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Poor Health (poor + health)
Terms modified by Poor Health Selected AbstractsSelf-reported prevalence and awareness of metabolic syndrome: findings from SHIELDINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 8 2008S. J. Lewis Summary Purpose:, This study assessed awareness of metabolic syndrome and evaluated health knowledge, attitudes and behaviours of respondents at risk. Methods:, Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD), a longitudinal US population-based survey initiated in 2004, included respondents, , 18 years of age, reporting a diagnosis of metabolic syndrome. Prevalence of metabolic syndrome was compared in SHIELD and National Health and Nutrition Examination Survey (NHANES) 1999,2002 survey. The proportion of SHIELD respondents who had heard of and/or understood metabolic syndrome was estimated. Respondents at high risk for metabolic syndrome were stratified into attitude-behaviour categories of ,Already Doing It', ,I Know I Should' and ,Don't Bother Me' and differences in attitudes and behaviours were evaluated with chi-square tests. Results:, Prevalence of reported metabolic syndrome was 0.6% in SHIELD screening questionnaire respondents (n = 211,097) vs. 25.9% in NHANES (n = 10,780). Less than 15% of SHIELD baseline questionnaire respondents (n = 22,001) had heard of or understood metabolic syndrome. Attitudes toward health status were more favourable in the ,Doing' group (27% reported fair/poor health) compared with those in the ,Should' (38%) and ,Don't' (54%) groups (p < 0.0001). The ,Don't' group was most likely to prefer medications to lifestyle change (13% vs. 2,4%) compared with ,Should' and ,Doing' groups (p < 0.0001). More ,Doing' respondents (79%) than ,Should' (59%) and ,Don't' (48%) respondents reported exercising regularly (p < 0.0001). Conclusions:, The lack of knowledge about metabolic syndrome reported in SHIELD indicates limited penetration of this concept into public awareness. With behaviour categories, respondents who report healthy attitudes are more likely to embrace lifestyle changes, while respondents who do not care may be more difficult to treat. [source] Food and Poverty: Insights from the ,North'DEVELOPMENT POLICY REVIEW, Issue 5-6 2003Elizabeth Dowler The role that food and nutrition play in the material definitions of poverty are contrasted with the social construction of malnutrition and poverty, drawing largely on British experience. The consequences for poor health and premature death are briefly examined; in particular, the connection is made to the world-wide growth in obesity, and in cardio-vascular disease, cancers and diabetes. The lived experience of those defined as poor in the North, and the implications of contemporary policy initiatives and responses by state, private and voluntary sectors, are explored. The challenges of the dominant policy framework remain consumer and individual choice, rather than public health and citizenship, which militates against the realisation of true food security. [source] Nutritional Risk Factors for Older RefugeesDISASTERS, Issue 1 2003Simone Pieterse This study describes risk factors for poor nutrition among older Rwandan refugees. The most important areas of nutritional risk for older refugees are: physical ability and mobility; income and access to land; access to appropriate food rations; meeting basic needs such as water, fuel, shelter; equal access to essential services (food distribution, health services, mills, feeding programmes); and psycho-social trauma. Women and older elderly (>70 years) are significantly more often in disadvantaged positions, such as having poor socio-economic status, poor health, poor mobility, lower food intake, diminished social status, respect and social network. Older refugees are at higher risk than younger refugees and at higher risk than older people in stable situations. They should remain in good nutritional and general health for their own well-being and that of their dependants. In addition to an adequate diet, a support network seems to be an important preventive aspect. [source] Explaining stunting in nineteenth-century FranceECONOMIC HISTORY REVIEW, Issue 2 2010GILLES POSTEL-VINAY We examine the share of French men with stunted growth during the nineteenth century using data on potential army conscripts. The share of stunted men (those whose height was below 1.62 metres) in France's 82 departments declined dramatically across the century, especially in the south and west. Our models examine the role of education expenditure, health care personnel, local wages, asset distribution, and a dummy variable for Paris as determinants of stunting, decomposing changes over time into the effects of levels and returns to the various explanatory variables used in the model of heights. All covariates are strongly significant, with