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[The hygienic assessment of the working conditions and health status of workers on the petroleum tank farms of Bashkiria].

Work conditions and the health status in workers of Bashkirian oil enterprises are characterized. Exposure to oil products composed of alkanes and aromatics, petrol and tetraethyl lead was proved to be the major hazard for workers of all the occupations. Complex of occupational and industrial hazards of Bashkirian oil enterprises harms the health status of workers, which induces the high prevalence of chronic diseases.

Adult↗

Impaired generic health status but perception of good quality of life in survivors of burn injury.

BACKGROUND: Although it is recognized that burn survivors face a variety of challenges related to physical, psychologic and social late-effects of their injury, the impact of thermal injury on the lives of patients is not fully understood. To learn more about burn patient needs and to obtain information relevant to the design of clinical programs for treatment and aftercare, self-reports on how burn patients perceive their health and quality of life may be of significant value. METHODS: The generic health status (evaluated by SF-36) and overall quality of life (evaluated by the Quality of Life Scale [QOLS]) of 95 adult burn patients (total body surface area burned = 18.5 +/- 14.2% [mean +/- SD]; 82.1% men) were assessed 47.0 +/- 23.8 months postburn and compared with population norms. RESULTS: The burn patient generic health status was significantly poorer than expected from general population scores, with reduced scores in the Physical Function (p < 0.001), Role Physical (p < 0.01), General Health (p < 0.001), Social Function (p < 0.001), and Role Emotional (p < 0.001) domains of the SF-36. Despite their reduced health status, overall quality of life was perceived as good, with QOLS scores similar to those of the general population. Patients living alone, unemployed, having nonburn physical illness, psychologic disorders, chronic pain, or having sustained full thickness injuries were found to be at particular risk. CONCLUSIONS: Forty-seven months postinjury, burn patients still experienced a significant reduction of generic health, reporting limitations related to both physical and psychosocial SF-36 domains. On the other hand, the patients as a group reported overall quality of life similar to that of the norm population, suggesting that they were able to feel satisfaction with their new situation of life. Identification of several risk factors for reduced generic health status and overall quality of life support the need for specialized multidisciplinary aftercare for burn patients.

Adult↗

Correlates of self-reported physical health status of students of the University of Ibadan, Nigeria.

BACKGROUND: Young people including university students are a justifiable target for health status assessment as they form a large group that only recently escaped the adverse mortality experiences of childhood. This study was conducted in the University of Ibadan to determine the state and correlates of students' physical health. STUDY DESIGN: Seven hundred and fifty students were randomly selected from all eleven halls of residence by multi stage sampling. Questionnaires derived from the Duke Health Profile, a generic health instrument were administered by trained student peers and responses scored using the recommended guidelines. RESULTS: The overall response rate was 96.5%. The sample consisted of 484 males and 240 females; 602 undergraduate and 122 graduate students giving a male:female ratio of 2:1 and undergraduate:graduate student ratio of 5:1, similar to the ratio in the 18,690 strong general student body. All the university's faculties were represented. Most (92.3%) of the respondents were single. The group had a mean age of 23.8 years (SD 4.6). The mean physical health score was 7.9 (SD 1.67) out of a possible maximum of 10. High scores were significantly associated with male gender and frequent exercise. Sixteen students (2.2%) reported a physical handicap and 122 (16.3%) a medically diagnosed chronic illness. A mean of 1.14 days of disability occurred among the students in the month preceding the survey. Common causes of morbidity reported included fever (59.8%), nervousness (12.4%), cough (12.3%) and sleeping disorders (11.2%). CONCLUSION: The high mean physical health score recorded in this study indicates that students have an overall good level of functioning. However physical health status was associated with several lifestyle and personal factors.

Adolescent↗

Health status measurements at diagnosis as predictors of survival among adults with brain tumors.

