Discriminative power of the health status questionnaire 12 in relation to age, sex, and longstanding illness: findings from a survey of households in Great Britain.

STUDY OBJECTIVE: To assess the ability of the health status questionnaire 12 (HSQ-12) to discriminate between older and younger age groups, its appropriateness for use with an older population in terms of the spread of responses across categories, floor or ceiling effects, and its ability to discriminate between those with and without a reported longstanding illness and type (sensitivity and specificity). DESIGN AND SETTING: The vehicle for the study was the Office for National Statistics (ONS) omnibus survey in Great Britain. The sampling frame was the British post-code address file of "small users", stratified by region, and socioeconomic factors. This file includes all private household addresses. The postal sectors were selected with probability proportional to size. Within each sector 30 addresses were selected randomly. The number of selected addresses was 3000. PARTICIPANTS: Altogether 1912 adults aged 16 and over were interviewed in person in their own homes, giving a response rate of 72%. MEASURES: The HSQ-12, and the ONS general household survey questions on longstanding illness; the ONS omnibus standard sociodemographic items. MAIN RESULTS: There were exceptionally high rates of item response in all age groups. The score differences by construct (e.g., age group, sex, longstanding illness) were in the expected directions with statistically significant age gradients. Age was associated with most of the HSQ-12 domains, although this association had interactions with longstanding illness or sex. The differences in HSQ-12 scores with reported longstanding illness and type of longstanding illness made theoretical sense, which supports the discriminative power of the scale. The frequency distributions for HSQ-12 items in relation to age and sex, and by reporting of longstanding illness are also presented here in order to demonstrate ceiling effects. Most respondents in all age groups achieved high (good) scores on the "social functioning" subscale. The HSQ-12 had good results for specificity when tested against reporting of a longstanding illness, although this was at the expense of sensitivity. CONCLUSIONS: The results support the use of the HSQ-12 with older populations, particularly for those with chronic illnesses, although it will reveal relatively few problems among younger populations. The results presented here indicate that it will require supplementation with more sensitive disease and/or domain specific scales in the areas of interest or intervention, but it provides an acceptable, brief, core measure of health related quality of life. This paper present the first British normative data using the HSQ-12.     

Prevalence and pattern of occupational exposure to whole body vibration in Great Britain: findings from a national survey

OBJECTIVES—To estimate the number of workers in Great Britain with significant occupational exposure to whole body vibration (WBV) and to identify the common sources of exposure and the occupations and industries where such exposures arise.
METHODS—A postal questionnaire was posted to a random community sample of 22 194 men and women of working age. Among other things, the questionnaire asked about exposure to WBV in the past week, including occupational and common non-occupational sources. Responses were assessed by occupation and industry, and national prevalence estimates were derived from census information. Estimates were also made of the average estimated daily personal dose of vibration (eVDV).
RESULTS—From the 12 907 responses it was estimated that 7.2 million men and 1.8 million women in Great Britain are exposed to WBV at work in a 1 week period if the occupational use of cars, vans, buses, trains, and motor cycles is included within the definition of exposure. The eVDV of >374 000 men and 9000 women was estimated to exceed a proposed British Standard action level of 15 ms^-1.75. Occupations in which the estimated exposures most often exceeded 15 ms^-1.75 included forklift truck and mechanical truck drivers, farm owners and managers, farm workers, and drivers of road goods vehicles. These occupations also contributed the largest estimated numbers of workers in Great Britain with such levels of exposure. The highest estimated median occupational eVDVs were found in forklift truck drivers, drivers of road goods vehicles, bus and coach drivers, and technical and wholesale sales representatives, among whom a greater contribution to total dose was received from occupational exposures than from non-occupational ones; but in many other occupations the reverse applied. The most common sources of occupational exposure to WBV are cars, vans, forklift trucks, lorries, tractors, buses, and loaders.
CONCLUSIONS—Exposure to whole body vibration is common, but only a small proportion of exposures exceed the action level proposed in British standards, and in many occupations, non-occupational sources are more important than those at work. The commonest occupational sources of WBV and occupations with particularly high exposures have been identified, providing a basis for targeting future control activities.


