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 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Risk factors of smoking, drug and alcohol abuse, obesity, and sedentary lifestyle were related to health problems of clients at a walk-in clinic for the homeless. The sample of 1252 clients was predominately male (91.4%) and multiethnic, with a majority (65%) age 18 to 40 years. Data on diagnoses of health-related conditions were collected from clinic charts, coded into ICD categories, analyzed for relationships of risk factors to health problems, and compared with categories of diagnoses in a matched national sample of ambulatory care visits. Findings indicate that a larger proportion of homeless suffered from health problems in 24 of 27 diagnostic categories than the nonhomeless. Most prevalent were respiratory, dermal conditions, injuries, and digestive problems, in that order. Risk factors of alcohol abuse, smoking, sedentary lifestyle, drug abuse, and obesity were predictive of health problems in 18 of the categories analyzed. The findings suggest that immediate interventions such as education and rehabilitation to reduce risk factors, and provision of facilities for personal hygiene and cleaning of clothing could reduce some of the health-related conditions in this population while longer-term solutions of housing and employment are sought. The analysis model developed here appears to be a useful way of comparing relative effects of risk factors as a basis for establishing priorities for interventions.
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PMID:Risk factors for disease in a homeless population. 148 17

Many studies of age-related cognitive decline have failed to distinguish between usual and successful aging. Although some degree of cognitive impairment is associated with aging, when one looks at average performance, there is great variability among individuals, with many showing little or no deleterious effects of aging on intellectual abilities. Many of the risk factors for dementia and for conditions associated with cognitive impairments can be treated or controlled. Among the preventable causes of cognitive decline are the following: AIDS, Alcohol and drug abuse, Cerebrovascular disease, Exposure to organic solvents or lead, Head trauma, Overmedication, Syphilis. Other conditions that may cause cognitive decline can be controlled or treated: Atherosclerosis, Depression, Diabetes, Emphysema, High blood pressure, Obesity, Sleep disorders, Thyroid dysfunction. In addition, it may be possible to enhance the cognitive performance of even healthy elderly people through changes in diet and lifestyle. Recent data raise the possibility that improved prenatal and perinatal care and greater access to educational opportunities may result in a decreased incidence of dementia in future generations of older adults. Although they are rapidly becoming more numerous, the efficacy of cognitive training programs in preventing or slowing cognitive decline has not yet been demonstrated. Nevertheless, such programs may ameliorate cognitive impairment by reducing the psychiatric disabilities associated with anxiety and depression. The general principle underlying these strategies for limiting cognitive impairment with age is to maximize brain reserve and minimize brain damage.
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PMID:Preventing cognitive decline. 157 76

Heart transplant programs were surveyed regarding psychosocial evaluation process, criteria, and outcomes. There was considerable disagreement among programs when a patient is rejected on psychosocial grounds with regard to the use of second opinions and how often patients are informed of the reasons. Wide discrepancies in criteria used and rates of patients refused on psychosocial grounds were discovered. More than 70% of all programs excluded patients for transplantation on the grounds of dementia, active schizophrenia, current suicidal ideation, history of multiple suicide attempts, severe mental retardation, current heavy alcohol use, and current use of addictive drugs. Lack of consensus was found for some exclusion criteria (cigarette smoking, obesity, noncompliance, recent alcohol or drug abuse, criminality, personality disorder, mild mental retardation, controlled schizophrenia, and affective disorder). The proportion of patients rejected for transplantation on psychosocial grounds ranged from 0% to 37%, with an average rate of 5.6% in the United States and 2.5% in non-U.S. programs. This survey thus supports the need for research on the validity and reliability of psychosocial selection criteria.
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PMID:Psychosocial evaluation of heart transplant candidates: an international survey of process, criteria, and outcomes. 175 61