PURPOSE: The intent of this study was to determine whether baseline measures of functional capacity and performance could be used to predict survival in adults following the diagnosis of brain tumors. PATIENTS AND METHODS: Comprehensive health status and health-related quality of life (HRQL) were measured using the Health Utilities Index (HUI; McMaster University, Hamilton, Canada) system by a self-assessment questionnaire in a survey of 100 consecutive patients. The Karnofsky Performance Score (KPS) and Folstein's Mini-Mental State Examination (MMSE) scores were measured by a physician blinded to the HUI results. The patients were observed for up to 5 years to recorded dates of death. RESULTS: An HUI questionnaire was completed for 93% of the patients and 69% died within 5 years of assessment. The HUI revealed a burden of morbidity and complexity of disability that far exceeded that reported for the general population. KPS and MMSE correlated strongly with each other (r = 0.52; P < .001). A decrease of 0.1 units in HUI Mark 2 (HUI2) self-care single-attribute utility score was associated with an increased hazard of death of 30% (P = .023) for patients with low-grade tumors (n=25). For patients with high-grade tumors (n=56), a 10 unit decrease in the KPS, a 5 unit decrease in MMSE, and a 0.1 decrease in HUI Mark 3 (HUI3) speech and dexterity single-attribute scores were associated with an increased hazard of death of 20% (P = .022), 26% (P = .015), 36% (P = .021), and 18% (P = .035), respectively. CONCLUSION: Scores derived from the measurement of HRQL following diagnosis can predict survival in adults with brain tumors.

Adult↗

Health status of dually eligible beneficiaries in managed care plans.

We conducted a descriptive study examining the health status of dually eligible beneficiaries using a sample from the Medicare Health Outcomes Survey (HOS), a measure of health status administered to enrollees in Medicare managed care (MMC). Overall, we found that dually eligible beneficiaries were sicker, more depressed, and reporting more pain than Medicare-only beneficiaries. Our results suggest that quality improvement initiatives that center on pain and depression management in the dually eligible population present important opportunities for collaboration between Medicare and Medicaid.

Aged↗

Parent-reported health status after pediatric thoracic organ transplant.

BACKGROUND: Thoracic organ transplantation is a life-changing event for a child and family from both a physical and a psychosocial perspective. Accurate pre-transplantation counseling and effective post-transplantation follow-up depend on a good understanding of post-transplantation health status, especially as perceived by families. METHODS: The Child Health Questionnaire-Parent Form 50 (CHQ-P50), an instrument that assesses parent-reported health status of pediatric patients, was administered to 47 pediatric thoracic organ transplant recipients (41 heart, 6 lung) 5 to 18 years of age. RESULTS: Transplant recipients scored lower on the Physical Health Summary (PhS) score than the general population, as evidenced by a lower median score (50.6 vs 55.1, p < 0.0001) and a difference in the distribution of quartiles (p = 0.001), skewed toward the lower quartiles of the general population. The distribution of PhS scores in transplant recipients was comparable to scores of 3 groups of pediatric patients with other chronic health conditions (juvenile rheumatoid arthritis, epilepsy and asthma). The distribution of the Psychosocial Health Summary (PsS) scores was similar to that of the general population, but the median score was lower (51.5 vs 53.2, p = 0.02). Transplant patients clearly scored lower than the general population on 4 of 12 sub-scales, including those assessing general health, physical functioning, family activities and parental emotional impact. No difference was found in sub-scales reflecting self-esteem, mental health, behavior, pain, peer interactions, family cohesion or parental time demands. CONCLUSIONS: Thoracic organ transplantation in children ages 5 to 18 years is associated with an ongoing deficit in parent-perceived physical health status.

Adolescent↗

Health status of disadvantaged adolescents entering the Job Corps program.

The health status of 2,203 disadvantaged young people entering the Job Corps was studied by reviewing the medical information collected during examinations performed upon entering the Job Corps. The study was conducted from February 1980 through January 1981. The sample records were obtained from eight representative Job Corps centers. The Job Corps is a federally funded residential vocational training program for youths between 16 and 22 years of age. During the study period, 100 Job Corps centers were in operation, serving a population of 38,000 corpsmembers. Long-term, chronic physical disease or disability was not prevalent among the applicants. The most common physical defect, affecting 10 percent of the youths examined, was uncorrected defective visual acuity. Obesity, defined as weight for height 20 percent or more over nationally calculated "desirable" weights, was present in 16.6 percent of the female trainees. In contrast, only 9.6 percent of a national sample of females have weights this high. Anemia, probably caused by iron deficiency, was prevalent among both sexes; sexually transmitted diseases were found to be common, especially among the females entering the Job Corps. Findings from this study were used by Job Corps staff to make changes in the health program as well as to provide instruction to its health personnel.

