Public health reports
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Public health reports · Jul 1987
Comparative StudyTerminal care preferences: hospice placement and severity of disease.
National Hospice Study data for 1981-82 were used to predict the location of care for terminal cancer patients. Sites of care were conventional care in hospitals, hospital-based hospice care, and hospice care in the home. Subjects were terminal cancer patients with a prognosis of less than 6 months of life who were attended by a primary concerned person. ⋯ Second, the location of care was found to be poorly explained by extent of organ involvement or specific symptoms. Third, the primary concerned persons of patients under hospice home care experienced more stress but reacted no differently when compared with primary concerned persons at other care sites. Fourth, patients under hospice home care survived the longest and reported greater family closeness than other care groups.
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Public health reports · Jan 1987
Use of hospital-based ambulatory care in New York City's Health Manpower Shortage Areas.
The development of a comprehensive data base for hospital-based ambulatory care has made possible the accurate determination of each community's use of hospitals in New York City and permits a reliable estimation of all ambulatory care received by residents of Health Manpower Shortage Areas (HMSAs). In spite of the city's abundant supply of private practitioners and widespread Medicaid coverage, residents of HMSAs in New York City are heavily dependent on hospital-based ambulatory care. Contrary to commonly held notions, however, HMSA residents do not appear to overuse hospital-based ambulatory care. Rather, that use appears to be quite modest, given their poorer health status.
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Public health reports · Jan 1987
1985 NHIS findings: nutrition knowledge and baseline data for the weight-loss objectives.
A nutrition objective for the nation is that, by 1990, 50 percent of the overweight population should have adopted weight regimens, balancing diet and physical activity. More than half of the overweight respondents in the 1985 National Health Interview Survey were trying to lose weight, and almost half of this group reported both increasing their physical activity and decreasing their intake of calories. Dietary restriction without exercise was the next most common weight-loss regimen, suggesting that educational efforts should emphasize the need to increase physical activity as part of appropriate weight-loss regimens. ⋯ More than 70 percent of adults in this survey were able to identify these as the two best ways to reduce weight, with greater proportions of the younger adults and the more highly educated being knowledgeable. The survey also provided data for an objective that targets some nutrition education and counseling as part of all routine health contacts with health professionals by 1990. Twenty-nine percent of all women and 22 percent of all men reported that eating proper foods was discussed sometimes or often in routine contacts.
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To reduce the incidence and prevalence of oral cancer, the Smokeless Tobacco Reduction Program will consist of a mass media campaign, public oral screening, and a week-long school health program for 350 students in the seventh, eighth, and ninth grades in Willows, Glenn County, CA. Mass media will include radio, television, newspapers, posters, and literature. The program will use resources of the public health department and junior high school; it will also depend on 8 teachers and 25 peer leaders, all trained in the program. ⋯ The incidence of leukoplakia will be reduced by 50 percent within 3 years of the end of the program. By the end of the program, 90 percent of the target population will be able to identify warning signs of oral cancer and leukoplakia, and 85 percent of the students will no longer believe that use of smokeless tobacco is less harmful than smoking. As a result of the program, use of smokeless tobacco will not be viewed favorably by 80 percent of the target population; usage will be regarded as socially unacceptable.
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Public health reports · Jul 1986
Integrating ophthalmological and optometric services in a VA hospital program.
Basic eye care has been available at the Veterans Administration Medical Center (VAMC), Northport, NY, for the past 20 years. The demand for these services increased as the mission of this medical center was broadened to include major medical and surgery services. Increased migration of veterans to Long Island and their subsequent aging further increased the demand for eye-vision care. ⋯ Both patients and providers became disenchanted with this practice mode. In December 1983, the administration of the Northport VAMC approved the establishment of a coordinated eye-vision care program that integrates ophthalmological and optometric services in a matrix structure. Since the program became operational in April 1984, patient satisfaction has increased, the working relationships between optometrists and ophthalmologists have improved, the ophthalmology residency program has been upgraded, and the combined staff productivity has increased.