Health care and subjective well-being in nations

With the ever-increasing costs incurred by medical health care in the majority of the industrialized nations of the world, attempts have been made to identify and rectify the deficiencies in the health industry and improve quality management assessment. A central question for politicians and researchers is, to what extent does a country's health care system influence the subjective well-being in its citizens

Effects of Pilates-Based Exercise on Life Satisfaction, Physical Self-Concept and Health Status in Adult Women

The objective of this study was to determine the effect of Pilates- based mat exercises on life satisfaction, perception of appreciation by other people, perception of physical appearance, perception of functionality, total physical self-concept, and perception of health status in healthy women. A randomized controlled trial was con- ducted in Évora, Portugal, in 2008, in which 62 healthy adult women were randomized to a Pilates-based mat (experimental group) (n D 38, mean age ̇ SD, 41.08 ̇ 6.64 years) or a control group (n D 24, mean age ̇ SD, 40.25 ̇ 7.70 years). Experimen- tal group participants performed the Initial Mat of Body Control Pilates twice per week, 60-minutes per session. Repeated measure- ments were performed at baseline, 3 months and 6 months. No significant differences between the two groups were observed in life satisfaction, perception of appreciation by other people, perception of physical appearance, perception of functionality, total physical self-concept, and perception of health status at three time point measures (baseline, after 3 months, and after 6 months). No sig- nificant differences were observed in the control group over time. The experimental group showed significant improvements between baseline and six months in life satisfaction (p D .04), perception of appreciation by other people (p D .002), perception of physical appearance (p D .001), perception of functionality (p D .01), total physical self-concept (p D .001), perception of health status (p D .013) and between three and six months in life satisfaction (p D .002), perception of appreciation by other people (p D .05), perception of physical appearance (p D .001), perception of func- tionality (p D .02), and total physical self-concept (p D .001). Life satisfaction, perception of appreciation by other people, perception of physical appearance, perception of functionality, total physical self-concept and perception of health status may improve after 6 months of Pilates-based mat exercise

Antimicrobial Resistance in Neisseria gonorrhoeae: Proceedings of the STAR Sexually Transmitted Infection-Clinical Trial Group Programmatic Meeting.

The goal of the Sexually Transmitted Infection Clinical Trial Group's Antimicrobial Resistance (AMR) in Neisseria gonorrhoeae (NG) meeting was to assemble experts from academia, government, nonprofit and industry to discuss the current state of research, gaps and challenges in research and technology and priorities and new directions to address the continued emergence of multidrug-resistant NG infections. Topics discussed at the meeting, which will be the focus of this article, include AMR NG global surveillance initiatives, the use of whole genome sequencing and bioinformatics to understand mutations associated with AMR, mechanisms of AMR, and novel antibiotics, vaccines and other methods to treat AMR NG. Key points highlighted during the meeting include: (i) US and International surveillance programs to understand AMR in NG; (ii) the US National Strategy for combating antimicrobial-resistant bacteria; (iii) surveillance needs, challenges, and novel technologies; (iv) plasmid-mediated and chromosomally mediated mechanisms of AMR in NG; (v) novel therapeutic (eg, sialic acid analogs, factor H [FH]/Fc fusion molecule, monoclonal antibodies, topoisomerase inhibitors, fluoroketolides, LpxC inhibitors) and preventative (eg, peptide mimic) strategies to combat infection. The way forward will require renewed political will, new funding initiatives, and collaborations across academic and commercial research and public health programs

Children’s learning from a Smokefree sports programme: implications for health education

Objective: This article reports on a qualitative evaluation of the Love Life, Smokefree Sports primary school pilot intervention. This 8-week programme used sports and physical activity sessions to convey Smokefree messages to 120 children aged 10 and 11 in two primary schools in Sheffield in 2018. The study aimed to understand children’s experiences of participating in the programme. Its objectives were to explore children’s recall of the health promotion messages associated with each of the learning sessions; explore children’s perceptions of the meaningfulness of those messages in the context of their everyday lives; and identify and understand any contextual factors that might impact upon children’s recall and/or the meaningfulness of the Smokefree messages. Method: Qualitative data were generated with 25 children through focus groups after the programme concluded. Data were analysed thematically using cross-sectional, categorical indexing. Results: Learning from the programme was particularly likely to be described as meaningful by children when they could interact with material and visual representations of complex ideas and when sessions involved strongly embodied experiences. However, children did not always find it easy to relate learning to their everyday lives and sometimes struggled to reconcile pre-existing, contextualised understandings with intervention messages. We mobilise the concept of critical health literacy as a theoretical lens through which to interpret these findings. Conclusion: Health education should be meaningful in the context of children’s everyday lives. Starting from the premise that children are active critical health literacy practitioners and working with them to design and evaluate health education initiatives can promote this