Keywords: whole body vibration; population; prevalence; exposure     

Prevalence and pattern of occupational exposure to hand transmitted vibration in Great Britain: findings from a national survey

OBJECTIVES—To estimate the number of workers in Great Britain with significant occupational exposure to hand transmitted vibration (HTV). Also, to identify the occupations and industries where such exposures arise, and the main sources of exposure.
METHODS—A questionnaire was posted to 22 194 men and women aged 16-64, comprising 21 201 subjects selected at random from the age-sex registers of 34 general practices in England, Scotland, and Wales, and a further 993 subjects selected at random from the central pay registers of the three armed services. Among other things, the questionnaire asked about exposure to sources of HTV in current and earlier employment. Responses were assessed by occupation and industry, and prevalence estimates for the country as a whole were derived from census information on occupational and industrial populations nationally. Estimates were also made in exposed workers of the average daily dose of vibration (A(8) root mean squared (rms) for the past week, based on their reported sources and durations of exposure.
RESULTS—Usable questionnaires were returned by 12 907 subjects (overall response rate 58%). From these it was estimated that some 4.2 million men and 667 000 women in Great Britain are exposed to HTV at work in a 1 week period, and that personal daily exposures to vibration exceed a suggested action level equivalent to 2.8 ms^-2 for 8 hours (A(8) >2.8 ms^-2 rms) in at least 1.2 million men and 44 000 women. High estimated doses (A(8) >5 ms^-2 rms) arose most often in bricklayers and masons, gardeners and groundsmen, carpenters and joiners, electricians and electrical maintenance fitters, and builders and building contractors. The industries where high A(8) values most often arose were construction, motor vehicle repair and maintenance, manufacture of basic metals, and agriculture. The most common sources of exposure were hammer drills, hand held portable grinders, and jigsaws.
CONCLUSIONS—Exposure to HTV is surprisingly prevalent, and preventive measures and health surveillance may be warranted for many men in Britain. Control strategies should focus on prevention at source, with priority accorded to the common sources of exposure and the occupations in which significant exposures tend to arise. Many vibratory tools that are common in Britain have been overlooked in previous surveys, highlighting an important focus for future research.


Keywords: hand transmitted vibration; population; prevalence; exposure     

The impact of influenza-like illness in young children on their parents: a quality of life survey

Background

Influenza-like illness can cause excess paediatric morbidity and burden on parents.

Objectives

We determined the quality of life (QoL) impact of children’s influenza-like illness (ILI) on their parents.

Methods

We conducted a prospective cohort study in childcare centres and a general practice in Sydney, Australia. Using PAR-ENT-QoL, we measured QoL of parents of children aged 6 months–3 years before the 2010 influenza season, then again for parents of children with ILI (ILI group) using SF-12v2 Acute Form and PAR-ENT-QoL, and contemporaneously for parents of aged-matched children without ILI (non-ILI group).

Results

Of 381 children enrolled from 90 childcare centres, 105 developed ILI. PAR-ENT-QoL scores of the ILI group were significantly lower in the post-ILI follow-up interviews than at baseline (60.99 vs. 79.77, p < 0.001), and those of non-ILI group at follow-up interviews (60.99 vs. 84.05, p < 0.001). SF-12v2 scores of the ILI group were also significantly lower than those of non-ILI group: physical component summary (50.66 vs. 53.16, p = 0.011) and mental component summary (45.67 vs. 53.66, p < 0.001). Two factors were significantly associated with parental QoL: total time spent caring child during ILI and whether the child had severe ILI or not. Correlations between PAR-ENT-QoL and SF-12v2 scores were satisfactory.

Conclusions

Parents had significantly lower QoL while their child had ILI, compared with before ILI and with parents of children without ILI. The public health impact of ILI in children on the QoL in families is far from negligible. QoL measurement can complement economic evaluation of ILI disease burden and provide a more complete picture of impact.     

Internalizing stigma associated with mental illness: findings from a general population survey in Jamaica.