education spending being particularly important. Our evidence clearly indicates that living in congested Paris contributed to poor health. [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] Multilevel analysis of effects of individual characteristics and household factors on self-rated health among older adults in rural VietnamGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 2 2010Hoang Van Minh Aim: This paper aims to describe self-rated health (SRH) status among older adults in a rural community of Vietnam, and examine individual and household-level factors associated with good health rating among the study populations. Methods: The study was carried out in the Bavi district, a rural community located 60 km west of Hanoi, the capital, within the Epidemiological Field Laboratory of Bavi (FilaBavi) in Vietnam in 2006. All people aged 50 years and over who lived within the district were surveyed. Face-to-face household interviews were conducted by trained surveyors using standard World Health Organization/INDEPTH network questionnaire,summary version. A logistic multilevel modeling approach was applied to analyze the association between SRH and both individual and household-level factors. Results: The proportion of people aged 50 years and older in FilaBavi reported having good/very good health and poor/very poor health was 15.1% and 24.8%, respectively. SRH status was reported to be better among: (i) men; (ii) younger people; (iii) people with higher education; (iv) people who were currently in marital a partnership; (v) those from wealthier households; and (vi) those who were living in riverside/island or highland areas compared to those of other categories of the same variable. Conclusion: The findings reveal that there exist problems of inequality in health among older adults in the study setting by sex, age, education, wealth status and place of residence. We also found a considerable contribution of the household-level factors to SRH of the study populations.. [source] Difference in subjective well-being between ethnic Korean and Japanese elderly residents in an urban community in JapanGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 4 2007Jong-Seong Moon Background: The ethnic Korean community in Japan has witnessed the increasing aging of their population structure. The purpose of our study was to clarify the differences in standards of living between elderly ethnic Korean and elderly Japanese populations living in Japan, and to examine whether there is any difference in subjective well-being between the two populations. Methods: We conducted a cross-sectional questionnaire-based survey that consisted of items addressing ethnicity, age, gender, literacy, living conditions, mental health, "sense of purpose in life", activities of daily living (ADL), medical history, quality of life (QOL), and receipt of pension benefits and public assistance; the participants were 425 elderly people (ethnic Korean residents in Japan, n = 204; Japanese, n = 221) aged 65 and older living in a community in Osaka City. Findings from the two groups were compared using the Student's t -test and the ,2 test. We also employed multiple linear regression analysis. Results: We found that the ethnic Korean group had less formal education (P < 0.001), lower ADL (P < 0.05) and QOL (P < 0.001), higher illiteracy (P < 0.05) and depression rates (P < 0.001), and a higher prevalence of hypertension, myocardial infarction and diabetes mellitus than the Japanese group. Ethnicity was a significant variable for subjective well-being in simple linear regression analysis. After adjusting for literacy, absence of sense of purpose in life and mental health in multiple regression analysis, ethnicity remained a significant variable. Conclusions: The present findings indicate that ethnic Korean elderly have poor health and social situations compared with the Japanese group, and that there was a difference in subjective well-being between the two ethnic groups. [source] The Onset of Health Problems and the Propensity of Workers to Change Employers and OccupationsGROWTH AND CHANGE, Issue 3 2003Jodi Messer Pelkowski Although many studies have investigated how poor health affects hours of work and labor force participation, few have examined the extent to which individuals adapt in order to remain in the labor market. Individuals experiencing health problems may move to different types of work in order to remain in the labor force or to reduce the negative labor market consequences of illness. This paper investigates the movement between employers, and among occupation categories when changing employers, using data from the Health and Retirement Study (HRS). One advantage of the HRS is that its questions on life-cycle employment and health patterns permit a long-term perspective on job mobility that is unavailable in most other datasets. Workers with