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PubMed2002

Oral health status of Asian and Hispanic women. A pilot study.

Data on the oral health of Asian and Hispanic women are rare in the dental literature. The objective of this study was to investigate the oral health status and needs of women from these two groups. Forty newly registered women from each group were the subjects of the study. Standard forms were used to collect sociodemographic information, medical histories, oral health status, oral hygiene practices and smoking habits. The oral examination recorded the DMFT and periodontal condition. Data were analyzed using SPSS Univariate General Linear Model, odds ratios and relative risks. Chi-Square tests were within the 95% confidence interval, and with @ = .05. The results showed that there was no statistical difference in age, education, oral health care, smoking habits, annual dental visits or DMFT between the two groups.

Adult↗
PubMed1995

[Relationship between perceived health status and career choice in a sample of wage-earners].

Many factors were related with subjective health status (SHS), but few studies have focused on identifying some intrinsic personal factors like the choice of job and perceived working situations. The present paper examines the relationships among such factors in a large French sample. Data were collected from 21,378 subjects who were randomly selected from the lists of male and female wage earners who were followed up by 380 occupational physicians and who were born in 1938, 1943, 1948 or 1953. SHS was evaluated using the French version of the Nottingham Health Profile (NHP). Socio-demographic and job characteristics were assessed by means of closed questions during the annual medical examination. Results showed that low subjective health status was related to sex, age and perceived working situation: for each of the six areas of the NHP (pain, physical mobility, energy, sleep, social isolation, emotional reactions) there was a lower SHS for women and a decrease with age for both sexes. The poorer the perceived working situations the worse was the SHS. Using general linear models it appeared that independently of these factors and the socio-economical category dichotomized in upper classes versus lower classes, those who had claimed to have not chosen their job had a lower SHS, whatever the area of SHS. Awaiting the second survey in 1995, it is difficult to explain these results from this cross sectional analysis: is the choice of job a possible risk factor or an artefact due to some unmeasured confounding factors like motivation or job satisfaction.

Adult↗
PubMed2000

[The effect of intensive traffic noise on well-being and self-assessed health status of urban population].

In the study health situation of inhabitants and their subjective reaction to different acoustic conditions in their place of living were analysed. Comparison of residents who spend most of the time in rooms at a street side with the residents who lived in rooms at a yard side revealed significant differences between the groups in mental state and self assessed health status. People, who live in worse acoustic conditions more often complain about difficulties and disturbances in different daily activities. They also more often reported different ailments, of which the most important are problems connected with cardiovascular system, feeling tiredness after night sleep, frequent nervousness and irritation. This group of people more often takes pain killers and tranquillisers. However, there was no difference between the groups in reporting diseases that could be associated with noise and were confirmed by physician. Observed differences in reporting negative symptoms and reactions mentioned above were not related to socio-economic and behavioral factors such as: gender, age, economical conditions or smoking which have similar distribution in both the groups.

Automobile Driving↗
PubMed2004

[Oral cavity health status among dentistry students in the Medical University of Bialystok].

The aim of this study was to analyse oral cavity hygiene, general health status and health behaviour of students studying on the last two years on the faculty of dentistry in the Medical University of Bialystok. 127 students were examined: 48 (37.8%) from the fourth and 79 (62.2%) from the fifth year of schooling. We used a standardized and anonymous questionnaire that was made in Collegium Medicum of the Jagiellonian University in Cracow. Obtained data were statistically elaborated. This work was a part of a multicenter study. 41 (32.3%) students suffered from chronic systemic diseases especially allergy (22.8%). 19 (15.1%) of them still undergo drug treatment. As for dental examination, it have been noted that caries prevention was unsatisfactory at early stages of life of the respondents. Oral hygiene was correct. University education has a bearing on quality of students' health behaviour. Parodontium status was adequate. High frequency of temporomandibular joint pathology is alarming and strongly suggests initiating diagnostics and treatment.

