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Health Status (health + status)
Kinds of Health Status Terms modified by Health Status Selected AbstractsImpact of Provider Self-Management Education, Patient Self-Efficacy, and Health Status on Patient Adherence in Heart Failure in a Veterans Administration PopulationCONGESTIVE HEART FAILURE, Issue 1 2008Usha Subramanian MD To address the need for more information on predictors of adherence to heart failure (HF) self-management regimens, this study analyzed surveys completed by 259 HF patients receiving care at 2 Veterans Affairs hospitals in 2003. Linear multivariable regression models were used to examine general health status, HF-specific health status (Kansas City Cardiomyopathy Questionnaire) self-management education, and self-efficacy as predictors of self-reported adherence to salt intake and exercise regimens. Self-management education was provided most often for salt restriction (87%) followed by exercise (78%). In multivariable regression analyses, education about salt restriction (P=.01), weight reduction (P=.0004), self-efficacy (P=.03), and health status (P=.003) were significantly associated with patient-reported adherence to salt restriction. In a similar model, self-efficacy (P=.006) and health status (P,.0001), but not exercise education, were significantly associated with patient-reported exercise adherence. Findings suggest that provider interventions may lead to improved adherence with HF self-management and thus improvements in patients' health. [source] Health Status among Emergency Department Patients Approximately One Year after Consecutive Disasters in New York CityACADEMIC EMERGENCY MEDICINE, Issue 10 2005William George Fernandez MD Abstract Objectives: Emergency department (ED) patients with disaster-related experiences may present with vague symptoms not clearly linked to the event. In 2001, two disasters in New York City, the World Trade Center disaster (WTCD) and the subsequent American Airlines Flight 587 crash, presented an opportunity to study long-term consequences of cumulative disaster exposure (CDE) on health-related quality of life (HRQOL) among ED patients. Methods: From July 15 to October 30, 2002, a systematic sample of stable, adult patients from two EDs in New York City were enrolled. Participants completed a self-administered questionnaire. The Short Form 36 (SF-36) was used to assess overall health status. Bivariate analyses were conducted to identify individual correlates of worsening health status. Multivariate regression was performed to identify the association between various factors and overall health status, while controlling for relevant sociodemographic variables. Results: Four hundred seventy-one patients (54.6% female) participated. The participation rate was 73.4%. One hundred sixty-one participants (36%) reported direct, indirect, or occupational exposure to the WTCD; 55 (13.3%) had direct, indirect, or occupational exposure to the plane crash; 33 (8.1%) had both exposures. In separate multivariate models, CDE predicted lower SF-36 scores for general health (p < 0.0096), mental health (p < 0.0033), and bodily pain (p < 0.0046). Conclusions: In the year following mass traumatic events, persons with CDE had lower overall health status than those with one or no disaster exposure. Clinicians should consider the impact that traumatic events have on the overall health status of ED patients in the wake of consecutive disasters. [source] Agreement between dementia patient report and proxy reports using the Nottingham Health ProfileINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 11 2004F. Boyer Abstract Objective The aim of the study was to examine the agreement between patient reports and their proxy reports (family and care provider proxies) on Health Status in a sample of patients with dementia. Method Ninety-nine patients with mild to moderate dementia and proxies completed the 38-item Nottingham Health Profile (NHP) questionnaire. Results Completion rates for the different NHP dimensions ranged from 78 to 90% for the dementia subjects. Inter-rater agreement between different proxies and subject was from moderate to good for physical assessment (ICCs from 0.54 to 0.78 for physical mobility scales). Patient/family proxy concordance was moderate to good for five out of six dimensions (physical mobility, social isolation, pain, energy, sleep) and poor for emotional reaction. Family proxies systematically reported lower functioning than did patients in the four subscales assessing: physical mobility (p,<,0.0001), energy (p,<,0.005), social isolation (p,<,0.01) and sleep (p,<,0.03). Care provider proxies only estimated physical mobility as lower (p,<,0.0001). Conclusion Age and physical status of the patient significantly affected agreement in patient-care provider proxy ratings. Thus, caution is appropriate when resorting to proxies to estimate the Health Status of a dementia patient. Copyright © 2004 John Wiley & Sons, Ltd. [source] Health Status of Temporary Migrants in Urban Areas in Vietnam1INTERNATIONAL MIGRATION, Issue 4 2007Liem T. Nguyen ABSTRACT The rapid economic growth after economic reform, known in Viet Nam as "Doi Moi", and the growing scope of urban migration raise specific questions for social policy, including migration and health policies. This paper compares issues of health status and its determinants as they affect temporary urban migrants versus permanent urban migrants and non-migrants. The analyses utilize multivariate logistic regression and data from the 1997 Vietnam Migration and Health Survey. The results show that temporary migrants staying in guest houses are most vulnerable to health problems. Though most of them are initially healthier, their reported health deteriorates faster than other groups of urban residents. The findings also present important implications for the current migration and health policies in Vietnam: 1) A special attention should be given to temporary migrants in guest houses; 2) Different priorities in health policy should be applied to different groups of migrants and non-migrants; 3) The current population management policy by registration system needs to be reviewed; 4) Providing clean water is one of the most important ways to improve health of temporary migrants; 5) Targeting educational investments and reducing unemployment would likely to improve overall health; 6) A