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Health Variables (health + variable)
Selected AbstractsOn the empirical association between poor health and low socioeconomic status at old ageHEALTH ECONOMICS, Issue 3 2002Christian Salas Abstract Epidemiologic studies using mortality rates as indicators of health fail to find any meaningful association between poor health and low socioeconomic status in older age-groups, whereas economic studies using self-assessed health consistently find a significant positive correlation, even after controlling for self-reporting errors. Such contradictory results have not been reported for working age individuals. A simple explanation might be that the elderly samples on which the epidemiologic and economic studies are based come from different populations. However, this paper shows that similar contradictory results are obtained even when the same samples are used, simply by switching between self-assessed health and mortality as health indicators. An alternative explanation is proposed, namely that these health indicators yield different results because they relate to different ranges of the latent health variable at old age. Copyright © 2002 John Wiley & Sons, Ltd. [source] Relationship between dental health and 10-year mortality in a cohort of community-dwelling elderly peopleEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 4 2003Piia Hämäläinen Dental examinations were carried out as part of the Evergreen project, which focuses on functional capacity and health among the elderly residents of the city of Jyväskylä, central Finland. Dental status was examined in 1990 for the whole population born in 1910 (n = 226). Mortality data were collected over 10 yr. The aim of the study was to assess the possible role of dental health as a predictor of mortality. The Kaplan,Meier method was used to analyse survival curves and Cox regression models, with the number of chronic conditions and self-rated health used as covariates in analysing the risks of death. The results showed that the more teeth or filled teeth a subject had, the smaller was their risk for death. The effect of missing teeth was significant after adjusting for the general health variables. Thus, our results support the hypothesis that poor dental health is linked to increased mortality among elderly people. [source] The Effects of Geography and Spatial Behavior on Health Care Utilization among the Residents of a Rural RegionHEALTH SERVICES RESEARCH, Issue 1 2005Thomas A. Arcury Objective. This analysis determines the importance of geography and spatial behavior as predisposing and enabling factors in rural health care utilization, controlling for demographic, social, cultural, and health status factors. Data Sources. A survey of 1,059 adults in 12 rural Appalachian North Carolina counties. Study Design. This cross-sectional study used a three-stage sampling design stratified by county and ethnicity. Preliminary analysis of health services utilization compared weighted proportions of number of health care visits in the previous 12 months for regular check-up care, chronic care, and acute care across geographic, sociodemographic, cultural, and health variables. Multivariable logistic models identified independent correlates of health services utilization. Data Collection Methods. Respondents answered standard survey questions. They located places in which they engaged health related and normal day-to-day activities; these data were entered into a geographic information system for analysis. Principal Findings. Several geographic and spatial behavior factors, including having a driver's license, use of provided rides, and distance for regular care, were significantly related to health care utilization for regular check-up and chronic care in the bivariate analysis. In the multivariate model, having a driver's license and distance for regular care remained significant, as did several predisposing (age, gender, ethnicity), enabling (household income), and need (physical and mental health measures, number of conditions). Geographic measures, as predisposing and enabling factors, were related to regular check-up and chronic care, but not to acute care visits. Conclusions. These results show the importance of geographic and spatial behavior factors in rural health care utilization. They also indicate continuing inequity in rural health care utilization that must be addressed in public policy. [source] Caffeine, cognitive failures and health in a non-working community sampleHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 1 2009Andrew P Smith Abstract Rationale Most studies of the effects of caffeine on performance have been conducted in the laboratory and further information is required on the real-life effects of caffeine consumption on cognition. In addition, possible effects of caffeine consumption on a range of health outcomes should also be assessed in these studies to enable cost-benefit analyses to be conducted. Objectives Secondary analyses of a large epidemiological database (N,=,3223 non-working participants, 57% female, with a mean age of 49.6 years, range 17,92 years) were conducted to examine associations between caffeine consumption (mean caffeine consumption was 140,mg/day, range 0,1800,mg) and cognitive failures (errors of memory, attention and action) in a non-working sample. Associations between caffeine consumption and physical and mental health problems were also examined. Methods The study involved secondary analyses of a database formed by combining the Bristol Stress and Health at Work and Cardiff Health and Safety at Work studies. Associations between caffeine consumption and frequency of cognitive failures and health outcomes were examined in a sample of