Adult↗
PubMed2004

Comparison of a single global item and an index of a multi-item health status measure among persons with and without diabetes in the US.

This study examined the hypothesis that a single global item can be substituted for an index of a multi-item assessment and lead to equivalent interpretative outcomes. Substitutability would be demonstrated if: (1) the two measures were strongly correlated, and regression analysis showed that the same variables accounted for variation in each measure, and (2) difference scores between multi-item and global scores were close to zero and remained so as socio-demographic and co-morbid conditions varied. A multi-item assessment was constructed by mapping items from the NHANES I Epidemiologic Follow-up Study (NHEFS), using available data for persons with and without diabetes, onto the health-status classification system of the Health Utilities Index Mark 1 (HUI), creating the NHEFS-HUI. NHEFS-HUI data, when correlated to the self-assessed health status (SAHS) item, revealed a coefficient of 0.55. Regression analyses identified 9 of 14 variables contributed to the variability of each health status index, but differences existed in which variables were significant for which measure. Five of the possible 14 difference scores for persons with diabetes and non-diabetics approached zero. Persons with diabetes had lower NHEFS-HUI scores than non-diabetics. These data were considered insufficient for demonstrating substitutability. Suggestions were made on how optimal substitutability could be achieved.

Adult↗
PubMedDate not supplied

The inverse association between age and cholesterol level among older patients: the role of poor health status.

BACKGROUND: The total cholesterol concentration decreases with age in older people. The reasons for this phenomenon are controversial. This study investigated the hypothesis that poor health status is a determinant of the inverse association between age and cholesterol in older persons. METHODS: Cross-sectional study of 2,486 (53% women) older medical patients (> or =65 years) admitted at 35 centers of the Gruppo Italiano di Farmacovigilanza nell'Anziano (GIFA) study in Italy. Total cholesterol was measured on the first day after admission to the hospital. Disease burden and comorbidity were assessed by the Charlson index; low serum albumin and iron were considered markers of frailty and poor health. RESULTS: In men there was a significant, inverse age-cholesterol relationship (-0.97 mg/dl per year, p<0.001). In women the association was nonlinear and cholesterol significantly decreased after the age of 75 (-0.95 mg/dl per year, p<0.005). In multiple linear regression analysis, indicators of poor health accounted for almost two thirds of the crude effect of age on the cholesterol level in both men and women (adjusted coefficients for age were: for men, -0.38 mg/dl per year, p = 0.044; for women after the age of 75, -0.37 mg/dl per year, p = 0.205). The unadjusted probability of having low cholesterol significantly increased with age among men (p for trend <0.005). In multiple logistic regression, indicators of poor health were strongly associated with low cholesterol in both men and women. After adjusting for indicators of poor health, the association between age and low cholesterol in men was no longer present. CONCLUSION: These findings suggest that the age-dependent reduction of cholesterol often observed in clinical and epidemiologic studies is substantially explained by the effect of poor health status. Low cholesterol in older persons may be a marker of poor health.

Age Factors↗
PubMed1994

Comparative health status of patients with 11 common illnesses in Wales.

OBJECTIVE: To assess the health status of patients with 11 common illnesses--asthma, diabetes, arthritis, back pain, sciatica, hypertension, angina, anxiety, depression, and heart attack and stroke. DESIGN: Face to face interview using a structured questionnaire which contained the Short Form 36 questionnaire (SF-36) and questions on lifestyle, health service utilisation, and self reported conditions treated by physicians. SETTING: Patients' homes, in West Glamorgan, Wales. SUBJECTS: Twelve hundred adults, aged 20-89 years, were randomly selected from the register of the family health services authority. MAIN OUTCOME MEASURES: The eight scales within the SF-36 health profile. RESULTS: The response rate was 82%. Each illness had a distinctive profile; patients with anxiety or depression reported the worst health experience in role limitations because of emotional problems and mental health, while patients with back pain, arthritis, or sciatica registered the three highest negative scores in bodily pain and role limitations due to physical problems. For all disease groups, the general health perceptions of those with the disease was significantly worse than those without it (p < 0.01). CONCLUSIONS: The SF-36 allows comparison of the health status of patients suffering from different conditions. Data such as these can be used to inform better purchasing decisions on how resources might be more effectively deployed and as a bench mark to monitor the effects of multiple health care interventions by conducting serial surveys.

