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PubMed2002

[Health status of delinquent male youths].

Objective. To assess the health status of delinquent male youths at the time of their admission to a juvenile correctional center.Design. Cross-sectional descriptive study over a 6-year period (1995-2000). Setting. Health primary care. Juvenile correctional center in Zaragoza, Spain. Participants. Two hundred forty male adolescents were admitted during the study period. Mean age was 15 years (SD, 1.3) (range, 13-17 years). Measurements and main results. Health status via medical history and physical examination was assessed according to standard protocols and individualized complementary laboratory examinations were performed. Most frequent health problems were smoking habit (97.1%), drug/alcohol abuse (54.1%), odontologic (40%), psychopathologic disorders (17.1%), incomplete immunization status (16.6%), growth and nutritional disorders (14.5%) growth delay (5.8%), malnutrition (3.3%), overweight (2.1%), obesity (3.3%) , infectious diseases associated with intravenous drug use and/or risk sexual behaviors (10.4%) hepatitis C (4.6%), hepatitis B (2.9%), AIDS (2.1%), syphilis (0.8%) , dermatological (10%), opthalmological (7.5%), and respiratory (5%). Less prevalent health problems were orthopedic (3.3%), anemia (3.3%), otic (2.5%), cardiovascular (2.5%), and intestinal parasitism (1.6%). Conclusions. Early intervention during the stay into juvenile correctional center regarding their physical health and especially their mental health, from the sanitary and educative viewpoint, presents a unique opportunity to solve the basic health needs of these high-risk adolescents.

Adolescent↗
PubMed2002

Fish consumption and self-reported physical and mental health status.

OBJECTIVE: The aim of this study was to assess whether self-reported mental health status, measured using the SF-36 questionnaire, was associated with fish consumption, assessed using a food-frequency questionnaire. DESIGN: The cross-national data were collected in the 1996/97 New Zealand Health Survey and 1997 Nutrition Survey, which were conducted using the same sampling frame. Survey respondents were categorised into those who consumed no fish of any kind and those who consumed some kind of fish, at any frequency. Data were adjusted for age, household income, eating patterns, alcohol use and smoking. Other demographic variables and potential confounding nutrients were included in the preliminary analyses but were not found to have a significant relationship with fish consumption. SUBJECTS: Data from a nationally representative sample of 4644 New Zealand adults aged 15 years and over were used in this analysis. RESULTS: Fish consumption was significantly associated with higher self-reported mental health status, even after adjustment for possible confounders. Differences between the mean scores for fish eaters and those who never eat fish were 8.2 for the Mental Health scale and 7.5 for the Mental Component score. Conversely, the association between fish consumption and physical functioning was in the opposite direction. CONCLUSIONS: This is the first cross-sectional survey to demonstrate a significant relationship between fish intake and higher self-reported mental health status, therefore offering indirect support for the hypothesis that omega-3 polyunsaturated fatty acids may act as mood stabilisers.

Adolescent↗
PubMed2005

Skeletal muscle weakness in patients with sarcoidosis and its relationship with exercise intolerance and reduced health status.

BACKGROUND: Skeletal muscle weakness is assumed to be present in patients with sarcoidosis but has never been reported in a consecutive group of patients. Moreover, its relationship with previously observed exercise intolerance and reduced health status has never been studied in these patients. METHODS: Pulmonary function, skeletal and respiratory muscle forces, peak and functional exercise capacity, health status, and the circulating levels of inflammatory and anabolic markers were determined in 25 patients with sarcoidosis who complained of fatigue (15 men) and in 21 healthy subjects (13 men). RESULTS: Patients with sarcoidosis had lower respiratory and skeletal muscle forces, reduced exercise capacity and health status, higher anxiety and depression scores, and higher circulating levels of tumour necrosis factor-alpha than healthy subjects (all p< or =0.01). Its soluble receptor p75 tended to be higher (p=0.04). Circulating levels of interleukin (IL)-6, IL-8, insulin-like growth factor I and its binding protein 3 were not significantly different between the two groups. Skeletal muscle weakness was related to exercise intolerance, depression, and reduced health status in patients with sarcoidosis, irrespective of age, sex, body weight and height (p< or =0.05). Quadriceps peak torque was inversely related to fatigue but not to the circulating levels of inflammatory or anabolic markers. The mean daily dose of corticosteroids received in the 6 month period before testing was related to quadriceps peak torque only in patients who received oral corticosteroids. CONCLUSION: Skeletal muscle weakness occurs in patients with sarcoidosis who complain of fatigue and is associated with reduced health status and exercise intolerance.