higher priority on health policies targeting women would likely pay dividends, and; 7) Improving management and collaboration between government offices and interested partners is important to improving health status and reducing inequity. [source] Effects of a Home Visiting Program for Older People with Poor Health Status: A Randomized, Clinical Trial in the NetherlandsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2008(See editorial comments by Drs. Andreas Stuck, Robert Kane, pp 56 OBJECTIVES: To evaluate the effectiveness of a home visiting program on health-related measures in a population of older people with poor health status. DESIGN: Randomized, clinical trial. SETTING: Community-dwelling citizens in the Netherlands. PARTICIPANTS: Three hundred thirty people aged 70 to 84 randomly assigned to an intervention group (n=160) or a control group (n=170). INTERVENTION: Eight home visits, lasting 1 hour or more, with telephone follow-up, over an 18-month period, conducted by experienced home nurses under supervision of a public health nurse; key elements of the (systematic) visits were assessment of health problems and risks, advice, and referral to professional and community services. MEASUREMENTS: Self-rated health, functional status, quality of life, and changes in self-reported problems. RESULTS: No differences were found between the intervention and control group in these and other outcome measures at the end of the intervention period (18 months). CONCLUSION: The home visiting program did not appear to have any effect on the health status of older people with poor health and are probably not beneficial for such persons. [source] Assessing Perceived Health and Associated Health-Promoting Behaviors: An Investigation of Methods Used to Assess Health StatusJOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 2 2007Craig M. Becker Health assessments have been integral in the development of health behavior and policy recommendations. As the nation's health status improves, information about positive health is needed to continue development of appropriate behavior and policy recommendations. In this study, perceived health, health behaviors, health care usage, and how participants defined health were assessed. Using reported health-promoting behaviors, respondents were grouped into high-, middle-, and low-health groups. Analyses found statistically significant differences (p<.05) for all health behaviors reported and for life satisfaction. Each group's understanding of health also differed significantly. Results document the discriminating value and importance of positive health-promoting behaviors beyond their traditional role in prevention. Recommendations for health professionals' use of positive health assessments are discussed. [source] Prospective Follow-Up of Empirically Derived Alcohol Dependence Subtypes in Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC): Recovery Status, Alcohol Use Disorders and Diagnostic Criteria, Alcohol Consumption Behavior, Health Status, and Treatment SeekingALCOHOLISM, Issue 6 2010Howard B. Moss Background:, We have previously reported on an empirical classification of Alcohol Dependence (AD) individuals into subtypes using nationally representative general population data from the 2001 to 2002 Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and latent class analysis. Our results suggested a typology of 5 separate clusters based upon age of onset of AD, multigenerational familial AD, rates of antisocial personality disorder (ASPD), endorsement of specific AD and Alcohol Abuse (AA) criteria, and the presence of comorbid mood, anxiety, and substance use disorders (SUD). In this report, we focus on the clinical follow-up of these cluster members in Wave 2 of the NESARC (2004 to 2005). Methods:, The mean interval between NESARC Wave 1 and NESARC Wave 2 interviews was 36.6 (SD = 2.6) months. For these analyses, we utilized a Wave 2 NESARC sample that was comprised of a total of 1,172 individuals who were initially ascertained as having past-year AD at NESARC Wave 1 and initially subtyped into one of 5 groupings using latent class analysis. We identified these subtypes as: (i) Young Adult, characterized by very early age of onset, minimal family history, and low rates of psychiatric and SUD comorbidity; (ii) Functional, characterized by older age of onset, higher psychosocial functioning, minimal family history, and low rates of psychiatric and SUD comorbidity; (iii) Intermediate Familial, characterized by older age of onset, significant familial AD, and elevated comorbid rates of mood disorders SUD; (iv) Young Antisocial, characterized by early age of onset and elevated rates of ASPD, significant familial AD, and elevated rates of comorbid mood disorders and SUD; (v) Chronic Severe, characterized by later onset, elevated rates of ASPD, significant familial AD, and elevated rates of comorbid mood disorders and SUD. In this report, we examine Wave 2 recovery status, health status, alcohol consumption behavior, and treatment episodes based upon these subtypes. Results:, Significantly fewer of the Young Adult and Functional subtypes continued to meet full DSM-IV AD criteria in Wave 2 than did the Intermediate Familial, the Young Antisocial, and the Chronic Severe subtypes. However, we did not find that treatment seeking for alcohol problems increased over Wave 1 reports. In Wave 2, Young Antisocial and Chronic Severe subtypes had highest rates of past-year treatment seeking. In terms of health status, the Intermediate Familial, the Young Antisocial, and the Chronic Severe subtypes had significantly worse mental health scores than the Young Adult and Functional subtypes. For physical health status, the Functional, Intermediate Familial, Young Antisocial, and the Chronic Severe subtypes had significantly worse scores than the Young Adult subtype. In terms of alcohol consumption behavior, the Young Adult, Functional, and Young Antisocial subtypes significantly reduced their risk drinking days between Wave 1 and Wave 2, whereas the Intermediate Familial and the Chronic Severe subtypes did not. Discussion:, The results suggest that the empirical AD typology predicts differential clinical outcomes 3 years later. Persistence of full AD, treatment seeking, and worse mental health status were associated most strongly with those subtypes manifesting the greatest degree of psychiatric