Meeting the needs of young adults with life‐limiting conditions: A UK survey of current provision and future challenges for hospices

Aim To seek views of UK children's and adult hospices on the availability and challenges of providing services for young adults with life‐limiting conditions. Background Internationally there are a growing number of young adults with life‐limiting conditions and/or complex needs which are degenerative, progressive and diverse and involve complex life‐long symptom, medication management as well as palliative care. There are 55,721 young adults, aged 18‐40 in England, which continues to increase. The hospice sector is experiencing demands to extend services for this population despite concerns about the appropriateness of adult hospices and their nursing staff to provide care for the complex and unfamiliar conditions of this patient group. Evidence is needed of hospices’ views and the main challenges faced providing services for young adults. Design Descriptive cross‐sectional survey. Methods Children and adult hospices completed an online survey exploring service provision and their views of respite care for young adults with life‐limiting conditions from 18 years old and onward. Data were collected between October 2015‐February 2016. Findings Respondents (N=76 hospices) reported that children's hospices predominantly provided short breaks and end‐of‐life care; adult hospices provided mainly symptom management, end‐of‐life care and day services. Main challenges were: a lack of existing adult respite services; lack of funding and capacity; lack of a skilled workforce in adult hospices; and the need for better integrated service provision. Conclusion Examples of good collaborative working were reported. With an increasing population of young adults and pressure on families, it is vital that services work together to find sustainable solutions to the challenges

Early Identification and Prevention of the Spread of Ebola - United States

In response to the 2014-2016 Ebola virus disease (Ebola) epidemic in West Africa, CDC prepared for the potential introduction of Ebola into the United States. The immediate goals were to rapidly identify and isolate any cases of Ebola, prevent transmission, and promote timely treatment of affected patients. CDC\u27s technical expertise and the collaboration of multiple partners in state, local, and municipal public health departments; health care facilities; emergency medical services; and U.S. government agencies were essential to the domestic preparedness and response to the Ebola epidemic and relied on longstanding partnerships. CDC established a comprehensive response that included two new strategies: 1) active monitoring of travelers arriving from countries affected by Ebola and other persons at risk for Ebola and 2) a tiered system of hospital facility preparedness that enabled prioritization of training. CDC rapidly deployed a diagnostic assay for Ebola virus (EBOV) to public health laboratories. Guidance was developed to assist in evaluation of patients possibly infected with EBOV, for appropriate infection control, to support emergency responders, and for handling of infectious waste. CDC rapid response teams were formed to provide assistance within 24 hours to a health care facility managing a patient with Ebola. As a result of the collaborations to rapidly identify, isolate, and manage Ebola patients and the extensive preparations to prevent spread of EBOV, the United States is now better prepared to address the next global infectious disease threat.The activities summarized in this report would not have been possible without collaboration with many U.S. and international partners (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/partners.html)

Physical activity and depressive symptoms in adolescents: a prospective study

Background: The frequency of mental illness amongst adolescents and its potential long-term consequences make it an important topic to research in relation to risk and protective factors. Research on the relationship between physical activity and depressive symptoms in adolescents is limited. There is a particular lack of evidence from longitudinal studies. This study examines the relationship between depression and physical activity using the Research with East London Adolescents: Community Health Survey (RELACHS).Methods: This was a prospective cohort study. Participants were recruited from three Local Education Authority boroughs in East London in 2001 from year 7 (aged 11-12) and year 9 (aged 13-14) and were followed-up in 2003. All pupils in the 28 schools that took part were eligible for the study. Of the total 3,322 pupils eligible for the survey the overall response rate was 84% (2,789 pupils). A total of 2,093 (75%) pupils were also followed-up in 2003. The sample was multiethnic (73% of respondents were non-white) and deprived. Just under half of the sample was male (49%). Depressive symptoms were measured using the Short Moods and Feelings Questionnaire (SMFQ). Logistic regression analyses were used to examine the association between physical activity and depressive symptoms both cross-sectionally and longitudinally.Results: After adjustments, there was evidence for a cross-sectional association between physical activity and depressive symptoms for both boys and girls at baseline, with a decrease in the odds of depressive symptoms of about 8% for each additional hour of exercise undertaken per week (boys: odds ratio (OR) = 0.92, 95% CI 0.85 to 0.99; girls: OR = 0.92, 95% CI 0.85 to 1.00). There was no evidence for an association between a change in physical activity from baseline to follow-up and depressive symptoms at follow-up.Conclusions: This study provides some evidence for an association between level of physical activity and decreased depressive symptoms in adolescents. Further longitudinal research of these associations is required before physical activity can be recommended as an intervention for depression in adolescents

