A Lifetime of Work: A Guide to Health Promotion and Wellness on the Farm

The purpose of this project is to develop a guide to health promotion, wellness and adapting to life changes on the farm from an occupational therapy perspective to enhance quality of life for aging farmers and rural community dwellers. The authors completed a focused literature review on topics related to health promotion, wellness, adapting to life changes, making changes and aging in place. Data was collected through an extensive study of relevant information through professional journals, clinical text books, class discussion and related state and national associations. Upon completion of the review of literature, it was determined that older adults would benefit from resources guiding their continued participation within their own contexts resulting in an increase in quality of life. The guide to health promotion and wellness is designed within the foundation of the Ecology of Human Performance (EHP) model and the Seven Dimensions of Wellness model for aging individuals on the farm. EHP provided a framework for interventions of adapting/modify, altering/ preventing (further problems) within the environment by looking at the person, task, context, and person-context-task interaction. The Seven Dimensions of Wellness (Witmer and Sweeney, 1992) encompasses a greater depth of the experience of the individual in all dimensions of his or her life. These dimensions include: social, emotional, spiritual, environmental, occupational, intellectual, and physical dimension. The Seven Dimensions of Wellness is being used within the product as a way to incorporate the holistic view of our consumers and provided a deeper understanding of the aging adult. The resulting guide is a self-assessment tool to be used by farmers to promote longevity while living on the farm. It addresses issues related to aging in place, how to survey the farm, and the importance of accessibility and participation within a chosen context. The guide is designed to be disseminated directly to working farmers, or provided by other healthcare and non-healthcare professionals working with farmers. This guide is tool for aging individuals, family/caregivers, and related professions working within the rural community. The goals of the guide are two-fold: (1) To increase the quality of life in aging farmers by empowering them to make the appropriate changes necessary to successfully age in place, and (2) to be used by all disciplines/professions in a variety of contexts working with aging farmers

A Character Study of Two Trouser Roles For Mezzo-Soprano In Opera: Cherubino From W. A. Mozart\u27s Le Nozze Di Figaro and Octavian From R. Strauss\u27s Der Rosenkavalier

Trouser roles are roles in opera in which women portray young men. These roles present a special problem for the singer-actor - the problem of performing a character through transvestism. This thesis is a study of two popular trouser roles for mezzo-soprano. It addresses the general history of trouser roles and the specific characters of Cherubino from W. A. Mozart\u27s Le Nozze di Figaro and Octavian from R. Strauss\u27s Der Rosenkavalier. The study analysis of these two roles incorporates the history of the characters as reflected through the development of librettos in which they appear, a character study focusing on acting and technical problems for the performer, and musical analysis relevant to the understanding of these two trouser roles

A morphological comparison of two Canadian populations of the pink striped oakworm (Anisota virginiensis Drury) (LEPIDOPTERA: SATURNIIDAE)

This thesis involves a morphological and physiological comparison of two Canadian populations (Manitoba and Nova Scotia), and several USA populations of adult pink-striped oakworm (Anisota virginiensis) moths. It was hypothesized that there would be no significant differences in morphological characteristics of these adult moths (i.e., body length, wingspan, and colouration). Adult moth body lengths and wingspans were measured. By using a series of t-tests none of the populations were deemed to be significantly different. However there appears to be a modest trend towards smaller adult moths from northern and western parts of the range of this moth. Additionally, adult wing colouration was quite different amongst populations. Further research using mDNA procedures may indicate that certain populations of the pink-striped oakworm are new species

Appetite suppressants and valvular heart disease - a systematic review

Background Although appetite suppressants have been implicated in the development of valvular heart disease, the exact level of risk is still uncertain. Initial studies suggested that as many as 1 in 3 exposed patients were affected, but subsequent research has yielded substantially different figures. Our objective was to systematically assess the risk of valvular heart disease with appetite suppressants. Methods We accepted studies involving obese patients treated with any of the following appetite suppressants: fenfluramine, dexfenfluramine, and phentermine. Three types of studies were reviewed: controlled and uncontrolled observational studies, and randomized controlled trials. Outcomes of interest were echocardiographically detectable aortic regurgitation of mild or greater severity, or mitral regurgitation of moderate or greater severity. Results Of the 1279 patients evaluated in seven uncontrolled cohort studies, 236 (18%) and 60 (5%) were found to have aortic and mitral regurgitation, respectively. Pooled data from six controlled cohort studies yielded, for aortic regurgitation, a relative risk ratio of 2.32 (95% confidence intervals 1.79 to 3.01, p < 0.00001) and an attributable rate of 4.9%, and for mitral regurgitation, a relative risk ratio of 1.55 (95% confidence intervals 1.06 to 2.25, p = 0.02) with an attributable rate of 1.0%. Only one case of valvular heart disease was detected in 57 randomized controlled trials, but this was judged unrelated to drug therapy. Conclusions The risk of valvular heart disease is significantly increased by the appetite suppressants reviewed here. Nevertheless, when considering all the evidence, valvulopathy is much less common than suggested by the initial, less methodologically rigorous studies