comorbidity. Reductions in alcohol consumption behavior and good physical health status were seen among the 2 younger subtypes. Overall, the least prevalent subtype, the Chronic Severe, showed the greatest stability in the manifestations of AD, despite having the highest rate of treatment seeking. [source] Oral Health Status of San Francisco Public School Kindergarteners 2000,2005JOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 4 2006Lisa H. Chung DDS Abstract Objectives:To determine the prevalence of dental caries and oral health disparities in San Francisco kindergarten public school children from 2000,2005. Methods:The San Francisco Department of Public Health in partnership with the San Francisco Dental Society and assistance from the National Dental Association, has been conducting annual dental screenings of kindergarten children enrolled in the San Francisco Unified School District since 2000. Outcomes assessed from this series of cross-sectional screenings included prevalence of caries experience, untreated caries, treatment needs, and caries severity by child's sex, race/ethnicity, residential zip code, and a proxy for socioeconomic status. Results:Of 76 eligible schools, 62,72 participated, and 86,92% of enrolled children (n=3,354-3,527) were screened yearly. Although there was a small, significant decrease over the time period, in 2005, 50.1% of children had caries experience; 28.8% had untreated caries and 7.6% had urgent treatment needs. Each year caries prevalence was greatest for Asian children, those attending schools with > 50% children eligible for the free or reduced-price meal program, and children living in zip codes in and around Chinatown and San Francisco's southern border. Conclusions:Despite signs of improvement, caries remains a public health problem especially in Asian and Hispanic children, and children living in certain sections of San Francisco. [source] General Health Status and Changes in Chewing Ability in Older Canadians over Seven YearsJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 2 2002David Locker PhD; Abstract Objectives: The purpose of this study was to describe the onset of and recovery from chewing problems in an older adult population over a seven-year period and to describe factors associated with these changes. Of particular interest was the relationship between general health and changes in oral functioning - Methods: The data came from a longitudinai study of community-dwelling individuals who were aged 50 years and older when first recruited. Data were collected at baseline (n=907) and at three (n=611) and seven-year (n=425) follow-ups. Oral function was assessed by means of a six-item index of chewing ability. Data were weighted to account for loss to follow-up using weights derived from the seven-year response proportions for dentate and edentulous subjects. Logistic regression analysis using backward stepwise selection was used to identify. predictors of onset and recovery. Results: At baseline, 25 percent of subjects reported a problem chewing. This rose to 26 percent at three years and 34 percent at seven years. The seven-year incidence of chewing dysfunction was 19 percent. Of those with a chewing problem at baseline, 21 percent did not have a problem at seven years. A logistic regression model predicting the seven-year incidence of chewing problems indicated that subjects aged 65 years or older, the edentulous, those rating their oral health as poor, those without dental insurance and those without a regular source of dentai care were more likely to be an incident case. In addition, a variable denoting the number of chronic medical conditions at baseline also entered the model. A logistic regression model predicting recovery indicated that older subjects, the edentulous, those from low-income households, and those with limitations in activities of daily living were less likely to recover over the observation period. Conclusion: The results of this study indicate a marked increase in the prevalence of chewing problems in this older adult population over the seven-year observation period. Poorer general health at baseline increased the probability of the onset of a chewing problem and decreased the probability of recovery. [source] Health Status of Incarcerated Adolescents: Implications for Juvenile Justice Decision MakingJUVENILE AND FAMILY COURT JOURNAL, Issue 1 2004ROBERT E. MORRIS ABSTRACT Adolescents arriving in detention often bring with them significant medical, dental, and psychological problems. These issues have important implications for courts that must decide the best disposition for offending youths. Appropriate treatment benefits the individual by enhancing his/her well-being and improving his/her chances of successful rehabilitation. Society also benefits by avoiding the higher cost of caring for neglected conditions later in life. A comprehensive health care program for detention facilities involves establishing standardized procedures that address both common adolescent problems plus those more peculiar to detainees. Health care professionals working in a correctional setting have unique duties such as clearing youths for boot camp, monitoring injuries, dealing with resistant patients, monitoring for safe activities, and planning aftercare for youths who may face impediments to accessing care such as poor motivation and poverty. Research concerning issues specific to the needs of incarcerated youths remains infrequent and should be undertaken by health care providers. This article provides an overview of medical issues confronting juvenile offenders that should be considered when a juvenile becomes involved in the juvenile justice system. [source] Prucalopride, a systemic enterokinetic, for the treatment of constipationALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 7 2002A. V. Emmanuel Summary Background : Laxatives are frequently ineffective in treating constipation. An alternative therapeutic approach is to target serotonin-4 receptors, which are involved in initiating peristalsis. Aim : In a double-blind, placebo-controlled trial, to assess the efficacy and safety of a systemically active serotonin-4 agonist, prucalopride. Methods : Seventy-four women with constipation were stratified into slow or normal transit groups, and each group was randomized to receive either placebo or 1 mg prucalopride daily for 4 weeks. A bowel function diary was