Initial health status

Changes in perceived physical and mental health status of a schizophrenia patient population following initiation of a conventional or an atypical antipsychotic medication. Poster presented at the American Psychiatric Association Annual Meeting, Toronto, June 1998. 

APACHE II Acute Physiology and Chronic Health Evaluation II a severity of disease classification system using a point score based on initial values of 12 routine physiologic measurements, age, and previous health status used to provide a general measure of disease severity. 

Serious interest in the health status of Adventists initially arose in the late 1950 s as part of a surge of research effort to investigate the health effects of tobacco use. Adventists provide an opportunity to evaluate the risk of smoking-related diseases among a group who reportedly abstain from both tobacco and alcohol. 

Therefore, an economic analysis must measure the quality of life of the patient to ensure that the value of the drug incorporates the patient s perspective. Quality of life is a concept that usually incorporates the physical, mental and social well-being of the patient. Initial doubts concerning the ability of schizophrenic patients to provide reliable and valid reports of their own quality of life led to the use of proxies for patient interviews. Caregivers and clinicians were consulted most often. However, recent research has shown that the use of proxies can produce very different results to those derived directly from the patient s responses. In addition, research now indicates that schizophrenic patients are able to provide stable, reliable and valid self-reports of their psychological well-being, health status and subjective evaluation of drug therapies (Awad et al., 1995). 

As with any decision to initiate an antidepressant trial, it should be based on the potential risks and benefits. The limited evidence that exists indicates that both drugs and ECT can be used safely and effectively in such patients when appropriate allowances are made for health status. Empirical trials are wanting but clearly warranted. 

Canadian Health Measures Survey Beginning in 2006, Statistics Canada will initiate a national survey of 5,000 people to collect data on health status and biological measurements to assess exposures to environmental chemicals, including lead and mercury. The surveys are currently in development and collection of data is expected to begin in the fall of 2006, with results released in 2009 (Statistics Canada 2006). 

What did initially come as a bit of a surprise [Table 19.1(b)] was an additional divide based on health status, with the sick/disabled being less favourable to the proposal than the healthy (P < 0.001). However it seemed unlikely that respondents ... 

The responsibility of caring for a patient usually falls on members of the family. Thus, they are not simply uninvolved bystanders. For example, it is not unusual for family members to prompt the patient to make the initial appointment with the therapist or physician. Because of the stigma of mental illness and the patient s worries about burdening family members, the family may not be fully informed on the health status of the patient. This lack of knowledge may be related to conflictual relationships in the family and a patient s preference to keep family members uninformed. 

Given these data, some advocates then suggest that it is self-evident that schools should expand what they do related to mental health. This position echoes the call of many others who have recognized that schools provide an important venue for enhancing the health status of children and adolescents. Such a view is well articulated, for instance, in an Institute of Medicine report (Allensworth et al., 1997) and in initiatives funded by the federal government designed to foster coordinated school health programs and mh in schools (Adelman et al., 1999 Marx, Wooley, Northrop, 1998 Weist, 1999). 

The prevalence of obesity in older adults is increasing therefore, it should not be surprising that more cardiovascular risk factors are present in this group of individuals. Additionally, obesity is a major predictor of functional limitation and mobility problems in older persons. Age alone should not prejudice the clinician from treating geriatric patients, whereas the benefits of cardiovascular health and functionality should be considered. Treatments should be initiated that minimize adverse effects on bone health and nutritional status and should include dietary and activity modifications.6... 

The FDA Modernization Act of 1997 contains a requirement for public disclosure and congressional reporting by October 2001 of Phase IV studies. FDA intends to meet the public disclosure requirement by posting Phase IV study commitments, the projected end of the study, and the current status of the study on their web site [102]. Sponsors whose new drug was approved with a Phase IV study requirement must submit an initial status report to FDA within one year of approval. According to data compiled by Public Citizen s Health Research Group [103], not one of the Phase IV study commitments for 107 new molecular entities approved between January 1995 and December 1999 had been completed as of December 1999. 

Calcium has earned a reputation as one of the most at-risk nutrients (Foote et ah, 2004) and in 2005 the Dietary Guidelines Advisory Committee classified Ca as a shortfall nutrient because average Ca intake often falls to <60% of the recommended intake in subsets of the population (Kennedy and Meyers, 2005). The pressing need to improve the Ca status of Americans has been highlighted by the Healthy People 2010 Objective, an initiative that endeavors to increase, to at least 75%, the number of US individuals 2 years or older that meet current Ca recommendations (Looker, 2003). The general population requires ongoing education to more fully appreciate the relevance of Ca in relation to current and future health, the imminent risks associated with habitual inadequate intakes, and practical means by which to achieve recommended intakes. 

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