequately studied is food. While adequate nutrition is an essential component of health, incarcerated populations lose the right to choose their diet. In some facilities, processed, tasteless foods are used as a punishment for inmates who have violated rules. In a few, agricultural programs provide incarcerated individuals with an opportunity to learn gardening or farming skills and to provide fresh produce for the facility and other facilities have offered heart-healthy diets. Few correctional facilities have examined the nutritional quality of food items offered in inmate canteens. Having access to a balanced diet that promotes health would appear to be a basic human right whether improved nutrition could lead to improved health or criminal justice outcomes has yet to be studied. Given high rates of diabetes and obesity in the low-income communities from which most people in correctional facilities come and return...
Healthy public policy makes it easier for individuals and institutions to choose behaviors that promote health. If we accept the premise that our correctional systems ought to contribute to improved societal well-being and improved public safety, then we need to ask what public policies will enable jails and prisons to realize these goals. To date, few elected officials or correctional systems have systematically considered the mission of prisons and jails from this perspective. What role can correctional health professionals play in creating healthier public policies As in other sectors, they can convene stakeholders to identify policy obstacles, provide evidence to support the value of policy change advocate for specific policies that will promote health and help to ensure that healthier policies are in fact implemented. For the most part, health professionals cannot achieve these goals on their own, but in our experience, the participation of health professionals often adds...
Time trade-off involves comparing QoL against length of survival. A typical strategy for evaluating TTO is to present a scenario under which health is impaired by specific disabilities or symptoms, and to ask the patient whether he or she would choose one year in perfect health or one year with impaired health presumably, the healthy year would be selected. Then the duration of the healthy period is gradually reduced Would you choose 11 months in perfect health, or one year with impaired health , and so on. At some stage equilibrium should be reached, and it may then be concluded that the value of impaired life is equivalent to a certain percentage of time relative to healthy life.
We invite you to take microsystem thinking into all the nooks and crannies of your health system. Make a line-of-sight plan for going from statements of vision and mission and values and strategy all the way to the front line of care where these statements either become actions for the benefit of patients and the community or they do not. Make it possible for your health system to have the characteristics of a hologram. By this we mean that the smallest units embody all of the elements of the largest units with respect to the ends (vision) and the means (strategy) and the worthy aims (values) that inspire people to put forth their best effort and feel good about their work, rather than feeling worn down by the grind.
I was in basically good health for a man of my age. My cholesterol count was under 180 blood pressure level was normal, I did not and do not have any cardiovascular problems, no allergies, no respiratory problems, etc. Like most men who were active athletically in their young adult years, I knew I was in good health and did not get a regular physical each year, as I felt I did not need a physical each year, as we all should do after age 40, and especially if there is a history of cancer or other diseases in your family history.
Severe resource constraint is a major issue in designing and managing the health services in developing countries. Since the available funds cannot meet all the health needs of the community, it is vital to ensure that the limited resources are wisely spent so as to achieve the maximum returns for minimum spending. A number of developing countries, notably Chile, Sri Lanka, China and Cuba have devised and managed highly successful health programmes with the limited resources available to them. Their models for achieving 'good health at low cost' have provided worthy examples for other countries to follow. There are relatively cost-effective interventions available against the diseases that account for most of disease, disability and death in developing countries and particularly to combat deaths and health losses among young school health programmes to treat worm infections and micronutrients deficiencies and to promote health education
The interpregnancy period offers an important window of opportunity for addressing these risk factors and optimizing women's health before their next pregnancy. At present, access to health care in the interpregnancy period is limited for many women, particularly low-income women, whose pregnancy-related Medicaid coverage generally terminates at 60 days postpartum (Gold, 1997). Expansion of Medicaid coverage to low-income women who had a preterm birth (e.g., through a Medicaid waiver) is one policy option for improving health care access for these women in the interpregnancy period. Several demonstration programs on interconception care have been completed or are ongoing (Donlop and Brann, 2005 IHPIT, 2003) however, their ef
Bassuk, ScD, Epidemiologist, Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA JoAnn E. Manson, MD, DrPH, Chief, Division of Preventive Medicine, Brigham and Women's Hospital Professor of Medicine and Elizabeth F. Brigham Professor of Women's Health, Harvard Medical School, Boston, MA Cheryl L. Rock, PhD, RD, Associate Professor, Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, CA
The SF-36, SF-12, and other HQOL measures, with manuals, instructional materials, etc., describing how to use them in research and clinical practice, are available from QualityMetric Inc., a company formed by John E. Ware, Jr., Ph.D., to develop and disseminate the next generation of outcome assessments and analytic services for improving health care from the patient point-of-view. QualityMetric Inc. and its affiliate, the Health Assessment Lab, have two locations
We have developed this workbook with tools to give ideas to those interested in improving health care. Dartmouth-Hitchcock Medical Center and the developers of this workbook are pleased to grant use of these materials without charge, providing that recognition is given for their development, that any alterations to the documents for local suitability and acceptance are shared in advance, and that users limit the uses of these documents to their own needs. These documents are not for re-sale.