non-workers. Results After controlling for possible confounding factors significant associations between caffeine consumption and fewer cognitive failures were observed. Initial analyses suggested that many health variables were associated with regular level of caffeine consumption. However, most of the significant effects of caffeine disappeared when demographic and lifestyle factors were controlled for. Consumption of caffeine was, however, associated with a reduced risk of depression. These effects were also observed in separate analyses examining the source of the caffeine (coffee and tea). Conclusions Overall, the results show that caffeine consumption may benefit cognitive functioning in a non-working population. This confirms earlier findings from working samples. This beneficial effect of caffeine was not associated with negative health consequences. Indeed, consumption of caffeine was found to be associated with a reduced risk of depression. Copyright © 2008 John Wiley & Sons, Ltd. [source] Health-related quality of life among old residents of nursing homes in NorwayINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 5 2009Jorunn Drageset RN PhD This study examined the health-related quality of life (HRQOL) of nursing home residents (, 65 years) using the Short-Form-36 Health Survey subscales and how these subscale scores are related to residents' sociodemographic and medical conditions. Residents 95,102 years old reported higher HRQOL than younger respondents. Those with more education reported higher HRQOL. Residents who reported hobbies or special interests had a higher HRQOL score on vitality and mental health variables. Finally, respondents with no comorbid illness scored highest on all HRQOL dimensions, and this was statistically significant for physical functioning and bodily pain. In conclusion, respondents generally reported highly limited physical functioning and slightly limited social functioning. To improve the situation of residents, more attention should be paid to the environment of nursing homes and residents' hobbies and special interests. [source] When Home Care Ends,Changes in the Physical Health of Informal Caregivers Caring for Dementia Patients: A Longitudinal StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2002Elmar Gräsel MD OBJECTIVES: To verify the change in health variables and parameters of health service utilization in a group of active caregivers for older persons with dementia in comparison with former caregivers who had ceased to provide home care for at least 6 months (death of the patient or institutionalized care). DESIGN: A prospective longitudinal study with 1-year follow-up. Active and former caregiver groups originated from a sample of active caregivers at baseline. SETTING: Participants were recruited mainly via advertisements placed in two magazines with large, nationwide circulation. The questionnaires were sent on request. PARTICIPANTS: Seven hundred twenty primary caregivers of dementia patients living in the community. All patients had a medical diagnosis of dementia and had a score of 20 or greater on the mental-mnestic disturbances factor of the Sandoz Clinical Assessment,Geriatric scale. Their care needs covered at least one of four activities of daily living (personal hygiene, eating, toilet use/excretion, mobility). After 12 months, 681 caregivers were reinterviewed. MEASUREMENTS: The physical complaints were assessed with the 24-item Giessen Symptom List (subscales: aching limbs, stomach complaints, heart complaints, physical exhaustion). Other key variables were the number of illnesses, number of somatic and psychotropic medications, and number of physician visits. RESULTS: Although the somatic symptoms of the active caregivers (n = 427) remained stable at a high level, they decreased significantly (24%) in the group of former caregivers (n = 121). Simultaneously, the number of visits former caregivers made to physicians almost doubled. The reason why home care was terminated (death or institutionalization) did not influence health variables or health service utilization. CONCLUSION: The physical health of former caregivers improves in the long term once they cease to provide home care. The fact that former caregivers go to the doctor much more frequently is to be interpreted as an indication that they take the time to attend to their own physical and medical needs. [source] Is there an association between periodontal disease, prematurity and low birth weight?JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2005A population-based study Abstract Background: The relationship between periodontal diseases in pregnancy and children born prematurely or with low birth weight has been increasingly investigated, showing inconclusive results. Objectives: To test the link between periodontal disease in pregnant women and low birth weight or prematurity. Methods: A population-based, cross-sectional study was carried out in Southern Brazil. The sample consisted of 449 parturients who were interviewed and examined up to 48 h post-partum. Three outcomes were investigated: low birth weight, prematurity and prematurity and/or birth weight. Periodontal disease, the exposure, was defined as (i) at least one site with a periodontal pocket; (ii) the presence of pockets at four or more sites. Socio-demographic information relating to health and maternal habits was collected through a questionnaire and by hospital medical records. Simple and multiple regression analysis was performed. Findings: There was no statistically significant association between periodontal disease and low birth weight. Periodontal pocket was not associated with low birth weight and/or pre-term birth after being adjusted. A periodontal pocket in at least one site