Adult↗
PubMed2003

Improving the oral health status of all Americans: roles and responsibilities of academic dental institutions: the report of the ADEA President's Commission.

Academic dental institutions are the fundamental underpinning of the nation's oral health. Education, research, and patient care are the cornerstones of academic dentistry that form the foundation upon which the dental profession rises to provide care to the public. The oral health status of Americans has improved dramatically over the past twenty-five to thirty years. In his 2000 report on oral health, the Surgeon General acknowledges the success of the dental profession in improving the oral health status of Americans over the past twenty-five years, but he also juxtaposes this success to profound and consequential disparities in the oral health of Americans. In 2002, the American Dental Education Association brought together an ADEA President's Commission of national experts to explore the roles and responsibilities of academic dental institutions in improving the oral health status of all Americans. They have issued this report and made a variety of policy recommendations, including a Statement of Position, to the 2003 ADEA House of Delegates. The commission's work will help guide ADEA in such areas as: identifying barriers to oral health care, providing guiding principles for academic dental institutions, anticipating workforce needs, and improving access through a diverse workforce and the types of oral health providers, including full utilization of allied dental professionals and collaborations with colleagues from medicine.

Dental Auxiliaries↗
PubMed2001

Health status deterioration in patients with chronic obstructive pulmonary disease.

This study examined health status decline in patients with chronic obstructive pulmonary disease (COPD). Data are from the Inhaled Steroids in Obstructive Lung Disease (ISOLDE) trial. After an 8-wk run-in, 751 patients (566 male), mean age 64 yr, were randomized to receive fluticasone propionate (FP) 500 microg twice daily (376 patients) or placebo (375 patients). Mean baseline postbronchodilator FEV1 was 50 +/- 15% predicted. Patients completed the St George's Respiratory Questionnaire (SGRQ) and the Short-Form 36 (SF-36) at baseline and every 6 mo for 3 yr. FEV1 and smoking status were assessed at baseline and at 3-mo intervals. A total of 387 (212 FP) patients completed the trial. All SGRQ components (p = 0.03 to 0.004) and Physical Function, Mental Health, Energy/ Vitality, and Physical Role Limitation scales of the SF-36 (p = 0.05 to 0.005) deteriorated faster in the placebo group. FEV1 and SGRQ scores correlated at baseline values (r = -0.25, p < 0.0001), as did change in FEV1 and change in SGRQ (Delta r = -0.24, p < 0.0001). At baseline values smokers had worse SGRQ Total, Symptoms, and Impacts scores than ex-smokers. This difference was maintained throughout the study. Smoking status did not influence the rate of decline in health status. The SGRQ Total scores of FP-treated patients took 59% longer than placebo to deteriorate by a clinically significant amount. We conclude that health status decline in moderate to severe COPD can be reduced by high-dose fluticasone.

Adult↗
PubMed1987

Smokers and drinkers in a health maintenance organization population: lifestyles and health status.