maintained. Whole-gut and orocaecal transit, visceral sensitivity, quality of life and psychological state were assessed before and after treatment. Results : Prucalopride, not placebo, increased spontaneous stool frequency (P=0.008) and reduced time to first stool (P < 0.001). Prucalopride reduced the number of retained markers in all patients compared to placebo (P=0.004). Prucalopride reduced the mean number of retained markers in slow transit (P=0.069), but did not alter the marker count in normal transit (P=0.86). Orocaecal transit was accelerated by prucalopride, not placebo (P=0.004). Prucalopride, notplacebo, increased rectal sensitivity to distension (urge volume, P=0.01) and electrical stimulation (P=0.001). Prucalopride significantly improved several domains of the Short Form Health Status Survey and the disease-specific quality of life. Adverse effects were similar for prucalopride and placebo. Conclusions : Prucalopride improves symptoms, upper gut transit and gut sensitivity in constipated patients with both slow and normal transit. It improves transit in patients with slow transit. These changes are associated with improved well-being. [source] The Chronic Fatigue Syndrome Activities and Participation Questionnaire (CFS-APQ): An overviewOCCUPATIONAL THERAPY INTERNATIONAL, Issue 2 2005Dr Jo Nijs Abstract Chronic fatigue syndrome (CFS) is characterized by severe fatigue and a reduction in activity levels. The purpose of this study was to provide an overview of design, reliability, and validity of the CFS Activities and Participation Questionnaire (CFS-APQ). The CFS-APQ was constructed based on a retrospective analysis of the Karnofsky Performance Status Questionnaire and the Activities of Daily Living Questionnaire (n = 141). In a reliability study of 34 participants the test-retest reliability coefficient of the CFS-APQ was 0.95. In two different studies, the Cronbach alpha coefficient for internal consistency varied between 0.87 (n = 88) and 0.94 (n = 47). The CFS-APQ was administered to 47 patients who listed 183 activities that had become difficult due to their chronic symptoms, and 157 (85.8%) answers matched the content of the CFS-APQ. The outcome of a cross-sectional study (n = 88) studying the correlations between the Medical Outcomes Short Form 36 Health Status Survey subscale scores and the CFS-APQ supported the validity of the CFS-APQ. The CFS-APQ scores correlated with a behavioural assessment of the patients' performance of activities encompassed by the questionnaire (r = 0.29,0.55; n = 63), and correlated with exercise capacity parameters (r = 0.26,0.39; n = 77) obtained during a maximal exercise capacity stress test. Finally, the CFS-APQ correlated with visual analogue scales for pain (r = 0.51) and fatigue (r = 0.50; n = 47). It is concluded that the CFS-APQ generates reliable and valid data, and can be used as a clinical measure of disease severity in patients with CFS. Future studies should aim at examining the sensitivity of the CFS-APQ. Copyright © 2005 Whurr Publishers Ltd. [source] Low Back Pain, Health Status, and Quality of Life in Older Adults: Challenge and OpportunityPAIN MEDICINE, Issue 4 2003Rollin M. Gallagher MD No abstract is available for this article. [source] Preconception Health Status of Iraqi Women After Trade EmbargoPUBLIC HEALTH NURSING, Issue 4 2008Wafa Abdul Karim Abbas ABSTRACT Objectives: To describe the preconception health status of Iraqi women in 2001 following the trade embargo imposed on Iraq beginning in 1991 and only partially removed in 1996. Design: A descriptive cross-sectional prevalence study. Sample: 500 Iraqi women at a premarital clinic in Baghdad in 2001. Measurements: Women were surveyed for age, area of residence, menstrual history, household crowding, consanguinity, and a family history of congenital problems. Clinical findings regarding height, weight, and hemoglobin level were included in the data. Results: Almost one third of the women were below the age of 20 and the majority were between 20 and 25 years of age. More than half of the women in this study had an intermediate-level education or less and lived in very crowded housing. Most of the women were anemic and reported a delay in menarche, suggesting malnutrition. Most of the women were planning consanguineous unions even though many reported congenital conditions in their family of origin. Conclusions: Young Iraqi women who endured embargo needed, and continue to need, aggressive preventive health services to recoup health gains lost during the 1990s and to address prevention of common congenital disorders. [source] Bortezomib is associated with better health-related quality of life than high-dose dexamethasone in patients with relapsed multiple myeloma: results from the APEX studyBRITISH JOURNAL OF HAEMATOLOGY, Issue 4 2008Stephanie J. Lee Summary Health-related quality of life (HRQL) was prospectively measured during the phase III APEX trial of bortezomib versus dexamethasone in relapsed multiple myeloma patients. The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire , Core (QLQ-C30) and Functional Assessment of Cancer Therapy/Gynecologic Oncology Group,Neurotoxicity (NTX) side-effects questionnaires were administered at baseline and every 6 weeks up to 42 weeks. Patients receiving bortezomib (1·3 mg/m2, days 1, 4, 8 and 11 for eight 3-week cycles, then days 1, 8, 15 and 22 for three 5-week cycles; n = 296) demonstrated significantly better mean Global Health Status over the study versus patients receiving dexamethasone (40 mg/d, days 1,4, 9,12, and 17,20 for four 5-week cycles, then days 1,4 only for five 4-week cycles; n = 302), plus significantly better physical health, role, cognitive, and emotional functioning scores, lower dyspnoea and sleep symptom scores, and better NTX questionnaire score, using multiple imputation to account for missing data. Results were similar using available-data analyses. Sensitivity analyses suggested that improved HRQL with bortezomib is at least partially explained by improved survival. These results show that bortezomib was associated with significantly better multidimensional HRQL compared with dexamethasone, consistent with the better clinical outcomes seen with bortezomib. [source] Health status of children with moderate to severe cerebral palsyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 6 2001Gregory S Liptak MD MPH The aim of the study was to evaluate