The cognitive processes underlying event-based prospective memory in school-age children and young adults: a formal model-based study.

PubMed

Smith, Rebekah E; Bayen, Ute J; Martin, Claudia

2010-01-01

Fifty children 7 years of age (29 girls, 21 boys), 53 children 10 years of age (29 girls, 24 boys), and 36 young adults (19 women, 17 men) performed a computerized event-based prospective memory task. All 3 groups differed significantly in prospective memory performance, with adults showing the best performance and with 7-year-olds showing the poorest performance. We used a formal multinomial process tree model of event-based prospective memory to decompose age differences in cognitive processes that jointly contribute to prospective memory performance. The formal modeling results demonstrate that adults differed significantly from the 7-year-olds and the 10-year-olds on both the prospective component and the retrospective component of the task. The 7-year-olds and the 10-year-olds differed only in the ability to recognize prospective memory target events. The prospective memory task imposed a cost to ongoing activities in all 3 age groups. Copyright 2009 APA, all rights reserved.

Predictors of young adults' amphetamine use and disorders: a prospective study.

PubMed

Hayatbakhsh, Mohammad R; Najman, Jake M; Bor, William; Williams, Gail M

2009-05-01

Understanding the risk factors that predict amphetamine use and development of amphetamine abuse or dependence (disorder) may help guide preventive interventions. This study aimed to investigate the correlates and predictors of young adults' amphetamine use and use disorders. Prospective cohort, population-based study which started in Brisbane, South East Queensland (Australia) in 1981. The study participants were a cohort of 2042 young adults, followed up from birth to young adulthood. At the 21-year follow-up, amphetamine use was assessed via a self-report questionnaire, and amphetamine use disorder (AUD) was assessed using the Composite International Diagnostic Interview (CIDI-Auto). Potential predictors (15 risk factors) were assessed between baseline (antenatal visit) and the 21-year follow-up. These included participant's gender, mother's age and education, maternal marital status and quality of marital relationship, maternal tobacco and alcohol consumption, mother-child communication, child mental health and problem behaviours, child smoking and alcohol consumption and child school performance. Young adult amphetamine users were more likely to have concurrent symptoms of mental illness and problem behaviours and to use or abuse cigarettes, cannabis, or other illicit drugs. In multivariate analyses, young adults' amphetamine use and disorder were disproportionately more common among males and those who have prospectively reported aggression/delinquency or smoking at 14 years, or who have experienced childhood sexual abuse. Our findings suggest that problem behaviours, smoking and childhood sexual abuse are predictors of initiation to use of amphetamines and development of amphetamine abuse and dependence.

Cross-sectional and prospective relationship between physical activity and chronic diseases in European older adults.

PubMed

Marques, Adilson; Peralta, Miguel; Martins, João; de Matos, Margarida Gaspar; Brownson, Ross C

2017-05-01

This study examined the relationship between physical activity (PA) and chronic diseases in European older adults, using a prospective analysis with data from 2011 and 2013. Participants were 37,524 older adults (16,204 men) who responded to the fourth (in 2011) and fifth (in 2013) wave of SHARE project, from 13 European countries. Participants' answers to interview questions about the presence of chronic conditions and PA. The cross-sectional and prospective association between PA and the number of chronic diseases was assessed using general linear models. Among men and women, moderate or vigorous physical activity (MVPA) in 2011 was associated with fewer reported chronic diseases in 2011 and 2013. In prospective analysis, MVPA in 2011 was inversely associated with the number of chronic diseases in 2013 in the unadjusted model. In the adjusted model MVPA more than once a week remained as a significant predictor of fewer chronic diseases. PA should be prescribed to older adults in order to prevent and reduce the number of chronic diseases, and, when possible, vigorous intensity PA should be recommended.

Self-projection in younger and older adults: a study of episodic memory, prospection, and theory of mind.