This study examines, among a large health maintenance organization population, the prevalence of two high-risk lifestyle practices (smoking and problem drinking), their interrelationships, and their relationships with other lifestyle practices, sociodemographic characteristics, and health status measures. Results, based on a random sample of 1,133 adults, showed that smoking and problem drinking are strongly correlated. Individuals with no drinking problems had an age-, sex-, and education-adjusted smoking prevalence of approximately 20%, while problem drinkers smoked at about twice that rate. In addition, reporting one type of problem drinking behavior (binge, chronic, or drinking and driving) at least doubled, and in one instance increased by sixfold, the likelihood of reporting another type of problem drinking behavior. Smokers and problem drinkers were more likely to be younger than age 65, to be irregular seat belt users (smokers and binge drinkers only), and not to belong to voluntary organizations. Results of the analysis suggest that detection, prevention, and treatment of drug use, in general, might prove more beneficial than only focusing on smoking and problem drinking. In addition, because binge drinking and drinking and driving were so widespread among younger age groups, it might prove more beneficial to consider preventive strategies that change the sale and distribution of alcohol and make the environment safer in which to drink, such as providing transportation to get drinkers back home.

Adult↗
PubMed2004

[Health status and socioeconomic factors related to home remedy practices among elderly subjects living in a community in Okinawa].

OBJECTIVE: The purpose of the present study was to clarify health status and socioeconomic characteristics of elderly persons who practice home remedies as complementary alternative medicine. Whether such usage is associated with health-related factors was also assessed. METHODS: The subjects are 243 independent elderly living at home in A-village of Okinawa prefecture, aged 65 years or older. A self-administered questionnaire was mailed to all subjects in 2001. Included were questions on socioeconomic indicators, health status, IADL, health habits, social network, social support and home remedy practices. All data were statistically analyzed by Student's t test and the chi-square test. In addition logistic regression was used to calculate the odds ratios for current practitioners for each of the factors. RESULTS: The present study included 200 subjects who responded and completed all questions. (Table 2). The main results are as follows: The practitioner rate for home remedies was 50.8% in males and 71.9% in females, the difference being significant (P<0.05). Usage was found to be significantly related to hypertension (P<0.05), arthritis and rheumatic disease (P<0.01), some health habits and provision nursing of social support (OR = P<0.05). Logistic regression analysis adjusted for age, gender, and income revealed current practitioners of acupuncture to have a significantly higher level of history of hospital admission in the previous year (OR = 0.2 P<0.05), food control habits (OR = 4.3 P<0.05) and provision nursing of social support (OR = 4.2 P<0.05) than non-current practitioners. CONCLUSION: The findings of this study suggest that home remedy practices are associated with health-related habit and provision of social support for good quality of elderly life. The purpose is not only physical care but also health maintenance and promotion.

Aged↗
PubMed1999

Development and validation of a short measure of health status for individuals with amyotrophic lateral sclerosis/motor neurone disease: the ALSAQ-40.

In recent years there has been an increased appreciation of the importance of measuring health status from the patient's point of view, but until now no attempt has been made to develop an amyotrophic lateral sclerosis (ALS)-specific health status measure. The development of such an instrument is especially relevant now with the introduction of drugs that prolong life in ALS but limited data is available on the impact such treatments have on quality of life. This paper reports on the development of an ALS-specific measure, the forty item ALS assessment questionnaire (ALSAQ-40). The development of the ALSAQ-40 followed three main stages. Stage 1 consisted of in-depth, semi-structured exploratory interviews conducted on a sample of 18 patients to identify areas of salience and concern to patients with ALS. These interviews generated 78 candidate questions. In stage 2, the 78-item questionnaire was used in a postal survey to identify appropriate rephrasing/shortening and to determine the acceptability of the measure. In addition, this exercise helped identify sub-scales of the instrument addressing different dimensions of ALS. Finally in stage 3 the data collected in stage 2 was analysed to areas measured by the instrument and to remove redundant questions. The resulting measure contains forty questions measuring five areas of health status: Eating and Drinking, Communication, ADL/independence, Physical mobility, Emotional Functioning. The measure has high face, internal and construct validity and is likely to prove a useful measure in the evaluation of treatment regimes for ALS/MND.

Activities of Daily Living↗
PubMed2001

Assessment of health status and quality of life outcomes for children with asthma.

