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1 – 10 of 244Noah Lorincz-Comi, Samba Bah, Howard T. Welser and Jack Maduka
The purpose of this paper is to identify the effect of depression symptoms and their associated severity on reducing treatment sought for chronic medical conditions in respondents…
Abstract
Purpose
The purpose of this paper is to identify the effect of depression symptoms and their associated severity on reducing treatment sought for chronic medical conditions in respondents living in a low-/middle-income country.
Design/methodology/approach
Data for this paper are provided by the national cross-sectional World Health Survey (2003) completed in Pakistan. The authors constructed two samples: one reporting an angina diagnosis (n=150) and another an arthritis diagnosis (n=176), each reporting two or more respective disease symptoms. Logistic regression models, after controlling for confounding variables, were performed to predict treatment received in the last two weeks for respondents’ respective disease.
Findings
In respondents with angina, depression severity significantly reduced the likelihood of angina treatment received in the two weeks before survey; depression treatment significantly increased this likelihood. In respondents with arthritis, no psychopathologic variables predicted arthritis treatment received.
Research limitations/implications
This paper works to elucidate the constructs underlying the heavy chronic disease burdens, we currently witness in low-/middle-income countries. As the authors’ design is cross-sectional, future research would benefit from using longitudinal designs to further investigate the relationship between these morbidities.
Practical implications
These findings encourage further collaboration between medical and mental health professionals to develop stratified treatment strategies, especially in potentially underdeveloped settings, such as Pakistan. This paper also encourages the development of policy intended to provide residents of Pakistan and countries in similar socioeconomic positions with more medical and psychiatric treatment services.
Originality/value
This paper is unique in identifying the relationship between these morbidities in a large, population-based sample of respondents from a low-/middle-income country, Pakistan.
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David H. Howard and Yu-Chu Shen
Purpose – Policymakers hope that comparative effectiveness research will identify examples of widely used therapies that are no better than less expensive alternatives and…
Abstract
Purpose – Policymakers hope that comparative effectiveness research will identify examples of widely used therapies that are no better than less expensive alternatives and, consequently, reduce health care spending. Comparative effectiveness research is unlikely to reduce spending if physicians are quick to adopt effective treatments but slow to abandon ineffective ones.
Methodology/approach – We present a theoretical model that shows how physicians will adopt new treatments in response to positive evidence more readily than they abandon existing treatments in response to negative evidence if the marginal costs of production decline post-adoption. We report trends in the use of two common procedures, percutaneous coronary intervention (PCI) for patients with stable angina and routine episiotomy in vaginal childbirth, where comparative effectiveness research studies have failed to find evidence of a benefit.
Findings – Use of PCI and episiotomy have declined over time but are still excessive based on the standards implied by comparative effectiveness research.
Practical implications (if applicable) – The findings suggest that comparative effectiveness research has the potential to reduce costs but additional efforts are necessary to fully realize savings from abandonment.
Originality/value of chapter – There is a large literature on technological adoption in health care, but few studies address technological abandonment. Understanding abandonment is important for efforts to decrease health care costs by reducing use of ineffective but costly treatments.
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Denelle Mohammed, Edrea Chan, Rezwan Ahmad, Aleksandar Dusic, Cheryl Boglarsky, Patrick Blessinger and Rana Zeine
The purpose of this paper is to analyze job-related stress, motivation and satisfaction in higher education institutions, and assesses their implications on health in various…
Abstract
Purpose
The purpose of this paper is to analyze job-related stress, motivation and satisfaction in higher education institutions, and assesses their implications on health in various industries including higher education. In total, 52 higher education faculty and administrators from institutions in more than 16 countries participated in the study that utilized the organizational surveys, Organizational Effectiveness Inventory® from human synergistics. Subgroup analysis was done to compare faculty and administrators; males to females, private, public, for-profit and not-for-profit institutions.
Design/methodology/approach
To assess health implications, 160 respondents employed in seven industries were surveyed using a custom medical/stress questionnaire to collect self-reported data on levels of job-related stress, motivation and satisfaction as well as the presence of several medical conditions, including myocardial infarction, stroke, angina pectoris/coronary heart disease, hypertension, gastro-esophageal reflux disease and diabetes mellitus. The results from each of the two surveys were statistically analyzed separately.
Findings
Results show undesirable levels of job-related stress, motivation and satisfaction in some segments of higher education employees; as well as associations between poorer health and high stress levels. The study established a potential justification consequently, the authors recommend organizational offerings of: stress relief programs; health fairs and health club memberships; stress management workshops; use of mobile apps for stress relief; job description reviews to eliminate work-related demands; changes to managerial styles that align with the culture of employees; re-evaluation of organizational structure; and enhanced communication amongst workplace management and employees.
