Aspects Of Health Status Research Articles

Modelling the Non-linear Associations between Age and Health: Implications for Care

Abstract Background Ageing is a complex biological process that weakens the body's defences against various health problems and diseases. This decline is not uniform or linear; rather, it varies significantly among individuals. Understanding the non-linear progression of ageing is crucial for identifying critical periods where intervention might be most beneficial. This study aimed to explore nonlinearities in the association between age and health outcomes. Methods Using generalised additive models, we analysed data from the 2020 wave of the United States Health and Retirement Study. This modelling approach allows for the detailed examination of nonlinearities in health outcomes across different ages. Our sample consisted of adults aged over 50 (n = 1338; mean = 68; range = 50 – 95). We assessed seven health outcomes (heart conditions, diabetes, cholesterol, blood pressure, fatigue, back pain, and headaches) and seven protective behaviours (prostate exams, mammograms, cholesterol screenings, pap smears, flu vaccinations, dental check-ups, and smoking patterns) reflecting various aspects of health status and behaviour. Results The analysis indicated a significant and pronounced non-linear relationship between age and certain health outcomes, namely headaches, blood pressure, diabetes, and heart conditions. Additionally, ageing was non-linearly associated with specific health behaviours, including the uptake of prostate exams, mammograms, flu vaccinations, and smoking prevalence. Notably, distinct patterns emerged concerning health behaviours in relation to age-specific screening policies. Conclusion The findings of this study reveal that the probability of developing health problems or engaging in health protective behaviours do not increase/decrease linearly in direct proportion to age. Rather, the probability curve exhibits fluctuations, presenting periods of heightened odds interspersed with phases of relative stability. Such non-linearity may be partially attributed to policy decisions but could also reflect a complex interplay of factors such as weakened immune systems, access to healthcare, personal health beliefs, and the evolving perception of risk as one grows older.

The Tools for Integrated Management of Childhood Illness (TIMCI) study protocol: a multi-country mixed-method evaluation of pulse oximetry and clinical decision support algorithms.

Effective and sustainable strategies are needed to address the burden of preventable deaths among children under-five in resource-constrained settings. The Tools for Integrated Management of Childhood Illness (TIMCI) project aims to support healthcare providers to identify and manage severe illness, whilst promoting resource stewardship, by introducing pulse oximetry and clinical decision support algorithms (CDSAs) to primary care facilities in India, Kenya, Senegal and Tanzania. Health impact is assessed through: a pragmatic parallel group, superiority cluster randomised controlled trial (RCT), with primary care facilities randomly allocated (1:1) in India to pulse oximetry or control, and (1:1:1) in Tanzania to pulse oximetry plus CDSA, pulse oximetry, or control; and through a quasi-experimental pre-post study in Kenya and Senegal. Devices are implemented with guidance and training, mentorship, and community engagement. Sociodemographic and clinical data are collected from caregivers and records of enrolled sick children aged 0-59 months at study facilities, with phone follow-up on Day 7 (and Day 28 in the RCT). The primary outcomes assessed for the RCT are severe complications (mortality and secondary hospitalisations) by Day 7 and primary hospitalisations (within 24 hours and with referral); and, for the pre-post study, referrals and antibiotic. Secondary outcomes on other aspects of health status, hypoxaemia, referral, follow-up and antimicrobial prescription are also evaluated. In all countries, embedded mixed-method studies further evaluate the effects of the intervention on care and care processes, implementation, cost and cost-effectiveness. Pilot and baseline studies started mid-2021, RCT and post-intervention mid-2022, with anticipated completion mid-2023 and first results late-2023. Study approval has been granted by all relevant institutional review boards, national and WHO ethical review committees. Findings will be shared with communities, healthcare providers, Ministries of Health and other local, national and international stakeholders to facilitate evidence-based decision-making on scale-up.Study registration: NCT04910750 and NCT05065320.

Health-related quality of life in persons with haemophilia in Afghanistan.