the health of children with cerebral palsy (CP) using a global assessment of quality of life, condition-specific measures, and assessments of health care use. A multicenter population-based cross-sectional survey of 235 children, aged 2 to 18 years, with moderate to severe impairment, was carried out using Gross Motor Function Classification System (GMFCS) levels III (n= 56), IV (n=55), and V (n=122). This study group scored significantly below the mean on the Child Health Questionnaire (CHQ) for Pain, General Health, Physical Functioning, and Impact on Parents. These children used more medications than children without CP from a national sample. Fifty-nine children used feeding tubes. Children in GMFCS level V who used a feeding tube had the lowest estimate of mental age, required the most health care resources, used the most medications, had the most respiratory problems, and had the lowest Global Health scores. Children with the most severe motor disability who have feeding tubes are an especially frail group who require numerous health-related resources and treatments. Also, there is a relationship among measures of health status such as the CHQ, functional abilities, use of resources, and mental age, but each appears to measure different aspects of health and well-being and should be used in combination to reflect children's overall health status. [source] Health status and labour force participation: evidence from AustraliaHEALTH ECONOMICS, Issue 3 2006Lixin Cai Abstract This paper examines the effect of health on labour force participation using the Household, Income and Labour Dynamics in Australia (HILDA) Survey. The potential endogeneity of health, especially self-assessed health, in the labour force participation equation is addressed by estimating the health equation and the labour force participation equation simultaneously. Taking into account the correlation between the error terms in the two equations, the estimation is conducted separately for males aged 15,49, males aged 50,64, females aged 15,49 and females aged 50,60. The results indicate that better health increases the probability of labour force participation for all four groups. However, the effect is larger for the older groups and for women. As for the feedback effect, it is found that labour force participation has a significant positive impact on older females' health, and a significant negative effect on younger males' health. For younger females and older males, the impact of labour force participation on health is not significant. The null-hypothesis of exogeneity of health to labour force participation is rejected for all groups. Copyright © 2005 John Wiley & Sons, Ltd. [source] Health status and heterogeneity of cost-sharing responsiveness: how do sick people respond to cost-sharing?HEALTH ECONOMICS, Issue 4 2003Dahlia K. Remler Abstract This paper examines whether the responsiveness of health care utilization to cost-sharing varies by health status and the implications of such heterogeneity. First, we show theoretically that if health care utilization of those in poor health is less responsive to cost sharing, this, combined with the skewness of health expenditures in health status, leads to overestimates of the effect of cost sharing. This bias is exacerbated when elasticities are generalized to populations with greater expenditure skewness. Second, we show empirically that cost-sharing responsiveness does differ by health status using data from the Medicare Current Beneficiary Survey. Medicare beneficiaries are stratified into health status groups based on activity of daily living (ADL) impairments and self-reported health status. Separately, for each of the health status groups, we estimate the effect of Medigap insurance on Part B utilization using a two-part expenditure model. We find that the change in expenditures associated with Medigap is smaller for those in poorer health. For example, when stratified using ADLs, Medigap insurance increases expenditures for ,healthy' groups by 36.4%, while the increase for the ,sick' group is 12.7%. Results are qualitatively the same for different forms of supplemental insurance and different methods of health status stratification. We develop a test to demonstrate that adjusting our results for selection bias would result in estimates of greater heterogeneity. Our results imply that a lowerbound estimate of the bias from neglecting heterogeneity is about 2,7%. Copyright © 2002 John Wiley & Sons, Ltd. [source] Health status impairment and costs associated with COPD exacerbation managed in hospitalINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 7 2007J. F. O'Reilly Summary Exacerbations of chronic obstructive pulmonary disease (COPD) have serious health consequences for patients and are strongly associated with unscheduled healthcare resource use. This study used a preference-based quality of life measure questionnaire (EQ-5D) to evaluate the impact of exacerbation on health status and utility during a patient's admission to hospital and short-term follow-up. Costs of admission were calculated. In total, 149 patients consented to take part in the study representing 222 admissions to hospital. At admission patients reported high levels of problems for all dimensions of the EQ-5D. Mean utility (,0.077) and Visual Analogue Scale (25.9) values indicated great impairment, with 61% of patients having a negative utility value representing a health state equivalent to ,worse than death' at admission. Many problems were still reported at discharge. By 3 months follow-up patients had deteriorated, with percentages of patients reporting problems in mobility (98%) and usual activity (88%) almost back up to admission levels. Health status and utility values were similar regardless of lung function at admission and at discharge. Approximately half of the patients in each category had a negative utility value at admission representing a health state ,worse than death', with similar levels of improvement by discharge. The mean cost of an admission was £2130.34 (SD 1326.09) with only a mean of £110.37 (5%) because of medication. No differences were noted by lung function category. In conclusion, all COPD patients requiring admission for an exacerbation suffer a serious deterioration in health status which, although improves during admission, notably deteriorates by 3 months postdischarge. [source] The complexity of