health problems are more likely than healthy workers to remain with their current employer than to switch employers. But among those who switch employers, those with health problems are more likely to change broad occupational categories than are healthy workers. While many individuals remain with the same employer after the onset of health problems, many do switch employers and occupations, even in the presence of ADA legislation. [source] Unemployment and self-assessed health: evidence from panel dataHEALTH ECONOMICS, Issue 2 2009Petri Böckerman Abstract We examine the relationship between unemployment and self-assessed health using the European Community Household Panel for Finland over the period 1996,2001. Our results show that the event of becoming unemployed does not matter as such for self-assessed health. The health status of those that end up being unemployed is lower than that of the continually employed. Therefore, persons who have poor health are being selected for the pool of the unemployed. This explains why, in a cross-section, unemployment is associated with poor self-assessed health. All in all, the cross-sectional negative relationship between unemployment and self-assessed health is not found longitudinally. Copyright © 2008 John Wiley & Sons, Ltd. [source] Measuring the effect of husband's health on wife's labor supplyHEALTH ECONOMICS, Issue 6 2006Michele J. SiegelArticle first published online: 31 JAN 200 Abstract A sizable proportion of women remain married well into late life and an increasing proportion of them participate in the labor force. Since women tend to marry men older than themselves and men tend to experience serious illnesses at younger ages than women, women frequently witness declining health in their husbands. This is likely to affect a wife's labor,leisure trade-off in offsetting ways. Prior studies have not sought to disentangle the effect of a husband's poor health on his wife's reservation wage from the income effect of his ill health. We argue that, if we control for husband's earnings, the coefficient of husband's health in models of his wife's labor force participation (and hours of work) will reflect, in part, her preference over whether to decrease her labor supply to provide health care for her husband or whether to instead increase it to purchase this care in the market. However, husband's earnings are likely to be endogenous in these models due to unobserved characteristics common to husbands and wives. We find that the estimated effect of husband's health depends on whether we instrument for husband's earnings and on the health measure used. This is indicative of the importance of using a variety of health measures and controlling for husband's earnings, and their endogeneity, in future research on the effect of husband's health on wife's labor supply. Copyright © 2006 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] On 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] Family health effects: complements or substitutesHEALTH ECONOMICS, Issue 8 2001Michael Lee Ganz Abstract Genetic endowments play a fundamental role in the production of health. At birth individuals have different capacities to be healthy, largely due to genetic dispositions. Whether or not individuals realize this health depends on their choice of health behaviours. Previous research has linked negative factors beyond the individual's control, which include genetic endowments, to both poor health and poor health behaviours. The health economics literature proposes that behaviours and genetic (or family health) endowments can be either substitutes or complements in the production of health. The goal of this paper is to investigate the behavioural consequences of changes in knowledge about one's genetic endowment. Using two waves of the National Health and Nutrition Examination Survey I Epidemiologic Followup Study, I find that for smokers, smoking intensity substitutes for newly diagnosed smoking-related family cancers, while smoking intensity is complementary to newly diagnosed non-smoking-related family cancers. I find no evidence for the hypothesized relationships with respect to alcohol consumption among drinkers. These results have implications for the growing field of genetic testing and test development. These results also reinforce current practices of ascertaining family health histories in the context of medical history taking. Copyright © 2001 John Wiley & Sons, Ltd. [source] Do Commercial Managed Care Members Rate Their Health Plans Differently than Medicaid Managed Care Members?HEALTH SERVICES RESEARCH, Issue 4 2003Patrick J. Roohan Objective. To determine if members of commercial managed care and Medicaid managed care rate the experience with their health plans differently. Data Sources. Data from both commercial and Medicaid Consumer Assessment of Health Plan Surveys (CAHPS) in