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PubMed2004

Forest health status in the Carpathian Mountains over the period 1997-2001.

The results of forest health status assessments in the Carpathian Mountains from the monitoring networks developed by the European Union Scheme on the Protection of Forest Against Atmospheric Pollution (EU Scheme) and International Co-operative Programme on Assessment and Monitoring of Air Pollution Effects on Forests (ICP-Forests), have led to a better understanding of the impact of air pollution and other stressors on forests at the regional scale. During the period 1997-2001, forests in the Carpathian Mountains were severely affected by air pollution and natural stresses with 29.7-34.9% of the trees included in defoliation classes 2-4. The broadleaves were slightly healthier than the conifers, and European beech (Fagus sylvatica) was the least affected species. Norway spruce (Picea abies) has poor health status, with 42.9-46.6% of the trees damaged (2-4% defoliation classes). Silver fir (Abies alba) damage was also high, with 46.0-50.9% in defoliation classes 2-4. Pines (primarily Pinus sylvestris) were the least affected of the conifers, with 24.9-33.8% in defoliation classes 2-4. The results from the transnational networks (16 x 16 km) show that the Carpathian forests are slightly more damaged than the average for the entire Europe. The correlative studies performed in individual European countries show the relationships between air pollution stressors with trends in defoliation and a possible effect of natural stresses at each site. More specific, effects of tree age, drought, ozone and acid deposition critical level exceedances were demonstrated to affect crown condition.

Abies↗
PubMed1991

Predictors of health status in middle-aged and older Mexican Americans.

Data from the Southwestern sample of the Hispanic Health and Nutrition Examination Survey (Hispanic HANES) were employed to investigate the association of socioeconomic variables with the health status of middle-aged (aged 45 to 59) and older (aged 60 and over) Mexican Americans. The most significant and consistent predictor of health status was employment. Less acculturated men had poorer self-assessed health; married men were more likely to have been hospitalized during the year prior to the interview, while less acculturated women were less likely to have been hospitalized (other things equal). Analysis involving interaction terms showed more significant associations in middle-aged than in older respondents, but only among men. Implications related to a selective survival thesis are discussed along with directions for future research.

Acculturation↗
PubMedDate not supplied

The SF-36 health status questionnaire in assessing patients with epistaxis secondary to hereditary hemorrhagic telangiectasia.

BACKGROUND: This study assesses the ability of the short form 36 (SF-36), a validated health status survey, to measure the health of patients with epistaxis due to hereditary hemorrhagic telangiectasia (HHT). METHODS: Thirty-eight patients completed the SF-36 and symptom-specific questionnaires. They were asked to rate their epistaxis as severe, moderate, or mild. The SF-36 data are compared with a reference population and analyzed with respect to the subgroups. RESULTS: The scores for each dimension of health were significantly reduced (p < 0.05) when compared with the reference population for all dimensions except pain. When compared with the patients' ratings of severity, a significant correlation was detected in five dimensions (p < 0.05). CONCLUSION: The SF-36 reflects the reduced health status of patients with epistaxis due to HHT. Changes in the SF-36 score could be used as an outcome measure in assessing efficacy of treatment of this condition.

Adolescent↗
PubMed1992

Anemia and hemoglobin levels in older persons: relationship with age, gender, and health status.

OBJECTIVE: To determine the relationship of hemoglobin levels and anemia with age and health status in older adults. DESIGN: Survey. SETTING: Community. PARTICIPANTS AND METHODS: Hematologic tests were obtained from 3,946 adults aged greater than or equal to 71 years in three communities (East Boston, MA; Iowa and Washington counties, IA; and New Haven, CT). RESULTS: Hemoglobin level was inversely associated with age, although this was more pronounced in men than in women. The proportion anemic was equal for men and women aged 71-74 years (8.6%) and increased differentially with age, reaching 41% and 21% for men and women aged greater than or equal to 90 years, respectively. Hemoglobin and anemia were independently associated with age, race, body-mass index, smoking, cancer, hospitalization, renal insufficiency, and hypoalbuminemia. The adjusted relative odds of anemia for a 5-year increase in age was 1.5 (95% confidence interval [CI] 1.3-1.8) for men and 1.2 (95% CI 1.1-1.4) for women. CONCLUSIONS: Age is significantly associated with both hemoglobin levels and anemia, with a stronger effect in men compared with women, even after simultaneously adjusting for demographic characteristics and health status. The decline of hemoglobin and concomitant increased anemia with age is not necessarily a result of "normal aging" so the detection of anemia in an older person should prompt appropriate clinical attention.