formulating diets for zoo animals: a matrixINTERNATIONAL ZOO YEARBOOK, Issue 1 2005S. Crissey The nutrition matrix presented here identifies a variety of factors that need to be considered when formulating diets for wild animals in captivity. The matrix is designed to be adapted so that it can be customized as required. Food consumption, nutritional requirements, health status and management constraints and opportunities are the four main categories to focus on when developing diets. Each of these categories may, in turn, be affected by other factors. (1) Food consumption is affected by the diet offered, client (zoo animal manager, keeper or veterinarian) wishes and animal preferences. (2) Nutritional requirements are defined by known species requirements and National Research Council recommendations, morphology and feeding ecology. Nutritional requirements may also be influenced by season, life-stage, activity, health status, stress and body temperature. (3) Health status can be affected by nutritional deficiencies or toxicities in the diet offered. Certain health conditions may require specific dietary input. (4) Animal-management protocols, such as housing, breeding opportunities and environment, are affected by other animals, food storage and preparation capacity, and feeding regime, which, in turn, can be affected by training, exercise and enrichment. [source] The Relationship Between Leg Power and Physical Performance in Mobility-Limited Older PeopleJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2002Jonathan F. Bean Md MS OBJECTIVES: The purpose of this study was to assess the influence of leg power and leg strength on the physical performance of community-dwelling mobility-limited older people. DESIGN: Cross-sectional analysis of baseline data from a 12-week randomized controlled exercise-intervention study. SETTING: Exercise laboratory within the Department of Health Science of an urban university. PARTICIPANTS: Forty-five community-dwelling mobility-limited people (34 women, 11 men), aged 65 to 83. MEASUREMENTS: Health status, depression, cognition, physical activity, and falls efficacy; physiological measures of lower extremity strength and power; and measures of physical performance. RESULTS: Through bivariate analyses, leg power was significantly associated with physical performance as measured by stair-climb time, chair-stand time, tandem gait, habitual gait, maximal gait, and the short physical performance battery describing between 12% and 45% of the variance (R2). Although leg power and leg strength were greatly correlated (r = .89) in a comparison of bivariate analyses of strength or power with physical performance, leg power modeled up to 8% more of the variance for five of six physical performance measures. Despite limitations in sample size, it appeared that, through quadratic modeling, the influence of leg power on physical performance was curvilinear. Using separate multivariate analyses, partial R2 values for leg power and leg strength were compared, demonstrating that leg power accounted for 2% to 8% more of the variance with all measures of physical performance. CONCLUSION: Leg power is an important factor influencing the physical performance of mobility-limited older people. Although related to strength, it is a separate attribute that may exert a greater influence on physical performance. These findings have important implications for clinicians practicing geriatric rehabilitation. J Am Geriatr Soc 50:461,467, 2002. [source] Resource Utilization, Cost, and Health Status Impacts of Coronary Stent Versus "Optimal" Percutaneous Coronary Angioplasty: Results from the OPUS-I TrialJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 4 2002NANCY NEIL Ph.D. In the OPUS-I trial, primary coronary stent implantation reduced 6-month composite incidence of death, myocardial infarction, cardiac surgery, or target vessel revascularization relative to a strategy of initial PTCA with provisional s tenting inpatients undergoing single vessel coronary angioplasty. The purpose of this research was to compare the economic and health status impacts of each treatment strategy. Resource utilization data were collected for the 479 patients randomized in OPUS-I. Itemized cost estimates were derived from primary hospital charge data gathered in previous multicenter trials evaluating coronary stents, and adjusted to approximate 1997 Medicare-based costs for a cardiac population. Health status at 6 months was assessed using the Seattle Angina Questionnaire (SAQ). Initial procedure related costs for patients treated with a primary stent strategy were higher than those treated with optimal PTCA/provisional stent ($5,389 vs $4,339, P<0.001). Costs of initial hospitalization were also higher for patients in the primary stent group ($9,234 vs $8,434, P<0.01) chiefly because of the cost differences in the index revascularization. Mean 6-month costs were similar in the two groups; however, there was a slight cost advantage associated with primary stenting. Bootstrap replication of 6-month cost data sustained the economic attractiveness of the primary stent strategy. There were no differences in SAQ scores between treatment groups. In patients undergoing single vessel coronary angioplasty, routine stent implantation improves important clinical outcomes at comparable, or even reduced cost, compared to a strategy of initial balloon angioplasty with provisional stenting. [source] Older and Younger Adults in Pain Management Programs in the United States: Differences and SimilaritiesPAIN MEDICINE, Issue 2 2006Harriėt M. Wittink PhD ABSTRACT Objectives., 1) To investigate health status of older (,60 years) and younger adults (<60 years) with chronic pain and to separately compare that with existing normative data; and 2) to examine more fully differences in health status between younger and older adults with chronic pain and explore their geographic variation across three multidisciplinary pain programs in the Pacific, Mountain, and New England regions of the United States. Design., We performed a cross-sectional analysis. Patients., Initial assessments of 6,147 patients dating from January 1998 to January 2003 were used. Outcomes Measures., We used the Treatment Outcomes of Pain Survey (TOPS), a disease-specific instrument that includes the Short Form-36. Results., The health status of the older pain patients in terms of their actual scores