Increasing interest has been directed to understanding health outcomes associated with pediatric disease processes, including asthma. Salient areas of interest to health outcomes research include the child's and parent's subjective experience with the disease, a concept most often identified as quality of life. Quality of life reports fit within a broader scope of outcome measures embodied in the concept of children's health status. This article provides a description for how a child's health status can be understood theoretically, from a research perspective and in clinical practice. Emphasis is directed to how information obtained from both the child and parent is critical to outcomes research and clinical practice. Unique methodologic problems in assessing child health outcomes such as the challenge of understanding how the child's changing cognitive development may have an impact on responses to outcome measures and the role of contextual variables such as family characteristics are discussed. A variety of subjective and objective outcome measures currently exist that may be used in research on children with asthma. Practical guidelines for implementing outcomes research for children with asthma are presented. Clinical researchers must use multiple outcome measures for assessing asthma characteristics, including psychosocial characteristics, which have an impact on adherence and treatment regimens.

Asthma↗
PubMed2005

Cost and health status analysis after autologous chondrocyte implantation and mosaicplasty: a retrospective comparison.

OBJECTIVES: Chondral defects of the knee cartilage are prevalent. Autologous chondrocyte implantation (ACI) and mosaicplasty are increasingly used to treat symptomatic knee defects. This study assessed the costs and health status outcomes after ACI and mosaicplasty. METHODS: Patients were eligible to participate in this cross-sectional study if they received ACI or mosaicplasty at the Royal National Orthopaedic Hospital between 1997 and 2001 or were on a waiting list for ACI. Secondary-care resource use was collected to 2 years postoperatively using a resource collection proforma. Participants responded to postal questions about sociodemographic characteristics and knee-related (Modified Cincinnati Knee Rating System) and general health status (EQ-5D). RESULTS: Fifty-three ACI, twenty mosaicplasty, and twenty-two patients waiting for ACI participated. The average cost per patient was higher for ACI (10,600 pounds sterling: 95 percent confidence interval [CI], 10,036 pounds sterling-11,214 pounds sterling) than mosaicplasty (7,948 pounds sterling: 95 percent CI, 6,957 pounds sterling-9,243 pounds sterling). Postoperatively, ACI and mosaicplasty patients (combined) experienced better health status than those waiting for ACI. ACI patients tended to have better health status outcomes than mosaicplasty patients (not statistically significant). Estimated average EQ-5D social tariff improvements for quality-adjusted life year (QALY) calculations were 0.23 (ACI) and 0.06 (mosaicplasty). Average costs per QALY were 23,043 pounds sterling (ACI) and 66,233 pounds sterling (mosaicplasty). The incremental cost effectiveness ratio (ICER) for providing ACI over mosaicplasty was 16,349 pounds sterling. CONCLUSIONS: Average costs were higher for ACI than mosaicplasty. However, both the estimated cost per QALY and ICER for providing ACI over mosaicplasty fell beneath an implicit English funding threshold of 30,000 pounds sterling per QALY. Prospective studies should include measures of utility to confirm the estimated cost utility ratios of ACI and mosaicplasty.

Adult↗
PubMed2006

Evaluation of male COPD patients' health status by proxies.

BACKGROUND: It is not always possible to collect information about health from patients, so information from proxies (relatives and others) is used to aid medical decision-making, but there has been no formal evaluation of the reliability of their reports. The aim of this study was to analyse the reliability and validity of the St. George's Respiratory Questionnaire (SGRQ) answered by proxies and to determine their accuracy as raters. METHODS: Stable symptomatic male COPD patients and relatives living in the same house independently completed the same version of the SGRQ. RESULTS: Forty-six male patients were studied; age 72.1+/-7.3 years, pre-bronchodilator FEV(1) 37.9+/-14.7% predicted, 30.4% on long-term oxygen therapy. Internal consistency (Cronbach's alpha) was over 0.73 for all domains and >0.9 for the total score. Their scores correlated with dyspnoea (r=0.30-0.45) and FEV(1) (r=0.4-0.61). The proxies could distinguish between levels of disease severity, but with a weaker discriminant power compared to patients. Seventy-two per cent of proxies over-reported the degree of the patient's overall health status impairment, especially at mild-moderate scores. Proxies showed weaker correlations at the more severe scores. CONCLUSIONS: The SGRQ was reliable and valid when administered to relatives of male COPD patients; however due to the systematic over-reporting of the level of the patient's health status impairment, caution should be applied whilst trying to use proxies as surrogates for male COPD patients.

