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Physical Health (physical + health)
Kinds of Physical Health Terms modified by Physical Health Selected AbstractsWhen 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] The Reliability, Validity and Practical Utility of Measuring Supports using the I-CAN Instrument: Part IIJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 4 2009Vivienne C. Riches Background, There is an urgent need for developing reliable, valid and practical instruments that assess and classify the support needed by persons with disability to function in their chosen living, working and social environments. I-CAN is an instrument that addresses the frequency and level of support needed (not individual skills or deficits) for each individual with a disability. Method, Studies were conducted to assess the test,retest reliability and inter-rater reliability. Concurrent validity was investigated by exploring the relationship between the I-CAN domain scales and the Inventory for Client and Agency Planning (ICAP) (Bruininks et al. 1986) and the Quality of Life Questionnaire (QOL-Q) (Schalock & Keith 1993). Predictive validity studies were undertaken using day- and night-time support hours. Regression analyses were run using these measures with I-CAN domain scales. Two independent studies were also conducted to ascertain the practical utility of the instrument. Results, The I-CAN instrument demonstrated excellent inter-rater and test,retest reliability in the Activities and Participation domains. Low-to-moderate test,retest results in Physical Health, Mental Emotional Health and Behaviour domains were tracked to actual change in support needs in these areas. Validity proved acceptable. The relationships between I-CAN domain scales and adaptive behaviour were mixed but in the expected direction. Low-to-moderate correlation coefficients were evident between the I-CAN scales and the QOL-Q Total, but greater support needed in certain domains was associated with less empowerment and independence, and less community integration and social belonging. Attempts to explain current support hours against the I-CAN scales were disappointing and suggest that a number of other factors apart from individual support need to play a significant role. There was general satisfaction with the assessment process from stakeholders and participant groups. Conclusions, I-CAN is a reliable, valid and user-friendly instrument for assessing the support needs of people with disabilities. It uses a process that involves the persons with disability, their family and friends and staff as appropriate. It is also apparent that the current provision of paid support hours by agencies is a complex phenomenon that is not based solely on individual support needs. Further research is warranted on the influence of the environment and the perceptions of need for support based on negotiable and non-negotiable support needs. [source] Physical Health and Drinking Among Medical Inpatients With Unhealthy Alcohol Use: A Prospective Study,ALCOHOLISM, Issue 7 2010Emily C. Williams Objective:, Unhealthy alcohol use is common in medical inpatients, and hospitalization has been hypothesized to serve as a "teachable moment" that could motivate patients to decrease drinking, but studies of hospital-based brief interventions have often not found decreases. Evaluating associations between physical health and subsequent drinking among medical inpatients with unhealthy alcohol use could inform refinement of hospital-based brief interventions by identifying an important foundation on which to build them. We tested associations between poor physical health and drinking after hospitalization and whether associations varied by alcohol dependence status and readiness to change. Methods:, Participants were medical inpatients who screened positive for unhealthy alcohol use and consented to participate in a randomized trial of brief intervention (n = 341). Five measures of physical health were independent variables. Outcomes were abstinence and the number of heavy drinking days (HDDs) reported in the 30 days prior to interviews 3 months after hospitalization. Separate regression models were fit to evaluate each independent variable controlling for age, gender, randomization group, and baseline alcohol use. Interactions between each independent variable and alcohol dependence and readiness to change were tested. Stratified models were fit when significant interactions were identified. Results:, Among all participants, measures of physical health were not significantly associated with either abstinence or number of HDDs at 3 months. Having an alcohol-attributable principal admitting diagnosis was significantly associated with fewer HDDs in patients who were nondependent [adjusted incidence rate ratio (aIRR) 0.10, 95% CI 0.03,0.32] or who had low alcohol problem perception (aIRR 0.36, 95% CI 0.13,0.99) at hospital admission. No significant association between alcohol-attributable principal admitting diagnosis and number of HDDs was identified for participants with alcohol dependence or high problem perception. Conclusions:, Among medical inpatients with nondependent unhealthy alcohol use and those who do not view their drinking as problematic, alcohol-attributable illness may catalyze decreased drinking. Brief interventions that highlight alcohol-related illness might be more successful. [source] Improving the Mental Health, Healthy Lifestyle Choices, and Physical Health of Hispanic Adolescents: A Randomized Controlled Pilot StudyJOURNAL OF SCHOOL HEALTH, Issue 12 2009Bernadette M. Melnyk PhD, CPNP/NPP, FAAN ABSTRACT BACKGROUND: Obesity and mental health disorders are 2 major public health problems in American adolescents, with prevalence even higher in Hispanic teens. Despite the rapidly increasing incidence and adverse health outcomes associated with overweight and mental health problems, very few intervention studies have been conducted with adolescents to improve both their healthy lifestyles and mental health outcomes. Even fewer studies