I did not have to awaken from that operation I have had a stable PSA reading of 0.1 since the operation with reasonable good health. I am a survivor, because I finally listened to my wife, started receiving a yearly medical examination, and lot of prayers. I'm on a 'Mission' to tell the story of my survival from prostate cancer and hopefully save many lives.
A 70-yr-old man presented with a slightly hyperpigmented nodule on his hand that had been growing slowly for the past 3-4 mo. It was not painful and he was otherwise in good health. The nodule was firm and had no overlying surface changes. The clinical differential diagnosis included dermatofibroma, dermatofibrosarcoma protuberans, Kaposi's sarcoma and a foreign body giant cell granulomatous reaction. A biopsy was performed and is represented in Fig. 5A,B.
Dency training program that leads to certification by the American Board of Preventive Medicine. Residencies are inspected and approved by the Board, and may be in one of four areas public health, general preventive medicine, occupational medicine, or aerospace medicine. Various concentrations in medical management are also becoming recognized. In the UK, registrar positions in most of these specialties are advertised, and the Diplomas in Occupational or Public Health, membership of the Faculties of Occupational or Public Health, and the Diploma in Aviation Medicine would provide equivalent experience and certification. In the USA, the academic equivalent of these, which can often be pursued in parallel, is to obtain the additional degree of Master of Public Health (MPH). Board certification through a preventive medicine residency requires such formal academic training and an MPH degree. Again, European equivalents exist. A 4-5 year program can accomplish all of these. Additionally,...
Medicinal plants have been the subject of man's curiosity and purpose since time immemorial. The importance of medicinal plants in the treatment of chronic diseases needs no elaboration. In fact, even with the tremendous advancement in the field of synthetic chemistry, almost 50 of the commercial drugs available in the market remain of plant origin. The herbal system was, however, pushed to the background with the advent of allopathic system. It is now back with a venegence and the age-old system of herbal medicine is being revived due to its long lasting curative effect, easy availability, natural way of healing and rare or no reported side effects. Due to growing world population, increased anthropogenic activities, rapidly eroding natural ecosystem etc., the natural habitat for a great number of plants are dwindling and many of them are facing extinction 1 . The inevitable ruthless exploitation of herbs leading to their rapid depletion from the wild is a cause for concern. In fact,...
Population genetic studies are a recent important expansion of the field of genetics and the knowledge thus acquired can be of practical value in preventive medicine, in the form commonly referred to as genetic counselling. This is particularly important in the situation, as it is at present in Africa, where sickle-cell anaemia has an incidence oJ iieifrJj 2 in some countries and may be responsible for -a childhood mortality of approximately 5 ,it i 1000.
Program, and targeted programs in areas such as improving health insurance coverage for children with special health care needs and grants to support the development of regional systems of care for various health conditions. Recent renewals of the Title V enabling legislation have charged the federal Maternal and Child Health Bureau with the responsibility of supporting the development of systems of care for children with special health care needs. The federal response to the U.S. Supreme Court Olmstead decision furthered this responsibility by again defining the bureau as the lead agency for community service systems, helping to ensure the integration of children with special health care needs into communities (New Freedom Initiative). These community service programs are meant to help organize the complex variety of services that children with chronic conditions may need.
The focus of this investigation is to compare the effects of different breast cancer screening policies and the costs directly related to these policies, based on the models introduced in the last sections. The health outcome of interest is the expected gain in quality-adjusted survival. We interpret this quality adjustment to be relative to a typical health history rather than that of a state of perfect health PBW99 . Quality adjustments are important because they allow, with certain limitations, to account for the effects of medical intervention on morbidity as well as mortality. In screening this is especially important becasue of the so-called overdiagnosis problem. While beneficial to many women, screening leads to discovering cancer that would have not otherwise affected certain womens health. While lenght of life may be unaffected, this is a considerable loss of quality of life. Also, early detection can prolong the portion of one's life spent as a cancer survivor. The specific...
Improved health and increased longevity in societies sets in motion a self-perpetuating system of longevity extension. This positive feedback relationship is based on the demographic tenet that (all else being equal) increased survival from birth to sexual maturity reduces the number of children desired by parents (15). Because of the reduced drain of childbearing and child rearing, parents with fewer children remain healthier longer and thus raise healthier children. The higher survival rate of these children fosters yet further reductions in fertility. Greater longevity of parents also increases the likelihood that they can contribute as grandparents to the fitness of both their children and their grandchildren. And, the self-reinforcing cycle continues.