Adult↗
PubMedDate not supplied

The influence of time on changes in health status and patient satisfaction.

This article develops a framework that investigates the impact that a change in health status has on satisfaction with structure and process elements of health care delivery over time. We develop and present a structural equation model that encompasses these relationships based on a survey of 284 consumers of health care services. The results indicate that health status is directly related to satisfaction with process of care elements but not directly related to structural elements. These results contribute to the literature by examining the impact of health status on satisfaction in two distinct elements related to structure and process.

Delivery of Health Care↗
PubMed1991

Enrollee health status under Medicare risk contracts: an analysis of mortality rates.

Previous studies comparing the health status of Medicare beneficiaries enrolled under HMO risk contracts to that of Medicare beneficiaries in fee-for-service (FFS) have generally focused on demonstration projects conducted before 1985. This study examines mortality rates in 1987 for approximately 1 million aged Medicare beneficiaries enrolled in 108 HMOs. We estimated adjusted mortality ratios (AMR) for each HMO and across all HMOs, by dividing the actual number of deaths among HMO enrollees by the "expected" number of deaths. The expected number of deaths was based on death rates among local FFS populations, adjusting for age, sex, Medicaid buy-in status, and institutional status. The AMR for all HMO enrollees pooled together was 0.80. For persons newly enrolled in 1987, the AMR was 0.69; in general, AMRs were higher for beneficiaries who had been enrolled for longer periods of time. Among individual HMOs, none exhibited an AMR substantially above 1.00. Regression analysis indicated lower AMRs for staff model HMOs than for either IPA or group models. Low mortality among Medicare HMO enrollees is consistent with favorable selection or with improvements in the health status of enrollees due to better access or quality of care in HMOs. In either case, health status differences between HMO enrollees and FFS beneficiaries have implications for the appropriateness of Medicare's Adjusted Average Per Capita Cost (AAPCC) payment formula for HMOs.

Aged↗
PubMed1997

Use of the short form 36 (SF36) for health status measurement in rheumatoid arthritis.

The patient-administered Health Assessment Questionnaire (HAQ) is widely used in rheumatology studies. Another health quality assessment technique commonly used for other non-rheumatological conditions is the 'Short Form 36' (SF36). This has questions designed to assess eight aspects of health ranging from physical limitations to general perceptions of vitality and mental well-being. This study presents information on the health status of 137 patients with rheumatoid arthritis (RA) assessed by both the SF36 and HAQ. Summary statistics are given for the elements of the SF36 according to age, gender, disease measures of RA and the presence of co-morbidity. There were significant associations between the physical functioning score of the SF36 and the HAQ score. with other measures of disease activity and severity, and with co-morbidity, although there was considerable inter-patient variability. These findings suggest that future applications of health status questionnaires are possible.

Adult↗
PubMed2000

Global health status: two steps forward, one step back.

Impressive improvements have occurred in global health status in the past century. Unfortunately, these improvements have not been shared equally and health in equalities within and among countries are entrenched. The fragility of health gains has been seen in response to economic, political, and social changes changes, and civil disruption. The limitations of health-status measure hinder our ability to map health trends except in the simplest way. There is an urgent need for better regional and national health surveillance systems to underpin efforts to address the complex mixture of old and new health concerns.

Adolescent↗
PubMed1999

[Lifestyle, living conditions and health status--a cross-sectional study of the Saxon population in the period 1993 to 1994].

The aim of this cross-sectional study was to record the living conditions, lifestyle variables and health status in a part of the population of Saxony and to examine statistical relationships between the three categories. The interview by post took place from March 1993 to August 1994. The sample consisted of 602 participants, i.e. a return of 52.3%. The survey proved conditionally representative for the population of Saxony. Statistical methods used were Chi2 test, H test, Spearman correlation and multiple regression procedures. Males and females showed clear differences in their lifestyles and in the state of health. It was found that the lifestyle was associated with age. The following variables were significantly associated with the subjective health status: sex, daily routine, number of negative life events, utilisation of preventive measures, contentment, age, and domicile. Significant connections were found between the objective health status (number of chronic diseases) and the variables: utilisation of preventive measures, number of negative life events, employment, daily routine, smoking, alcohol consumption, contentment, and age. In the statistical relationship the primary health status had the most distinct influence on the lifestyle and this covered the influence of lifestyle on health status.

Adolescent↗
PubMed2002

Service use and health status of persons with severe mental illness in full-risk and no-risk medicaid programs.

