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Although the interest of economists in food has a long tradition, mainly from the work of Malthus, it is only since 1945 that a more microeconomic approach has been applied. Recently attention has shifted from food, per se, to nutrition and its role as a determinant of health status. The purpose of this note is to comprehend how nutritional research, and nutritional advice, can be understood in an economic framework. For this purpose the "new" characteristics theory associated with Lancaster is appropriate. Such economic research is relevant to the policy concern of the relative emphasis on curative vs preventive health services.
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PURPOSE: The purpose of the present study was to examine the nutritional, functional and psychosocial correlates of disability among 54 older adults aged 65 years of age or older. METHODS: Using validated questionnaires and tests, nutritional risk (Mini-Nutritional Assessment), functional capacity (mobility, balance, endurance, grip strength and lower extremity strength), the psychosocial factors (life satisfaction, depression, and social support) and level of disability of the participants were examined. RESULTS: The study showed that functional mobility was the strongest correlate of disability, even after controlling for age, gender and residential living status (p<.05). Life satisfaction and nutrition risk had marginal significance as being related to disability. CONCLUSION: The results of the present study have implications for the development of evidence-based health promotion interventions for older adults.
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Few issues have been able to capture the attention of the scientific community and the lay public in the manner that the acquired immunodeficiency syndrome (AIDS) has. Despite significant advances in many areas, the morbidity and mortality statistics remain as somber reminders of the devastation attributed to this epidemic. This devastation appears particularly acute among those portions of the population already subject to the least desirable health status indicators. Efforts directed at known methods of disease acquisition and populations with a disproportionately greater susceptibility may serve as important foci of health prevention. To this end, intravenous drug users and minority group members present some interesting interrelationships.
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Arm circumference has been recommended as a useful indicator for malnutrition screening, particularly in rural areas. The great advantages of the arm circumference over other anthropometric indicators are that the measure is easily obtained in rural areas and that the method for assessing arm circumference is simple, inexpensive and rapid. In this paper the validity (specificity and sensitivity) of arm circumference is analyzed as compared to more valid indicators of nutritional status in preschool children. We conclude that arm circumference is relatively valid for detecting global malnutrition (as indicated by weight-for-age), but of limited validity when used for detecting acute or chronic protein-calorie malnutrition. Furthermore, when compared to weight-for-age in detecting populations or individuals at high risk of acute or chronic protein-calorie malnutrition, it was found that weight-for-age has a higher level of specificity and sensitivity than arm circumference. Finally, it was found that sensitivity and specificity of arm circumference vary with age, suggesting that arm circumference cannot be considered an age-independent indicator of nutritional status. It is therefore recommended that these possible limitations of arm circumference be kept in mind when used in public health programs.
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OBJECTIVE: To compare the relationships between food (nutrient) intakes and biochemical markers of nutritional status of asymptomatic HIV-infected with HIV-uninfected subjects, to gain more information on the appropriate diet for HIV-infected persons at an early stage of infection. DESIGN: Cross-sectional population-based survey. SETTING: North West Province, South Africa. SUBJECTS: Two hundred and sixteen asymptomatic HIV-infected and 1550 HIV-uninfected men and women volunteers aged 15 years and older, recruited as 'apparently healthy' subjects from 37 randomly selected sites. OUTCOME MEASURES: Food and nutrient intakes, measured with a validated food-frequency questionnaire, and nutritional status indicated by anthropometric and biochemical variables, measured by a standardised methodology. RESULTS: The prevalence of HIV infection in the study population was 11.9%. The anthropometric indices and nutrient intakes of HIV-infected and uninfected subjects did not differ significantly, indicating that these 216 HIV-infected subjects were at an early stage of infection. Of the biochemical nutritional status variables, high-density lipoprotein cholesterol and total cholesterol, haemoglobin, albumin and triglycerides were significantly lower in infected subjects. They also had higher globulin and liver enzyme levels than uninfected subjects. In infected subjects, serum albumin correlated significantly with serum lipids, serum vitamin A, serum vitamin E, serum iron, total iron-binding capacity and haemoglobin. The significant positive correlations of the liver enzymes with serum lipids, albumin, vitamin A and iron, observed in HIV-uninfected subjects, disappeared in the infected subjects. Polyunsaturated fat intake showed significant positive correlations with the increased liver enzymes in infected subjects. A principal components analysis indicated that, in infected subjects, increased liver enzymes correlated with higher consumption of maize meal and lower consumption of meat and vegetables. CONCLUSIONS AND RECOMMENDATIONS: This survey indicated that asymptomatic HIV-infected subjects who followed a diet rich in animal foods had smaller decreases in serum albumin, haemoglobin and lipid variables, and smaller increases in liver enzymes, than those who consumed a diet based on staple foods. This suggests that animal foods are associated with improved nutritional status in HIV-infected persons. These results should be confirmed with intervention studies before dietary recommendations for asymptomatic HIV-infected individuals can be made.
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The authors introduce the Population Health Information System, its conceptual framework, and the data elements required to implement such a system in other jurisdictions. Among other innovations, the Population Health Information System distinguishes between indicators of health status (outcomes measures) and indicators of need for health care (socioeconomic measures of risk for poor health). The system also can be used to perform needs-based planning and challenge delivery patterns.
BACKGROUND: Recently attention has focused on the assessment of functional health status in substance-dependent individuals. The addiction severity index (ASI) is a widely used assessment instrument that includes scales to reflect current medical and psychiatric status. This study examines the concurrent validity of these ASI composite scores in relation to the short form 36-item health survey (SF-36), a well-established measure of health-related quality of life/functional health status. METHODS: Veterans (n=674) were assessed at admission to substance dependence treatment. Correlations were performed between ASI composite scores and SF-36 scales and the physical and mental summary components (PSC and MSC, respectively). Areas under receiver operating characteristic (ROC) curves determined the descriminative ability of the ASI composites to ascertain impairment. RESULTS: The ASI medical composite score demonstrated robust correlations with the four SF-36 scales that relate to physical health and with the PCS. The ASI psychiatric composite score had robust correlations with the four SF-36 scales related to mental health and with the mental component summary (MCS). ROC curves indicated that the ASI medical (AUC=0.83) and psychiatric composites (AUC=0.90) accurately detected subjects with impairment. CONCLUSIONS: ASI medical and psychiatric composite scores provide effective initial screening for patients with impaired functional status as measured by the corresponding SF-36 component summary scores.
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