Adolescent↗

Latino parents' perception of their children's health status.

Descriptive and multivariate analyses of the Hispanic health and nutrition examination survey were undertaken to describe Mexican American and Puerto Rican parents' perceptions of the health status of their young children, and to test a model of perceived health. Results suggest that ratings of poor health are substantially higher than reports for children from the general population and that the two ethnic groups differed from each other in the apparent basis for their ratings. Key predictors of health ratings for both populations were children's functional limitations, current and resolved medical conditions, and educational attainment of the head of household. Mexican-American ratings were also predicted by current and resolved developmental conditions, acculturation, and family income.

Adult↗

Behavioral lifestyle and mental health status of Japanese factory workers.

BACKGROUND: Lifestyle factors, sometimes associated with physical health and mortality, have also been known to be associated with mental health status. This study seeks to correlate behavioral lifestyles with major components of mental health among Japanese factory workers. METHOD: We administered the 28-item version of the General Health Questionnaire (GHQ-28) and a questionnaire concerning eight personal health practices to 2,132 male and 668 female factory workers at a camera-manufacturing company in Japan. RESULTS: There were strong negative relationships of a higher total number of favorable lifestyles as indicated by the Health Practice Index (HPI) to psychological distress and its components: somatic symptoms, anxiety-insomnia, and social dysfunction. After controlling for the effects of confounding factors that included age, marital status, and somatic condition, multiple logistic regression analysis indicated that five of the eight health factors among male workers--mental stress, nutritional balance, eating breakfast regularly, physical exercise, and working hours--were significantly related to the grade of psychological distress or its three components. Among female workers, five health practices, i.e., mental stress, physical exercise, sleeping hours, working hours, and cigarette smoking, were significantly associated with the grade of psychological distress or its three components. CONCLUSION: Good health practices might be individually and as a whole associated with better mental health status in factory workers.

Adult↗

Social structural influences on emotional support from parents early in life and adult health status.

The authors' purpose in this study was to identify social structural predictors of receiving emotional support from parents early in life and structural factors responsible for variations in the associations between early parental support and adult health status. Data from a US representative sample of 2,786 adults aged 25-74 years suggest that men, non-Whites, and individuals from socioeconomically advantaged families report having received higher levels of early parental support. Furthermore, these analyses suggest that although adult health status is predicted by early parental support in general, health status among adults is particularly sensitive to levels of support received from a same-sex parent during childhood. These findings emphasize the pervasive influence of gender in American society and add focus to researchers' understanding of the long-term health effects of early parental support.

Adult↗

[Cross sectional study of the relationship between physical fitness and life style, health-status in healthy aged males].

PURPOSE: The purpose of this study was to investigate the relationships between physical fitness and life style, as well as health-status in aged males living in a community. METHOD: A total of 304 males aged 60 to 89 years volunteered as subjects for this study. Eleven performance-test items were selected from four physical fitness domains of muscle, joint, neuromuscular and lung functions, with consideration given to the safety, reliability, and feasibility of the tests. To assess life style and health-status, a questionnaire consisting of 40 items was constructed. Principal component analysis was applled to the correlation matrix consisting of 11 physical fitness variables. Statistical techniques for Creamer's association coefficient and theory of quantification I were used to examine the relationships between life style, medical condition and fundamental physical fitness (FPF). RESULTS: Cramer's association coefficient was only significant for the variable of quantity consumed at dinner. Multiple correlation coefficient between FPF and age-grade, life style, and health-status were significant (P < 0.01). Partial correlation coefficients were high for the variables of aged-grade, sleeping hours, and receiving medical treatment. CONCLUSION: Fundamental physical fitness showed a decreasing trend with age. It was inferred that acquisltion of adequate sleeping hours and not taking medical treatment for injury of illness might be related to the decline of FPF level with aging in aged males.

Aged↗

A case-control study of the health status of male farmers registered at Ash Tree House Surgery, Kirkham, Lancashire.