PubMed

Jarvis, Shoshana N; Miller, Jeremy K

2017-07-01

Self-projection is the ability to orient the self in different places in time and space. Episodic memory, prospection, and theory of mind (ToM) are all cognitive abilities that share an element of self-projection. Previous research has posited that each of these abilities stems from the same neural network. The current study compared performance of cognitively healthy older adults and younger adults on several self-projection tasks to examine the relatedness of these constructs behaviorally. Episodic memory and prospection were measured using an episodic interview task where the participants were asked to remember or imagine events that either had happened in the past or could happen in the future and then gave ratings describing the extent to which they were mentally experiencing the event and from what perspective they viewed it. ToM was measured by asking participants to make judgments regarding the intentions of characters described in stories that involved cognitive, affective, or ironic components. Our results demonstrate that aging influences episodic memory, prospection, and ToM similarly: older adult participants showed declines on each of these measures compared to younger adults. Further, we observed correlations between performance on the measures of episodic memory and prospection as well as between episodic memory and ToM, although no correlation between prospection and ToM was observed after controlling for chronological age. We discuss these results in the light of theories suggesting that each of these abilities is governed by a common brain system.

The Cognitive Processes Underlying Event-Based Prospective Memory in School-Age Children and Young Adults: A Formal Model-Based Study

ERIC Educational Resources Information Center

Smith, Rebekah E.; Bayen, Ute J.; Martin, Claudia

2010-01-01

Fifty children 7 years of age (29 girls, 21 boys), 53 children 10 years of age (29 girls, 24 boys), and 36 young adults (19 women, 17 men) performed a computerized event-based prospective memory task. All 3 groups differed significantly in prospective memory performance, with adults showing the best performance and with 7-year-olds showing the…

The Perception on Fundamentals of Online Courses: A Case on Prospective Instructional Designers

ERIC Educational Resources Information Center

Genç, Zülfü; Tinmaz, Hasan

2016-01-01

This study focuses on prospective instructional designers' perception toward creating online courses including which elements are essential for developing such platforms. The study is significant for revealing what the prospective instructional designers focus on while they design certain learning opportunities. The participants of the study were…

Adherence to and effectiveness of an individually tailored home-based exercise program for frail older adults, driven by mobility monitoring: design of a prospective cohort study.

PubMed

Geraedts, Hilde A E; Zijlstra, Wiebren; Zhang, Wei; Bulstra, Sjoerd; Stevens, Martin

2014-06-07

With the number of older adults in society rising, frailty becomes an increasingly prevalent health condition. Regular physical activity can prevent functional decline and reduce frailty symptoms. In particular, home-based exercise programs can be beneficial in reducing frailty of older adults and fall risk, and in improving associated physiological parameters. However, adherence to home-based exercise programs is generally low among older adults. Current developments in technology can assist in enlarging adherence to home-based exercise programs. This paper presents the rationale and design of a study evaluating the adherence to and effectiveness of an individually tailored, home-based physical activity program for frail older adults driven by mobility monitoring through a necklace-worn physical activity sensor and remote feedback using a tablet PC. Fifty transitionally frail community-dwelling older adults will join a 6-month home-based physical activity program in which exercises are provided in the form of exercise videos on a tablet PC and daily activity is monitored by means of a necklace-worn motion sensor. Participants exercise 5 times a week. Exercises are built up in levels and are individually tailored in consultation with a coach through weekly telephone contact. The physical activity program driven by mobility monitoring through a necklace-worn sensor and remote feedback using a tablet PC is an innovative method for physical activity stimulation in frail older adults. We hypothesize that, if participants are sufficiently adherent, the program will result in higher daily physical activity and higher strength and balance assessed by physical tests compared to baseline. If adherence to and effectiveness of the program is considered sufficient, the next step would be to evaluate the effectiveness with a randomised controlled trial. The knowledge gained in this study can be used to develop and fine-tune the application of innovative technology in home

Age effects in emotional prospective memory: cue valence differentially affects the prospective and retrospective component.