Haemophilia is the most common severe congenital bleeding disorder and can significantly influence patients' quality of life. The health-related quality of life (HRQoL) is a multi-dimensional concept that assess effect of different aspects of health status, including physical, mental, and social domains. Identification of the factors affecting the HRQoL of Persons with Haemophilia (PWH) can guide health care system to better management of patients. The aim of the present study is to evaluate HRQoL in PWH in Afghanistan. This cross-sectional study was conducted on 100 PWH in Kabul City, Afghanistan. Data were collected using 36-Item-Short-Form Health Survey (SF-36) questionnaire and analysed using correlation coefficients and regression analysis. The mean scores for the SF-36 questionnaire 8 domains range from 33±38.3 to 58.15±20.5. The highest mean value belongs to physical function (PF) (58.15), whereas the lowest is related to restriction of activities due to emotional problems (RE) (33.00). A significant association (p<.005) was observed between all domains of SF-36 and patients' age except for PF (p=.055) and general health (GH) (p=.75). A significant association was also observed between all HRQoL domains and the severity of haemophilia (p<.001). The severity of haemophilia was the significant predictor for Physical Component Summary (PCS) and Mental Component Summary (MCS) (p<.001). Due to the reduced HRQoL in Afghan PWH, special attention by health care system should be paid to improve patients' quality of life.

Comparative evaluation of the health utilities index mark 3 and the short form 6D: evidence from an individual participant data meta-analysis of very preterm and very low birthweight adults

BackgroundThe most appropriate preference-based health-related quality of life (HRQoL) instruments for trials or research studies that ascertain the consequences of individuals born very preterm and/or low birthweight (VP/VLBW) are not known. Agreement between the HUI3 and SF-6D multi-attribute utility measures have not been previously investigated for VP/VLBW and normal birthweight or term-born controls. This study examined the agreement between the outputs of the HUI3 and SF-6D measures among adults born VP/VLBW and normal birthweight or term born controls.MethodsWe used two prospective cohorts of individuals born VP/VLBW and controls contributing to the ‘Research on European Children and Adults Born Preterm’ (RECAP) consortium which assessed HRQoL using two preference-based measures. The combined dataset of individual participant data (IPD) included 407 adult VP/VLBW survivors and 367 controls, ranging in age from 18 to 26 years. Bland–Altman plots, intra-class correlation coefficients, and generalized linear mixed models in a one-step approach were used to examine agreement between the measures.ResultsThere was significant discordance between the HUI3 and SF-6D multi-attribute utility measures in the VP/VLBW sample, controls, and in the combined samples. Agreement between the HUI3 and SF-6D multi-attribute utility measures was weaker in controls compared with VP/VLBW individuals.Conclusions and relevanceThe HUI3 and SF-6D each provide unique information on different aspects of health status across the groups. The HUI3 better captures preterm-related changes to HRQoL in adulthood compared to SF-6D. Studies focused on measuring physical or cognitive aspects of health will likely benefit from using the HUI3 instead of the SF-6D, regardless of gestational age at birth and birthweight status.

Impact of Socioeconomic Determinants on Infant Mortality in Pakistan

The recent study was carried out to estimate the impact of socioeconomic, demographic and the aspect of health status on child mortality in Pakistan. The data for the study was collected from the PSLM (Pakistan Social and Living Standard measurement survey) for the year 2011-12. The data were analyzed through cross-tabulation and binary logistic model using MLE (Maximum likelihood estimation) technique. Overall, 13216 households were selected for the analysis. The result of the study of the cross-tabulation shows that the overall child mortality was low in Baluchistan province, the maximum number of children survived in Punjab province further, and the child mortality was low in an urban area where 290 children died out of 3984 houses as compared to rural area household in Pakistan. Child mortality was high among females than males in Pakistan. The result of binary logistics shows that out of the total independent variable, nine variables significantly affect child mortality in Pakistan, location of the household, gender, education of father, education of mother, income and mother feeding, positively associated the infant mortality; all these aspects reduce the chance of child mortality, while there was a less likely chance that child survives in Punjab, Sindh as compared to KPK in Pakistan. In the case of Baluchistan, there was also the same situation as KPK in terms of child mortality. Infant mortality was high in female children compared to male children, which means there is a less likely chance of surviving among the female child than the male child. All other variables were insignificant in Pakistan. It is suggested that the central authority provide basic children and mothers health facilities at minimum cost to the rural areas of Pakistan.