OBJECTIVES: The culture of stigma associated with mental illness is particularly intense when persons who are normally victims of that stigmatization (mentally ill persons and their family members) themselves act negatively toward others whom they associate with mental illness. We attempt to determine the extent of this internalization and assimilation of stigmatizing attitudes, cognitions, and behaviors in persons who are at risk for such stigmatization in Jamaica. METHODS: Data from a 2006 national survey on mental health were analyzed. Demographic variables, the presence or absence of mental illness in respondents and in their family members, and responses pertaining to behaviors and attitudes toward mentally ill persons were examined. Subsamples (respondents with mental illness, respondents with a family member with mental illness, respondents with neither) were compared using the chi-square test. RESULTS: Respondents with family members with mental illness were less likely to demonstrate a number of different manifestations of stigmatization than others (P=0.009-0.019). Respondents with mental illness showed no difference in the demonstration of a number of different manifestations of stigmatization from other respondents (P=0.069-0.515). CONCLUSIONS: The small number of mentally ill respondents resulted in low statistical power for demonstrating differences between that subgroup and other respondents. The significantly more positive attitudes and behavior of respondents with family members with mental illness suggest that some benefit may be gained by creating more opportunities for the general public to interact with persons with mental illness.     

Framing and signalling effects of taxes on sugary drinks: A discrete choice experiment among households in Great Britain

Taxes on sugar‐sweetened beverages (SSBs) are in place in many countries to combat obesity with emerging evidence that these are effective in reducing purchases of SSBs. In this study, we tested whether signalling and framing the price increase from an SSB tax explicitly as a health‐related, earmarked measure reduces the demand for SSBs more than an equivalent price increase. We measured the demand for non‐alcoholic beverages with a discrete choice experiment (DCE) administered online to a randomly selected group of n = 603 households with children in Great Britain (GB) who regularly purchase SSBs. We find a suggestive evidence that a price increase leads to a larger reduction in the probability of choosing SSBs when it is signalled as a tax and framed as a health‐related and earmarked policy. Respondents who did not support a tax on SSBs, who were also more likely to choose SSBs in the first place, were on average more responsive to a price increase framed as an earmarked tax than those who supported the tax. The predictive validity of the DCE, to capture preferences for beverages, was confirmed using actual purchase data. The findings imply that a well‐signalled and earmarked tax on SSBs could improve its effectiveness at reducing the demand.     

Mutual support groups in Great Britain: A survey

In the fall of 1979 an attempt was made to locate and survey as many mutual support groups in the United Kingdom as could be readily identified. For purposes of this study, mutual support groups were characterized as groups meeting in small units around a specific focal issue; meeting regularly and frequently for purposes of mutual support.Out of a total mailing of 154 questionnaires, 143 packets were delivered and responses received from 112 self-help organizations. Of these, 71 were determined to fit the criteria for mutual support groups and these responses constitute the basis for the present report.The range of focal issues in these groups was quite broad, divisible into three subgroupings: physical conditions, mental and emotional conditions and social status conditions. There appears to have been a more or less steady growth in the number of these groups founded since the end of World War II, with only 3 groups in the sample predating 1940.Mutual support groups vary tremendously in the number of branches and size of membership. Twelve were local (single branch) groups; 35 were national (multibranch) groups and 18 were international organizations. The number of branches ranged from 1 to 30,000 and total membership ranged from 19 to 70,000. A typical branch register contained the names of 84 persons and the typical attendance at a branch meeting was 28 persons.Mutual support groups usually served those who share the focal condition though there are numerous groups open to family and other interested persons. Conditions for membership were generally found to be unrestrictive. The average group meets monthly. Members tend to be adults aged 30–44 years, more often female than male and recruited largely by publicity in the mass media.Aside from the meetings, important activities were identified as book service-literature, social events, newsletter, contact with other members and information—referral services. The groups are, in the main, funded out of voluntary contributions and membership fees. Professional persons and their services were, in the main, regarded in a positive light. The report includes a commentary on the methodological problems in doing research of this nature.     

Organization specific predictors of job satisfaction: findings from a Canadian multi-site quality of work life cross-sectional survey

Background  

Organizational features can affect how staff view their quality of work life. Determining staff perceptions about quality of work life is an important consideration for employers interested in improving employee job satisfaction. The purpose of this study was to identify organization specific predictors of job satisfaction within a health care system that consisted of six independent health care organizations.     