The therapeutic power of the doctor in initiating discussion on health concerns is greater than appreciated. Topics suitable for this approach include--smoking, drug abuse, obesity, contraception, breast self examination, Papanicolaou smears, cholesterol checks, diet, exercise, hormonal replacement therapy, immunisation, glaucoma checks, and so on. The only limit is the GP's imagination. This approach is not appropriate for every consultation, nor is it the only way to help patients modify their behaviour or learn healthier practices. It is, however, one simple but effective approach, and is available to any GP. Gill and Bauman emphasise that most GPs are ready to meet the challenge given by Taylor in 1982. "General practitioners and other health professionals providing primary care must take the main share of preventive medicine in the next decade." However, one handicap is a perceived lack of expertise by GPs themselves. This article emphasises that GPs can practise preventive medicine using the skills they already possess.
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PMID:Health promotion in general practice. 200 9

The behaviors associated with Gilles de la Tourette's syndrome (TS), including impulsive, compulsive, attentional, learning, conduct, and mood disorders, have often been described as substrates for the development of alcoholism and/or drug abuse. As the authors' experience with TS pedigrees indicated that alcoholism and/or drug abuse were common in relatives of TS probands, they examined, by the family history technique, 1750 relatives over 14 years of age in 130 TS proband and 25 control families. Significant, life-disrupting problems with alcoholism and/or drug abuse were present in 14.5% of the relatives of TS probands compared with 4.4% of the control relatives (p less than .00001). Among parents of TS probands, the ratio of affected fathers to mothers was 2:1. Marked obesity (greater than 100 lb) was present in 10.8% of the mothers and 3.2% of all relatives of TS probands compared with 0.8% of all control relatives (p = .01). In parents of TS probands, the ratio of marked obesity in fathers to that in mothers was 1:4.5. When the categories of alcoholism and/or drug abuse and marked obesity were combined, 17.4% of all relatives of TS probands were affected compared with 4.6% of all control relatives (p less than .0001) and the ratio of fathers to mothers with these disorders was 1.1:1. Among all relatives of TS probands, 20.8% of those with tics and 17.4% of those without tics had problems with alcoholism and/or drug abuse or obesity or both. This finding suggests that when the Gts gene(s) is expressed in this form it is about equally likely to occur in persons with and persons without tics. The similarities between TS and early onset, male predominant, Type II alcoholism suggest that in some cases, alcoholism and/or drug abuse in males and severe obesity in females are related, genetically controlled, compulsive behaviors.
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PMID:A controlled family history study of Tourette's syndrome, II: Alcoholism, drug abuse, and obesity. 236 66

Three animal models, based on genetic differences in endogenous opioid peptides and opioid receptors, are described. Obese mice and rats, whose pituitary opioid content is elevated, may be used to investigate eating disorders. Recombinant inbred strains of mice, which differ in brain opioid receptors and analgesic responsiveness, can be used for study of opioid- and nonopioid-mediated mechanisms of pain inhibition. Individual reactivity to opioids can be examined in C57BL/6 and DBA/2 inbred strains of mice. A model that combines a variety of opioid effects is offered and suggests the existence of a genetically determined dissociation of opioid effects on locomotor activity and pain inhibition. In addition, stimulatory locomotor responses in the C57BL/6 reaction type are linked to a high risk of drug addiction and facilitatory effects on adaptive processes, while high analgesic potency in the DBA/2 reaction type is accompanied by a low proneness to drug abuse and amnesic properties of opioids.
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PMID:Opioids and behavior: genetic aspects. 283 10

The report on aversion therapy by the American Medical Association's (AMA) Council on Scientific Affairs was submitted to the AMA House of Delegates in June 1987 as an informational report and is not intended to serve as a standard of care. It reflects the views of the scientific literature as of February 1987. Aversive techniques designed to reduce dangerous or unwanted behaviors are applied most commonly to obesity, smoking, alcoholism and drug abuse, sexual behavior, and self-injurious and aggressive behavior in the mentally retarded. Specific techniques that have obtained the most positive results in some of these areas are described. The report notes, however, that carefully designed and controlled studies are needed before definitive conclusions can be drawn.
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PMID:Aversion therapy. Council on Scientific Affairs. 331 61