have been conducted with Hispanic youth. The purpose of this study was to evaluate the preliminary efficacy of the COPE (Creating Opportunities for Personal Empowerment) Healthy Lifestyles TEEN (Thinking, Emotions, Exercise, and Nutrition) program, a manualized educational and cognitive behavioral skills-building program, on Hispanic adolescents' healthy lifestyle choices as well as mental and physical health outcomes. METHODS: A cluster randomized controlled pilot study was conducted with 19 Hispanic adolescents enrolled in 2 health classes in a southwestern high school. One class received COPE and the other received an attention control program. RESULTS: Adolescents in the COPE program increased their healthy lifestyle choices and reported a decrease in depressive and anxiety symptoms from baseline to postintervention follow-up. A subset of 7 overweight adolescents in the COPE program had a decrease in triglycerides and an increase in high-density lipoproteins. In addition, these overweight adolescents reported increases in healthy lifestyle beliefs and nutrition knowledge along with a decrease in depressive symptoms. CONCLUSION: The COPE TEEN program is a promising school-based strategy for improving both physical and mental health outcomes in adolescents. [source] Potential outcome measures and trial design issues for multiple system atrophy,MOVEMENT DISORDERS, Issue 16 2007Susanne May PhD Abstract Multiple system atrophy (MSA) is a neurodegenerative disorder exhibiting a combination of parkinsonism, cerebellar ataxia, and autonomic failure. A disease-specific scale, the Unified Multiple System Atrophy Rating Scale (UMSARS), has been developed and validated to measure progression of MSA, but its use as an outcome measure for therapeutic trials has not been evaluated. On the basis of twelve months of follow-up from an observational study of 67 patients with probable MSA, we evaluated three disease-specific scores: Activities of Daily Living, Motor Examination, and a combined score from the UMSARS and two general health scores, the Physical Health and Mental Health scores of the SF-36 health survey, for their use as outcome measures in a therapeutic trial. We discuss related design issues and provide sample size estimates. Scores based on the disease-specific UMSARS seemed to be equal or superior to scores based on the SF-36 health survey. They appeared to capture disease progression, were well correlated and required the smallest sample size. The UMSARS Motor Examination score exhibited the most favorable characteristics as an outcome measure for a therapeutic trial in MSA with 1 year of follow-up. © 2007 Movement Disorder Society [source] The Impact of Hurricane Katrina on the Mental and Physical Health of Low-Income Parents in New OrleansAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 2 2010Jean Rhodes The purpose of this study was to document changes in mental and physical health among 392 low-income parents exposed to Hurricane Katrina and to explore how hurricane-related stressors and loss relate to post-Katrina well-being. The prevalence of probable serious mental illness doubled, and nearly half of the respondents exhibited probable posttraumatic stress disorder. Higher levels of hurricane-related loss and stressors were generally associated with worse health outcomes, controlling for baseline sociodemographic and health measures. Higher baseline resources predicted fewer hurricane-associated stressors, but the consequences of stressors and loss were similar regardless of baseline resources. Adverse health consequences of Hurricane Katrina persisted for a year or more and were most severe for those experiencing the most stressors and loss. Long-term health and mental health services are needed for low-income disaster survivors, especially those who experience disaster-related stressors and loss. [source] Exposure to Interparental Conflict and Children's Adjustment and Physical Health: The Moderating Role of Vagal ToneCHILD DEVELOPMENT, Issue 6 2001Mona El-Sheikh Physiological regulation, as indexed by baseline vagal tone and delta vagal tone (the change in vagal tone during an attention-demanding or challenging task), was examined as a moderator in the relations between exposure to verbal and physical parental marital conflict and children's adjustment and physical health. Higher vagal tone was posited to serve a protective function (i.e., buffer) for children exposed to higher levels of marital conflict. Seventy-five 8- to 12-year-olds and their mothers completed measures of parental conflict, and children's adjustment and physical health. Children's vagal tone was assessed during baseline conditions and during exposure to an audiotaped interadult argument. Results indicate that higher vagal tone buffered children against increased externalizing, internalizing, and health problems related to exposure to more frequent marital conflict, especially verbal conflict. Further, higher levels of delta vagal tone protected boys against externalizing problems associated with verbal conflict, and health problems associated with physical conflict. [source] The Oldest Old in the Last Year of Life: Population-Based Findings from Cambridge City over-75s Cohort Study Participants Aged 85 and Older at DeathJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2010Jun Zhao MSc OBJECTIVES: To characterize people of advanced old age in their last year of life and compare those dying in their late 80s with those dying aged 90 and older to inform policy and planning. DESIGN: Retrospective analysis of prospectively collected population-based data from the Cambridge City over-75s Cohort (CC75C) Study, United Kingdom. PARTICIPANTS: Men and women aged 85 and older at death who died less than 1 year after taking part in any CC75C survey (N=321). MEASUREMENTS: Physical health, functional disability, self-rated health, cognitive status. RESULTS: Functional and cognitive impairments were markedly higher for those who died aged 90 and older, predominantly women,than for those who died aged 85 to 89. At least