The Importance of School Leaders' Attitudes and Health Literacy to the Implementation of a Health-Promoting Schools Approach.

Schools are considered as important settings for health education and the promotion of functioning, healthy people. Health-promoting schools (HPS) take a holistic approach to health promotion that addresses all school levels and members of the school community. Although it is assumed that school leaders are crucial in the implementation of HPS, little is known so far about which specific factors are relevant. The purpose of this study was to analyze the role of school leaders' attitudes, health literacy, and health status in HPS implementation. An online survey was conducted in June 2021, and the final sample consisted of N = 358 school leaders. Regression and moderation analyses were conducted to answer the research questions. The results showed the relevance of health literacy and attitudes toward HPS for the implementation of HPS. By contrast, only some aspects of health status are relevant. Attitudes toward HPS moderate the effect of health literacy on HPS implementation, with positive attitudes toward HPS amplifying the effect. Implications for practice and future research are discussed.

The effects of curcumin-containing supplements on inflammatory biomarkers in hemodialysis patients: A systematic review and meta-analysis.

In the past decade, the effect of curcumin or turmeric supplementation on many aspects of health status in different populations has been evaluated. In the present study, a systematic review and meta-analysis were conducted to estimate the effect of curcumin administration on inflammatory markers in hemodialysis (HD) patients. A systematic search was performed in MEDLINE, EMBASE, Scopus, and Clarivate Analytics Web of Science databases from 1997 until June2022 for terms related to curcumin/turmeric and hemodialysis (HD). Randomized, double-blind/single-blind studies examining the effects of curcumin/turmeric on the inflammation of HD participants older than 18 years were considered eligible for inclusion. Data were pooled using the weighted mean difference (WMD) and 95% CI as the summary statistic, considering a random-effects analysis model. The data that were pooled from nine studies with 472 patients indicated that curcumin-containing supplement had significant effect on serum C-reactive protein (CRP) levels (WMD=-3.3mg/L; 95% CI: -5.4 to -1.3; p< 0.001, I2 = 76.7%, 8 studies, 467 participants), and interlukine-6 (IL-6) levels (SMD: -0.4; 95% CI: -0.8 to -0.07; p= 0.02, I2 = 31.6%, 3 studies, 153 participants) compared control group. Although curcumin intervention could not change tumor neurosis factor-α (TNF-α) concentration (SMD=-0.3; 95% CI: -0.7 to 0.04; p= 0.08, I2 = 25.3%, 3 studies, 153 participants), when compared with the placebo group. Our study's main limitations were small number of studies, overall high risk of bias in the included trials, and high heterogeneity in some results. The present meta-analysis suggested that intervention with curcumin-containing supplements was associated with a significant reduction in serum hs-CRP and IL-6 concentrations in HD patients. The curcumin intervention in the reduction of hs-CRP levels was greater than the minimal clinically important difference (MCID) for CRP (0.5mg/L), which can be helpful in physicians' clinical decisions.

Decoding health status transitions of over 200 000 patients with traumatic brain injury from preceding injury to the injury event

For centuries, the study of traumatic brain injury (TBI) has been centred on historical observation and analyses of personal, social, and environmental processes, which have been examined separately. Today, computation implementation and vast patient data repositories can enable a concurrent analysis of personal, social, and environmental processes, providing insight into changes in health status transitions over time. We applied computational and data visualization techniques to categorize decade-long health records of 235,003 patients with TBI in Canada, from preceding injury to the injury event itself. Our results highlighted that health status transition patterns in TBI emerged along with the projection of comorbidity where many disorders, social and environmental adversities preceding injury are reflected in external causes of injury and injury severity. The strongest associations between health status preceding TBI and health status at the injury event were between multiple body system pathology and advanced age-related brain pathology networks. The interwoven aspects of health status on a time continuum can influence post-injury trajectories and should be considered in TBI risk analysis to improve prevention, diagnosis, and care.