Research limitations/implications
Limitations of this study include small sample sizes and the presence of confounding factors that were not considered. In addition, this study did not look into whether occupational position or occupational difficulty compromised the nature of work causing employees to experience lower levels of satisfaction, since the extent to which employees feel satisfied with their work may influence their physical well-being.
Originality/value
There are a number of factors that can affect employees with regards to medical illnesses in a job-related setting. There are three factors in particular that have been shown to negatively affect the health of employees: job-related stress; motivation; and satisfaction. These effects have not been studied in depth in faculty and administrators of higher education institutions, hence this study seeks to achieve that.
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Reviews available literature on gender bias and the process ofmedical care. Current findings point to possible gender bias intreatment protocols for kidney and cardiac patients…
Abstract
Reviews available literature on gender bias and the process of medical care. Current findings point to possible gender bias in treatment protocols for kidney and cardiac patients. Other clinical conditions have not been studied. Identifies methodological challenges to such research and discusses the need for further research.
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Antonio Koceski and Vladimir Trajkovski
The aim of this study is to determine what changes occur in the health status of people with autism spectrum disorder (ASD) compared to neurotypical controls.
Abstract
Purpose
The aim of this study is to determine what changes occur in the health status of people with autism spectrum disorder (ASD) compared to neurotypical controls.
Design/methodology/approach
The authors performed a comparative analysis of data collected from 72 subjects with ASD and 75 neurotypical controls aged 3–24 years using the Rochester Health Status Survey IV (RHSS-IV). A structured individual interview was conducted to compare the health status of subjects in Macedonia.
Findings
A majority of people with ASD take vitamins, supplements and use recommended drug therapies compared to the neurotypical population and experience a larger number of side effects (p = 0.000). Compared to people with neurotypical development, children with ASD have a higher prevalence of oral ulcers (31.9% vs 17.3%; p = 0.039), changes in neurological health status – epilepsy (19.4% vs 2.7%; p = 0.001) and ADD/ADHD (only persons with ASD-19.4%; p = 0.000); respiratory diseases – angina (30.5% vs 8%; p = 0.000), rhinitis and/or sinusitis (40.3% vs 17.3%; p = 0.02); changes in the gastrointestinal system – constipation (31.9% vs 10.6%; p = 0.02), intestinal inflammation (19.4% vs 8%; p = 0.043), permeable intestines (only persons with ASD – 13.9%; p = 0.000) and the presence of the fungus Candida albicans (19.4% vs 4%; p = 0.043); psychiatric disorders – sleep problems (only in people with ASD – 18%; p = 0.000) and tics (6.9% vs 2.6%; p = 0.25) and skin diseases – eczema/allergic skin rash (36.1% vs 18.7%; p = 0.02).
Originality/value
Many children with ASD have health problems. These findings support and complement the professional literature on their mutual causality.
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Cardiovascular diseases (CVDs) are responsible for one-third of global deaths. Work stress is a major risk factor for CVDs in the workforce. Construction professionals endure…
Abstract
Purpose
Cardiovascular diseases (CVDs) are responsible for one-third of global deaths. Work stress is a major risk factor for CVDs in the workforce. Construction professionals endure excessive work stress, yet their vulnerability to CVDs remains underexplored. The study investigated the prevalence of CVDs among construction professionals and its relationships to job stressors, stress coping methods and socio-demographics.
Design/methodology/approach
An online survey was conducted among construction professionals in Australia wherein data related to job stressor experiences, stress management methods adopted, and incidents of CVDs were collected. Structural path analysis was conducted to discover associations.
Findings
Junior level professionals reported higher incidents of angina and heart muscle weakening than others. Statistically significant positive associations were discovered between the reported CVDs, and job stressors such as excessive workload, unpredictable work hours, lack of support, discrimination and work–life conflict and negative stress coping methods such as consuming alcohol and/or drugs, emotional eating and aggression. However, no evidence was found to support the claim that demographic factors such as age and gender were also risk factors for CVDs.
Originality/value
The workers' compensation system provides financial protection to injured employees. It extends similar protection for work-related illnesses; however, it is more difficult to prove work-related causes for illnesses. The study provides scientific evidence to support the recognition of CVDs among construction professionals as work-related diseases, mediated by work stress.
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Fatemeh Nouri, Fahimeh Haghighatdoost, Noushin Mohammadifard, Marjan Mansourian, Masoumeh Sadeghi, Hamidreza Roohafza, Azam Khani and Nizal Sarrafzadegan
The associations between legume consumption and cardiovascular events (CVEs) have extensively been studied. However, there are few studies that considered longitudinal association…
Abstract
Purpose
The associations between legume consumption and cardiovascular events (CVEs) have extensively been studied. However, there are few studies that considered longitudinal association between legume consumption (with repeated measurements across time) and CVEs in low-income countries where legume consumption is lower than the Western countries. The authors aimed to investigate the long-term longitudinal relationship between soybean, non-soybean and overall legume consumption and CVEs using repeated measures of legumes and time-varying confounders in a cohort study of the general population.