PubMed

Schnitzspahn, Katharina M; Horn, Sebastian S; Bayen, Ute J; Kliegel, Matthias

2012-06-01

While first studies suggested that emotional task material may enhance prospective memory performance in young and older adults, the extent and mechanisms of this effect are under debate. The authors explored possible differential effects of cue valence on the prospective and retrospective component of prospective memory in young and older adults. Forty-five young and 41 older adults performed a prospective memory task in which emotional valence of the prospective memory cue was manipulated (positive, negative, neutral). The multinomial model of event-based prospective memory was used to analyze effects of valence and age on the two prospective memory components separately. Results revealed an interaction indicating that age differences were smaller in both emotional valence conditions. For older adults positive cues improved the prospective component, while negative cues improved the retrospective component. No main effect of valence was found for younger adults on an overt accuracy measure, but model-based analyses showed that the retrospective component was enhanced in the positive compared with the negative cue condition. The study extends the literature in demonstrating that processes underlying emotional effects on prospective memory may differ depending on valence and age. PsycINFO Database Record (c) 2012 APA, all rights reserved

A Lead User Approach to Universal Design - Involving Older Adults in the Design Process.

PubMed

Raviselvam, Sujithra; Wood, Kristin L; Hölttä-Otto, Katja; Tam, Victoria; Nagarajan, Kamya

2016-01-01

The concept of Universal Design has received increasing appreciation over the past two decades. Yet, there are very few existing designs that cater to the needs of extraordinary users who experience some form of physical challenge. Previous work has shown promising results on involving users with physical challenges as lead users - users who have the potential to identify needs that could be latent among the general population. It has also been shown that older adults can act as such lead users. They can help design universal product ideas that satisfy both older adults and the general population. In this paper we build on this and examine if involving older adults in the design phase can result in universal products, products preferred by both older adults and the general population over a current option. Eighty-nine older adult participants and thirty-four general population participants took part in the study. Products were redesigned and prototyped based on the needs of older adults and tested among both populations. Results show that, although older adults and the general population did share certain needs and demands, the majority of older adults had needs and demands that were different from those of the general population. However, even though the needs differed between the populations, on average 89% of the general population participants preferred products designed based on design needs expressed by older adults over the current option. This provides further evidence supporting the use of older adults in designing products for all.

Innovation and design approaches within prospective ergonomics.

PubMed

Liem, André; Brangier, Eric

2012-01-01

In this conceptual article the topic of "Prospective Ergonomics" will be discussed within the context of innovation, design thinking and design processes & methods. Design thinking is essentially a human-centred innovation process that emphasises observation, collaboration, interpretation, visualisation of ideas, rapid concept prototyping and concurrent business analysis, which ultimately influences innovation and business strategy. The objective of this project is to develop a roadmap for innovation, involving consumers, designers and business people in an integrative process, which can be applied to product, service and business design. A theoretical structure comprising of Innovation perspectives (1), Worldviews supported by rationalist-historicist and empirical-idealistic dimensions (2) and Models of "design" reasoning (3) precedes the development and classification of existing methods as well as the introduction of new ones.

Predicting remembering and forgetting of autobiographical memories in children and adults: A 4-year prospective study

PubMed Central

Bauer, Patricia J.; Larkina, Marina

2015-01-01

Preservation and loss to forgetting of autobiographical memories is a focus in both the adult and developmental literatures. In both, there are comparative arguments regarding rates of forgetting. Children are assumed to forget autobiographical memories more rapidly than adults, and younger children are assumed to forget more rapidly than older children. Yet few studies can directly inform these comparisons: few feature children and adults, and few prospectively track the survival of specific autobiographical memories over time. In a 4-year prospective study, we obtained autobiographical memories from children 4, 6, and 8 years, and adults. We tested recall of different subsets of the events after 1, 2, and 3 years. Accelerated rates of forgetting were apparent among all child groups relative to adults; within the child groups, 4- and 6-year-olds had accelerated forgetting relative to 8-year-olds. The differences were especially pronounced in open-ended recall. The thematic coherence of initial memory reports also was a significant predictor of the survival of specific memories. The pattern of findings is consistent with suggestions that the adult distribution of autobiographical memories is achieved as the quality of memory traces increases (here measured by thematic coherence) and the rate of forgetting decreases. PMID:26566236

Design of instructions for evacuating disabled adults.