Association between different outcomes of students’ health status, health behavior &amp; health literacy

Abstract Background Next to classic full-time studies, a significant part of students of universities of applied (UAS) chooses part-time or dual study formats leading to double burden and higher stress levels. Up to now, the impact of different study formats on student's health status (HS) and health behavior (HB) has not been analysed in the context of UAS comprehensively. Also, the role of health literacy (HL) is not sufficiently investigated (Bai et al., 2019; Krüsmann, 2019; Plotnikoff et al., 2019). The primary aim of the study is to collect associated data on various aspects of HS, HB and HL of UAS students. Methods The prospective cohort study collects data on HS, HB and HL every semester from winter semester 20/21 to 22/23. HS is operationalized with stress level (SL), sleep quality (SQ) and life-study-satisfaction (LSS). HB included physical activity (PA), screen-time (ST) nutrition (NU), smoking, drinking and drug-use behavior (SDB); HL was assessed with the HLS-EU-Q16. At t1 n = 295 students (n: ♂=213; ♀=82; age∅=28,8 (SD = 8,49) could be included. Results Analysis revealed that all HS-domains correlated significantly with all HL (Range: r=.14** to .31**) and most HB-scores (NU: r=.22** to .35**; ST: r=.15** to .28**). PA correlated significantly with most HS-scores (r=.13** to .29**), but not with HL. Also, no correlations could be found between SQ, SDB and HS, HB and HL. With regard to gender difference, female students show significantly lower SDB (t = 4,38***), higher SL (t=-3,92***) and ST (t = 3,99***). Also, NU (R2 =, 30***; F = 27,21; f2 =, 32) and PA (R2 =, 34***; F = 17.9; f2 =, 37) reveal a strong explanation of variance of HS. Conclusions HS, HB and HL are complex dimension of students' health. The results indicate that HL AS a major impact on overall HS, but not necessarily on all HB-scores such as PA. Health promoting interventions should consider these findings on HS, HB and HL and target specific groups with individualized interventions. Key messages Health literacy plays an important role in students’ health, but is not linked to physical activity as a health behavior. Student health promotion should be target group specific and focus on different aspects of health behaviours.

Aspects of Health Status in Pre-Sedentism Populations of Southwestern Asia

The Qafzeh site in Lower Galilee yielded a unique set of early modern Homo sapiens skeletal remains dated to ca. 100 ka BP and represents all age categories from perinatal to adulthood. Numerous and varied developmental abnormalities, dental and bone lesions, are reported that provide insights into life history among these Middle Palaeolithic nomadic hunter-gatherers from Southwestern Asia. Several pathological conditions affecting young subadults enable us to understand childhood mortality in past human populations. In addition, other skeletal variations provide information related to social care and funerary practices among the inhabitants at Qafzeh, ca. 100 ka BP.

The Pattern and Causes of Neonatal Mortality in a Tertiary Hospital in the Southwest of Nigeria

Background: The neonatal mortality rate remains high in developing countries despite the significant reduction in under-five mortality globally. Therefore, periodic evaluations on the causes of mortality are an aspect of health status, which could be performed to improve the neonatal mortality rate. Objectives: The present study aimed to determine the pattern and causes of neonatal mortality in the Federal Medical Center in Owo, Ondo State, Southwest Nigeria. Methods: This retrospective study was conducted using the hospital records of the neonates admitted over a five-year period from 1st of January 2015 to 31st of December 2019. Results: In total, 2,065 neonates were admitted, including 208 cases of neonatal deaths. Mortality occurred in 127 males (61.1%) and 81 females (38.9%), with the male-to-female ratio of 1.6:1. Among the recorded deaths, 114 cases (54.8%) occurred within the first 24 hours of admission, while 94 neonates (45.2%) died after 24 hours of admission. In addition, the mortality rate was higher among outborn neonates (n = 120; 57.7%) compared to inborn neonates (n = 88; 42.3%). The major causes of neonatal deaths included birth asphyxia (46.6%), prematurity (23.1%), and sepsis (17.8%). The overall mortality rate over the five-year period was 10.1%, which is equivalent to 19 deaths per 1,000 live births. Conclusions: According to the results, preventable diseases such as birth asphyxia, prematurity, and sepsis remain the major causes of neonatal mortality, of which neonatal deaths occur mostly within 24 hours of admission.