was comparable with that of younger pain patients across the three sites. Health status is impaired to a lesser degree in older than in younger adults with chronic pain as compared with normative adults. Statistically significant differences were found in a number of domains of the TOPS. Older adults with chronic pain present with pain intensity similar to that of younger patients with chronic pain, but report better mental health (P < 0.002), less fear-avoidance (P < 0.05), less passive coping (P < 0.0001), more life control (P < 0.05), and more lower body physical limitations (P < 0.005) than younger patients with chronic pain. Conclusions., Older adults with chronic pain differ in a number of important domains from younger adults with chronic pain: overall the former present with greater physical, and less psychosocial impairment. [source] Biological condition of adult migrants and nonmigrants in Wroc,aw, PolandAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 2 2008Alicja Szklarska Human migration and its economic, social, and demographic effects can lead to health consequences for individuals and populations. In the present study, we estimated differences in health status between migrant (those who had come to Wroc,aw at the age of ,16 years) and nonmigrant (those who had lived in Wroc,aw since birth or had come with their parents) inhabitants of Wroc,aw, Poland. Three hundred and sixty seven males and 496 females aged 40 and 50 underwent medical examination, and were asked to fill out a questionnaire comprising social, demographic, and life style information. Health status was assessed by blood pressure, heart rate, fasting lipid profile, glucose, height, and measures of fatness (BMI, WHR, sum of skinfolds). Comparisons were made based on Borkan's and Norris's profiles. Student's t -test showed significant differences in diastolic blood pressure, heart rate, total cholesterol, and glucose levels between two groups of males, in favor of migrants. Male migrants were also significantly taller than their peers born in Wroc,aw. In females, migrants had significantly lower blood pressure and heart rate than nonmigrants. In interpreting the results two possible, not mutually exclusive, mechanisms are proposed: selective spatial mobility, and changes toward healthier life style as an adaptation to new urban environment. Am. J. Hum. Biol., 2008. © 2007 Wiley-Liss, Inc. [source] Health status and life satisfaction among breast cancer survivor peer support volunteersPSYCHO-ONCOLOGY, Issue 3 2002B. Alex Matthews Two measures of health-related quality of life (HRQOL), the Medical Outcomes Survey Short Form 36 (SF-36) and the Satisfaction with Life Domains Scale for Cancer (SLDS-C), were compared to examine the relationship between health status and life satisfaction among breast cancer survivors (BCSs). A total of 586 BCSs, all of whom were volunteers in peer support programs, met inclusion criteria and completed the self-report measures. Significant correlation coefficients were shown between life satisfaction and measures of health status. SF-36 scores were significantly higher for physical functioning, emotional well-being, and vitality subscales compared to population norms. BCSs expressed greatest dissatisfaction with their sexual ability, physical strength, and bodies in general. Small age differences were found. Results suggest that incorporating multiple measures of HRQOL contribute to the understanding and measurement of the effects of cancer on perceived health status and life satisfaction. Copyright © 2002 John Wiley & Sons, Ltd. [source] Sexual Behaviors, Condom Use, and Sexual Health of Americans Over 50: Implications for Sexual Health Promotion for Older AdultsTHE JOURNAL OF SEXUAL MEDICINE, Issue 2010Vanessa Schick PhD ABSTRACT Introduction., In the contemporary U.S., men and women are living longer and healthier lives. As such, many people spend greater portions of their lives as sexually active individuals. Yet, little is known about the myriad of ways that older adults experience their sexual lives. Aim., This study sought to assess the context and frequency of sexual behaviors, condom use, sexual pleasure, and sexual experience of men and women over age 50. Methods., Information regarding the sexual experiences of a nationally representative sample of men and women over age 50 within the past year was examined. Main Outcome Measures., Sexual behavior over the past year was assessed in relation to several situational and contextual characteristics (e.g., event location, type of partner, health status, condom use). Participants were also asked about their experience (i.e., pleasure, arousal, pain, lubrication/erectile difficulties, and orgasm) during their most recent partnered sexual event. Bivariate or ordinal logistic regression models were used to investigate the relationship of age, health and partner status to sexual frequency and experience. Results., Although sizable proportions (20,30%) of both men and women remained sexually active well into their 80s age was related to a lower likelihood of solo and most partnered sexual behaviors. When controlling for age, relationship status, and health remained significant predictors of select sexual behaviors. The participant's evaluation of their most recent sexual experience in terms of arousal, erectile difficulty, and orgasm all declined with age. Health status was related to men's evaluation of the experience. Relationship status was the most consistent predictor of women's evaluation of the experience. Condom use rates remained low for participants across age groups. Conclusion., Many older adults continue be sexually active well into advanced age (80+). Thus, providers need to be attentive to the diverse sexual health needs of older adults. Schick V, Herbenick D, Reece M, Sanders SA, Dodge B, Middlestadt SE, and Fortenberry JD. Sexual behaviors, condom use, and sexual health of Americans over 50: Implications for sexual health promotion for older adults. J Sex Med 2010;7(suppl 5):315,329. [source] The comparison of health status and health services utilisation between Indigenous and non-Indigenous infants in AustraliaAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2010Lixin Ou Abstract Objective: To examine the differences in health services utilisation and the associated risk factors between Indigenous and non-Indigenous infants at a national level in