Current drinking and health-risk behaviors among male high school students in central Thailand

<p>Abstract</p> <p>Background</p> <p>Alcohol drinking is frequently related to behavioral problems, which lead to a number of negative consequences. This study was to evaluate the characteristics of male high school students who drink, the drinking patterns among them, and the associations between current drinking and other health risk behaviors which focused on personal safety, violence-related behaviors, suicide and sexual behaviors.</p> <p>Method</p> <p>A cross-sectional study was conducted to explore current alcohol drinking and health-risk behaviors among male high school students in central Thailand. Five thousand one hundred and eighty four male students were classified into 2 groups according to drinking in the previous 30 days (yes = 631, no = 4,553). Data were collected by self-administered, anonymous questionnaire which consisted of 3 parts: socio-demographic factors, health-risk behaviors and alcohol drinking behavior during the past year from December 2007 to February 2008.</p> <p>Results</p> <p>The results showed that the percent of current drinking was 12.17. Most of them were 15-17 years (50.21%). Socio-demographic factors such as age, educational level, residence, cohabitants, grade point average (GPA), having a part time job and having family members with alcohol/drug problems were significantly associated with alcohol drinking (p < 0.05). Multiple logistic regression analysis, after adjusting for socio-demographic factors, revealed that health-risk behavioral factors were associated with current alcohol consumption: often drove after drinking alcohol (OR = 3.10, 95% CI = 1.88-5.12), often carried a weapon (OR = 3.51, 95% CI = 2.27-5.42), often got into a physical fight without injury (OR = 3.06, 95% CI = 1.99-4.70), dating violence (OR = 2.58, 95% CI = 1.79-3.71), seriously thought about suicide (OR = 2.07, 95% CI = 1.38-3.11), made a suicide plan (OR = 2.10, 95% CI = 1.43-3.08), ever had sexual intercourse (OR = 5.62, 95% CI = 4.33-7.29), alcohol or drug use before last sexual intercourse (OR = 2.55, 95% CI = 1.44-4.53), and got someone pregnant (OR = 3.99, 95% CI = 1.73-9.25).</p> <p>Conclusions</p> <p>An increased risk of health-risk behaviors, including driving vehicles after drinking, violence-related behaviors, sad feelings and attempted suicide, and sexual behaviors was higher among drinking students that led to significant health problems. Effective intervention strategies (such as a campaign mentioning the adverse health effects and social consequences to the risk groups, and encouraging parental and community efforts to prevent drinking) among adolescents should be implemented to prevent underage drinking and adverse consequences.</p

Inequalities, harm reduction and non-combustible nicotine products:A meta-ethnography of qualitative evidence

BACKGROUND: We sought to review qualitative evidence on how smokers in different socioeconomic groups engage with non-combustible nicotine products (NCNP), including electronic cigarettes and nicotine replacement therapies, in order to provide insight into how these products might impact on smoking inequalities. METHODS: We searched ten electronic databases in February 2017 using terms relating to NCNP and socioeconomic status. We included qualitative studies that were published since 1980 and were available in English. We used guidelines adapted from the Critical Appraisal Skills Programme for appraising qualitative research. RESULTS: The review only identified studies exploring the attitudes of socioeconomically disadvantaged smokers towards NCNP for harm reduction or cessation purposes (i.e. we did not identify any relevant studies of more advantaged socioeconomic groups). Using a lines-of-argument meta-ethnographic approach, we identified a predominantly pessimistic attitude to NCNP for harm reduction or cessation of smoking due to: wider circumstances of socioeconomic disadvantage; lack of a perceived advantage of alternative products over smoking; and a perceived lack of information about relative harms of NCNP compared to smoking. Optimistic findings, although fewer, suggested the potential of NCNP being taken up among smokers experiencing socioeconomic disadvantage. CONCLUSIONS: Overall, our review highlights the importance of considering the social, cultural and economic circumstances that influence experiences of smoking and of alternative product use