Relationship between aspects of health status and quality of life among widow elderly women

The study was conducted in five cultural zones of Haryana state. For the rural sample 400 widow elderly women of age group 60-75 years were selected. Quality of life scale developed by World Health Organization (1997) was accessed to quality of life of widow elderly women. The questionnaire short form-36 health survey by Mchorney (1993) was used to assess the health status of widow elderly women. Clearly shows that relationship between aspects of perceived health status and quality of life among widow elderly women. Physical aspects of quality of life was positively significantly correlated with vitality (r =0.13**, p 0.01), body pain (r =0.39**, p 0.01), physical role functioning (r= 0.23**, p 0.01) , mental health ((r =0.10*, p 0.01) negatively significantly correlated with general health perception (r = -0.17**, p 0.01) and emotional role functioning (r = - 0.28**, p 0.01). Psychological aspects of quality of life was positively significantly correlated with physical functioning (r =0.13**, p 0.01) and body pain (r =0.10*, p 0.05). Another aspects social relationship of quality of life was negatively significantly correlated with physical functioning (r = -0.18**, p 0.01), body pain (r = -0.12**, p 0.01) and social role functioning (r = -0.11**, p 0.01), Physical role functioning, Emotional role function was negatively correlated with (r = 0.28**, p 0.01). Further aspects of environment was positively significantly correlated with vitality (r = 0.09*, p 0.05), Physical Functioning (r = 0.46**, p 0.01), body pain (r = 0.14**, p 0.01), General health perception (r = 0.30**, p 0.01) and physical role functioning (r = - 0.09*, p 0.05).

Influence of participation in multiple school-based health promotion programmes on students’ health

Objective: The objective of this study was to investigate the impact of experiencing diverse, multi-dimensional health promotion programmes in school on students’ self-reported health status. Design: Cross-sectional design. Methods: We surveyed 2,568 students from 15 middle schools and 15 high schools in Korea between August 2014 and January 2015. Self-reported information related to health status, attendance at physical, social, mental or spiritual health promotion programmes, and socio-demographics was collected and analysed. Results: Male students, students aged 15 and below, and students living in rural areas were more satisfied with their health status. Regardless of programme type, the number of health promotion programmes attended correlated positively with better overall health status ( p &lt; .001–.032). Attending physical health promotion programmes was significantly associated with physical, mental, spiritual and overall health (adjusted odds ratio [aOR] = 1.28–1.40). Attending mental health programmes was significantly related to all aspects of health status (aOR = 1.49–2.17), and participating in social health programmes was significantly related to all aspects of health status except physical and social health (aOR = 1.36–1.67). Participation in spiritual health programmes was related to spiritual and overall health (aOR = 1.33, 1.58). In hierarchical regression analyses, health promotion programme attendance was independently associated with subjective health status after controlling for differences between schools. Conclusion: Participation in health promotion programmes was found to be related not only to the targeted health status but also to other aspects of subjective health.

Physical, mental, and physiological health benefits of green and blue outdoor spaces among elderly people

ABSTRACT This study investigated the influence of designed natural outdoor spaces and space type on the physical, mental, and physiological health status of elderlies. A total of 978 questionnaires were distributed among a population-based randomized sample of elderlies residing in Bandar Abbas city, Iran. Blue space users reported better health status. Park access was associated with physical and physiological health. Those participants who had cardiovascular diseases were more likely to visit the parks more often, while the people with hypertension visited the parks less often. Length of park stay positively was associated with all aspects of health status. In addition, the level of physical activity positively was associated with physical and mental health. The park organizations should work on establishing parks in shorter distances and consider the opportunity for elderlies to participate in social programs to encourage them to frequently visit the parks and increase their length of park stay.