Belgrave, Lewis, & Scott (1994) investigated the role of social support on health care adherence in a population of African Americans with sickle cell disease and diabetes. One hundred twenty-seven persons (49 with sickle cell disease and 78 with diabetes) completed a questionnaire that assessed the availability of emotional, cognitive, and material support. Health care adherence regarding appointments and health behaviors (i.e., diet, exercise, regular blood pressure tests, taking medication) were also obtained through this self-report questionnaire. The results of this study indicated a significant correlation between the availability of social support and health care adherence. Social support was related to whether or not the person kept his or her medical appointments and whether or not the person engaged in good health behaviors such as
To describe the origin of clinical microsystem thinking, and the research on it, and to identify microsystems in your health care system. Define and identify the clinical microsystems in your health care system. This chapter will assist you and your interdisciplinary lead improvement team to gain insight about the origins and significance of clinical microsystems in your health care system.
Why does one child who watches a violent cartoon hit a playmate afterward, while another plays peacefully Why does one teenager abuse drugs and alcohol, while another chooses a healthier lifestyle Why does one employee stay motivated to succeed, while another falls prey to apathy and self-doubt These are some of the kinds of questions addressed by personality psychology.
Single-item global questions are frequently categorical in form, and these offer limited precision. For example, the SF-36 asks In general, would you say your health is . . . (response categories from 1 excellent to 5 poor), while the EORTC QLQ-C30 asks How would you rate your overall quality of life during
There was one study of a type 1 intervention, four of type 2 interventions, one of a type 3 intervention, none of a type 4 intervention, two of a type 5 intervention and eight of type 6 interventions. All of the studies included actions in the community, and all of the interventions that had activities aimed at improving health facilities also included training for service providers and, sometimes, other clinic staff.
It has been suggested that hardiness is a broad, positive personality variable that affects one's propensity for developing stress-related illness. Hardiness is made up of three more specific characteristics commitment (becoming involved in things that are going on around oneself), challenge (accepting the need for change and seeing new opportunities for growth in what others see as problems), and control (believing that one's actions determine what happens in life and that one can have an effect on the environment). It has been hypothesized that people who possess these characteristics are less likely to develop stress-related disorders because they view stressful situations more favorably than do other people. Commitment and control seem to be more influential in promoting health. Locus ofcontrol is a related concept which has received much attention.
The specialty practice of preventive medicine extends into the realm of pharmaceutical medicine just as deeply as better-recognized disciplines such as clinical pharmacology or toxicology. Pharmaceutical physicians may often be found practicing preventive medicine under the guise of clinical research or regulatory affairs, or in separate departments of pharmacoepidemiology, health economics or outcomes research, as well as the perhaps more predictable aegis of drug safety and pharmacovigi-lance. Preventive Medicine Public Health physicians, alias pharmacoeconomists and pharmacoepide-miologists, are trained in the core sciences of public health epidemiology and statistics along with their non-physician pharmacoepidemiology colleagues. But, being physicians, they are also steeped in pathophysiology, diagnostics, therapeutics, and behavioral sciences. Additionally, specialization in preventive medicine requires detailed education in environmental health and general management and...
The word has three components, from the Greek epi, upon demos, the people and logos, the study. These elements describe the fundamentals of what epidemiology is all about, the application of scientific principles to the understanding of health issues which are 'upon the people'. All pharmaceutical physicians need an understanding ofthe fundamentals of this field, in order to understand and harness the value that epidemiology, and epidemiologists, can bring to drug development and product surveillance programs. Epidemiology is taught in all schools of public health and, in varying depth and quality, in schools of medicine. Epidemiological techniques are used by many people who would not describe themselves as epidemiologists. Board certification in preventive medicine requires a Master's degree with a large epidemiology component, and further tough examinations.
F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14, 245-258.
Maslow is still recognized as an important influence on counseling and psychotherapy. While the field of counseling psychology has moved beyond many of Maslow's ideas, a large number of clinical and counseling psychologists continue to identify themselves as humanistic in their orientation. Maslow's works are still read by students in these fields, and his books, particularly Toward a Psychology of Being, can be found in the libraries of many practicing counselors and psychotherapists. Maslow's insistence on studying healthy functioning is now seen as an obvious step toward understanding human behavior, and his thoughts on human potential and aspirations continue to inspire people in the helping professions.
)3-Sitosterol, which chemically resembles cholesterol, inhibits the absorption of cholesterol. 3-Sitosterol alone or combined with other phytosterols has been shown to reduce the plasma total cholesterol and low-density lipoprotein (LDL) levels in human subjects (8). It is also able to relieve the symptoms of benign prostatic hyperplasia (BPH) and is used in herbal remedies indicated for the treatment of this ailment (9). 3-Sitosterol and its saturated derivative, j3-sitostanol, are used as cholesterol-lowering agents in different kinds of functional foods.
Maintaining The Body
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