half (49.4,93.6%) of subjects aged 90 and older needed maximum assistance in virtually every daily activity; those aged 85 to 89 needed this only for shopping and laundry. Disability in basic and instrumental activities rose from 59.1% before to 85.4% after the age of 90 and cognitive impairment (Mini-Mental State Examination score ,21) from 41.7% to 69.4%. Despite this and proximity to death, 60.5% and 67.0%, respectively, rated their health positively. Only one in five reported needing more help. CONCLUSION: This study provides new data identifying high levels of physical and cognitive disability in very old people in the year before death. As the very old population rises, so will support needs for people dying in extreme old age. The mismatch between health perceptions and functional limitations suggests that these vulnerable older adults may not seek help from which they could benefit. These findings have major policy and planning implications for end-of-life care for the oldest old. [source] Testing a model of exercise behavior in older adultsRESEARCH IN NURSING & HEALTH, Issue 2 2001Barbara Resnick Abstract The purpose of this study was to test a model of exercise behavior in older adults. It was hypothesized that (a) mental and physical health directly influence self-efficacy expectations; (b) mental and physical health, age, and self-efficacy expectations influence outcome expectations; and (c) all these variables directly and/or indirectly influence exercise behavior. The sample was composed of 175 older adults living in a continuing-care retirement community, each of whom was interviewed once. Seven of the 10 hypothesized paths were significant. Physical health, self-efficacy expectations, and outcome expectations directly influenced exercise behavior, and age and mental health indirectly influenced exercise through self-efficacy expectations and outcome expectations. Combined these variables accounted for 30% of the variance in exercise behavior. To improve exercise behavior in older adults, health care providers should focus on developing interventions to strengthen self-efficacy and outcome expectations related to exercise. © 2001 John Wiley & Sons, Inc. Res Nurs Health 24: 83,92, 2001 [source] The effect of depression on quality of life of patients with type II diabetes mellitusDEPRESSION AND ANXIETY, Issue 2 2008brahim Eren M.D. Abstract Diabetes mellitus (DM) is a frequently encountered metabolic disease with chronic features and involves numerous complications throughout its course, which causes severe restriction and disability in an individual's life. It has been reported that the incidence of depression is higher in diabetic patients and that diabetes is one of the risk factors in the development of depression. It has also been reported that co-morbid psychiatric disorders cause further deterioration in the quality of life in diabetic patients. The aim of this study was to investigate the effects of depression on the quality of life in type II DM patients. Sixty patients (30 females and 30 males) with current major depressive episode diagnosed according to DSM-IV criteria, and 48 type II DM patients (30 females and 18 males) without a major depressive episode (non-depressed group) were included in the study. All patients were evaluated with a semi-structured interview form to assess the clinical features of DM, Hamilton Rating Scale for Anxiety (HRSA), Hamilton Rating Scale for Depression (HRSD), and the Turkish version of The World Health Organization Quality of Life Assessment-Brief (WHOQOL-BREF). The HRSD and HRSA scores in the depressed group were 24.87±4.83 and 21.07±5.44, respectively, whereas those in the non-depressed group were 7.83±3.92 and 6.88±3.43, respectively. The physical health, psychological health, social relationship, environmental and social pressure domain, general health-related quality of life, overall quality of life, and WHOQOL-BREF total scores were found significantly lower in the depressed group than the non-depressed group. There were significant negative correlations between HRSD and HRSA scores and physical health, psychological health, social relationship, environmental and social pressure domain, general health-related quality of life, overall quality of life, and WHOQOL-BREF total scores. Furthermore, there were significant negative correlations between the HbA1c level and physical health, social relationship, environmental domain, social pressure domain, general health-related quality of life, overall quality of life, and WHOQOL-BREF total scores. However, there was a significant positive correlation between the level of education and physical health, psychological health, social relationship, environmental social pressure domain, overall quality of life, and WHOQOL-BREF total scores. There were significant negative correlations between social relationship domain score, and age and duration of illness. Our study demonstrates that the presence of depression in type II DM further deteriorates the quality of life of the patients. Since treating depression would have a beneficial effect on the quality of life, clinicians should carefully assess for depression associated with type II DM. Depression and Anxiety 0:1,9, 2007. © 2007 Wiley-Liss, Inc. [source] Impact of substance use on the physical health of patients with bipolar disorderACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2010M. P. Garcia-Portilla Garcia-Portilla MP, Saiz PA, Benabarre A, Florez G, Bascaran MT, Díaz EM, Bousoño M, Bobes J. Impact of substance use on the physical health of patients with bipolar disorder. Objective:, To describe the impact of tobacco, alcohol and cannabis on metabolic profile and cardiovascular risk in bipolar patients. Method:, Naturalistic, cross-sectional, multicenter Spanish study. Current use of tobacco, alcohol and cannabis was determined based on patient self-reports. Metabolic syndrome was defined using the National Health and Nutrition Examination Survey 1999,2000 and the American Heart Association/National Heart, Lung and Blood Institute