Activities of Daily Living↗
PubMedDate not supplied

The concept of race and health status in America.

Race is an unscientific, societally constructed taxonomy that is based on an ideology that views some human population groups as inherently superior to others on the basis of external physical characteristics or geographic origin. The concept of race is socially meaningful but of limited biological significance. Racial or ethnic variations in health status result primarily from variations among races in exposure or vulnerability to behavioral, psychosocial, material, and environmental risk factors and resources. Additional data that capture the specific factors that contribute to group differences in disease must be collected. However, reductions in racial disparities in health will ultimately require change in the larger societal institutions and structures that determine exposure to pathogenic conditions. More attention needs to be given to the ways that racism, in its multiple forms, affects health status. Socio-economic status is a central determinant of health status, overlaps the concept of race, but is not equivalent to race. Inadequate attention has been given to the range of variation in social, cultural, and health characteristics within and between racial or ethnic minority populations. There is a growing emphasis, both within and without the Federal Government, on the collection of racial or ethnic identifiers in health data systems, but noncoverage of the Asian and Pacific Islander population, Native Americans, and subgroups of the Hispanic population is still a major problem. However, for all racial or ethnic groups, we need not only more data but better data. We must be more active in directly measuring the health-related aspects of belonging to these social categories.

Cultural Characteristics↗
PubMed1995

Relationships of patient satisfaction with experience of system performance and health status.

This article investigates the relationship between three types of measures obtained from consumer surveys: satisfaction, health status, and report of systems performance. Analyses demonstrate that patient reports of the quality of processes of care or system performance (such as receiving results of tests or receiving conflicting information from staff members) are significantly related to satisfaction independently of perception of health status. Since dissatisfaction is known to be associated with disenrollment, patient reports of system performance are of great interest to health plans.

Adult↗
PubMed1983

Dental visits and self-assessment of dental health status in the adult Danish population.

The purpose of the present investigation was to study dental visits and self-assessment of dental health status in the adult Danish population. The study group comprised 5151 persons (86.7% of the original sample) who were interviewed in order to determine living conditions. Questions on dental visits and self-assessment of dental health status were included. 61% of the adult Danish population in the age group 20-69 had regular dental visits. Dental visit habits varied according to urbanization, age, sex and social group. Among well off persons 85% had regular dental visits as opposed to only 40% in the disadvantaged social group. Well off persons and persons with regular dental visits more often claimed good dental health than persons in the disadvantaged social group and among the non-regular visitors. In the higher social group 13% reported to have removable dentures in contrast to 51% in the disadvantaged social group. To isolate determinants of dental visits a multiple dummy-regression analysis was performed. Nearly 50% of the variation in dental visit habits was explained by the variables: urbanization, sex, age, perceived dental health status, education, work in exhausting jobs, income, social background and perceived psychological problems. Efforts to bring a greater part of the adult population in Denmark in contract with the dental health service system should consider these findings.

Adult↗
PubMed1984

Dental visits and self-assessment of dental health status in the adult Danish population.

The purpose of the present investigation was to study dental visits and self-assessment of dental health status in the adult Danish population. The study group comprised 5151 persons (86.7% of the original sample) who were interviewed in order to determine living conditions. Questions on dental visits and self-assessment of dental health status were included. 61% of the adult Danish population in the age group 20-69 had regular dental visits. Dental visit habits varied according to urbanization, age, sex and social group. Among well off persons 85% had regular dental visits as opposed to only 40% in the disadvantaged social group. Well off persons and persons with regular dental visits more often claimed good dental health than persons in the disadvantaged social group and among the non-regular visitors. In the higher social group 13% reported to have removable dentures in contrast to 51% in the disadvantaged social group. To isolate determinants of dental visits a multiple dummy-regression analysis was performed. Nearly 50% of the variation in dental visit habits was explained by the variables: urbanization, sex, age, perceived dental health status, education, work in exhausting jobs, income, social background and perceived psychological problems. Efforts to bring a greater part of the adult population in Denmark in contact with the dental health service system should consider these findings.

Adult↗
PubMedDate not supplied

[Evaluation of health status using Survey SF-36: preliminary results in Mexico].