Self-management in condition-specific health: a systematic review of the evidence among women diagnosed with endometriosis

BackgroundEndometriosis is a chronic condition, requiring long-term care as there is no cure. Self-management is the active participation of a person in managing their chronic condition and has been associated with improved knowledge, self-efficacy, performance of self-management tasks and some aspects of health status in interventions for other chronic diseases. The aim was to review the available evidence about the impact of self-management on condition-specific health among women with endometriosis.MethodsThe Medline, PsycINFO, CinahlPlus, Web of Science and Scopus databases were searched and PRISMA guidelines were followed. Search terms were entered both as keywords and mapped to individual database subject headings. Inclusion criteria were: papers that reported investigations of any approach to self-management; among women (at least 18 years) diagnosed with endometriosis and published in English in a peer-reviewed journal. All study designs using quantitative or qualitative methods were eligible for inclusion. Two reviewers independently examined the quality of studies using standard criteria. The systematic review was registered with Prospero (CRD42016042028).ResultsA total of 1164 records were identified (after duplicates were removed), and 27 papers, reporting 19 studies met inclusion criteria. Two papers reported findings from RCTs of complementary therapies, seven reported survey data and 18 qualitative studies. No study had investigated all elements of self-management. Women with endometriosis utilise a range of self-care activities and complementary therapies to assist them to manage their symptoms. Women reported both positive and negative experiences with health care providers.ConclusionsThere is some evidence that self-care activities, complementary therapies and positive patient–healthcare provider relationships are important components of self-management for endometriosis. Self-management among women with endometriosis is an emerging field of research and no investigations of all elements of self-management, informed by a comprehensive definition and theoretical framework are available. Health and wellbeing outcomes and barriers and facilitators to self-management for women with endometriosis require further investigation.

Assessment of quality of life among elderly population of rural areas of Etawah district: a cross sectional study

Background: All the aspects of health status, lifestyle, life satisfaction, mental health and well-being together reflects the multidimensional nature of quality of life (QOL) in an individual. The objective of the study was to assess the quality of life among rural elderly population of Etawah district and their association with various socio demographic factors.Methods: A community based cross-sectional study was conducted among 316 elderly subjects in rural areas of Etawah district. QOL was assessed by using WHOQOL-OLD tool. Socio-demographic factors were assessed by using a self-structured questionnaire. Data was analysed by using Microsoft Excel 2010 and statistical software SPSS-22. Transformed facet sore were calculated using WHOQOL- OLD manual and Independent sample t- test were applied.Results: Majority (86%) were in the (≤75) years of age. Among the study participants, 52.8% were females, 67.5% were illiterate, 72.5% belong to nuclear family. The mean scores of QOL domains was maximum in death and dying (83.20), followed by sensory ability (62.99).The lowest mean score was seen Intimacy domain (22.80). Gender, type of family, financial status and staying with partner were found to be the determinants of better QOL (p&gt;0.05).Conclusions: The mean quality of life score was below average in intimacy domain. It was maximum in death and dying domain.

Hygienic and clinical functional aspects of health status in phthalate production

Introduction. Polyesters of terephthalic acids are major products of organic synthesis, widely used in various industries: for packing materials production, including those for foods and medicaments. Polyesters of terephthalic acids are stable chemicals and highly toxic with cumulative eff ects. Phthalates production requires further studies. Objective. To determine hygienic and clinical functional aspects of workers’ health formation in phthalates production. Materials and methods. Special clinical functional study covered workers who first started work activity in production of terephthalic acids, purified terephthalic acid and polyethylene terephthalate over 5 years of JSC “POLYEF” exploitation. Hematologic, cytochemical, biochemical and immunologic studies covered workers with primary 5-year service in the production. Hygienic evaluation covered work conditions of workers engaged into production of terephthalic acid polyesters. Results. Th e work conditions are characterized by increased level of terephthalic acids from 1.5 to 2.8 MACs. By 5 years of service, most the workers demonstrate anemia, reticulocytosis, thrombocytopenia, eosinophilia, lymphocytosis, lower enzymatic activity. Investigations also covered the most marked and early changes in cardiovascular, nervous systems, ENT organs, locomotory system and connective tissue. Major factors infl uencing the stated disorders are acting concentrations of terephthalic acid, exceeding MAC 1.5–2.8 times; character of infl uence caused by complex of chemicals with acute and unidirectional action; occupational noise exceeding MAL of 5–21 dBA. Conclusions. General principles of occupational factors action: anemic syndrome; polymorphic regulatory disorders of metabolism; sensitization, allergization; formation of secondary immune defi ciency of cytopenia type; vegetative vascular disorders — the most fr equent and early syndrome of clinical and structural health disorders; locomotory disorders caused probably by phthalates toxicity; upper respiratory tract disorders (summarized eff ects of chemical irritants); specifi c changes associated with increased noise parameters (vegetative disorders, hypertension, neurosensory deafness, etc.).

