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PubMed1997

A four-year comparison of physical health benefit expenditures of mental and physical health claimants.

The pattern of covered physical health benefit expenditures before and after initiation of mental health treatment for a cohort of individuals with mild to moderate mental health problems was examined in this study. The results indicated the mental health treatment group (MHTG) began to have higher total covered benefits expenditures about one year prior to starting mental health treatment. Statistically significant differences between the MHTG and comparison groups (groups with no mental health treatments during the study period and matched on age and gender) began at the quarter just before treatment and continued through the seventh quarter after treatment initiation. The higher pattern of total health benefit expenditures of the MHTG declined gradually for two years before it returned to pretreatment levels. The study suggests the need for a better understanding of the types of physical health benefits expenditures preceding and following mental health treatment. It further indicates that the integration of physical and mental health benefits case management may have potential for reducing overall health benefit costs.

Adult↗
PubMed2000

Physical health consequences of physical and psychological intimate partner violence.

BACKGROUND: Past studies that have addressed the health effects of intimate partner violence (IPV) have defined IPV as violence based on physical blows that frequently cause injuries. To our knowledge, no epidemiologic research has assessed the physical health consequences of psychological forms of IPV. OBJECTIVE: To estimate IPV prevalence by type and associated physical health consequences among women seeking primary health care. DESIGN: Cross-sectional survey. SETTING AND PARTICIPANTS: A total of 1152 women, aged 18 to 65 years, recruited from family practice clinics from February 1997 through January 1999 and screened for IPV during a brief in-clinic interview; health history and current status were assessed in a follow-up interview. RESULTS: Of 1152 women surveyed, 53.6% ever experienced any type of partner violence; 13.6% experienced psychological IPV without physical IPV. Women experiencing psychological IPV were significantly more likely to report poor physical and mental health (adjusted relative risk [RR], 1.69 for physical health and 1.74 for mental health). Psychological IPV was associated with a number of adverse health outcomes, including a disability preventing work (adjusted RR, 1.49), arthritis (adjusted RR, 1.67), chronic pain (adjusted RR, 1.91), migraine (adjusted RR, 1.54) and other frequent headaches (adjusted RR, 1.41), stammering (adjusted RR, 2.31), sexually transmitted infections (adjusted RR, 1.82), chronic pelvic pain (adjusted RR, 1.62), stomach ulcers (adjusted RR, 1.72), spastic colon (adjusted RR, 3.62), and frequent indigestion, diarrhea, or constipation (adjusted RR, 1.30). Psychological IPV was as strongly associated with the majority of adverse health outcomes as was physical IPV. CONCLUSIONS: Psychological IPV has significant physical health consequences. To reduce the range of health consequences associated with IPV, clinicians should screen for psychological forms of IPV as well as physical and sexual IPV.

Adolescent↗
PubMed2002

Behavioral change in persons with dementia: relationships with mental and physical health of caregivers.

The purpose of this study was to examine the effects that changes in behavioral and psychological symptoms of dementia of persons with Alzheimer's disease have on their caregivers' mental health and physical health. The research design was a prospective, longitudinal follow-up study conducted in a major medical center and in participants' homes. Longitudinal analysis linking change in behavior to caregiver outcomes was based on 64 cases. Care recipients were assessed at the time of diagnosis with the Mini-Mental State Examination (MMSE). To provide information on the care recipient's behaviors, caregivers participated in an interview with the Modified Neuropsychiatric Inventory at diagnosis and at follow-up. Caregivers also completed a battery of established instruments to measure stress appraisal, mental health, and perceptions of their physical health at follow-up. Results showed that increases in problem behaviors among persons living with dementia, along with residence status, were significant predictors of caregivers' mental health and also their physical health. However, these relationships were mediated through stress appraisal. Variables such as MMSE score of the person with dementia, number of years caregiving, relationship status, and education level were not significant predictors of caregivers' health when behavior change was in the model.

Adaptation, Psychological↗
PubMed1991

Psychological health, self-reported physical health and health service use. Risk differential observed after one year of unemployment.

One year after the closure of a furniture factory the health consequences of long-term unemployment were studied among the 215 former employees and an interviewer-administered questionnaire was used to measure psychological health, self-perceived physical health and health service use. Those remaining unemployed 12 months after the closure were found to be 8 times more likely to report poor psychological health than were the re-employed (Odds ratio (OR): 8.5; 95% CI: 4.2-17.0). Self-reported physical ill-health was generally thought be respondents to be due to former work (56 percent of all disorders were related by subjects to former work history) and was also found to be associated with current employment status (OR 5.6; 95% CI: 2.7-11.5). Health services were over-utilized by the unemployed (OR 2.2; 95% CI: 1.2-4.1) and this differential was demonstrated to be even greater for the older and those reporting more diseases. Given the increasing proportion of long term unemployed in many Western countries this health service over-utilization will impose a substantial burden on public health expenditures unless other means of psychological and social support are provided.

Adaptation, Psychological↗
PubMed2000

Patterns of alcohol consumption in young Australian women: socio-demographic factors, health-related behaviours and physical health.

