Eighty years of the Slovenian Institute of Public Health: challenges for the future

Eighty years after the first national public health institution was founded in Slovenia, the Institute of Public Health of the Republic of Slovenia (IPHRS) endeavors to meet ever-growing national demands. With the independence of Slovenia in 1991, new tasks had to be tackled, many of which were initially coupled with typical difficulties of a postcommunist country in transition. Also, increasing demands of the European Union (EU) and other international partners had to be met. The IPHRS monitors the health of the Slovenian population and its determinants and contributes to planning and implementation of population-based interventions for the better health of the whole nation. The diversity of the IPHRS activities is mirrored by the organization's internal complexity, multi-disciplinary approach, and links to various sectors. Currently, activities are organized within five centers: Center for Population Health Research; Center for Health Care Organization, Economics and Informatics; Center for Environmental Health; Center for Communicable Diseases; and Center for Health Promotion. The IPHRS is the key national institution in public health research, which is an integral part of all the areas covered by the Institute. The IPHRS also provides education programs in the field of public health. In the near future, it will be important to sustain current activities while integrating into the new program of Community action in the field of public health as well as contributing to the response to challenging public health issues in the wider context of the whole European region. Our aim is to integrate the Institute's activities in the programs relevant to public health issues of outstanding importance in this European sub-region. The IPHRS, given the geographic position and recent history, can act as an intermediate between the public health networks in EU and other countries in the sub-region.     

Mental Health of Young Adults with Chronic Illness: The Mediating Effect of Perceived Impact

Examined psychological symptomatology in a community-based sampleof 286 young adults with chronic health conditions randomlydrawn from the rolls of two state programs for Children withSpecial Health Care Needs. The Psychiatric Symptom Index wasused to assess mental health. We investigated how selected conditioncharacteristics (e.g., indices of severity, symptom predictability,prognosis, age of onset, and visibility of condition) increasedrisk of psychological symptoms. Analyses indicate that (a) thispopulation is at high risk for psychological symptoms, (b) selectedrisk factors (i.e., prognosis, restricted activity days, presenceof hearing and speech problems, and perceived unpredictabilityof symptoms) have significant effects on mental health statuswhen other variables are taken into account, and (c) respondents'perceptions of the impact of the condition mediates associationsbetween selected risk factors and mental health. Results arediscussed in relation to preventive interventions for this populationof young adults     

北京中小企业雇主对精神疾病、艾滋病、慢性病患者的雇佣歧视研究

目的:考察中小企业的基本岗位需求倾向,了解雇主对精神疾病,艾滋病和慢性病求职者的雇佣顾虑.方法:选取中小企业30名雇主为被试,进行半结构化深度访谈.结果:①50%以上的雇主认为语言技能、任职资格、工作-积极性、忠诚、与同事和睦相处、负责、沟通能力、较少请病假、掌握工作所在地常用语言、外表干净是企业的基本岗位需求.②对精神疾病求职者的雇佣顾虑主要包括工作绩效和人际关系;对艾滋病求职者的顾虑主要为传染威胁;对慢件病求职者的雇佣顾虑集中在工作绩效方面.结论:中小企业雇主对不同类型疾病求职者有不同的雇佣顾虑.     

A New Source of Data for Public Health Surveillance: Facebook Likes

Background

Investigation into personal health has become focused on conditions at an increasingly local level, while response rates have declined and complicated the process of collecting data at an individual level. Simultaneously, social media data have exploded in availability and have been shown to correlate with the prevalence of certain health conditions.

Objective

Facebook likes may be a source of digital data that can complement traditional public health surveillance systems and provide data at a local level. We explored the use of Facebook likes as potential predictors of health outcomes and their behavioral determinants.

Methods

We performed principal components and regression analyses to examine the predictive qualities of Facebook likes with regard to mortality, diseases, and lifestyle behaviors in 214 counties across the United States and 61 of 67 counties in Florida. These results were compared with those obtainable from a demographic model. Health data were obtained from both the 2010 and 2011 Behavioral Risk Factor Surveillance System (BRFSS) and mortality data were obtained from the National Vital Statistics System.

Results

Facebook likes added significant value in predicting most examined health outcomes and behaviors even when controlling for age, race, and socioeconomic status, with model fit improvements (adjusted R ²) of an average of 58% across models for 13 different health-related metrics over basic sociodemographic models. Small area data were not available in sufficient abundance to test the accuracy of the model in estimating health conditions in less populated markets, but initial analysis using data from Florida showed a strong model fit for obesity data (adjusted R ²=.77).

Conclusions

Facebook likes provide estimates for examined health outcomes and health behaviors that are comparable to those obtained from the BRFSS. Online sources may provide more reliable, timely, and cost-effective county-level data than that obtainable from traditional public health surveillance systems as well as serve as an adjunct to those systems.     

The Rising Tide of Elderly African-American Suicides: A Call for Action

Suicides are among the leading causes of death in elderly Americans. The problem is expected to grow with an aging population in the U.S. Suicides in African-American elderly are not well studied. This article enumerates the risk factors for suicidal behaviors in elderly African-Americans; presents an epidemiological assessment of suicides in elderly African-Americans from 2010 to 2018 with gender-specific differences, and explores public health considerations for helping to reduce the growing numbers of suicides in elderly African-Americans. Currently, there are very limited evidence-based interventions to reduce or prevent suicides in older African-Americans. This article also provides implications and recommendations for prevention practice and research that is needed to help alleviate suicides in older African-Americans.     