Aged↗
PubMed1992

Using health status measures in the hospital setting: from acute care to 'outcomes management'.

In recent years, employers, insurers, and government purchasers have paid increased attention to the measurement of patient outcomes and health status. Such interest is stimulated less by policy or quality concerns than by the need to reduce health care expenditures. Any expected benefits which might accrue from health status measurement will require active participation by community hospitals and their affiliated physicians. St. Vincent Hospital and Medical Center in Portland, Oregon has begun hospital-wide use of outcomes measurement systems. This study presents case studies of outcomes measurement for low back pain and total hip replacement, summarizes the hospital's objectives in implementing such measures, and identifies several strategies for successful adoption of health status measures in community practice.

Activities of Daily Living↗
PubMed1999

Performance of a short lung-specific health status measure in outpatients with chronic obstructive pulmonary disease.

The objective of this study was to assess the performance of a lung-specific health status measure in patients with chronic obstructive pulmonary disease (COPD). We used the Respiratory Quality of Life Questionnaire (RQLQ), a modification of an Australian questionnaire intended for asthma patients and adapted in this study to fit patients with COPD also. For comparison we chose the general health profile measure Short Form 36 (SF-36). We assessed the five RQLQ scales and eight SF-36 scales for reliability, validity and responsiveness in 59 outpatients attending a Norwegian hospital for COPD. Statistical analysis included internal consistency, test-retest reliability and convergent validity between the two questionnaires. Responsiveness was assessed in patients reporting global change in health status over 1 year. All scales of the RQLQ showed good internal consistency (Cronbach's a = 0.85-0.94) and test-retest reliability (intraclass correlation coefficient = 0.86-0.94), as did the SF-36 scales (a = 0.66-0.90) and intraclass correlation coefficient = 0.60-0.86). Pearson correlations between scales with similar items ranged from 0.54 to 0.76, supporting the construct validity of both questionnaires. The RQLQ had responsive scales, showing significant changes in the expected direction over 1 year. We conclude that the RQLQ showed an acceptable reliability, construct validity and responsiveness in COPD patients, encouraging further use of this questionnaire.

Ambulatory Care↗
PubMed2004

Household food insecurity is associated with adult health status.

The prevalence of household food security, which reflects adequacy and stability of the food supply, has been measured periodically in the United States and occasionally in high-risk groups or specific regions. Despite a plausible biological mechanism to suggest negative health outcomes of food insecurity, this relation has not been adequately evaluated. This study was conducted in the Lower Mississippi Delta region to examine the association between household food insecurity and self-reported health status in adults. A two-stage stratified cluster sample representative of the population in 36 counties in the Delta region of Arkansas, Louisiana, and Mississippi was selected using list-assisted random digit dialing telephone methodology. After households were selected and screened, a randomly selected adult was interviewed within each sampled household. Data were collected to measure food security status and self-reported mental, physical, and general health status, using the U.S. Food Security Survey Module and the Short Form 12-item Health Survey (SF-12). Data were reported on a sample of 1488 households. Adults in food-insecure households were significantly more likely to rate their health as poor/fair and scored significantly lower on the physical and mental health scales of the SF-12. In regression models controlling for income, gender, and ethnicity, the interaction between food insecurity status and race was a significant predictor of fair/poor health and lower scores on physical and mental health. Household food insecurity is associated with poorer self-reported health status of adults in this rural, high-risk sample in the Lower Mississippi Delta.

Adult↗