The relative health status of 74 male working farmers registered at Ash Tree House Surgery, Kirkham, Lancashire, was compared with a control group taken from the same surgery. Medical records over a five-year period were analysed to reveal differences in the health status of the two groups. Overall more farmers visited the surgery for acute consultations with the General Practitioner (GP) and significantly (using the chi-squared test for significance) less for health promotion (P < 0.05) than the control group. When visits were classified by disease type, more farmers were found to have visited the surgery with infections (P < 0.05); disorders of the nervous system (P < 0.01); disorders of the skin (P < 0.05) and external causes of injury (P < 0.01). The finding that farmers visit the surgery more often for acute consultations and less for health promotion, coupled with the finding that there are significant differences in the pattern of ill health between the two groups suggest that there is a need for health promotion among the farming community of Kirkham, Lancashire.

Acute Disease↗

Health services, health status, and work loss.

The numbers of workdays lost because of illness, coupled with records of health service utilization patterns, were studied to establish possible links between health status and different forms of prepayment coverage. The records of industrial workers at four branches of the same company were analyzed. Records of employees with broad-benefit coverage were compared with those who had less-comprehensive indemnity coverage. A free choice of providers was available to the study population. Data for workers covered by the broader plans revealed fewer medical admissions to hospitals, more surgical admissions, and more outpatient physician visits. As hypothesized, their number of days absent from work were lower. Because few of these results were statistically significant, caution is necessary in their interpretation. Some aspects of the project warranting further consideration are discussed. Data suggest a positive correlation between breadth of health plan coverage and health status, with possible economic benefits to be derived from such coverage. The data also indicate the desirability of additional investigations to be based on employers' and health plan records, that involve other types of populations and other benefit options.

Absenteeism↗

Measuring health status with the Dartmouth COOP charts in low-functioning elderly. Do the illustrations affect the outcomes?

The Dartmouth COOP method consists of seven questions measuring seven domains of health status: physical fitness, feelings, daily activities, social activities, change in health status, current overall health perceptions and bodily pain. Each question has five response options and each option is accompanied by an illustration. In this paper, we present the results of a randomized study of the effects of the illustrations of the seven Dartmouth COOP charts in a low-functioning elderly sample. In addition, the subjective evaluation of the illustrations was examined. The results showed no significant differences between the outcomes obtained with the illustrated COOP charts and the unillustrated COOP charts: the mean scores, patterns of intercorrelations and associations with other measures for the research participants who filled in the illustrated COOP charts hardly differed from those obtained from the participants who filled in the unillustrated charts. Furthermore, the results showed that approximately three-quarters of the research participants considered the illustrations informative, while approximately 17% of the participants considered the pictures exaggerated. We conclude that, as long as there is no empirical support for the advantages of the COOP charts with respect to cross-cultural standardization or use in subjects who have, for example, difficulty in reading, there seems to be no need for the illustrated COOP charts. The results of our study showed that both types of COOP charts appear to be interchangeable.

Aged↗

Correlations of Mini-Mental State and modified Dementia Rating Scale to measures of transitional health status in dementia.

Information regarding the relationships of the Mini-Mental State (MMS) and a modified Dementia Rating Scale (mDRS) to measures of change, that is, "transitional" health status, in dementia would be potentially useful in the evaluation and care of demented patients. In a longitudinal study of demented outpatients, MMS and mDRS at entry and at 1- to 2-year follow-up were significantly correlated with five measures of physician- and advocate-rated transitional health status and change in living arrangement during this interval (p less than .01). MMS and mDRS at follow-up also predicted mortality during a subsequent year of follow-up (p less than .01). Estimated change in MMS and mDRS was significantly correlated with all transition variables, except for MMS and results suggest MMS, mDRS, and estimated change in them reflect these aspects of transitional health status in dementia.

Aged↗

Indicators of deprivation, voting patterns, and health status at area level in the Republic of Ireland.