Australia. Methods: We analysed data from a national representative longitudinal study, the Longitudinal Study for Australian Children (LSAC) starting in 2004. We used survey logistic regression and survey multiple linear regression to examine the factors associated with health services utilisation. Results: Health status of Indigenous infants was poorer than that of non-Indigenous. In comparison to non-Indigenous infants, in the previous 12-month period, the Indigenous infants were significantly less likely to use the following health services: maternal and child health centre or help lines (OR=0.35, 95%CI: 0.24-0.49); maternal and child health nurse visits (OR=0.45, 95%CI: 0.32-0.63); general practitioners (GPs) (OR=0.45, 95%CI: 0.31-0.64); and paediatrician (OR=0.52, 95%CI: 0.35-0.77). In contrast, they were more likely to visit a hospital outpatient clinic (OR=1.82, 95%CI: 1.16-2.85). Mothers' age, education and marital status were associated with certain health services use. Financial status and residential location were the important predictors of the use of health services. Conclusion: The rates of health services utilisation by Indigenous infants were lower and were associated with mothers' characteristics and socio-economic status. Implications: The gaps in health services utilisation between Indigenous and non-Indigenous infant requires immediate policy initiatives. Further research is needed to explore the causal pathways between health status, health services utilisation and multiple risk factors at different levels. [source] Latent Transition Regression for Mixed OutcomesBIOMETRICS, Issue 3 2003Diana L. Miglioretti Summary. Health status is a complex outcome, often characterized by multiple measures. When assessing changes in health status over time, multiple measures are typically collected longitudinally. Analytic challenges posed by these multivariate longitudinal data are further complicated when the outcomes are combinations of continuous, categorical, and count data. To address these challenges, we propose a fully Bayesian latent transition regression approach for jointly analyzing a mixture of longitudinal outcomes from any distribution. Health status is assumed to be a categorical latent variable, and the multiple outcomes are treated as surrogate measures of the latent health state, observed with error. Using this approach, both baseline latent health state prevalences and the probabilities of transitioning between the health states over time are modeled as functions of covariates. The observed outcomes are related to the latent health states through regression models that include subject-specific effects to account for residual correlation among repeated measures over time, and covariate effects to account for differential measurement of the latent health states. We illustrate our approach with data from a longitudinal study of back pain. [source] Health status and life satisfaction after decompressive craniectomy for malignant middle cerebral artery infarctionACTA NEUROLOGICA SCANDINAVICA, Issue 5 2008T. S. Skoglund Objectives,,, To study the long-term outcome in patients with malignant middle cerebral artery (MCA) infarction treated with decompressive craniectomy. The outcome is described in terms of survival, impairment, disabilities and life satisfaction. Materials and methods,,, Patients were examined at a minimum of 1 year (mean 2.9, range 1,6) after the surgery and classified according to the Glasgow Outcome Scale (GOS), the National Institutes of Health Stroke scale (NIHSS), the Barthel Index (BI), the short-form health survey (SF-36) and the life satisfaction checklist (LiSat-11). Results,,, Eighteen patients were included. The long-term survival was 78%. The mean NIHSS score was 13.8 (range 6,20). No patient was left in a vegetative state. The mean BI was 63.9 (5-100). The SF-36 scores showed that the patients' view of their health was significantly lower in most items compared with that of a reference group. According to the LiSat checklist, 83% found their life satisfying/rather satisfying and 17% found their life rather dissatisfying/dissatisfying. Conclusion,,, We conclude that the patients remained in an impaired neurological condition, but had fairly good insight into their limitations. Although their life satisfaction was lower compared with that of the controls, the majority felt that life in general could still be satisfying. [source] Health status of the oldest adult survivors of cancer during childhood,,CANCER, Issue 2 2010Lisa B Kenney MD Abstract BACKGROUND: Young adult survivors of childhood cancer have an increased risk for treatment-related morbidity and mortality. In this study, the authors assessed how treatment for childhood cancer affects older-adult health and health practices. METHODS: One hundred seven adults treated for childhood cancer between 1947 and 1968, known to have survived past age 50 years, were identified from a single-institution cohort established in 1975. Updated vital status on eligible cases was obtained from public records. Survivors and a control group of their age-matched siblings and cousins completed a mailed survey to assess physical and social function, healthcare practices, and the prevalence of common adult illnesses. RESULTS: Of the 107 survivors known to be alive at age 50 years, 16 were deceased at follow-up; 7 deaths could be associated with prior treatment (second malignancy in radiation field [3], small bowel obstruction after abdominal radiation [2], and cardiac disease after chest irradiation [2]). The 55 survivors (median age, 56 years; range, 51-71 years), and 32 family controls (median age, 58 years; range, 48-70 years), reported similar health practices, health-related quality of life, and social function. However, survivors reported more frequent visits to healthcare providers (P < .05), more physical impairments (P < .05), fatigue (P = .02), hypertension (P = .001), and coronary artery disease (P = .01). An increased risk of hypertension was associated with nephrectomy during childhood (odds ratio, 18.9; 95% confidence interval, 3.0-118.8). CONCLUSIONS: The oldest adult survivors of childhood cancer continue to be at risk for treatment-related complications that potentially decrease their life expectancy and compromise their quality of life. Cancer 2010. © 2010 American Cancer Society. [source] | |||||||||||||||||||||||||||||||||||||||||||||||||