Effect of Lifestyle Modification Intervention on Health Status of Coronary Artery Disease Patients: Randomized Control Trial

Background: Coronary artery disease is a major cause of morbidity and mortality throughout the world. Modification of life style can be achieved by patients' education to improve their health status. Aim: To evaluate effect of lifestyle modification intervention on health status of coronary artery disease patients. Design: Randomized control trial used to achieve the aim of this study. Setting: The current study conducted at the coronary care unit and cardiology out-patient clinics of Benha University Hospital, Benha City. Subjects: Purposive sample of 92 coronary artery disease patients (study and control) were included in the study. Tools: Two tools used in this study 1) Interview questionnaire. 2) Health status questionnaire. Results: Significant percentage of the study participants from both groups were adhered to unhealthy life-style practices as smoking, eating salty and fatty foods, drinking tea and coffee as well as they didn't practice exercises and recreational activities. After lifestyle modification intervention, there were significant statistical differences between the two groups favoring the study group regarding all aspects of health status; physical function, bodily pain, social function, role limitation due to physical or emotional problems and mental health (P&lt;0.05). Conclusion and recommendations: This study concluded that life style modification intervention for coronary artery disease patients is effective and useful for enhancing their health status. This study recommended that coronary artery patients` education should be held in permanent approach, because it is a crucial part of their treatment.

Conceptualizing and measuring health-related quality of life in critical care

IntroductionWhen assessing health-related quality of life (HRQL), critical care outcomes research generally uses generic measures in the absence of a suitable critical care–specific measure. Our aims were to construct a conceptual framework of survivors' HRQL and assess the extent to which the 2 most commonly used generic measures (the Short Form 36 Health Survey and EuroQol-5D) covered the framework. MethodsA preliminary framework for survivors' HRQL was constructed based on a systematic literature review and on a secondary analysis of 40 existing in-depth interviews with adult, critical care survivors. Its adequacy was then tested using new in-depth interviews with a maximum variation sample of critical care survivors. The extent of coverage of the final framework by the 2 generic HRQL instruments was then evaluated in 2 ways: by comparison with critical care survivors' accounts from the new in-depth interviews and by eliciting survivors' views on the adequacy of the 2 generic HRQL instruments using cognitive debriefing. ResultsThe final framework recognized 3 aspects of health status that affected 9 areas of life. The 2 most commonly used generic measures had substantial gaps in their coverage of the framework of survivors' HRQL. ConclusionsThe findings argue strongly for a new critical care–specific HRQL measure.

Association between the diagnosis of atrial fibrillation and aspects of health status: a Danish cross-sectional study.

Caring for patients living with atrial fibrillation (AF) is expected to be an increasing challenge for the healthcare sector in the future. Inconclusive results on self-reported health-related quality of life and health status in patients living with AF have previously been reported, ranging from being similar to those observed in patients who have sustained and survived a myocardial infarction to not being different from those of healthy subjects. In these studies, gender differences were not taken into account. To investigate the association between the diagnosis of atrial fibrillation and self-reported health status. An observational, cross-sectional study was conducted using data from the Danish Diet, Cancer and Health cohort. Information on health status was obtained using the Danish version of the Short Form 36 version 2 questionnaire. The analyses were stratified on gender. In adjusted analysis, we considered potential confounding from comorbidity expressed by the Charlson Comorbidity Index and effect modification by age. The local ethical committees of Copenhagen and Frederiksberg municipalities (Approval no.: (KF) 01-345/93) approved the study. We included 42 598 participants of whom 873 had a diagnosis of AF and/or atrial flutter. We found a lower adjusted physical component score among AF patients. No systematic differences in the mental component score (MCS) were observed. Participants diagnosed with AF report a clinically and statistically significantly lower physical health component score. No systematic differences in the MCS were found when comparing with the remaining participants in the cohort. As healthcare professionals caring for patients living with AF are not always expecting patients living with AF to experience a burden from their disease, the individual patients' experience of their situation, feelings, preferences, symptoms and needs leading to physical limitations should always be articulated.