articles+ search results

CLUSTER analysis (Statistics), CORRELATION (Statistics), QUESTIONNAIRES, STATISTICAL sampling, SELF-evaluation, STATISTICS, DATA analysis, DESCRIPTIVE statistics, TUMOR risk factors, CHI-squared test, CONFIDENCE intervals, ALCOHOL drinking, EPIDEMIOLOGY, MEDICAL protocols, SEX distribution, SOCIAL skills, LOGISTIC regression analysis, PREDICTIVE validity, CROSS-sectional method, and HEALTH literacy

Objective: To examine self-reported alcohol consumption and relationships between consumption, awareness of the 2009 NHMRC guidelines of no more than two standard drinks per day, drinking in excess of the guideline threshold and perceptions of alcohol as a risk factor for cancer. Methods: Questions were included in annual, cross-sectional surveys of approximately 2,700 South Australians aged 18 years and over from 2004 to 2012. Consumption data for 2011 and 2012 were merged for the majority of analyses. Results: In 2011 and 2012, 21.6% of adults drank in excess of the guideline threshold (33.0% males; 10.7% females). While 53.5% correctly identified the NHMRC consumption threshold for women, only 20.3% did so for men (39.0% nominated a higher amount). A large minority said they did not know the consumption threshold for women (39.2%) or men (40.4%). In 2012, only 36.6% saw alcohol as an important risk factor for cancer. Important predictors of excess consumption for men were: higher household income; and not perceiving alcohol as an important risk factor for cancer. Predictors for women were similar but the role of household income was even more prominent. Conclusions: Men were nearly three times as likely to drink in excess of the guidelines as women. The majority of the population did not see an important link between alcohol and cancer. Awareness of the latest NHMRC guidelines consumption threshold is still low, particularly for men. Implications: A strategy to raise awareness of the NHMRC guidelines and the link between alcohol and cancer is warranted. [ABSTRACT FROM AUTHOR]

PSYCHOLOGICAL burnout, PERSONALITY, ANGER, CITY traffic, AFRICAN Americans, AUTOMOBILE drivers, and ATTITUDE (Psychology)

This study evaluates the psychosocial correlates of anger-related traits. Participants include New York City traffic enforcement agents (TEAs), who issue summonses for vehicular and parking violations and are frequently confronted by angry motorists. This sample of TEAs is 53% African American and 57% female. Participants completed surveys at 2 points, 4 months apart, which measured attitudinal, affective, and expressive components of hostility and anger, as well as dimensions of workplace psychosocial response. Results indicate that trait anger-in was positively associated with frequency of conflict, anger intensity, and burnout in cross-sectional analyses; and positively associated with frequency of conflict in prospective analyses. Trait anger was positively associated with an increase in burnout over a 4-month period. These findings provide support for the transactional model of hostility and health and have implications for worksite interventions promoting cardiovascular health. [ABSTRACT FROM AUTHOR]

DECISION making, INSURANCE companies, BANKRUPTCY, INSURANCE, BUSINESS enterprises, and REASONING

A series of studies investigate the decision processes of actuaries, underwriters, and re insurers in setting premiums for ambiguous and uncertain risks. Survey data on prices reveal that all three types of these insurance decision makers are risk averse and ambiguity averse. In addition, groups appear to be influenced in their premium-setting decisions by specific reference points such as expected loss and the concern with insolvency. This behavior is consistent with a growing analytical and empirical literature in economies and decision processes that investigates the role that uncertainty plays on managerial choices. Improved risk-assessment procedures and government involvement in providing protection against catastrophic losses may induce insurers to reduce premiums and broaden available coverage. [ABSTRACT FROM AUTHOR]

SEPSIS, BLOOD diseases, MORTALITY, and PUBLIC health

Abstract: Sepsis is the 10th leading cause of death in the United States. A 14‐hospital health system formed a multidisciplinary team to build an evidence‐based sepsis‐mortality reduction program (SMRP). SMRP leads to a statistically significant decrease in sepsis mortality, significant improvement in compliance with SEP‐1 (core measure), and statistically significant negative correlation between SEP‐1 bundle compliance rates and the sepsis‐mortality rates. Patients who received the SEP‐1 bundle were 51% more likely to survive. [ABSTRACT FROM AUTHOR]