OBJECTIVE: To establish a multidimensional profile of the health status in a population of southeastern Mexico and analyze the psychometric properties of a translation of the SF-36 survey authorized by the International Quality of Life Assessment Project. MATERIAL AND METHODS: The SF-36 was administered to 257 volunteers of a clinic and a control group in a governmental institution. The methodology proposed by the author of the survey to build the health scales was used without modifications. The validity and reliability of the SF-36 adaptation to Mexico was psychometrically analyzed. RESULTS: Eight scales or health concepts related to physical function, physical role, body pain, general health, vitality, social function, emotional role and mental health were constructed. In the health service volunteers, the scale with the lowest mean was general health (63), and that with the highest (89) was physical role. In the control population, the lowest mean was general health (73) and the highest (94.6) was physical function. A comparison of the health scales of both groups showed significant differences in physical function, physical role, body pain, general health and vitality. CONCLUSIONS: Based on the psychometric evaluation, the SF-36 shows satisfactory consistency with its supposed validity and reliability, although the translation of certain items will be further analyzed for subsequent modifications.

Adolescent↗
PubMed2000

An empirical test of the validity of the Oral Health Status Index (OHSI) on a minority population.

Disease varies in different populations based on sociodemographic variables, and there is limited understanding of this interaction. The purpose of this methodological study was to determine the validity of the Oral Health Status Index, a disease-based index, on a Hispanic population by comparing it with the NIDCR epidemiological measures of disease, with the addition of demographic and behavioral variables. The epidemiologic data were collected according to the criteria defined by the NIDCR, including: a modified Decayed Missing Filled Surfaces Index, gingival inflammation, calculus, and destructive periodontal disease measures. The demographic and behavioral variables were gathered from 240 interviews with Hispanic adults in two community clinics. Bivariate analysis was used to determine relationships between the descriptive epidemiologic, demographic, and behavioral variables and the Oral Health Status Index (OHSI). There were statistically significant differences (p < 0.05) in mean OHSI scores among the demographic variables age, education, income, and place of birth; and the behavioral variables alcohol consumption, flossing, and acculturation. Multiple regression analysis with the OHSI as the dependent variable showed that the statistically significant (p < 0.001) epidemiologic predictors were: percentage of Decayed Teeth/Decayed, Filled Teeth; Number of Replaced Teeth/Missing Teeth; and millimeters of mesial attachment loss. These collectively explained 47.49% of the variance in the regression. The addition of demographic variables to the epidemiologic regression identified age (p < 0.05), gender (p < 0.01), and place of birth (p < 0.01) as significant predictors that explained an additional 4.12% of the variance, collectively bringing the total explained variance to 51.61%. The behavioral variables did not contribute significantly to predicting the OHSI regression score. The Oral Health Status Index in this study is validated by its correlation with both the epidemiologic measures and the demographic variables. This combination of variables separated the Hispanics into Mexicans and Central/South Americans.

Acculturation↗
PubMed2003

Melatonin improves health status and sleep in children with idiopathic chronic sleep-onset insomnia: a randomized placebo-controlled trial.

OBJECTIVE: To investigate the effect of melatonin treatment on health status and sleep in children with idiopathic sleep-onset insomnia. METHOD: A randomized, double-blind, placebo-controlled trial was conducted in a Dutch sleep center, involving 62 children, 6 to 12 years of age, who suffered more than 1 year from idiopathic chronic sleep-onset insomnia. Patients received either 5 mg melatonin or placebo at 7 pm. The study consisted of a 1-week baseline period, followed by a 4-week treatment. Health status was measured with the RAND General Health Rating Index (RAND-GHRI) and Functional Status II (FS-II) questionnaires. Lights-off time, sleep onset, and wake-up time were recorded in a diary, and endogenous dim light melatonin onset was measured in saliva. RESULTS: The total scores of the RAND-GHRI and FS-II improved significantly more during melatonin treatment compared to placebo. The magnitude of change was much higher in the melatonin group than in the placebo group, with standardized response means for the RAND-GHRI of 0.69 versus 0.07 and for the FS-II of 1.61 versus 0.64. Melatonin treatment also significantly advanced sleep onset by 57 minutes, sleep offset by 9 minutes, and melatonin onset by 82 minutes, and decreased sleep latency by 17 minutes. Lights-off time and total sleep time did not change. CONCLUSIONS: Melatonin improves health status and advances the sleep-wake rhythm in children with idiopathic chronic sleep-onset insomnia.