New York State. Study Design. Regression models were used to determine the effect of population (commercial or Medicaid) on a member's rating of their health plan, controlling for health status, age, gender, education, race/ethnicity, number of office visits, and place of residence. Data Collection. Managed care plans are required to submit to the New York State Department of Health (NYSDOH) results of the annual commercial CAHPS survey. The NYSDOH conducted a survey of Medicaid enrollees using Medicaid CAHPS. Principal Findings. Medicaid managed care members in excellent or very good health rate their health plan higher than commercial members in excellent or very good health. There is no difference in health plan rating for commercial and Medicaid members in good, fair, or poor health. Older, less educated, black, and Hispanic members who live outside New York City are more likely to rate their managed care plan higher. Conclusions. Medicaid members rating of their health care equals or exceeds ratings by commercial members. [source] Older Married Workers and Nonstandard Jobs: The Effects of Health and Health InsuranceINDUSTRIAL RELATIONS, Issue 3 2009JEFFREY B. WENGER We examine the effects of health and health insurance coverage on older married workers' decisions to work in temporary, contract, part-time, self-employment, and regular full-time jobs. We model the behavior of older married workers as interdependent, showing that one spouse's health and insurance status affects the employment of the other. In general, we find that men and women are less likely to be employed in regular full-time jobs when they are in fair or poor health and are more likely to be in regular full-time employment when their spouses are in poor health. [source] Influence of infant and child facial cues of low body weight on adults' ratings of adoption preference, cuteness, and healthINFANT MENTAL HEALTH JOURNAL, Issue 5 2005Anthony A. Volk Infant and child facial cues have been shown to influence decisions and perceptions associated with parental care in adults. Low body weight reflects health problems in infants and children; therefore, facial cues associated with low body weight may influence adult cognitive processes associated with parental care and investment. Facial images of infants and children were digitally manipulated to simulate cues of low body weight and presented to adults using a hypothetical adoption paradigm. Participants' ratings of adoption preference, cuteness, and health were significantly lower for the digitally manipulated low body weight facial images than their unaltered counterparts. These findings support the hypothesis that facial cues of poor health negatively influence adults' responses to infants and children. [source] The Education-Contingent Association Between Religiosity and Health: The Differential Effects of Self-Esteem and the Sense of MasteryJOURNAL FOR THE SCIENTIFIC STUDY OF RELIGION, Issue 4 2008SCOTT SCHIEMAN Using data from a representative sample of adults in Toronto, Canada, I examine the education-contingent association between religiosity (subjective religiosity and religious attendance) and four health-related outcomes: depression, anxiety, alcohol use, and self-rated health. I also test the extent that two personal resources,the sense of mastery and self-esteem,contribute to those associations. Findings indicate that subjective religiosity and attendance are generally associated with lower levels of depression, anxiety, alcohol use, and poor health. Moreover, although not entirely uniform, subjective religiosity and attendance tend to be associated more negatively with these outcomes among individuals with fewer years of education. While the sense of mastery suppresses the education-contingent influence of religiosity on distress outcomes, self-esteem generally contributes to those patterns. On balance, the suppression effects of mastery are offset by the explanatory effects of self-esteem. These findings elaborate on the well-established association between religiosity and health by illustrating education-contingent effects and potential counterbalancing roles of personal resources in these processes. [source] Managing job stress in nursing: what kind of resources do we need?JOURNAL OF ADVANCED NURSING, Issue 1 2008Marieke Van Den Tooren Abstract Title.,Managing job stress in nursing: what kind of resources do we need? Aim., This paper is a report of a study to investigate the functionality of different kinds of job resources for managing job stress in nursing. Background., There is increasing recognition that healthcare staff, and especially nurses, are at high risk for burnout and physical complaints. Several researchers have proposed that job resources moderate the relationship between job demands and job-related outcomes, particularly when there is a match between the type of