Moderating Effects of Family Structure on the Relationship Between Physical and Mental Health in Urban Children with Chronic Illness

Examined whether certain family structures modify the relationshipbetween psychological adjustment and severity of physical illness,as measured by an index of functional status, among childrenwith chronic illness. 352 families were divided into four types:two biological parents (n = 149), mother plus another adultrelative (n = 47), mother plus unrelated spouse or partner (n= 23), and mother alone (n = 133). Correlations between children'sfunctional status and adjustment were higher in the mother plusunrelated partner and mother alone families, and lower whenmother lived with either the biological father or another adultrelative. Children in the mother plus unrelated partner groupalso tended to have poorer overall adjustment than other children.Results are discussed in terms of family structure, childhoodillness and adjustment, and the possible mechanisms that interrelatethese variables.     

A Call to Action for Bioengineers and Dental Professionals: Directives for the Future of TMJ Bioengineering

The world’s first TMJ Bioengineering Conference was held May 25–27, 2006, in Broomfield, Colorado. Presentations were given by 34 invited speakers representing industry, academics, government agencies such as NIH, and private practice, which included surgeons, engineers, biomedical scientists, and patient advocacy leaders. Other attendees included documentary film makers and FDA officials. The impetus for the conference was that the field of TMJ research has been lacking continuity, with no open forum available for surgeons, scientists, and bioengineers to exchange scientific and clinical ideas and identify common goals, strengths, and capabilities. The goal was thus to plant the seeds for establishing a forum for multidisciplinary and interdisciplinary interactions. The collective wisdom and interactions brought about by a melting pot of these diverse individuals has been pooled and is disseminated in this article, which offers specific directives to bioengineers, basic scientists, and medical and dental professionals including oral and maxillofacial surgeons, pain specialists, orthodontists, prosthodontists, endocrinologists, rheumatologists, immunologists, radiologists, neurologists, and orthopaedic surgeons. A primary goal of this article was to attract researchers across a breadth of research areas to lend their expertise to a significant clinical problem with a dire need for new talent. For example, researchers with expertise in finite element modeling will find an extensive list of clinically significant problems. Specific suggestions for TMJ research were presented by the leading organizations for TMJ surgeons and TMJ patients, and further research needs were identified in a series of group discussions. The specific needs identified at the conference and presented here will be essential for those who endeavor to engage in TMJ research, especially in the areas of tissue engineering and biomechanics. Collectively, it is our hope that many of the questions and directives presented here find their way into the proposals of multidisciplinary teams across the world with new and promising approaches to diagnose, prevent and treat TMJ disorders.     

Public Health in an Era of Personal Health Records: Opportunities for Innovation and New Partnerships

In the near future, citizens will be able to control and manage their own health information through electronic personal health record systems and tools. The clinical benefits of this innovation, such as cost savings, error reduction, and improved communication, have been discussed in the literature and public forums, as have issues related to privacy and confidentiality. Receiving little attention are the benefits these will have for public health. The benefits and potential for innovation are broad and speak directly to core public health functions such as health monitoring, outbreak management, empowerment, linking to services, and research. Coupled with this is a new relationship with citizens as key partners in protecting and promoting the public’s health.     

Structure and Determinants of Illness Representations in Chronic Disease: A Comparison of Addison's Disease and Chronic Fatigue Syndrome

Although the clinical relevance of illness representations has been demonstrated in several studies, research on the structure and determinants of illness representations is rare. This article examines the illness representations of chronically ill patients, using a structured interview technique and taking chronic fatigue syndrome (CFS) and Addison's disease (AD) as examples. Considerable differences were found between the group of CFS patients (n = 98) and the group of AD patients (n = 63) with regard to their ideas about the identity, time line, control/cure , and consequences of their illness. Despite these differences, the pattern of correlations among these four dimensions of illness representation was found to be similar for the two groups. Moreover, the strength of the correlations points to the coherent nature of illness representations. The relations between the illness representations, personal variables, and disease- related variables were also explored. Regression analyses showed the dimensions of illness representation to be explained rather well by personal and disease-related variables. Disease-related variables were the most important predictors for the dimensions of identity and consequences; personal variables showed strong associations with time line and control/cure.     

Hypertension and Health Education Intervention in the Caribbean: A Public Health Appraisal

Epidemiologic data on morbidity and mortality have established hypertension and its related diseases as posing a public health problem for the developing world.     

Public Health Service study on Reye's syndrome and medications. Report of the pilot phase

Between February and May 1984, we conducted a pilot study to examine the methods for a larger study of a previously reported relation between Reye's syndrome and medications. Thirty patients with Reye's syndrome, whose diagnosis was confirmed by an expert panel, and 145 controls were matched for age, race (black or not black), and antecedent illness (respiratory infection, chickenpox, or diarrhea) and selected from the same hospital, emergency room, or school, or identified by random digit dialing. Significantly more cases (93 per cent, 28 of 30) than members of each of the four control groups or all controls combined (46 per cent, 66 of 145) had received salicylates during matched antecedent illnesses (odds ratio of all 30 cases vs. all controls = 16.1; lower 95 per cent confidence limit = 4.6). The prevalence and mean severity score of signs, symptoms, and selected events during the antecedent illness tended to be lower among cases than controls. Thus, differences in the severity of this illness between cases and controls did not explain differences in medication exposures. This pilot study suggests an association between Reye's syndrome and the use of salicylates during an antecedent illness.