Antioxidants↗
PubMed1992

Determinants of perceived health status of medical outpatients.

The aim of this study was to examine the relative contributions made by medical morbidity, psychiatric disorder, functional status, and hypochondriacal attitudes to medical patients' opinions of their overall health status. The study was conducted in the general medical clinic of a large academic teaching hospital. Consecutive clinic visitors on randomly selected days were screened with a hypochondriasis self-report questionnaire, since the overall project was designed as a study of hypochondriasis. A random sample of the patients below a pre-established cutoff (n = 100), along with all those exceeding the cutoff (n = 88), returned to undergo a research battery. For this analysis, a representative sample of the entire clinic was reconstituted by weighting the data from patients above and below the screening cutoff in proportion to their prevalence in the clinic. Measures of psychiatric disorder (the Diagnostic Interview Schedule), personality disorder, functional status and disability, medical morbidity (from physician ratings and medical record audit), and hypochondriacal attitudes were obtained. Patient self-ratings of global health status were significantly correlated with aggregate medical morbidity (r = 0.36; P less than 0.001); psychiatric morbidity (r = 0.48; P less than 0.001); functional disability (for intermediate activities of daily living, r = 0.62; P less than 0.001); hypochondriacal attitudes (r = 0.79; P less than 0.001); and with the tendency to somatize (r = 0.77; P less than 0.001). Using multiple regression analysis, the most powerful correlates of perceived global health were hypochondriasis, somatization and disability (model R2 = 0.762).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed2000

Association of patients' perception of health status and exercise electrocardiogram, myocardial perfusion imaging, and ventricular function measures.

BACKGROUND: Patients' viewpoint of their health status is increasingly used as an important outcome measure of the success of treatments. Because clinicians rarely formally measure patients' health-related quality of life, the question arises whether noninvasive testing for ischemia can provide similar information regarding physical functioning and general health perception. METHODS: We measured physical functioning and general health status with the Medical Outcomes Study Short Form (SF-36) survey in 195 consecutive patients (68% male, mean age 55.6 +/- 11.1 years) referred for exercise testing with myocardial perfusion imaging. The survey was completed immediately before the exercise test. RESULTS: In the multivariate analysis, the strongest predictor of physical functioning and general health perception was metabolic equivalents. However, the best model, including demographic, clinical, and test variables, predicted only 14% of the variation in physical functioning and 10% of the variability in general health perception. CONCLUSIONS: The variation in physical functioning and general health perception, as measured by the SF-36, among patients referred for exercise testing is not predicted well by the results of the test. As expected, several test results are significantly associated with physical functioning and general health perception; however, there was substantial overlap among individual patients, suggesting that the parameters are poor surrogates for the actual assessment of the domains. If these domains are deemed important to tracking patient outcomes, then they should supplement the current assessments of these patients.

Adult↗
PubMed1997

Determination of future health status expectation in rheumatoid arthritis.

While examining the relationship between, neuroticism, somatic factors and future health status expectation in rheumatoid arthritis (RA) patients, the present study found a considerable level of pessimism in patients, which may be related to perceived limitation of the quality of life. However, psychosocial disposition (i.e., neuroticism) did not prove to be a crucial factor by which RA patients assessed their future health status expectation. These results may be important in future treatment procedures.

Aged↗
PubMed2002

Effects of systematic nursing instruction of mothers on using medication and on health status of asthmatic children.

The purpose of this study was to investigate the effects of systematic nursing instruction for mothers of children with asthma on their knowledge of the medication, ability to use inhalation devices, self-efficacy of medication use, and on children's health status. A quasi-experimental study was conducted at the Pediatric Allergy Clinic of a major academically based medical center in Taipei, Taiwan. The sample consisted of 82 mothers and their children recruited by purposive sampling. The intervention group (n = 41) received systematic nursing instruction from the researchers and the control group (n = 41) received regular nursing care from staff nurses. The effects of systematic nursing instruction were evaluated two months later using four questionnaires: the mother's knowledge of medication, inhaling steps, self-efficacy of medication use, and child's health status. The results of this study showed that systematic nursing instruction of mothers of children with asthma significantly improved their knowledge of the medication, ability to use inhalation devices, and self-efficacy, as well as decreasing the number of episodes of respiratory disease of children over a two month period. To sum up, these findings demonstrate that systematic nursing instruction of mothers about asthma medication not only benefited mothers directly, but also improved children's health status indirectly.