OBJECTIVE: To determine which socio-demographic factors, health-related behaviours and physical health conditions are associated with non-drinking, binge drinking and hazardous/harmful drinking in young Australian women. METHODS: Cross-sectional data were obtained from the baseline survey of 14,762 young women (aged 18-23 years) enrolled in the Women's Health Australia study in 1996. Associations between a range of drinking patterns and socio-demographic factors, health-related behaviours and health conditions were examined. RESULTS: Half the women were 'low intake' drinkers, a third 'rarely drank' and 9% were non-drinkers; however, 70% reported binge drinking with one-quarter of the binge drinkers doing so at least weekly. Non-drinkers were more likely than drinkers to be married, pregnant, non-smokers, born in non-English speaking countries, to live in the Northern Territory, and to have lower levels of education, employment, and private health insurance. 'Low intake/binge weekly' drinkers (12%) and 'hazardous/harmful' drinkers (5%) were more likely than 'low risk' drinkers to be unmarried; to live in shared accommodation, alone or with their parents; to live in rural or remote areas; to have ever had any sexually transmitted infection; to be current smokers or ex-smokers and to have used unhealthy weight-control practices. CONCLUSIONS: The results confirm findings from other countries about the importance of social conditions as determinants of alcohol consumption by young women. IMPLICATIONS: Health promotion to reduce young women's alcohol consumption needs to be carefully targeted to take account of their demographies, living environments and beliefs.

Adolescent↗
PubMed2006

Systematic review of the literature on postpartum care: effectiveness of postpartum support to improve maternal parenting, mental health, quality of life, and physical health.

BACKGROUND: Postpartum support is recommended to prevent infant and maternal morbidity. This review examined the published evidence of the effectiveness of postpartum support programs to improve maternal knowledge, attitudes, and skills related to parenting, maternal mental health, maternal quality of life, and maternal physical health. METHODS: MEDLINE, Cinahl, PsycINFO, and the Cochrane Library were searched for randomized controlled trials of interventions initiated from immediately after birth to 1 year in postnatal women. The initial literature search was done in 1999 and was enhanced in 2003 and 2005. Studies were categorized based on the the above outcomes. Data were extracted in a systematic manner, and the quality of each study was reviewed. RESULTS: In the 1999 search, 9 studies met the inclusion criteria. The 2003 and 2005 searches identified 13 additional trials for a total of 22 trials. Universal postpartum support to unselected women at low risk did not result in statistically significant improvements for any outcomes examined. Educational visits to a pediatrician showed statistically significant improvements in maternal-infant parenting skills in low-income primiparous women. In women at high risk for family dysfunction and child abuse, nurse home visits combined with case conferencing produced a statistically significant improvement in home environment quality using the HOME (Home Observation for Measurement of the Environment) program. Similarly, in women at high risk for either family dysfunction or postpartum depression, home visitation or peer support, respectively, produced a statistically significant reduction in Edinburgh Postnatal Depression Scale scores (difference - 2.23, 95% CI -3.72 to -0.74, p= 0.004; and 15.0% vs 52.4%, OR 6.23, 95% CI 1.40 to 27.84, p= 0.01, respectively). Educational programs reduced repeat unplanned pregnancies (12.0% vs 28.3%, p= 0.003) and increased effective contraceptive use (RR 1.35, 95% CI 1.09 to 1.68, p= 0.007). Maternal satisfaction was higher with home visitation programs. CONCLUSIONS: No randomized controlled trial evidence was found to endorse universal provision of postpartum support to improve parenting, maternal mental health, maternal quality of life, or maternal physical health. There is some evidence that high-risk populations may benefit from postpartum support.

Adult↗
PubMed2002

Physical health correlates of overprediction of physical discomfort during exercise.

This study sought to determine if overprediction of physical discomfort prior to and following exercise was related to a number of self-report and objective measures of physical health status in a general population sample. Cross-sectional findings indicated a significant and specific relation between patterns of discomfort overprediction (vs under- or accurate prediction) and negative self-reported health status and attitudes to exercise, lower levels of physical activity, as well as poorer scores for resting heart rate, cardiorespiratory fitness and body mass index (but not waist:hip ratio). Females were more likely to overpredict discomfort, were less active and had poorer physical health than males. The potential usefulness of the prediction match-mismatch paradigm for studying exercise-related appraisal processes as proximal determinants of physical activity are discussed. Information obtained from such studies could prove useful in public health education campaigns aimed at increasing levels of physical activity in the general population, particularly among the less active.

Adult↗
PubMed2005

Operational health physics.

A review of the operational health physics papers published in Health Physics and Operational Radiation Safety over the past fifteen years indicated seventeen general categories or areas into which the topics could be readily separated. These areas include academic research programs, use of computers in operational health physics, decontamination and decommissioning, dosimetry, emergency response, environmental health physics, industrial operations, medical health physics, new procedure development, non-ionizing radiation, radiation measurements, radioactive waste disposal, radon measurement and control, risk communication, shielding evaluation and specification, staffing levels for health physics programs, and unwanted or orphan sources. That is not to say that there are no operational papers dealing with specific areas of health physics, such as power reactor health physics, accelerator health physics, or governmental health physics. On the contrary, there have been a number of excellent operational papers from individuals in these specialty areas and they are included in the broader topics listed above. A listing and review of all the operational papers that have been published is beyond the scope of this discussion. However, a sampling of the excellent operational papers that have appeared in Health Physics and Operational Radiation Safety is presented to give the reader the flavor of the wide variety of concerns to the operational health physicist and the current areas of interest where procedures are being refined and solutions to problems are being developed.

Computers↗