OBJECTIVE: The service use patterns and health status outcomes of Medicaid recipients with severe mental illness in a system that assigned full financial risk to managed care organizations through capitation and a system that paid for mental health care on a no-risk fee-for-service basis were compared. METHODS: With use of a quasi-experimental design, initial interviews (time 1) and follow-up interviews six months later (time 2) were conducted among 92 clients in the full-risk group and 112 clients in the no-risk group. Regression models were used to compare self-reported service use and health status between the two groups. RESULTS: Service use patterns differed between the two groups. When symptom severity at time 1 was controlled for, clients in the full-risk group were more likely to have received case management but less likely to report contact with a psychiatrist or to have received counseling than clients in the no-risk group. When health status at time 1 was controlled for, clients in the full-risk group reported poorer mental health at time 2 than clients in the no-risk group. When physical health status at time 1 was controlled for, clients in the full-risk group reported poorer physical health at time 2 than clients in the no-risk group. CONCLUSIONS: Capitation was associated with lower use of costly services. Clients with serious mental illness in the full-risk managed care system had poorer mental and physical health outcomes than those in the no-risk system.

Adult↗
PubMed1996

Do school-based health centers improve adolescents' access to health care, health status, and risk-taking behavior?

PURPOSE: The purpose of this investigation was to assess the School-Based Adolescent Health Care Program, which provided comprehensive health-related services in 24 school-based health centers. METHODS: The outcomes evaluation compared a cohort of students attending 19 participating schools and a national sample of urban youths, using logit models to control for observed differences between the two groups of youths. Outcome measures included self-reports concerning health center utilization, use of other health care providers, knowledge of key health facts, substance use, sexual activity, contraceptive use, pregnancies and births, and health status. RESULTS: The health centers increased students' access to health care and improved their health knowledge. However, the estimated impacts on health status and risky behaviors were inconsistent, and most were small and not statistically significant. CONCLUSIONS: School-based health centers can increase students' health knowledge and access to health-related services, but more intensive or different services are needed if they are to significantly reduce risk-taking behaviors.

Adolescent↗
PubMed2005

1-year pulmonary function and health status in survivors of severe acute respiratory syndrome.

STUDY OBJECTIVES: To characterize the long-term pulmonary function and health status in a prospectively identified cohort of patients who survived the severe acute respiratory syndrome (SARS). DESIGN: Prospective follow-up cohort study. SETTING: University-affiliated hospital. PATIENTS: Ninety-four patients who recovered from SARS were assessed at a uniform time point of 1 year after hospital discharge. MEASUREMENTS: The study included the measurement of static and dynamic lung volumes, the determination of the diffusing capacity of the lung for carbon monoxide (D(LCO)), and a health status evaluation using the St. George Respiratory Questionnaire (SGRQ). RESULTS: Eleven patients (12%) had mild impairment of FVC, 20 (21%) had mild impairment of FEV1, 5 (5%) had mild impairment of the FEV1/FVC ratio, and 17 (18%) had mild impairment of the D(LCO). There was one patient (1%) who had moderate impairment of FVC, one patient (1%) who had moderate impairment of the FEV1/FVC ratio, and three patients (3%) who had moderate impairment of the D(LCO). No pulmonary function abnormalities were detected in 59 patients (63%). Mean scores were significantly higher (ie, worse) than the population norms in the activity (p < 0.001), impacts (p < 0.001), and total (p < 0.001) domains of the SGRQ. CONCLUSIONS: One year after recovery from SARS, persistent pulmonary function impairment was found in about one third of patients. The health status of SARS survivors was also significantly worse compared with the healthy population. The main determinants of morbidity in recovered SARS patients need to be further defined.

Adult↗
PubMed2001

Influence of sociodemographic and health status variables on the American Urological Association symptom scores in patients with lower urinary tract symptoms.

OBJECTIVES: To evaluate the relationship between sociodemographic and health status variables and the American Urological Association Symptom Score (AUA-7) because low associations between clinical measures of lower urinary tract symptoms and scores on the AUA-7 suggest that symptoms may be influenced by other variables. METHODS: Sociodemographic, clinical, and health status variables were recorded for 666 patients with benign prostatic hyperplasia (BPH). BPH symptoms were measured with the AUA-7. Bivariate and multivariate analyses were used to determine correlations between sociodemographic and health status variables and AUA-7 scores. RESULTS: BPH-related variables (clinical rating of severity, number of BPH treatments, and being scheduled for surgery) were included in the final regression model, which explained 25% of the overall variability in scores. An additional 7% of the total variability was explained by other non-BPH-related variables (educational level, presence of depression/anxiety, and pain/discomfort). CONCLUSIONS: The AUA-7 is a robust questionnaire that is little influenced by sociodemographic variables and general health status. The educational level, mood, and presence of pain/discomfort of patients should be taken into account when interpreting scores, as a combination of these characteristics could mean a difference of up to 6 points on the AUA-7.