Teenage childbearing in Great Britain and the spatial concentration of poverty households

STUDY OBJECTIVE: To investigate the association between the spatial concentration of deprived households and teenage non-marital childbearing. Associations with area deprivation are tested before and after allowing for levels of personal deprivation. DESIGN AND SETTING: The individual data are derived from the 2% sample of anonymised records (SAR) from the census of 1991 in Great Britain, and are combined with area data from the 278 districts of residence identifiable in the SAR. PARTICIPANTS: Sample is restricted to unmarried women living at home (with at least one parent) and aged 16 to 19. MAIN RESULTS: The results suggest generally higher risk of teenage childbearing for women who are economically inactive, women from households with no access to a car or households resident in local authority accommodation. Without adjusting for personal circumstances, the risk of teenage pregnancy shows a clear, significant and approximately linear association with social deprivation of area of residence in 1991. Residual analysis shows that many urban areas have much higher levels of teenage childbearing than expected. When adjustment is made for personal disadvantage the simple association with local area deprivation is attenuated. A higher risk of teenage childbearing is still seen in urban areas while the areas having the highest negative differentials are heterogeneous. CONCLUSIONS: Both individual and spatial characteristics are important in influencing levels of teenage childbearing. Teenage childbearing shows an association with residence in more deprived areas. The association seems to be largely because residence in more deprived areas is associated with personal disadvantage, which increases the risk of teenage childbearing. Area characteristics are of lesser significance in determining teenage non-marital childbearing than individual and household characteristics.     

The effects of clinical illness severity and physical activity on health-related quality of life in schizophrenia

Background

Quality of life is an important clinical outcome in individuals with schizophrenia. Illness severity and physical activity (PA) were independently reported to influence health-related quality of life (HRQoL) in people with schizophrenia. This study attempts to examine the intensity and types of PA and their impact on HRQoL, as well as the relative contributions of illness severity, PA, and sedentary behavior (SB) to HRQoL in people with schizophrenia.

Methods

Demographic information was collected from 297 community-dwelling individuals with schizophrenia. Severity of illness was assessed on the Clinical Global Impression—Severity (CGI-S); PA and SB were assessed on the Global Physical Activity Questionnaire (GPAQ); HRQoL was assessed on the RAND-36. Regression analyses were conducted to examine the impact of different types and intensities of PA on HRQoL, and the relative impact of CGI-S, GPAQ-PA, and GPAQ-SB on HRQoL.

Results

Most participants had low PA level, and travel is the main type of PA adopted. Leisure time, travel-related, work-related, moderate-, and vigorous-intensity PA were all not associated with HRQoL. Lower severity of illness was significantly associated with better physical (PHC), mental (MHC) and global (GHC) health composites of the RAND-36 (GHC: t?=???5.628, p?<?0.001, PHC: t?=???4.026, p?<?0.001, MHC: t?=???5.534, p?<?0.001). Both PA and SB were not significantly associated with PHC, MHC, and GHC.

Conclusion

Severity of illness has a significant impact on HRQoL in people with schizophrenia. However, we found no evidence to support the association between physical activity and sedentary behavior with HRQoL.

     

Use of complementary or alternative medicine in a general population in Great Britain. Results from the National Omnibus survey

BACKGROUND: A representative sample of the adults in England, Scotland and Wales was interviewed to estimate levels of use of complementary or alternative medicines (CAMs) and their socio-economic correlates. METHODS: The Omnibus survey is a multi-purpose survey carried out in the United Kingdom by the Office for National Statistics on behalf of non-profit making organizations. The survey is carried out in 2 out of 3 months each quarter using a stratified random, probability sample of households. An eight-question module was added to the interview schedule of the survey in March 2001. Topics included practitioner-based use of 23 named CAM therapies in the past 12 months. The resulting data were analysed in conjunction with socio-economic and demographic variables. RESULTS: A response rate of 65 per cent (1794/2761) was achieved. An estimated 10.0 per cent of the population [95 per cent confidence interval (CI) 8.7-11.5 per cent] had received any CAM therapy from a practitioner in the past year. No individual therapy was used by more than 2 per cent of the sample. An estimated 6.5 per cent (95 per cent CI 5.4-7.6) had used one of the five main therapies: acupuncture, homeopathy, chiropractic, osteopathy or herbal medicine. Estimates of CAM use were similar in England, Scotland and Wales. There was a significant positive association between CAM use and non-manual social class (p < 0.002), age left full-time education (p < 0.001), and gross income over pounds sterling 15,600 (p < 0.001). More than half (52 per cent) of the respondents that had used CAM in the past year had not told their general practitioner. CONCLUSIONS: Strong correlations between the use of CAM and gross socio-economic indicators are demonstrated in the survey. Repeated national surveys of this type could provide a useful vehicle for collecting information about changing patterns of CAM use on a routine basis.     