RESEARCH funding, HYPOTHYROIDISM, WEIGHT gain, CONSTIPATION, LEVOTHYROXINE, THYROID hormones, HYPOTHYROIDISM diagnosis, HORMONES, THERAPEUTICS, DISEASE management, and THYROXINE

Hypothyroidism is a common condition of thyroid hormone deficiency, which is readily diagnosed and managed but potentially fatal in severe cases if untreated. The definition of hypothyroidism is based on statistical reference ranges of the relevant biochemical parameters and is increasingly a matter of debate. Clinical manifestations of hypothyroidism range from life threatening to no signs or symptoms. The most common symptoms in adults are fatigue, lethargy, cold intolerance, weight gain, constipation, change in voice, and dry skin, but clinical presentation can differ with age and sex, among other factors. The standard treatment is thyroid hormone replacement therapy with levothyroxine. However, a substantial proportion of patients who reach biochemical treatment targets have persistent complaints. In this Seminar, we discuss the epidemiology, causes, and symptoms of hypothyroidism; summarise evidence on diagnosis, long-term risk, treatment, and management; and highlight future directions for research. [ABSTRACT FROM AUTHOR]

TUBERCULOSIS prevention, MEDICAL care of HIV-positive persons, ISONIAZID, PTERIDINES, and DRUG efficacy

Studies the effectiveness of isoniazid versus rifampicin with pyrazinamide for prevention of tuberculosis in HIV-1 positive individuals. Methods for comparing efficacy of the chemoprophylaxis regimens; Findings; Interpretation. INSET: Disease categories.

COMMUNITY health services, MEDICAL care, EMERGENCY medical services, HOSPITAL & community, HOSPITAL care, and SOCIAL values

Objectives: This collaborative project between two community hospitals, a Metropolitan Home Care Program and the University, was designed to quantify the applicability (who is eligible for) and acceptability (who will likely comply with) Home Care services, provided through a Quick Response Program (QRP) initiative as compared to usual hospital care services, .to patients, families and physicians. Methods: During a 6 week period of `sampling (5 days per week, 8 hours per day) in two Emergency Departments (ED) in moderately sized community hospitals in a major metropolitan city, all patients triaged to the urgent category were assessed for eligibility for QRP services by on-site Home Care Coordinators using specific criteria. Patients meeting the criteria initially were reviewed by the ED physician for approval for QRP services and then randomized to experimental and control conditions. Patients not meeting the eligibility criteria were managed by the usual ED services procedures. Demographic and clinical data were obtained on all urgent category patients at presentation to the ED. Additionally, the nature and cost of all health care services used by the ED patients during the ED event and 10 days follow up, were obtained through hospital and Home Care record abstraction and compared among the different sample groups. Results: The QRP Initiative was applicable to 2% of the total ED patient population and 5% of the urgent category of patients triaged in the ED. It was acceptable to 97% of this eligible group. One hundred and fifty-five patients who initially qualified for QRP were excluded from eligibility at a subsequent assessment. Ninety of these patients were admitted to hospital and 65 were discharged home. In the total "exclusion" group, 37 refused Home Care services including the QRP. Health care practice implications: The sampling results raise important questions about broader system issues concerning the role of the hospital and community in providing health care services and the social value or utility that guides the allocation of health care funds. What level of applicability and acceptability would justify priority services for certain target groups. In the future, policy makers will need to be able to show that it is in the best interest of patients and society to prioritize mixtures of services to certain target groups. [ABSTRACT FROM AUTHOR]

SEPTEMBER 11 Terrorist Attacks, 2001, DISEASE incidence, COHORT analysis, RESPIRATORY diseases, and MENTAL health -- United States

The article presents a cohort study which examines the 9-year incidence and prevalence of physical and mental health disorders of the rescue and recovery workers in the September 11, 2001 (9/11) terrorist attacks on the World Trade Center (WTC) in New York City. The study explores the incidence rates of multiple health problems and their associations with occupational risk exposures. Findings show incidences of physical disorders such as asthma and sinusitis and mental disorders like depression.