Age Factors↗
PubMed1998

Predictors of health status and life satisfaction in spinal cord injury.

OBJECTIVE: To analyze relationships between injury-related variables, demographic variables, functional health status, and life satisfaction of people with spinal cord injury (SCI). DESIGN: Cross-sectional survey. SETTING: A community in the Netherlands. SUBJECTS: Three hundred eighteen people with SCI, aged 18 to 65 years. Mean age was 39.4 years and mean time after injury was 3.6 years. MAIN OUTCOME MEASURES: Health status was measured with the SIP68. Its six scales were aggregated to three dimensions, measuring physical, psychologic, and social functioning. Life satisfaction was measured with the Life Satisfaction Questionnaire. Data were analyzed by path analysis using LISREL V8. RESULTS: Obtained scores showed that respondents suffered from serious limitations in physical functioning and social functioning, had only a few limitations in psychologic functioning, and were satisfied with their lives in general and with most life domains. Physical functioning was accurately predicted by injury-related variables, but psychologic functioning was not. Next to level and completeness of the injury, the number of secondary complications turned out to be a predictor of functional health. In a path model that had a close fit with the data, injury-related variables were related to health status but not to life satisfaction. Social functioning (-.48), marital status (-.38), psychologic functioning (-.19), and age (-.16) were significant predictors of life satisfaction (total R2=.44). CONCLUSIONS: This study points out the high prevalence of secondary complications and their importance to the health status of people with SCI. Level of social and psychologic functioning are more important predictors of life satisfaction than the seriousness of the injury.

Adolescent↗
PubMed2001

[A survey of oral health status of the elderly individuals in Chengdu of China].

OBJECTIVE: The aim of this survey is to investigate the oral health status of the oldsters over 65-year-old in Chengdu of China. METHODS: The oral health status, including oral hygiene, caries, periodontal diseases and the tooth loss of 468 elderly individuals over 65 years old were surveyed and analyzed. RESULTS: It was found that all these older individuals brushed their teeth everyday, but most of them had tooth decay, gingivitis and periodontitis. About 7.47% of them were edentulous, and 2.56% of them were half edentulous. The masticatory ability of most of them declined and the chewing ability of them was low. CONCLUSION: The oral health status of these elderly individuals in Chengdu is poor. It is therefore necessary to improve the health status of this population.

Aged↗
PubMed2001

Effects of cost sharing on care seeking and health status: results from the Medical Outcomes Study.

OBJECTIVES: This study sought to determine the effect of cost sharing on medical care use for acute symptoms and on health status among chronically ill adults. METHODS: Data from the Medical Outcomes Study were used to compare (1) rates of physician care use for minor and serious symptoms and (2) 6- and 12-month follow-up physical and mental health status among individuals at different levels of cost sharing. RESULTS: In comparison with a no-copay group, the low- and high-copay groups were less likely to have sought care for minor symptoms, but only the high-copay group had a lower rate of seeking care for serious symptoms. Follow-up physical and mental health status scores were similar among the 3 copay groups. CONCLUSIONS: In a chronically ill population, cost sharing reduced the use of care for both minor and serious symptoms. Although no differences in self-reported health status were observed, health plans featuring cost sharing need careful monitoring for potential adverse health effects because of their propensity to reduce use of care that is considered necessary and appropriate.

Adult↗
PubMed2007

At what age can children report dependably on their asthma health status?

OBJECTIVE: This study examined psychometric properties and feasibility issues surrounding child-reported asthma health status data. METHODS: In separate interviews, parents and children completed 3 visits. Child questionnaires were interviewer administered. The primary instrument was the Children's Health Survey for Asthma-Child Version, used to compute 3 scales (physical health, activities, and emotional health). The following were assessed: reliability (internal consistency and test-retest reliability), validity (general health status, symptom burden, and lung function), and feasibility (completion time, missing data, and inconsistent responses). RESULTS: A total of 414 parent-child pairs completed the study (mean child age: 11.5 years). Reliability estimates for the activities and emotional health scales were > .70 in all but 1 age category; 5 of 9 age groups had acceptable internal consistency ratings (> or = .70) for the physical health scale. Cronbach's alpha tended to increase with child age. In general, test-retest correlations between forms and intraclass correlation coefficients were strong for all ages but tended to increase with child age. Correlations between forms ranged from .57 (7-year-old subjects, physical health) to .96 (14-year-old subjects, activities). Intraclass correlation coefficients ranged from .76 (13-year-old subjects, emotional health) to .94 (15-16-year-old subjects, physical health). Children with less symptom burden reported higher mean Children's Health Survey for Asthma-Child Version scores (indicating better health status) for each scale, at significant levels for nearly all age groups. Children's Health Survey for Asthma-Child Version completion times decreased from 12.9 minutes at age 7 to 6.9 minutes at age 13. CONCLUSIONS: This research indicates that children with asthma as young as 7 may be dependable and valuable reporters of their health. Data quality tends to improve with age.