PubMed

Boyce, Michael W; Al-Awar Smither, Janan; Fisher, Daniel O; Hancock, P A

2017-01-01

We investigated how the design of instructions can affect performance in preparing emergency stair travel devices for the evacuation of disable individuals. We had three hypotheses: 1) Design of instructions would account for a significant portion of explained performance variance, 2) Improvements in design of instructions would reduce time on task across device type and age group, and 3) There would be a performance decrement for older adults compared to younger adults based on the slowing of older adult information processing abilities. Results showed that design of instructions does indeed account for a large portion of explained variance in the operation of emergency stair travel devices, and that improvements in design of instructions can reduce time on task across device type and age group. However, encouragingly for real-world operations, results did not indicate any significant differences between older versus younger adults. We look to explore ways that individuals with disabilities can exploit these insights to enhance the performance of emergency stair travel devices for use. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cell Phone Use While Driving: Prospective Association with Emerging Adult Use.

PubMed

Trivedi, Neha; Haynie, Denise; Bible, Joe; Liu, Danping; Simons-Morton, Bruce

2017-09-01

Secondary task engagement such as cell phone use while driving is a common behavior among adolescents and emerging adults. Texting and other distracting cell phone use in this population contributes to the high rate of fatal car crashes. Peer engagement in similar risky driving behaviors, such as texting, could socially influence driver phone use behavior. The present study investigates the prospective association between peer and emerging adult texting while driving the first year after high school. Surveys were conducted with a national sample of emerging adults and their nominated peers. Binomial logistic regression analyses, adjusting for gender, race/ethnicity, parental education, and family affluence, showed that participants (n=212) with peers (n=675) who reported frequently texting while driving, were significantly more likely to text while driving the following year (odds ratio, 3.01; 95% CI, 1.19-7.59; P=0.05). The findings are consistent with the idea that peer texting behavior influences the prevalence of texting while driving among emerging adults. Copyright © 2017 Elsevier Ltd. All rights reserved.

Improving everyday prospective memory performance in older adults: comparing cognitive process and strategy training.

PubMed

Brom, Sarah Susanne; Kliegel, Matthias

2014-09-01

Considering the importance of prospective memory for independence in old age recently, research has started to examine interventions to reduce prospective memory errors. Two general approaches can be proposed: (a) process training of executive control associated with prospective memory functioning, and/or (b) strategy training to reduce executive task demands. The present study was the first to combine and compare both training methods in a sample of 62 community-dwelling older adults (60-86 years) and to explore their effects on an ecologically valid everyday life prospective memory task (here: regular blood pressure monitoring). Even though the training of executive control was successful in enhancing the trained ability, clear transfer effects on prospective memory performance could only be found for the strategy training. However, participants with low executive abilities benefited particularly from the implementation intention strategy. Conceptually, this supports models suggesting interactions between task demands and individual differences in executive control in explaining individual differences in prospective memory performance. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Prospective study of physical activity and sleep in middle-aged and older adults.

PubMed

Tsunoda, Kenji; Kitano, Naruki; Kai, Yuko; Uchida, Ken; Kuchiki, Tsutomu; Okura, Tomohiro; Nagamatsu, Toshiya

2015-06-01

Few prospective cohort studies have examined the association between physical activity (PA) and insomnia prevention, and the effective PA intensity remains unclear. This prospective study explores how PA intensity prevents incident short sleep duration and subjective insufficient sleep in middle-aged and older adults. A self-reported questionnaire gathered data on sleep and PA variables, including moderate low-intensity PA (MLPA); moderate high-intensity PA (MHPA); and vigorous-intensity PA (VPA), during health checkups conducted in Meiji Yasuda Shinjuku Medical Center in Tokyo. This study followed two cohorts from a 2008 baseline survey: (1) participants free of short sleep duration (n=7,061) and (2) participants free of insufficient sleep (n=7,385). They were divided into middle-aged (<60 years; 45.7 [8.8] years for sleep duration and 45.5 [8.8] years for sleep sufficiency) and older adults (both groups aged 65.3 [4.7] years) and followed for a mean 3.4 years until 2013. Data were analyzed in 2014. Engaging in MHPA (hazard ratio [HR]=0.81, 95% CI=0.67, 0.98) and VPA (HR=0.83, 95% CI=0.71, 0.97) had a significant preventive effect on incident subjective insufficient sleep among middle-aged adults. For older adults, only MLPA (HR=0.58, 95% CI=0.42, 0.81) had a significant preventive effect on incident insufficient sleep, and PA did not significantly affect incident short sleep duration. Middle-aged adults engaging in MHPA and VPA and older adults engaging in MLPA can effectively maintain sleep sufficiency. When providing an effective PA program to prevent insomnia, the intensity of PA should correspond to the participant's age. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Design of smart home sensor visualizations for older adults.