Sixty-three percent of a random sample of 866 members within three practice groups of The American Dietetic Association responded to a survey designed to assess (a) perceived competency of nutrition management in 20 major areas of adolescent health, (b) desire to increase skill level in each area, and (c) preferred approaches for continuing education activities. Of the 549 respondents, 92% were registered dietitians (R.D.s), 5% were registration-eligible, and more than half (51%) had advanced degrees. Twenty-five percent or more of all practitioners reported deficiencies in 17 of the 20 categories. The five top areas in which respondents believed that they had insufficient skills were psychosomatic problems (87%), handicapping conditions (82%), sports nutrition (81%), alcohol/drug abuse-related nutrition concerns (80%), and anorexia nervosa/bulimia nervosa (72%). The strongest desires to improve skills were in the areas of obesity, poor dietary patterns, sports nutrition, food fads, supplement misuse, alternative diets, and eating disorders. There was low interest in strengthening skills in family planning, psychosomatic problems, and handicapping conditions. The implications of the results are discussed. Continuing education methods respondents believed to be most beneficial for learning were small conferences, lectures with ample discussion, and "hands-on" workshops.
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PMID:Adolescent nutrition: self-perceived deficiencies and needs of practitioners working with youth. 336 17

Recent literature on the diagnosis, differentiation, and identification of alcoholism, substance abuse, smoking, obesity, compulsive gambling, and sociopathy was reviewed. Research evidence suggests that these behavior disorders are associated with high levels of the trait of arousability. Highly arousable individuals often experience intense, easily aroused emotional reactions to stressful stimulation, and they are strongly predisposed toward alcohol and/or substance abuse. For these individuals, psychoactive chemicals have strongly reinforcing effects, since they alleviate unpleasant emotions associated with excessive arousal. Reduced Environmental Stimulation Therapy (REST) consistently lowers arousal to optimal, subjectively comfortable levels, without psychoactive chemicals. REST has demonstrated its effectiveness for alcohol and drug abuse, smoking, and obesity, all of which are associated with high arousability.
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PMID:Studies in REST. III. REST, arousability, and the nature of alcohol and substance abuse. 339 56

Behavior change professionals have developed treatment programs for a wide variety of health care problems affecting adolescents. Although a substantial data base of experimentally tested techniques exists for obesity, smoking prevention, and dysmenorrhea, much work remains in other areas. For example, the case studies reported on neurodermatitis and the survey work in teenage alcohol abuse must give way to systematic interventions employing group experimental designs. In addition, behavioral procedures should be compared to other treatments. Also, component analysis should be performed when multiple treatment strategies are used. Finally, strategies aimed at increasing the generalization of treatment, such as from classrooms to different community settings in substance abuse prevention programs and maintenance of treatment effects over long follow-up periods, are necessary. Only in this way will the efficacy of behavioral interventions for specific health problems be established. The leading causes of mortality among adolescents are due to accidents. Of the total number of deaths due to accidents, approximately 50% are attributed to motor vehicle accidents (National Safety Council, 1977). Many of these accidents are due to negligence, substance abuse, and, in general, immature behavior (Bakwin & Bakwin, 1972). In spite of a slow but consistent trend toward lower accidental deaths over time (National Safety Council, 1977), there still is a need for interventions designed to decrease risk-taking behavior, substance abuse, and carelessness in adolescents. Again, behavior change professionals might follow the example set by researchers who have begun to develop successful strategies for decreasing onset of cigarette smoking. These interventions and research methods, designed for use in schools, may provide a promising approach for addressing other kinds of prevention problems. It also seems appropriate to categorize cigarette smoking not only as a risk factor in the development of cardiovascular disease (Kuller, 1976), but also as a member of the risk-taking behaviors. Thus, procedures used to prevent cigarette smoking might also be adapted to prevent other kinds of risk-taking behaviors among adolescents. The work of McAlister et al. (1980), in preventing alcohol abuse as well as cigarette smoking by use of the same or similar procedures, is a case in point. Use of a procedure designed to train competency in refusing peer pressure has clear implications for reducing other risk-taking behaviors, such as reckless driving, drug abuse, and swimming and boating accidents.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Advances in behavioral approaches to adolescent health care. 639 85


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