Design/methodology/approach
The current study was performed within the framework of the Isfahan cohort study among 5,432 healthy participants. The participants were followed-up for fatal and non-fatal myocardial infarction, unstable angina, fatal and non-fatal stroke and sudden cardiac death for 13 years. Dietary intake was evaluated using a validated food frequency questionnaire in 2001, 2007 and 2013. The hazard ratios (HRs) and 95% confidence intervals (CI) for CVEs between categories of soybean, non-soybean and overall legumes intake were examined using marginal Cox's regression analysis.
Findings
Long-term consumptions of overall legumes more than three times per week and non-soybean three times or more per week compared with those who had less than once a week were associated with 19.5% (HR = 0.805, 95% CI: 0.650,0.998; p < 0.048) and a 18.5% (HR = 0.815, 95% CI: 0.673, 0.988; p < 0.037) lower risk of CVEs in the general population, respectively. However, our findings revealed no significant reduction in CVEs following a higher intake of soybeans.
Originality/value
In the long run, even modest consumption of legumes, but not soybeans alone, can be effective to reduce CVEs risk in a low-income population. Further studies are warranted to confirm our results in other populations, examine the associations by the type of cardiovascular events and determine any possible threshold effects in this regard.
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Shokoofeh Talebi, Zamzam Paknahad, Mohammad Hashemi and Akbar Hasanzadeh
Coronary artery disease (CAD) is developed by an insufficient supply of oxygen-rich blood to the myocardium. Recent studies have shown that increased oxidative stress has…
Abstract
Purpose
Coronary artery disease (CAD) is developed by an insufficient supply of oxygen-rich blood to the myocardium. Recent studies have shown that increased oxidative stress has implicated in the pathogenesis of coronary atherosclerosis. Anxiety and CAD have a mutual relationship, as the effect of long-lasting anxiety on atherosclerosis and CAD is well known. The purpose of this study is to investigate the relationship between dietary / serum total antioxidant capacity and CAD.
Design/methodology/approach
A total of 160 male patients were enrolled in this cross-sectional study. Diagnosis and analysis of angiograms were performed visually by a cardiologist. The subjects were categorized into CAD− (coronary artery obstruction <75 per cent) and CAD+ (coronary artery obstruction ≥ 75 per cent) groups. Anthropometric indices, blood pressure, blood sugar and lipid profile and physical activity (PA) were assessed. Information about anxiety was obtained by Spielberger questionnaire. Dietary total antioxidant capacity (TAC) was obtained by using a semi-quantitative food frequency questionnaire and an oxygen radical absorbance capacity of selected foods.
Findings
Mean of dietary TAC was significantly lower in CAD+ than CAD− group (P < 0.001). However, there was not any significant differences about serum TAC (P = 0.28). The mean of body mass index (BMI) (P = 0.04) and triglyceride (TG) level (P = 0.03) and the frequency of smoking (P = 0.03) were significantly higher in the CAD+ than the CAD− group. There was no significant relationship between CAD with apparent (P = 0.33) and hidden anxiety level (P = 0.16). Confounding factors such as smoking and medications were adjusted.
Research limitations/implications
This study had certain limitations. Being a single center cross-sectional design does not permit analysis of causal relationships; the sample size was geographically limited. The authors could not exclude the medication of patients, which could affect the total antioxidant capacity levels. Measurement error in self-reported dietary consumption may results misclassification of exposure.
Practical implications
A diet high in total antioxidant capacity is inversely associated with CAD. Serum TAC does not vary between men with and without CAD when confounders including age, BMI, TG, smoking, SBP, DBP, energy intake, PA, HDL-C, LDL-C, T-C, FBS, family history of CAD, education and anxiety are taken into consideration.
Social implications
High consumption of vegetables and fruits may play a major role in the prevention of CAD.
Originality/value
The study was approved by the ethics committee of Isfahan University of Medical Sciences (No:394888).
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The system for the provision of supplies in the UK National Health Service is being continually ‘redisorganised’ in an effort to improve efficiency and get better value for money…
Abstract
The system for the provision of supplies in the UK National Health Service is being continually ‘redisorganised’ in an effort to improve efficiency and get better value for money. Alongside these reorganisations, the regulation of the supply of pharmaceuticals to the NHS is also being altered. What are the differences between these two processes and can any obvious lessons be learnt from the ways in which the NHS seeks to control the prices, qualities and quantities of products in these two closely related areas of supplies?
Benjamin C. Amick and Olov Östberg
This paper reviews research examining how the use of new office technologies can contribute to the risk of stress‐related health changes. Looking to the future of office work, the…
Abstract
This paper reviews research examining how the use of new office technologies can contribute to the risk of stress‐related health changes. Looking to the future of office work, the potential stressors associated with expert systems are discussed and the conditional nature of stress demonstrated.