criteria, and cardiovascular risk using the Framingham and the Systematic Coronary Risk Evaluation functions. Results:, Mean age was 46.6 years, 49% were male. Substance use: 51% tobacco, 13% alcohol and 12.5% cannabis. Patients who reported consuming any substance were significantly younger and a higher proportion was male. After controlling for confounding factors, tobacco was a risk factor for coronary heart disease (CHD) (unstandardized linear regression coefficient 3.47, 95% confidence interval 1.85,5.10). Conclusion:, Substance use, mainly tobacco, was common in bipolar patients. Tobacco use negatively impacted CHD risk. [source] Schizophrenia and physical health problemsACTA PSYCHIATRICA SCANDINAVICA, Issue 2009Y. Von Hausswolff-Juhlin Objective:, To estimate the prevalence of physical health problems in patients with schizophrenia, and to appraise the impact on mortality rates and quality of life (QoL) in such patients. Method:, A selective review of clinical articles relating to physical health such as cardiovascular disease, metabolic syndrome and QoL. In addition, current guidelines and recommendations for the monitoring of physical health in schizophrenia were reviewed. Results:, Cardiovascular events contribute most strongly to the excess mortality observed in schizophrenia. Other factors that contribute significantly include obesity, metabolic aberrations, smoking, alcohol, lack of exercise and poor diet , all of which might be targets for health promoting activities. Conclusion:, Physical health problems in patients with schizophrenia are common, and contribute to the excess mortality rate, as well as decreasing QoL. Many adverse physical factors are malleable in such patients, and physical benefit may be gained by following practical guidelines for their monitoring and improvement. [source] Connecting patient needs with treatment managementACTA PSYCHIATRICA SCANDINAVICA, Issue 2009R. Kerwin Objective:, To propose ideas for the development of a core strategy for monitoring patients with schizophrenia to ensure physical health and optimal treatment provision. Method:, A panel of European experts in the field of schizophrenia met in Bordeaux in June 2006 to discuss, ,Patient management optimisation through improved treatment monitoring.' Results:, Key consensus from the discussion deemed that weight gain, oral health and ECG parameters were core baseline parameters to be monitored in all patients with schizophrenia. Further, an identification of a patient's own barriers to treatment alongside local health service strategies might comprise elements of an individualised management strategy which would contribute to optimisation of treatment. Any monitoring strategy should be kept simple to encourage physician compliance. Conclusion:, A practical solution to the difficulties of providing holistic patient care would be to suggest a limited set of physical parameters to be monitored by physicians on a regular basis. [source] The relationship between quality of life and functioning for children with cerebral palsyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 3 2008A Shelly BSc (Hons) Given that quality of life (QOL) is commonly confused with functioning, the aim of this study was to examine the association between functioning and QOL domains for children with cerebral palsy (CP). Two hundred and five parents of children aged 4 to 12 years with CP and 53 children aged 9 to 12 years with CP, completed the Cerebral Palsy Quality of Life Questionnaire for Children. Children were distributed reasonably evenly between sex (male, 54.6%) and Gross Motor Function Classification System levels (I 17.8%, II 28.3%, III 14.1%, IV 11.2%, and V 27.3%). For parent proxy-report, all domains of QOL were significantly associated with functioning level except access to services. For child self-report, feelings about functioning, participation and physical health, and pain and feelings about disability, were significantly associated with functioning level. Physical type domains of QOL accounted for more of the variance in functioning than psychosocial type domains. Children with CP have the potential to report a high psychosocial QOL score even if they have poor functioning. [source] The characteristics of heroin users entering treatment: findings from the Australian Treatment Outcome Study (ATOS)DRUG AND ALCOHOL REVIEW, Issue 5 2005JOANNE ROSS Abstract The current study aimed to describe the characteristics (demographics, drug use, mental and physical health) of entrants to treatment for heroin dependence in three treatment modalities; and to compare these characteristics with heroin users not in or seeking treatment. Participants were 825 current heroin users recruited from Sydney, Adelaide and Melbourne: 277 entering methadone/buprenorphine maintenance treatment (MT), 288 entering detoxification (DTX), 180 entering drug-free residential rehabilitation (RR) and 80 not in treatment (NT). Treatment entrants were generally long-term heroin users with previous treatment experience. The majority of the sample (55%) were criminally active in the month preceding interview. Injection-related health problems (74%) and a history of heroin overdose (58%) were commonly reported. There were high degrees of psychiatric co-morbidity, with 49% reporting severe psychological distress, 28% having current major depression, 37% having attempted suicide and 42% having a lifetime history of post-traumatic stress disorder. Personality disorders were also prevalent, with 72% meeting criteria for antisocial personality disorder and 47% screening positive for borderline personality disorder. Striking similarities were noted between the non-treatment and treatment groups in length of heroin use career, drug use and treatment histories. [source] Changes and predictors of change in the physical health status of heroin users over 24 monthsADDICTION, Issue 3 2009Anna Williamson ABSTRACT Aims (i) To describe the course of physical health among the ATOS cohort over 24 months; and (ii) to examine the effects of treatment, drug use patterns