was associated with prematurity (odds ratio=2.6; 95% confidence interval 1.0,6.9) even after adjusting for maternal schooling, parity, number of previous children of low birth weight, number of pre-natal consultations and body mass index. After the introduction of variables relating to maternal health during pregnancy, this association disappeared. Conclusions: No association was found between periodontal disease in the mother and the low birth weight. An association between prematurity and periodontal pockets was found but it was confounded by maternal health variables. [source] Self-Esteem and Socioeconomic Disparities in Self-Perceived Oral HealthJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 1 2009David Locker Abstract Objective: To determine if psychosocial factors explain the socioeconomic disparities in self-perceived oral health that persist after controlling for oral status variables. Methods: Data came from the participants in the Canadian Community Health Survey 2003 who were residents in the city of Toronto. Oral health variables included self-rated oral health, a 13-item oral health scale, denture wearing, and having a tooth extracted in the previous year. The last two measures were regarded as proxy indicators of tooth loss. Psychosocial variables included a self-esteem scale, a depression scale, and single items measuring life satisfaction, life stress, and sense of cohesion. Socioeconomic status was assessed using total annual household income. Results: Interviews were completed with 2,754 dentate persons aged 20 years and over. Bivariate analyses confirmed that there were income gradients in self-rated oral health and scores on the oral health scale. Linear regression analyses confirmed that these persisted after controlling for age, gender, denture wearing, and having a tooth extracted in the previous year. In the model predicting self-rated oral health self-esteem, life satisfaction, stress, a sense of cohesion, and depression also contributed to the model, increased its explanatory power, and reduced the strength of but did not eliminate the association between income and self-rated oral health. Broadly, similar results were obtained when the oral health scale score was used as the dependent variable. In both analyses and all models, denture wearing had the strongest and most enduring effect. Conclusion: Psychosocial factors partly but do not wholly explain the socioeconomic disparities in self-perceived oral health in this population after controlling for tooth loss and denture wearing. Other variables need to be added to the models to increase their explanatory power. [source] Toward a predictive model of patient satisfaction with nurse practitioner careJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 4 2005A/G/FNP, Ann Green PhD Purpose (a) To determine if caring behaviors of nurse practitioners (NPs), gender of NPs, setting (urban or rural), and age, gender, ethnicity, education, and income of patients were predictors of patient satisfaction; (b) to determine which of these characteristics was the best predictor(s) of patient satisfaction; and (c) begin to develop a conceptual model for explaining patient satisfaction with NP care. Data sources Responses to the Caring Behaviors Inventory (CBI) and a demographic inquiry by 348 NPs in Louisiana and completion of the Di'Tomasso,Willard Patient Satisfaction Questionnaire (DWPSQ) and a demographic inquiry from 817 patients in Louisiana served as data sources. A predictive modeling design explored which variable(s) is the best predictor of patient satisfaction, and multiple regression was used to determine the equation for the best-fitting line and the optimal model for the best predictor(s) of patient satisfaction. Conclusions CBI mean scores were high for all NPs. No statistically significant difference was found between male NPs' and female NPs' total mean CBI scores and between urban or rural total mean CBI scores. DWPSQ mean scores and subscale scores indicated high satisfaction with NP care. No statistically significant relationships were found between the NPs' CBI mean scores and the patients' DWPSQ mean scores. There were significant relationships between the DWPSQ subscales, including Wait Time and Patient Management. Stepwise linear regression revealed that patients' age group was a predictor of DWPSQ total mean scores. Implications for practice NPs need to be aware of developmental differences in all age groups and the differences in perceptions of care. There are many variables to consider when determining patient satisfaction with care, including the patients' sociodemographic and health variables, the healthcare system, and characteristics of the healthcare providers. Awareness of these variables may affect how NPs deliver care and ensure quality care with which the patients are satisfied. [source] Nocturia: An austrian study on the multifactorial etiology of this symptom,,NEUROUROLOGY AND URODYNAMICS, Issue 5 2009H. Christoph Klingler Abstract Aims To identify the different factors contributing to nocturia in a clinical setting. Patients and Methods Three hundred twenty-four patients (133 women, 191 men; mean age 63 years) were entered into this multi-institutional study. When presenting with nocturia we obtained detailed medical history and performed urine analysis, post-void residual volume and renal ultrasonography. Bothersome score and quality of life were evaluated using visual analogue scale and Kings' Health Questionnaire (KHQ), respectively. Patients were asked to complete a 48-hr voiding diary (VD). Nocturia and its associated problems were evaluated using KHQ and VD in conjunction with concurrent health variables. Results Mean nocturia was 2.8 in men versus in 3.1 women. Fifty