demands, resources, and outcomes. Method., Based on the Demand-Induced Strain Compensation Model, cross-sectional survey data were collected between November 2006 and February 2007 by a paper-and-pencil questionnaire. The final sample consisted of 69 nurses from a Dutch nursing home (response rate 59·4%). Data were analyzed by hierarchical regression analyses. Results., High physical demands had adverse effects on both physical complaints and emotional exhaustion (i.e. burnout), unless employees had high physical resources. A similar pattern was found for high physical demands and emotional resources in predicting emotional exhaustion. The likelihood of finding theoretically-valid moderating effects was related to the degree of match between demands, resources, and outcomes. Conclusion., Job resources do not randomly moderate the relationship between job demands and job-related outcomes. Both physical and emotional resources seem to be important stress buffers for human service employees such as nurses, and their moderating effects underline the importance of specific job resources in healthcare work. Job redesign in nursing homes should therefore primarily focus on matching job resources to job demands in order to diminish poor health and ill-being. [source] Burnout and its correlates among nursing staff: questionnaire surveyJOURNAL OF ADVANCED NURSING, Issue 1 2008Mustafa N., lhan Abstract Title.,Burnout and its correlates among nursing staff: questionnaire survey Aim., This paper is a report of a study to determine the burnout level and its correlates in nurses. Background., Healthcare providers and especially nurses are generally considered a high risk group regarding work stress and burnout and this syndrome has been a major concern in the field of occupational health. Method., The study was carried out at a university hospital in Turkey during May,June 2005. A total of 418 nurses from the 474 working at the hospital at the time (88·2%) answered a self-administered questionnaire including the Maslach Burnout Inventory. Findings., All the nurses were female, with a mean age of 30·6 (5·4) and a median age of 29 years. The mean score was 17·99(6·35) for the Emotional Exhaustion subscale, 5·72 (3·87) for the Depersonalization subscale and 19·83 (4·66) for the Personal Accomplishment subscale. Emotional Exhaustion decreased with increasing age (P < 0·05). Total time in the job, weekly working hours, shift-working and the unit where employed influenced burnout scores (P < 0·05). Not being happy with relations with superiors, not finding the job suitable, feeling anxious about the future, perceived poor health, problems with personal life and financial difficulties were also factors influencing burnout scale scores (P < 0·05). Conclusion., It is necessary to consider nurses having the characteristics shown as the correlates of burnout in this study as a target group, to screen periodically the burnout status and improve their working conditions, especially relationships with colleagues. [source] A concept analysis of malnutrition in the elderlyJOURNAL OF ADVANCED NURSING, Issue 1 2001Cheryl Chia-Hui Chen RN MSN GNP A concept analysis of malnutrition in the elderly Purpose.,Malnutrition is a frequent and serious problem in the elderly. Today there is no doubt that malnutrition contributes significantly to morbidity and mortality in the elderly. Unfortunately, the concept of malnutrition in the elderly is poorly defined. The purpose of this paper is to clarify the meaning of malnutrition in the elderly and to develop the theoretical underpinnings, thereby facilitating communication regarding the phenomenon and enhancing research efforts. Scope, sources used.,Critical review of literature is the approach used to systematically build and develop the theoretical propositions. Conventional search engines such as Medline, PsyINFO, and CINAHL were used. The bibliography of obtained articles was also reviewed and additional articles identified. Key wards used for searching included malnutrition, geriatric nutrition, nutritional status, nutrition assessment, elderly, ageing, and weight loss. Conclusions.,The definition of malnutrition in the elderly is defined as following: faulty or inadequate nutritional status; undernourishment characterized by insufficient dietary intake, poor appetite, muscle wasting and weight loss. In the elderly, malnutrition is an ominous sign. Without intervention, it presents as a downward trajectory leading to poor health and decreased quality of life. Malnutrition in the elderly is a multidimensional concept encompassing physical and psychological elements. It is precipitated by loss, dependency, loneliness and chronic illness and potentially impacts morbidity, mortality and quality of life. [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] Weight, Mortality, Years of Healthy Life, and Active Life Expectancy