Nasjonale faglige retningslinjer for forebygging og behandling av underernæring

Retningslinjen omfatter anbefalinger om identifisering og behandling av underernærte samt pasienter i ernæringsmessig risiko i sykehus, sykehjem og hjemmebaserte tjenester

Do Health Beliefs and Behaviors Differ According to Severity of Obesity? A Qualitative Study of Australian Adults

Public responses to obesity have focused on providing standardized messages and supports to all obese individuals, but there is limited understanding of the impact of these messages on obese adults. This descriptive qualitative study using in-depth interviews and a thematic method of analysis, compares the health beliefs and behaviors of 141 Australian adults with mild to moderate (BMI 30−39.9) and severe (BMI ≥ 40) obesity. Mildly obese individuals felt little need to change their health behaviors or to lose weight for health reasons. Most believed they could “lose weight” if they needed to, distanced themselves from the word obesity, and stigmatized those “fatter” than themselves. Severely obese individuals felt an urgent need to change their health behaviors, but felt powerless to do so. They blamed themselves for their weight, used stereotypical language to describe their health behaviors, and described being “at war” with their bodies. Further research, particularly about the role of stigma and stereotyping, is needed to fully understand the impact of obesity messaging on the health beliefs, behaviors, and wellbeing of obese and severely obese adults

Use of dietary supplements by female seniors in a large Northern California health plan

BACKGROUND: Women aged ≥ 65 years are high utilizers of prescription and over-the-counter medications, and many of these women are also taking dietary supplements. Dietary supplement use by older women is a concern because of possible side effects and drug-supplement interactions. The primary aim of this study was to provide a comprehensive picture of dietary supplement use among older women in a large health plan in Northern California, USA, to raise awareness among health care providers and pharmacists about the need for implementing structural and educational interventions to minimize adverse consequences of self-directed supplement use. A secondary aim was to raise awareness about how the focus on use of herbals and megavitamins that has occurred in most surveys of complementary and alternative therapy use results in a significant underestimate of the proportion of older women who are using all types of dietary supplements for the same purposes. METHODS: We used data about use of different vitamin/mineral (VM) supplements and nonvitamin, nonmineral (NVNM) supplements, including herbals, from a 1999 general health survey mailed to a random sample of adult members of a large Northern California health plan to estimate prevalence of and characteristics associated with supplement use among women aged 65–84 (n = 3,109). RESULTS: Based on weighted data, 84% had in the past 12 months used >1 dietary supplement, 82% a VM, 59% a supplement other than just multivitamin or calcium, 32% an NVNM, and 25% an herbal. Compared to white, nonHispanic women, African-Americans and Latinas were significantly less likely to use VM and NVNM supplements and Asian/Pacific Islanders were less likely to use NVNM supplements. Higher education was strongly associated with use of an NVNM supplement. Prevalence did not differ by number of prescription medications taken. Among white, nonHispanic women, multiple logistic regression models showed that college education, good health, belief that health practices have at least a moderate effect on health, and having arthritis or depression significantly increased likelihood of NVNM use, while having diabetes decreased likelihood. CONCLUSIONS: An extremely high proportion of older women are using dietary supplements other than multivitamins and calcium, many in combination with multiple prescription medications. Increased resources should be devoted to helping clinicians, pharmacists, supplement vendors, and consumers become more aware of the safety, effectiveness, and potential side effects of dietary supplements

Risk of valvular heart disease associated with use of fenfluramine

BACKGROUND: Estimates of excess risk of valvular heart disease among prior users of fenfluramine and dexfenfluramine have varied widely. Two major forms of bias appear to contribute to this variability and also result in a systematic under-estimation of risk. The first, a form of nondifferential misclassification, is the result of including background, prevalent cases among both exposed and unexposed persons in calculations of risk. The second bias results from not considering the relatively short duration of exposure to drugs. METHODS: We examined data from all available echocardiographic studies reporting the prevalence of aortic regurgitation (AR) and mitral regurgitation (MR) among persons exposed to fenfluramine or dexfenfluramine and a suitable control group. We also included one study in which previously existing AR or MR had been excluded. We corrected for background prevalent cases, estimated incidence rates in unexposed persons, and performed a person-years analysis of apparent incidence rates based on exposure time to provide an unbiased estimate of relative risk. RESULTS: Appearance of new AR was strongly related to duration of exposure (R(2 )= 0.75, p < 0.0001). The summary relative risk for mild or greater AR was 19.6 (95% CI 16.3 – 23.5, p < 0.00001); for moderate or greater MR it was 5.9 (95% CI 4.0 – 8.6, p < 0.00001). CONCLUSION: These findings provide strong support for the view that fenfluramine and dexfenfluramine are potent causal factors in the development of both aortic and mitral valvular heart disease