PubMed

Le, Thai; Reeder, Blaine; Chung, Jane; Thompson, Hilaire; Demiris, George

2014-01-01

Smart home sensor systems provide a valuable opportunity to continuously and unobtrusively monitor older adult wellness. However, the density of sensor data can be challenging to visualize, especially for an older adult consumer with distinct user needs. We describe the design of sensor visualizations informed by interviews with older adults. The goal of the visualizations is to present sensor activity data to an older adult consumer audience that supports both longitudinal detection of trends and on-demand display of activity details for any chosen day. The design process is grounded through participatory design with older adult interviews during a six-month pilot sensor study. Through a secondary analysis of interviews, we identified the visualization needs of older adults. We incorporated these needs with cognitive perceptual visualization guidelines and the emotional design principles of Norman to develop sensor visualizations. We present a design of sensor visualization that integrate both temporal and spatial components of information. The visualization supports longitudinal detection of trends while allowing the viewer to view activity within a specific date. Appropriately designed visualizations for older adults not only provide insight into health and wellness, but also are a valuable resource to promote engagement within care.

Design of smart home sensor visualizations for older adults.

PubMed

Le, Thai; Reeder, Blaine; Chung, Jane; Thompson, Hilaire; Demiris, George

2014-07-24

Smart home sensor systems provide a valuable opportunity to continuously and unobtrusively monitor older adult wellness. However, the density of sensor data can be challenging to visualize, especially for an older adult consumer with distinct user needs. We describe the design of sensor visualizations informed by interviews with older adults. The goal of the visualizations is to present sensor activity data to an older adult consumer audience that supports both longitudinal detection of trends and on-demand display of activity details for any chosen day. The design process is grounded through participatory design with older adult interviews during a six-month pilot sensor study. Through a secondary analysis of interviews, we identified the visualization needs of older adults. We incorporated these needs with cognitive perceptual visualization guidelines and the emotional design principles of Norman to develop sensor visualizations. We present a design of sensor visualization that integrate both temporal and spatial components of information. The visualization supports longitudinal detection of trends while allowing the viewer to view activity within a specific date.CONCLUSIONS: Appropriately designed visualizations for older adults not only provide insight into health and wellness, but also are a valuable resource to promote engagement within care.

Design Principles to Accommodate Older Adults

PubMed Central

Farage, Miranda A.; Miller, Kenneth W.; Ajayi, Funmi; Hutchins, Deborah

2012-01-01

The global population is aging. In many industrial countries, almost one in five people are over age 65. As people age, gradual changes ensue in vision, hearing, balance, coordination, and memory. Products, communication materials, and the physical environment must be thoughtfully designed to meet the needs of people of all ages. This article summarizes normal changes in sensory function, mobility, balance, memory, and attention that occur with age. It presents practical guidelines that allow design professionals to accommodate these changes and better meet the needs of older adults. Designing for older adults is inclusive design: it accommodates a range of physical and cognitive abilities and promotes simplicity, flexibility, and ease of use for people of any age. PMID:22980147

Design principles to accommodate older adults.

PubMed

Farage, Miranda A; Miller, Kenneth W; Ajayi, Funmi; Hutchins, Deborah

2012-02-29

The global population is aging. In many industrial countries, almost one in five people are over age 65. As people age, gradual changes ensue in vision, hearing, balance, coordination, and memory. Products, communication materials, and the physical environment must be thoughtfully designed to meet the needs of people of all ages. This article summarizes normal changes in sensory function, mobility, balance, memory, and attention that occur with age. It presents practical guidelines that allow design professionals to accommodate these changes and better meet the needs of older adults. Designing for older adults is inclusive design: it accommodates a range of physical and cognitive abilities and promotes simplicity, flexibility, and ease of use for people of any age.