and social and psychological factors on health status over 24 months. Design Longitudinal cohort. Setting Sydney, Australia. Participants A total of 615 heroin users recruited for the Australian Treatment Outcome Study (ATOS). Findings The general health of the cohort improved significantly over 24 months. Significant predictors of poor health over 24 months were: being older, being female, past month heroin, other opiate and tobacco use, past month unemployment and current major depression. Spending a greater proportion of time in residential rehabilitation (RR) was associated with better health over 24 months. No other treatment factors demonstrated a significant, independent relationship with health. Conclusions The physical health of dependent heroin users is affected by drug use and psychosocial problems. RR treatment appears to be particularly beneficial to the health of heroin users, suggesting the importance of a comprehensive approach to improving health among this group. [source] Analysis of dust pollution in slate and granite transformation plantsENVIRONMENTAL PROGRESS & SUSTAINABLE ENERGY, Issue 2 2007Celestino Ordóñez Abstract The production of dust in natural stone transformation plants causes respiratory illnesses in workers that, over time, may seriously affect their physical health. In this article we study dust contamination in a number of ornamental slate and granite transformation plants located in Galicia, in northwest Spain. Using dust concentration measures combined with other factors that increase or decrease the noxious effects of dust (noise, duration over time, etc.), and applying multivariate and geostatistical techniques, we were able to construct dust concentration and associated environmental impact maps. The results were integrated in a GIS (Geographical Information System), which allows us to view the contamination maps, as also information on the machinery used, the associated work stations, the most contaminated areas of each plant, etc. This information was then used to analyze the problem in each plant and to compare results between plants. We propose a method designed to reduce worker exposure to dust using an individualised dust capture system at each of the work stations. The pollution control system and its characteristics were finally incorporated into the GIS to allow interested parties such as the managers of the plants studied or people interested in designing a new plant to consult the available information. © 2007 American Institute of Chemical Engineers Environ Prog, 2007. [source] Alcohol drinking pattern and subjective health in a population-based studyADDICTION, Issue 9 2006Saverio Stranges ABSTRACT Aims Some patterns of alcohol consumption (e.g. binge drinking, drinking outside of meals) have been associated with detrimental effects on health outcomes. Subjective health provides a global assessment of health status and is a strong predictor of total mortality; however, little is known about its relationship with alcohol drinking pattern. The association between several drinking patterns (i.e. drinking intensity and frequency, frequency of intoxication, drinking outside of meals, and beverage type) and subjective health was examined in a random sample of 3586 women and men. Design A population-based cross-sectional study. Methods Subjective health was assessed using the physical and mental health component summaries of the Short Form-36 health survey questionnaire. Alcohol consumption refers to the 30 days before the interview. Analysis of covariance compared gender-specific mean scores across alcohol drinking patterns. Findings Overall, non-current drinkers reported poorer physical and mental health than life-time abstainers and current drinkers, while no consistent differences were found between life-time abstainers and current drinkers. In female current drinkers, daily drinking, beer and mixed beverage consumption were associated with better mental health. In male current drinkers, moderate alcohol consumption (2,2.9 drinks per day), wine and mixed beverage consumption were associated with better physical health. Intoxication and liquor consumption were associated with poorer mental health in women and poorer physical health in men. No consistent associations were found for drinking outside meals. Conclusions Aspects of drinking pattern may affect subjective health differentially in women and men. Overall, intoxication and liquor drinking are associated with poorer self-perceived health status than regular, moderate consumption of other alcoholic beverages. [source] Educational needs, metabolic control and self-reported quality of lifeEUROPEAN DIABETES NURSING, Issue 1 2005A study among people with type 2 diabetes treated in primary health care Abstract The prevalence of type 2 diabetes is increasing. In order to reduce long-term complications and to promote a better life for these patients, health care professionals are important advocates in education and counselling. More knowledge is therefore needed to explore the association between educational needs and quality of life. In total, 211 people with type 2 diabetes (response rate 48%) were recruited from general practices in a geographically well-defined district in Bergen, Norway. All participants completed a questionnaire measuring demographical and clinical variables, quality of life (WHOQOL-Bref), satisfaction with education and counselling, and symptoms related to the disease. A blood sample was taken from each patient for determination of HbA1c. The participants reported receiving most information on diet, physical activity and treatment and less information on foot care and long-term complications. Satisfaction with education was significantly positively correlated with self-reported overall quality of life, and quality of life within domains for psychological health, social relationships and environment. More intensive treatment was significantly associated with lower quality of life within the physical health and social relationships domains. For 32% of the participants, HbA1c