Adolescent↗
PubMed2003

Serum acute phase proteins and swine health status.

The purpose of this study was to investigate the relationship between swine health status and the concentration of the serum acute phase proteins, haptoglobin (HP), and C-reactive protein (CRP). A total of 378 clinically healthy pigs from farms A and B, plus 20 pigs culled from farm A due to poor growth, were used in this experiment. Each pig was examined and blood samples were collected during slaughter. The HP concentration was measured by using an HP-hemoglobin binding assay. The CRP concentration was measured by using a CRP enzyme immunoassay. Gross and histopathological lesions were examined and recorded at slaughter. Representative samples were then collected in order to isolate pathogens. Swine enzootic pneumonia, found in 47.7% of the pigs, was the most common lesion. Other lesions included pleuropneumonia (32.7%), suppurative pneumonia (10.3%), fibrinous pericardititis (4.3%), Ascaris migration in the liver (33.9%), and intestinal serositis (3.0%). On farm A, the percentage of pigs with 1 or more lesions was 88.2%. For culled pigs from farm A, the mean serum concentrations of HP and CRP were 2.23 +/- 0.14 mg/mL and 252.93 +/- 11.62 microg/mL, which were significantly higher than concentrations in clinically normal pigs (1.42 +/- 0.02 mg/mL and 84.88 +/- 2.61 microg/mL, respectively, P < 0.01). Moreover, among clinically normal farm A pigs, the mean HP concentration in pigs with lesions (1.43 +/- 0.02 mg/mL) was significantly higher than in pigs without lesions (1.32 +/- 0.07 mg/mL) (P < 0.05). However, the mean serum CRP concentrations in these animals were not significantly different. On farm B, the percentage of pigs with one or more lesions was 50.0%. Interestingly, the mean serum HP concentration in clinically normal pigs with lesions was significantly lower in farm B pigs (1.23 +/- 0.07 mg/mL) than in the farm A pigs (1.43 +/- 0.02 mg/mL; P < 0.01). However, serum CRP concentrations in farm A and B pigs were not significantly different. Serum HP concentration, which is a better indicator of inflammatory reactions in pig herds than serum CRP concentration, provides an important marker for swine health status.

Animals↗
PubMed2001

Can skin wrinkling in a site that has received limited sun exposure be used as a marker of health status and biological age?

OBJECTIVES: to determine if skin wrinkling in a site that had received limited sun exposure may be a marker of health status and biological age. DESIGN: population-based, cross-sectional study. PARTICIPANTS: we evaluated the health status of representative samples of elderly Greek-born people living in Melbourne, Greeks living in rural Greece, Anglo-Celtic Australians living in Melbourne and Swedes living in Sweden. We carried out microtopographic assessment of their skin and measured plasma dehydroepiandrosterone concentrations. METHODS: we derived activities of daily living, well-being, memory and general health status scores from a cross-cultural questionnaire. We measured skin wrinkling using cutaneous microtopographic methods and plasma dehydroepiandrosterone by enzyme immuno-assay. RESULTS: skin wrinkling was positively correlated with age (r(s)=0.27, P<0.0001) and negatively with body mass index (r(s)=-0.19, P<0.0001). Therefore, all analyses were controlled for these variables. Plasma dehydroepiandrosterone was higher in smokers than non-smokers (2.86 vs 2.08; P<0.001) and men had significantly higher plasma dehydroepiandrosterone than women (2.74 vs 1.69; P<0.0001). In the pooled data, skin wrinkling was negatively associated with general health score (r(s)=-0.13, P<0.01) and activities of daily living score (r(s)=-0.14, P<0.05) after controlling for age, body mass index and smoking. These associations were more pronounced in women. Finally, those with the least skin wrinkling had the highest dehydroepiandrosterone level (r(s)=-0.12, P=0.06) after adjusting for age, smoking and sex. CONCLUSION: skin wrinkling in a site with limited sun exposure might be used as a marker of health status and, to some extent, biological age--particularly for women.

Aged↗