CONTEXT Many rural and inner-city communities in the United States have persistent shortages of health professionals. In addition, health services are increasingly delivered in community-based settings by interdisciplinary teams. Yet, health professions students in the US continue to receive most of their training in urban hospitals. OBJECTIVE To assess the extent to which national and state ...

BACKGROUND Congestive heart failure (CHF) is an increasing public health problem. METHODS AND RESULTS Among Framingham Heart Study subjects who were free of CHF at baseline, we determined the lifetime risk for developing overt CHF at selected index ages. We followed 3757 men and 4472 women from 1971 to 1996 for 124 262 person-years; 583 subjects developed CHF and 2002 died without prior CHF. ...

Background: Worsening chronic heart failure (CHF) is largely characterised by disabling symptoms, poor quality of life, frequent hospital admissions and need of specialist care. Lack of alternative care results in involuntary hospitalisation. Aim: In a pilot study evaluate home care (HC) versus conventional care (CC) in relation to medical safety, health-related quality of life (HRQL) and cost-...

This cross-sectional study was performed to establish the rationale for BNP testing for identifying subjects at high risk of congestive heart failure (CHF) in a screening setting. Plasma BNP concentrations were measured in 8,178 community-dwelling residents (mean age, 62 +/- 12 years; 3,194 males). First, in order to determine age- and sex-related reference values for plasma BNP levels, subject...

Background—Experimental studies support a key role for cytokines in left ventricular remodeling. In congestive heart failure (CHF) patients, elevated plasma cytokine levels are associated with worse functional status and adverse prognosis. It is unclear whether cytokine levels can predict the incidence of CHF in asymptomatic individuals. Methods and Results—We investigated the relations of seru...

aNew York Programs, bThe Children’s Health Fund, New York, New York; cDepartment of Pediatrics, Children’s Hospital at Montefiore, New York, New York; dDepartment of Pediatrics, Albert Einstein College of Medicine, New York, New York; ePhoenix Children’s Health Project, The Children’s Health Fund, Phoenix, Arizona; fDepartment of General Pediatrics, Phoenix Children’s Hospital, Phoenix, Arizona...

Health technology A comprehensive multidisciplinary care programme for patients hospitalised with congestive heart failure (CHF). The programme was designed according to the guidelines of the Agency for Health Care Policy and Research (AHCPR) and consisted of intensive patient and family education on diet, compliance and symptom recognition. The programme also included outpatient infusion of in...

BACKGROUND In India, Village Health Sanitation and Nutrition Committees (VHSNCs) are participatory community health forums, but there is little information about their composition, functioning and effectiveness. Our study examined VHSNCs as enablers of participatory action for community health in two rural districts in two states of eastern India - West Singhbhum in Jharkhand and Kendujhar, in ...

Abnormalities of autonomic control of the cardiovascular system are seen in chronic heart failure (CHF) and confer a poor prognosis. Nitric oxide appears to be important in the regulation of baroreflex control in health and in disease states. The antioxidant vitamin C increases nitric oxide bioavailability in CHF. We evaluated the effects of vitamin C on baroreceptor sensitivity (BRS) by sequen...

Background. Peripheral arterial disease (PAD) often coexists with congestive heart failure (CHF) and can be masked by symptoms of CHF such as functional limitation (FL), a common manifestation for both. Therefore, we sought to estimate the prevalence of PAD and its independent association with FL in CHF. Methods. We conducted a cross-sectional study on National Health and Nutrition Examination ...