percent of patients were aged >65 years, 60% had daytime lower urinary tract symptoms (LUTS) as well as nocturia, 33% had cardiac pathologies and 7% had peripheral edema. Principal causes for nocturia were global polyuria in 17%, nocturnal polyuria (NP) in 33% and reduced functional capacity <250 ml in 16.2%; 21.2% had mixed forms of NP and reduced bladder capacity and 12.6% suffered from other causes. Mean bothersome score was higher in women (P,<,0.001) and in patients with NP (P,=,0.012). Quality of life was significantly lower in women (P,=,0.001), in patients aged >65 years (P,=,0.029) and in those with reduced functional capacity (P,<,0.001). Mean voided 24-hr urine was higher in women (P,=,0.033) and in patients aged <65 years (P,=,0.019). Conclusions Nocturia had a high impact on bothersome score, strong associations with poor health and other LUTS. NP was the predominant cause of nocturia. Neurourol. Urodynam. 28:427,431, 2009. © 2009 Wiley-Liss, Inc. [source] Retinal photography for diabetic retinopathy screening in Indigenous primary health care: the Inala experienceAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2010Geoffrey K. P. Spurling Abstract Objective: We aimed to determine the impact of clinic based retinal photography on access to appropriate screening for diabetic retinopathy (DR). Design, setting and participants: We opportunistically recruited patients undergoing their annual diabetic cycle of care over a two year period in the urban Indigenous primary health care clinic. Data were collected on retinal outcomes, health variables and referral patterns. Main outcome measures: Access to appropriate screening and ophthalmic follow up, prevalence of DR, acceptability and feasibility of clinic-based retinal photography were the main outcome measures of this study. Results: One hundred and thirty-two of a possible 147 patients consented to participate. 30% of participants had DR. Appropriate screening and ophthalmic follow up increased six fold, from 20 to 124 participants, following the introduction of the retinal camera. Most participants felt very positive about DR screening. Conclusions: Primary care DR screening using retinal photography can improve access to DR screening for indigenous patients, reduce the burden on busy outpatient departments and should reduce visual loss. Policy-makers could contribute to screening sustainability by funding a medicare item-number for primary care based DR screening associated with the annual diabetic cycle of care. An upfront Practice Incentive Program (PIP) payment could offset set up costs. [source] A population study of nocturia in SingaporeBJU INTERNATIONAL, Issue 1 2006LEWIS C.H. LIEW OBJECTIVE To estimate the prevalence of nocturia in the multiracial Asian population of Singapore, using the new International Continence Society standardized definition of one or more voids per night, and to assess its associations, bothersomeness and impact on sleep. SUBJECTS AND METHODS A door-to-door interview questionnaire survey was conducted amongst a randomly selected sample of 3000 individuals (response rate 78.2%). Nocturia and its associated problems were evaluated using questions from the International Prostate Symptom Score (IPSS), and concurrently, sociodemographic and health variables were recorded. RESULTS Data from 1134 women (aged 20,95 years) and 1139 men (aged 20,92 years) were analysed; the overall prevalence of nocturia (one or more voids/night) was 55.5%, with an increasing proportion in older groups (P < 0.01). Women had nocturia significantly (P = 0.015) more often than men (58% vs 53%), and it was positively associated with poor health, with the highest odds ratios (95% confidence interval) for diabetes mellitus of 2.0 (1.3,3.1), for renal disease of 6.4 (2.3,18.2), and for strokes of 3.1 (1.1,9.2). In both men and women, the median IPSS in patients with nocturia was significantly higher than that in patients without nocturia (P < 0.001). For individuals waking once a night, only 9.5% considered nocturia a problem and 13.5% complained of sleep disturbances; these values increased to 36% and 40% for individuals waking up twice or more /night. CONCLUSION Nocturia is a common condition amongst Singaporean adults, especially in the elderly; it has strong associations with poor health and other lower urinary tract symptoms. The degree of nocturia determines whether patients are likely to be bothered by it or have sleep disturbance, which will influence their help-seeking behaviour. [source] Adolescent life events and adult mental health 5,9 years after referral for acute psychiatric outpatient treatmentCLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 6 2004T. Skarbø Knowledge is needed of mental health in relation to life events of former acute child and adolescent outpatients at risk of suicide. The present study describes the long-term mental health outcome of young adults who as children or adolescents were referred to outpatient psychiatry for mental health problems, and identifies putative mental health statistical outcome predictors at follow-up, with focus on life events. One hundred patients referred to treatment at child and adolescent outpatient clinics in Nordland County, Norway, during 1990,1994 were interviewed face to face, 5,9 years after referral. At follow-up, life events at young age were associated with the mental health status in spite of referral and acute psychotherapeutic intervention. There was a general effect of life events at young age, affecting a large number of mental health variables. Childhood and adolescence difficulties were highly correlated, indicating a possible continuation of effects from childhood to adolescence.,Copyright © 2004 John Wiley & Sons, Ltd. [source] | ||||||||||