values did not satisfy the Norwegian guidelines (adjusted for age). The results from the present study emphasise a need for health education in diabetes primary health care especially in relation to foot care and long-term complications. The association between satisfaction with education and quality of life makes it important to develop educational and counselling methods for nurses in primary health care. Copyright © 2005 FEND. [source] Are patient assistance programmes able to meet the needs of New York City women with breast cancer?EUROPEAN JOURNAL OF CANCER CARE, Issue 1 2009Women's perspectives Women with breast cancer report needs that may interfere with their ability to obtain necessary treatments. High-quality community-based patient assistance programmes exist; however, their ability to identify and meet women's needs is unknown. We surveyed women with breast cancer attending such programmes to assess programmes' ability to identify and meet their needs. We surveyed 117 (42% minority) women utilizing nine programmes in the New York City area about expectations, needs and experiences. Ninety-two (89%) women wanted information, 102 (95%) psychosocial support and 15 (20%) practical assistance. Seventy-three per cent had all or most of their needs identified, and 74% had all or most of their needs met. Seventy per cent stated programmes met needs they were not previously aware they had. Needs identified and met were lower among minority women (57% vs. 84%; P = 0.003), those with lower income (46% vs. 79%; P = 0.02) and those in poor physical health (56% vs. 78%; P = 0.04), independent of the type of need. High-quality community-based patient assistance programmes effectively identify and meet the needs of women with breast cancer but traditionally at-risk women appear less likely to have needs identified and met. Programmes should enhance the systemization and sensitivity of needs assessments to improve women's experience with cancer. [source] Forgiveness in Marriage: Current Status and Future DirectionsFAMILY RELATIONS, Issue 4 2006Frank D. Fincham Abstract: Interest in forgiveness has exploded in recent years as researchers and clinicians have begun to recognize its value for maintaining emotional well-being, physical health, and healthy intimate relationships. Forgiveness appears to be especially important in the marital relationship. This article offers an overview of forgiveness in marriage including a review of major research and clinical efforts in this area. A number of recommendations are offered for practitioners and future research directions are outlined. Marital forgiveness is seen as an exciting area for future exploration and one that is ripe with possibility. [source] Linking Employment Status, Maternal Psychological Well-Being, Parenting, and Children's Attributions About Poverty in Families Receiving Government Assistance,FAMILY RELATIONS, Issue 2 2002Velma McBride Murry Functional changes in rural African American single-mother-headed families after the implementation of Temporary Assistance for Needy Families were explored from an ecological risk,protection perspective. The sample included 96 single mothers who received government assistance and their 10- or 11-year-old children. Links among maternal employment status, mothers' physical health and psychological functioning, parenting, and children's attributions about the causes of poverty were examined. Maternal psychological distress was linked with children's attributions about the causes of poverty, both directly and indirectly through its association with parenting. Children who did not attribute poverty to social causes had higher academic goals than did those who attributed poverty to social, economic, or political barriers. Further research is needed on barriers to employment and the influence of maternal psychological functioning on parenting. [source] Masturbation and Discourse on Female Sexual Practices in Early Modern JapanGENDER & HISTORY, Issue 1 2009Anne Walthall Much of the discourse on female sexual practices in early modern Japan centred on masturbation, usually with a dildo, deemed necessary for a woman's mental and physical health when the male member was unavailable. References to female same-sex relations suggest that they too made sense in situations where men were absent. Some sex manuals treated female sexual arousal within the context of conjugal relations, while a text written for wives in polygamous marriages places female sexual practice at the service of male interests. The texts analysed here show not only that early modern Japanese held different attitudes toward sex than their western counterparts, but also that they could hold multiple attitudes at the same time. [source] Relationship between intensity of physical activity and health-related quality of life in Portuguese institutionalized elderlyGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 4 2008Alexandrina Lobo Aims: Health-related quality of life (HRQOL) is considered to be the key goal for health promotion in older people. This study explores the relationship between HRQOL and objectively measured intensity of physical activity (PA) in institutionalized older adults. The analysis of the PA patterns of the subjects in relation to recommended levels of PA was also performed. Methods: One hundred and eighty-five residents of long-term care homes aged 65 years or more, volunteered for this study. The Medical Outcome Study Short Form 36-Item health survey (MOS SF-36) questionnaires and the uni-axial MTI Actigraph were used to assess HRQOL and PA, respectively. Participants were classified as less active, reasonably active and more active by tertile of moderated physical activity (MPA). Results: (i) The men represented a greater number of counts/h and min of MPA in all the tertile groups; (ii) men from the less active group had a significantly higher body mass index; (iii) women came third and exhibited less total activity even though they used this time in more intense activities; (iv) there was a higher significant correlation