STUDY OBJECTIVE: To determine what relation, if any, exists between mortality patterns, indicators of deprivation, general lifestyle and social attitudes, as exemplified by general election voting pattern, in the Republic of Ireland. A relation has been demonstrated previously between voting and mortality patterns in the United Kingdom. DESIGN: Cross sectional ecological study using three data sources. Standardised mortality ratios (SMR) were based on mortality rates at county level and 1996 census data from the Central Statistics Office, 1997 general election first preference voting data in all 41 constituencies were aggregated to county level. Selected reported measures of health status, lifestyle and social circumstances are from the first ever National survey on lifestyles, attitudes and nutrition (SLAN). This study comprised adults over 18 years sampled by post using the electoral register from 273 representative district electoral divisions. Univariate inter-relations were examined at individual level for the dataset as a whole, adjusting for age and at aggregated level for 26 county borough areas, which included the two largest cities and for 22 county areas, which afforded correlation with voting pattern, using the method of Pearson's correlation coefficient. PARTICIPANTS: 1,806,932 votes were cast nationally at the 1997 general election, representing a voter turnout of 65.92 %. There was an overall response rate of 62% to SLAN comprising 6539 adults (47% male). The demographic pattern of survey respondents was consistent with that of the general population over 18 years. MAIN RESULTS: At individual level there was a large number of highly significant inter-relations between indicators of deprivation, various measures of self rated health status and lifestyle factors. Aggregated at 26 county level percentage unemployed (r=0.408, p=0.038), and level of education (r=0.475, p=0.014) related significantly to SMR and inversely to both fruit and vegetable consumption (r= -0.672, p=0.001) and excess alcohol consumption among men (r= -595, p=0.003). Those rating their health as fair or poor were more likely to report a poor quality of life (r=0.487, p=0.022), to have none or primary school education only (r=0.428, p=0.047), or to have a means tested medical services card (r=0.428, p=0.047). There was no significant relation between SMR and voting pattern for the two main political parties (67.28% first preferences) but a significant relation with left wing voting (r=0.446, p=0.037). Fianna Fail voting pattern was inversely related to level of dissatisfaction with health (r= -0.59, p<0.05). There was a positive significant relation between left wing voting and dissatisfaction with health (r=0.51, p<0.02) and rate of smoking (r=0.47, p=0.03). Smoking pattern also related positively to rates of voter abstention (r=0.526, p=0.12). CONCLUSIONS: These data are consistent with those in other countries in showing a relation between deprivation indicators and lifestyle, but differ in that no relation with SMR and the votes cast for the main parties was seen in a country with a mainly centre right voting pattern. The relation between left wing voting pattern and some indicators of deprivation and lifestyle suggest that party political voting patterns and affiliations could be a useful indicator of vertical social capital. However, its variability as a measure across countries suggests that the inter-relation between sociocultural and economic factors and the consequent influence on health status is not straightforward.

Adolescent↗

The relation between measures of health status and quality of life in COPD.

Because quality of life (QoL) and health status (HS) scales contain different kinds of items and are shown not to be equivalent, there is a recommendation to use both types of scales. We investigated the relationship between either type of scale but focusing on the subscales of HS measures. A sample of chronic obstructive pulmonary disease (COPD) patients completed two QoL scales and two HS scales (BPQ and SGRQ), neuroticism, six-minute walk test and FEV1. Factor analysis revealed a two-factor structure (consistent with previous research), and showed that one type of HS subscale is different from QoL but another is equivalent to QoL. If total HS scores are used then it is valuable to include a QoL measure, but if HS subscales are reported, then these cover both latent variables, with the BPQ providing a clearer separation of the latent variables than the SGRQ.

Aged↗

The relationship between health status and blood pressure in urban African Americans.

African Americans have higher rates of hypertension and poorer health status than their white counterparts. This study assessed the relationship between health status, cardiovascular risk factors, and measured blood pressure. Free blood pressure screenings were performed at businesses and organizations located in west Baltimore. All individuals with cardiovascular risk factors were offered health education. Also, participants with a measured blood pressure of > or = 140/90 mm Hg were referred for free medical treatment. Participants completed a questionnaire that included demographics, cardiovascular risk factors, the Medical Outcomes Study SF 36, and two tests on cholesterol and heart disease knowledge. A total of 1389 African-American men and women were screened; 20% were found to have high normal blood pressure and 31% had stage 1 hypertension or higher. Those with hypertension reported lower physical functioning and poorer general health than those without high blood pressure. When compared with US normative data, participants reported higher levels in vitality and physical and emotional role functioning, more bodily pain, and poorer general health, but they were similar in physical functioning, social functioning, and mental health. Preliminary data suggest that hypertension does have an effect on health function.

Adult↗