Adult↗
PubMed1994

Measuring functional health status in primary care using the COOP-WONCA charts: acceptability, range of scores, construct validity, reliability and sensitivity to change.

BACKGROUND: The COOP-WONCA charts comprise six scales designed to measure functional health status in primary care. AIM: A study was undertaken to describe the acceptability, distribution of chart scores, construct validity, test-retest reliability and sensitivity to change when these charts were used in the United Kingdom. METHOD: For acceptability, distribution of scores and construct validity, data were obtained from 100 consecutive consulting patients aged 16 years and over and 100 non-consulting age-sex matched individuals from one general practice. In order to examine reliability and sensitivity to change, both groups were followed up two weeks later. RESULTS: Regarding acceptability, four patients refused to complete the charts during the initial recruitment of the consulters; 74 out of 100 non-consulters returned the first postal questionnaire. The follow-up questionnaire was returned by 68 out of 100 consulters and 57 out of 74 non-consulters. Overall distributions of scores demonstrated reasonable variation. Regarding construct validity, differences between the consulters and non-consulters were all in the anticipated direction and reached statistical significance for three of the six charts. For reliability, the proportion of non-consulters whose scores were unchanged ranged from 56% to 73%. For those whose scores changed, the differences were small and evenly balanced. For sensitivity to change, the proportion of consulters whose scores altered ranged from 45% to 59% with mean changes all indicating improvements in health. There were larger changes for patients consulting about acute problems than for those with chronic problems. CONCLUSION: It appears that the charts were acceptable, with reasonable distributions of scores and evidence of construct validity. Moderate levels of reliability and sensitivity to change were demonstrated. This study suggests that the COOP-WONCA charts are suitable for measuring functional health status in primary care in the UK.

Adolescent↗
PubMed1997

Influence of proxy respondents and mode of administration on health status assessment following central nervous system tumours in childhood.

Central nervous system (CNS) tumours account for 20% of childhood cancers. Survivors often experience severe physical, neuropsychological and social sequelae of the disease and its treatment. Health status assessment in these individuals is an essential clinical outcome measure, yet little consensus exists regarding the optimum methodology. The influence of proxy respondents (parents, physiotherapists and doctors) and mode of administration (home and clinic) in which assessments is performed has been evaluated in a cohort of 37 survivors of childhood CNS tumours. A health-related quality of life (HRQOL) questionnaire, incorporating the Mark II and III Health Utilities Indices, was completed at home and in clinic by patients and parents. Doctors and physiotherapists completed this questionnaire plus Lansky Play-Performance and Karnofsky Performance scores. No significant differences between raters for single attribute scores occurred either at home or in clinic, although a wide range of agreement (kappa = 0.05-1.00, percentage agreement 53-100%) between observers was revealed. Most agreement occurred between parents and patients: this was greatest on home completion (kappa = 0.48-1.00, percentage agreement 53-100%). Doctors and physiotherapists agreed less on subjective attributes (emotion, cognition and pain). Better if responses were classified as normal and abnormal. Inter-observer agreement was greater for the HRQOL questionnaire than for Karnofsky and Lansky scores. Home completion of questionnaires provides a reliable, acceptable and convenient method of assessing health status.

Adolescent↗
PubMed1991

[Towards a better health status in pig farming].

UNLABELLED: The Dutch pig-farming industry is on the verge of sweeping changes due to national and European legislation and changes towards a buyers market. An improved health-status is a necessity. Such improvements must fall in line with changes in the industry. This paper presents the characteristics of primary, secondary and tertiary infectious disease, and methods by which improvements can be achieved. These are: stamping out; systematic vaccinations; systematic pre-medications; improved husbandry; in-line production; breeding for improved disease-resistance; the SPF system; and Early Medicated Weaning. In the Dutch pig-farming industry the number of farms will decrease to approx. 10,000. These farms will be organised in vertically integrated production systems. IN CONCLUSION: improvement of the national pig-health status is acquired through vertically integrated production systems under improved husbandry conditions. Particular infectious microorganisms will be banned through EEC regulations; other diseases will be minimised by vaccination. Selection for disease-resistance will contribute to some extent to an improved health-status in the future.

Animal Husbandry↗