Associations between illness duration and health-related quality of life in specified mental and physical chronic health conditions: results from a population-based survey

Purpose

We compared health-related quality of life (HRQOL) in incident (≤1 year since diagnosis), mid-term (>1–5 years since diagnosis), and long-term (>5 years since diagnosis) cases of mental and physical chronic illness with the general population and assessed the modifying effects of age and gender on the association between HRQOL and illness duration.

Methods

Data from the 2007 Australian National Health and Mental Wellbeing Survey were used. HRQOL was captured by the Assessment of Quality of Life Scale 4D. Multivariable linear regression analyses compared HRQOL of individuals with different duration of illnesses with those who did not have the condition of interest.

Results

The 8841 survey respondents were aged 16–85 years (median 43 years, 50.3% female). For the overall sample, worse HRQOL was associated with incident (P = 0.049) and mid-term (P = 0.036) stroke and long-term depression (P < 0.001) and anxiety (P = 0.001). Age had moderating effect on the associations between HRQOL and duration of asthma (P < 0.001), arthritis (P = 0.001), diabetes (P = 0.004), stroke (P = 0.009), depression (P < 0.001), bipolar disorder (P < 0.001), and anxiety (P < 0.001), but not heart disease (P = 0.102). In older ages, the greatest loss in HRQOL was associated with incident asthma, depression, and bipolar disorder. In younger ages, the greatest loss in HRQOL was associated with arthritis (any duration) and incident diabetes and anxiety. Additionally, gender moderated the association between HRQOL and arthritis, with worse HRQOL among men with incident arthritis (P = 0.047).

Conclusions

Loss of HRQOL associated with longer duration of chronic illness is most apparent in stroke and mental illness and differs between age groups.

     

The quality of life of families of female-headed households in Botswana: a secondary analysis of case studies

Previous studies note a positive relationship between female-headed households (FHHs) and poverty in urban and rural areas of Botswana. To explore this further, data were collected from 7 FHHs through participant observation and open-ended interviews. A secondary analysis of data described the quality of life (QOL) of members of the households according to one's ability to meet basic human needs (food, water, shelter, safety, and health). FHHs ranged in age from 40-91 years, with family size ranging from 1-11 members. Monthly income for 6 of the 7 families was 30 dollars (U.S.) per month or less. Physical living environments were overcrowded, with poorly maintained latrines and unsafe refuse disposal. Family illnesses included hypertension, cataracts, mental illness, knee pain, ringworm, leg sores, and tonsillitis. Health risk behaviours included unprotected sex, alcohol abuse, and breastfeeding among potentially HIV positive mothers. Although Botswana claims rapidly rising levels of national income after independence, the QOL of FHHs remains poor. We suggest that, to alleviate poverty, governments in developing African countries should explore strategies that effectively target families headed by women.     

Respiratory illness in households using gas and electricity for cooking. II. Symptoms and objective findings.

An earlier study examined the incidence of reported respiratory illness in members of households cooking with gas or electricity. The present investigation extends that study in order to confirm and validate the reports of illness, and to determine the frequency distribution of reported symptoms among parents and children in the two settings. One hundred twenty households with school-age children were selected from the gas and electric cohorts. Reports of respiratory illness and symptoms were obtained by telephone interview every 2 weeks for a period of 13 months by a nurse—epidemiologist. Where the onset of respiratory illness occurred within 3 days of the call, a household visit was arranged to examine the person reported ill and to obtain a throat culture. In addition, two sets of “well” controls were examined. The results validate the reporting method and replicate earlier findings of no significant difference in acute respiratory illness incidence between gas- and electric-cooking households.