between MPA, physical function and negative association with body pain in relation to the time of institutionalization in both sexes but was more strongly visible in men; and (v) only men presented a significant positive association with physical health, mental health and vitality. Conclusion: Any intensity of PA seems to be better than no activity for HRQOL, but MPA confers greater benefits for the perception of physical function and body pain in the case of institutionalized elderly persons. [source] Predictors and correlates of edentulism in the healthy old people in Edinburgh (HOPE) studyGERODONTOLOGY, Issue 4 2008John M. Starr Objectives:, To determine the extent to which correlates of edentulism are explained by an association between tooth loss and cognitive ability. Methods:, Participants in the Healthy Old People in Edinburgh (HOPE) study aged 70 or more at baseline were assessed and health, cognitive, socio-economic and socio-environmental data collected on four consecutive occasions. It was noted whether the participant had any retained teeth and if not, the age when the last tooth was lost. Prior determinants of edentulism were investigated with binary logistic regression models. At the 9-year follow-up, associations with edentulism were examined using general linear models with edentulism as an independent factor. Results:, 201 participants were adequately tested, of whom 104 (51.7%) were edentulous. A logistic regression model that considered age, sex, education, social class, deprivation index of residence, objective distance from dentist, participant's estimate of distance from dentist and NART-estimated IQ (NARTIQ) found age (p = 0.032), occupational class (p = 0.019) and NARTIQ (p = 0.027) as significant predictors of edentulism. Cox's proportional hazards modelling found only NARTIQ (p = 0.050) to be correlated. Being edentulous was associated with poorer respiratory function but not hand grip strength (p = 0.23). Edentulous participants had lower self esteem scores (p = 0.020) and poorer dietary assessment scores (p = 0.028). Being edentulous was also associated with significantly lower mean scores on all cognitive testing, although these associations became non-significant after adjustment for NARTIQ and age. Conclusions:, In healthy older people, edentulism is associated with relative impairment of cognitive ability, although this association is explained by the fact that lower original intelligence predisposes to edentulism and poorer performance on cognitive tests in old age. Once original intelligence is adjusted for, tooth loss is not related to cognitive ability. Tooth loss is, however, associated with poorer status across a wide range of health measures: physical health, nutrition, disability and self-esteem. Establishing the degree to which these health outcomes are causally related to edentulism could usefully be factored into cost,benefit analyses of programmes designed to prevent tooth loss. [source] Formal support of stroke survivors and their informal carers in the community: a cohort studyHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2008Chantal Simon PhD MSc MRCGP Abstract This cohort study, aims to explore formal care provision to stroke survivors and their informal carers in the community in the UK. An initial cohort of 105 cohabitant carers of first-time stroke patients was recruited while the stroke patient was in hospital. Structured face-to-face interviews were carried out with carers prior to discharge of the stroke patient home, at 6 weeks after discharge, and 15 months after stroke. Questionnaires included measures of psychological health (CIS-R), physical health (self-rated health), social well-being (relationship quality and Sarason's social support questionnaire), handicap of the stroke survivor (Oxford Handicap Scale) and formal community support (amount of formal support and carer satisfaction). Multiple services were involved with most survivor,carer pairs (mean 5.4; range 2,9; SD = 1.7), and 74% of carers were satisfied with formal support provided. Number of services decreased with time (5.5 versus 4.1, t = 4.201, d.f. = 52, P < 0.001, 95% confidence interval: 0.71,2.01) but not time allocated. Using stepwise linear regression, service provision early after discharge was predicted by: level of handicap, recruitment centre, carer self-rated health, number of informal supporters and other care commitments. Satisfaction was predicted by quality of informal support and activity restriction. Fifteen months after stroke, predictors of formal care were: level of handicap, quality of informal support and previous caring experience. Predictors of satisfaction were: quality of the relationship between the stroke survivor and carer, age and mood. Quality of services was good, but carers lacked information, had insufficient help and were not consulted enough. Carer distress is common, yet not currently a factor influencing support provision. Formal care provided adapts with time reflecting the importance of quality of support from friends and family rather than quantity of informal supporters. These factors should be taken into consideration when planning and providing formal support for stroke survivors and their carers. [source] Caring for mom and neglecting yourself?HEALTH ECONOMICS, Issue 9 2009The health effects of caring for an elderly parent Abstract We examine the physical and mental health effects of providing care to an elderly mother on the adult child caregiver. We address the endogeneity of the selection in and out of caregiving using an instrumental variable approach, using the death of the care recipient and sibling characteristics. We also carefully control for baseline health and work status of the adult child. We explore flexible specifications, such as Arellano,Bond estimation techniques. Continued caregiving over time increases depressive symptoms and decreases self-rated health for married women and married men. In addition, the increase in depressive symptoms is persistent for married women. While depressive symptoms for single men