in Older AdultsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2008Paula Diehr PhD OBJECTIVES: To determine whether weight categories predict subsequent mortality and morbidity in older adults. DESIGN: Multistate life tables, using data from the Cardiovascular Health Study, a longitudinal population-based cohort of older adults. SETTING: Data were provided by community-dwelling seniors in four U.S. counties: Forsyth County, North Carolina; Sacramento County, California; Washington County, Maryland; and Allegheny County, Pennsylvania. PARTICIPANTS: Five thousand eight hundred eighty-eight adults aged 65 and older at baseline. MEASUREMENTS: The age- and sex-specific probabilities of transition from one health state to another and from one weight category to another were estimated. From these probabilities, future life expectancy, years of healthy life, active life expectancy, and the number of years spent in each weight and health category after age 65 were estimated. RESULTS: Women who are healthy and of normal weight at age 65 have a life expectancy of 22.1 years. Of that, they spend, on average, 9.6 years as overweight or obese and 5.3 years in fair or poor health. For both men and women, being underweight at age 65 was associated with worse outcomes than being normal weight, whereas being overweight or obese was rarely associated with worse outcomes than being normal weight and was sometimes associated with significantly better outcomes. CONCLUSION: Similar to middle-aged populations, older adults are likely to be or to become overweight or obese, but higher weight is not associated with worse health in this age group. Thus, the number of older adults at a "healthy" weight may be much higher than currently believed. [source] Epidemiology of Anemia in the Elderly: Information on Diagnostic EvaluationJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3s 2003Lodovico Balducci MD A rise in the aging population has been predicted, and, as a result, it is expected that the incidence of age-related health conditions will also increase. Although common in the elderly, anemia is often mild and asymptomatic and rarely requires hospitalization. However, untreated anemia can be detrimental, because it is associated with increased mortality, poor health, fatigue, and functional dependence and can lead to cardiovascular and neurological complications. Several factors have been suggested to cause anemia in this population, for example, blood loss or chronic disease. In some cases, the cause is unknown. It has been suggested that this is a result of the presence of comorbid conditions that can mask the symptoms of anemia. Therefore, appropriate diagnosis and management strategies of anemia in the elderly need to be identified, particularly because anemia may indicate the presence of other serious diseases. [source] Association Between Vertebral Fracture and Increased Mortality in Osteoporotic Patients,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 7 2003Tarja Jalava Abstract Determinants of mortality were studied in a prospective study of 677 women and men with primary or secondary osteoporosis. Prevalent vertebral fractures were associated with increased mortality, but other known predictors of mortality explain a significant proportion of the excess risk. Introduction: In population studies, prevalent vertebral fractures are associated with increased mortality. It is unknown whether this excess mortality is related to low bone mineral density or its determinants or whether there is an additional component associated with fracture itself. Methods: We studied 677 women and men with osteoporosis, 28,88 years old, of whom 352 had morphometrically determined vertebral fracture, to examine the risk and causes of mortality in patients with osteoporosis (defined densitometrically as a spine bone mineral density T-score < ,2.5 and ,3.0 for women and men, respectively, and/or one or more prevalent vertebral fractures without a history of significant trauma). The participants had enrolled in a double-blind placebo-controlled study in osteoporosis and were comprised of 483 women with postmenopausal osteoporosis, 110 women with secondary osteoporosis, and 84 men with osteoporosis of any cause. Demographics, medical history, and other measures of skeletal and nonskeletal health status were assessed at entry. Results: During a median follow-up of 3.2 years, 37 (5.5%) participants died, with 31 of these deaths occurring in those with prevalent vertebral fractures. Compared with participants who did not have a prevalent vertebral fracture, those with one or more fractures had a 4.4-fold higher (95% CI, 1.85, 10.6) mortality rate. After adjustment for predictors for poor health,including number of medications, number of diseases, use of oral corticosteroids, alcohol intake, serum albumin and erythrocyte sedimentation rate (ESR), renal