and women are not affected by continued caregiving, there is evidence of increased incidence of heart conditions for single men, and that these effects are persistent. Robustness checks indicate that these health changes can be directly attributable to caregiving behavior, and not due to a direct effect of the death of the mother. The initial onset of caregiving has modest immediate negative effects on depressive symptoms for married women and no immediate effects on physical health. Negative physical health effects emerge 2 years later, however, suggesting that there are delayed effects on health that would be missed with a short recall period. Initial caregiving does not affect health of married men. Published in 2009 by John Wiley & Sons, Ltd. [source] County-Level Income Inequality and Depression among Older AmericansHEALTH SERVICES RESEARCH, Issue 6p2 2003Naoko Muramatsu Objectives. To examine (1) whether county-level income inequality is associated with depression among Americans aged 70 and older, taking into consideration county-level mean household income and individual-level socioeconomic status (SES), demographic characteristics, and physical health, and (2) whether income inequality effects are stronger among people with lower SES and physical health. Data Sources. The individual-level data from the first wave of the Assets and Health Dynamics among the Oldest Old survey (1993,1994) were linked with the county-level income inequality and mean household income data from the 1990 Census. Study Design. Multilevel analysis was conducted to examine the association between income inequality (the Gini coefficient) and depression. Principal Findings. Income inequality was significantly associated with depression among older Americans. Those living in counties with higher income inequality were more depressed, independent of their demographic characteristics, SES, and physical health. The association was stronger among those with more illnesses. Conclusions. While previous empirical research on income inequality and physical health is equivocal, evidence for income inequality effects on mental health seems to be strong. [source] Gender differences in clinical presentation and response to sertraline treatment of generalized anxiety disorder,HUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 1 2005Meir Steiner Abstract Objective To evaluate gender differences in the clinical presentation of generalized anxiety disorder (GAD) and response to sertraline treatment. Methods Adult outpatients who met DSM-IV criteria for GAD with a minimum Hamilton rating scale for anxiety (HAM-A) total score,,,18 were randomized to 12 weeks of double-blind treatment with flexible doses (50,150,mg) of sertraline (n,=,182; female, 59%) or placebo (n,=,188; female, 51%). Results Clinical presentation of GAD was very similar in men and women in terms of the severity of the HAM-A psychic factor, severity of concomitant depression symptoms, duration of GAD, quality of life and impairment in physical health. Women had an earlier age of onset and higher HAM-A somatic factor scores compared with men. For both men and women, treatment with sertraline resulted in greater change from baseline to endpoint on the HAM-A compared with placebo (adjusted change,±,SE: men: ,12.1,±,0.9 vs ,8.8,±,0.9; women: ,11.4,±,0.8 vs ,7.1,±,0.9, p,<,0.001); the interaction between gender and treatment group was not significant, nor was there a significant difference between the average change from baseline for men compared with women. Similarly, responder rates based upon clinical global impression,improvement (CGI-I) scores at endpoint showed no significant interaction between gender and treatment, nor was there a significant difference in the response rates by gender; however, the response rate of sertraline compared with placebo was significantly different (p,<,0.0001) (men: 64% vs 40%; women: 62% vs 34%). Similar findings were evident at week 4 assessment and for completers (week 12). Overall, sertraline was well tolerated by both men and women. Discussion Women and men with GAD showed similar clinical presentations, with the exception that women had an earlier age of onset and reported more somatic anxiety symptoms. Sertraline was an effective and well tolerated treatment for GAD in both men and women. Copyright © 2004 John Wiley & Sons, Ltd. [source] Antecedents and outcomes of workplace incivility: Implications for human resource development research and practiceHUMAN RESOURCE DEVELOPMENT QUARTERLY, Issue 3 2009Thomas G. Reio Jr. This cross-sectional, correlational study (N = 402) examined the relationships among select demographics, workplace adaptation, employee affect, and incivility and physical health and job satisfaction. The paper-and-pencil survey battery consisted of nine scales. The hypotheses were tested through correlational, factor analytic, and hierarchical regression analytic procedures. Younger males engaged more frequently in uncivil behavior. After statistically controlling for the demographic variables, high negative affect and low degree of establishing relationships with coworkers and supervisors (adaptation) predicted more incivility. For the physical health model, establishing relationships with coworkers and positive affect positively contributed to perceived physical health, while organizational incivility negatively contributed to the dependent variable. As for the job satisfaction model, establishing relationships with coworkers and supervisors and positive affect positively predicted satisfaction, whereas negative affect and incivility made negative contributions to the regression equation. In all cases, the magnitude of effect ranged from medium to large, supporting the theoretical, empirical, and practical relevance of understanding the detrimental effects of uncivil behaviors on organizational outcomes. HRD researchers and professionals are highlighted as possible means for reducing uncivil workplace behaviors and improving organizational performance. [source] | |||||||||||||||||||||||||||||||||||||||||||