function, height, weight, gender, and age,the point estimate of risk remained elevated but was no longer statistically significant (hazard ratio, 2.4; 95% CI. 0.93, 6.23). Conclusions: Prevalent vertebral fractures in osteoporotic patients are associated with increased mortality. Other known predictors of mortality can explain a significant proportion of the excess risk. [source] Suicidality among Finnish anaesthesiologistsACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 8 2009P. M. LINDFORS Background: Suicide rates among physicians have constantly been reported to be higher than in the general population and anaesthesiologists appear to lead the suicide statistics among physicians. Methods: A cross-sectional questionnaire study was sent to all working Finnish anaesthesiologists (n=550) investigating their suicidality (ideation and/or planning and/or attempt). The response rate was 60%. Results: One in four had at some time seriously been thinking about suicide. Respondents with poor health (crude odds ratios 11.2 and 95% confidence interval 3.8,33.0), low social support (10.5, 4.0,27.9), and family problems (6.5, 3.4,12.5) had the highest risk of suicidality. The highest risks at work were conflicts with co-workers (4.1, 2.3,7.1) and superiors (2.1, 1.2,3.6), on-call-related stress symptoms (3.9, 1.9,8.3) and low organizational justice (1.9, 1.1,3.2). If a respondent had several risk factors, the risk of suicidality doubled with each cumulating factor. Conclusions: The reported level of suicidal ideation among Finnish anaesthesiologists is worth concern. It should be of utmost importance to screen the risk factors and recognize suicidal physicians in order to help them. Interpersonal relationships, decision-making procedures, and on-call-burden should be focused on when aiming to prevent suicidality among physicians. [source] Views of xerostomia among health care professionals: a qualitative studyJOURNAL OF CLINICAL NURSING, Issue 6 2009Solgun Folke Aim., To explore and describe views of xerostomia among health care professionals. Background., Xerostomia (dry mouth) is caused by changes in quality and quantity of saliva due to poor health, certain drugs and radiation therapy. It is a common symptom, particularly among older people and has devastating consequences with regard to oral health and general well-being. Methods., Data were obtained and categorised by interviewing 16 health care professionals. Qualitative content analysis was chosen as the method of analysis. Design., Qualitative. Results., The latent content was formulated into a theme: xerostomia is a well-known problem, yet there is inadequate management of patients with xerostomia. The findings identified three categories expressing the manifest content: awareness of xerostomia, indifferent attitude and insufficient support. Conclusions., Although xerostomia was recognised as commonly occurring, it was considered to be an underestimated and an ignored problem. Proper attention to conditions of xerostomia and subsequent patient management were viewed as fragmentary and inadequate. Additional qualitative studies among patients with xerostomia would be desirable to gain further understanding of the problems with xerostomia, its professional recognition and management. Relevance to clinical practice., A holistic view, positive professional attitudes and enhanced knowledge of xerostomia seem essential to augment collaboration among health care professionals and to improve compassion for and support of patients with xerostomia. [source] Demographic aspects of sympatric Praomys jacksoni and P. stella in a tropical lowland forest in Kakamega, KenyaAFRICAN JOURNAL OF ECOLOGY, Issue 2 2004Catherine W. Waweru Abstract Populations of coexisting tropical forest rodents Praomys jacksoni and P. (Hylomyscus) stella were investigated to test whether lower relative densities in regenerating forest compared with mature forest were because of poor health and/or reduced chances for females to breed. Relative frequencies, litter size, mass, length of embryos, presence or absence of ecto- and/ or endoparasites, and liver condition were recorded and analysed. Higher numbers of either species occurred in the mature compared with regenerating forest. Mottled livers and endoparasites were associated with heavier rodents; litter size related positively to mass of pregnant females in both species. Litter size, embryo size, sex ratios, liver condition, and infestation of ecto- and endoparasites were independent of forest and species. Apparently, reduced female density in regenerating forest had no breeding cost on individual females occurring there. Résumé Les populations de rongeurs coexistants en forêt tropicale Praomys jacksoni et P. (Hylomyscus) stella ont étéétudiées pour vérifier si les densités relatives, plus faibles dans les forêts en voie de régénération que dans les forêts mâtures, étaient dues à une moins bonne santé et/ou à de plus faibles chances de se reproduire pour les femelles. On a noté et analysé les fréquences relatives, la taille des portées, le poids, la taille des embryons, la présence ou l'absence d'ecto- et/ou d'endoparasites et l'état du foie. On a constaté des nombres plus importants des deux espèces dans les forêts mâtures que dans les forêts en voie de règénération. Des foies tachetés et des endoparasites étaient associés à des rongeurs plus lourds; la taille des portées était positivement liée au poids des femelles pleines dans les deux espèces. La taille de la portée, le poids des petits, le sex-ratio, l'état du foie et l,infestation par des ecto- et endoparasites étaient indépendants de la forêt et de l'espèce. Apparemment, la densité réduite des femelles dans la forêt en voie de régénération n'avait aucun impact sur la reproduction locale des femelles prises individuellement. [source] Comparing adults in Los Angeles County who have and have not been homelessJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 6 2001Michael R. Cousineau This study compares the formerly homeless with those who have not been homeless on several characteristics, based on a telephone survey of the general adulate population. The study was conducted in Los Angeles County. Researchers estimate how many and what percentage of adults (aged 18 or older) have been homeless in the past 5 years and the types of places people stayed while they were homeless. An estimated 370,000 adults have experienced homelessness within the past 5 years, 5.7% of the adult population (95% confidence interval [CI] 5.2,6.2). A third were literally homeless (in a shelter, street, or car). Just over half (56%) stayed with a friend or relative while homeless. Nine percent had a mixed experience. Compared to those who were not homeless, the formerly homeless are disproportionately poor, African American, not in the job market, on public assistance, and in poor health. There are few differences when comparing place of birth, citizenship status, or length of residence in Los Angeles County. Yet many homeless have been able to achieve some economic stability. Implications for the development of intervention and prevention programs are discussed. © 2001 John Wiley & Sons, Inc. [source] Impact of Policy Shifts on South Asian Carers in the United KingdomJOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 1 2005Elizabeth Hensel Abstract, The aim of this study was to assess how the introduction of new service policies in the United Kingdom , such as person-centered planning and the active development of support networks , was impacting the lives of carers of people with intellectual disability from South Asian backgrounds. Using a semistructured interview schedule, 19 families of South Asian background living in an urban conurbation were interviewed about their service use and needs with respect to providing care for their family member with an intellectual disability. The families experienced material disadvantage, poor health, and did not access services to the same extent as did the general population in the UK. Overall, community participation was low and only two individuals with an intellectual disability had a care plan as outlined in the latest UK government policies. The introduction of these new policies did not appear to have positively impacted the lives of the individuals interviewed in this study. The results were similar to findings of studies in other parts of Britain: that is, the culture of caring and protecting the individual with an intellectual disability, combined with the importance of family life over an outside social life, ran somewhat counter to the underlying principles of current national disability policy (i.e., promoting individual rights and independent living). It is suggested that attempts to implement these policies risks alienating carers of South Asian descent from service providers and their implementation must be done in a culturally sensitively context. [source] Reservation wages, labour market participation and healthJOURNAL OF THE ROYAL STATISTICAL SOCIETY: SERIES A (STATISTICS IN SOCIETY), Issue 3 2010Sarah Brown Summary., The concept of the reservation wage has played an important role in labour market theory, particularly in models of job search, labour supply and labour market participation. We focus on the determinants of reservation wages, with a particular focus on health, which has attracted very little attention despite its importance from a policy perspective. Using UK data we estimate an endogenous switching model which predicts reservation wages for the unemployed and market wages for the employed. Our results have important policy implications since they suggest that poor health is a major cause of economic inactivity. [source] | |||||||||||||||||||||||||||||||||||||