Measuring childhood maltreatment to predict early-adult psychopathology: Comparison of prospective informant-reports and retrospective self-reports.

PubMed

Newbury, Joanne B; Arseneault, Louise; Moffitt, Terrie E; Caspi, Avshalom; Danese, Andrea; Baldwin, Jessie R; Fisher, Helen L

2018-01-01

Both prospective informant-reports and retrospective self-reports may be used to measure childhood maltreatment, though both methods entail potential limitations such as underestimation and memory biases. The validity and utility of standard measures of childhood maltreatment requires clarification in order to inform the design of future studies investigating the mental health consequences of maltreatment. The present study assessed agreement between prospective informant-reports and retrospective self-reports of childhood maltreatment, as well as the comparative utility of both reports for predicting a range of psychiatric problems at age 18. Data were obtained from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally-representative birth cohort of 2232 children followed to 18 years of age (with 93% retention). Childhood maltreatment was assessed in two ways: (i) prospective informant-reports from caregivers, researchers, and clinicians when children were aged 5, 7, 10 and 12; and (ii) retrospective self-reports of maltreatment experiences occurring up to age 12, obtained at age 18 using the Childhood Trauma Questionnaire. Participants were privately interviewed at age 18 concerning several psychiatric problems including depression, anxiety, self-injury, alcohol/cannabis dependence, and conduct disorder. There was only slight to fair agreement between prospective and retrospective reports of childhood maltreatment (all Kappa's ≤ 0.31). Both prospective and retrospective reports of maltreatment were associated with age-18 psychiatric problems, though the strongest associations were found when maltreatment was retrospectively self-reported. These findings indicate that prospective and retrospective reports of childhood maltreatment capture largely non-overlapping groups of individuals. Young adults who recall being maltreated have a particularly elevated risk for psychopathology. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All

Fluid mechanics moderate the effect of implementation intentions on a health prospective memory task in older adults.

PubMed

Brom, Sarah Susanne; Schnitzspahn, Katharina Marlene; Melzer, Marlen; Hagner, Franziska; Bernhard, Anka; Kliegel, Matthias

2014-03-01

The aim of the present study was to test if a cognitive strategy improves older adults' prospective memory performance in a naturalistic health task. Moreover, it was tested if a possible strategy effect is moderated by individual differences. Therefore, a group of older adults was asked to perform a task taken from the medication adherence literature (i.e., blood pressure monitoring). Half of them were asked to form implementation intentions. Additionally, crystallized pragmatics and fluid mechanics, conscientiousness, self-efficacy, and lifestyle factors were assessed as possible moderators. Results showed a strong positive strategy effect on prospective memory. Moreover, the effect was qualified by a significant interaction and only emerged for participants with low levels in fluid mechanics. No other moderator showed an effect. In conclusion, an enhancing effect of implementation intentions on prospective memory seems to be dependent on individual differences in cognitive capacity and less related to key motivational or personality variables.

Factors associated with exercise adherence among older adults. An individual perspective.

PubMed

Rhodes, R E; Martin, A D; Taunton, J E; Rhodes, E C; Donnelly, M; Elliot, J

1999-12-01

This paper reviews the literature concerning factors at the individual level associated with regular exercise among older adults. Twenty-seven cross-sectional and 14 prospective/longitudinal studies met the inclusion criteria of a mean participant age of 65 years or older. The findings are summarised by demographics, exercise experience, exercise knowledge, physiological factors, psychological factors, activity preferences and perceived social influences. In general, education and exercise history correlate positively with regular exercise, while perceived physical frailty and poor health may provide the greatest barrier to exercise adoption and adherence in the elderly. Social-cognitive theories identify several constructs that correlate with the regular exercise behaviour of older adults, such as exercise attitude, perceived behavioural control/self-efficacy, perceived social support and perceived benefits/barriers to continued activity. As well, stage modelling may provide additional information about the readiness for regular exercise behaviour among older adults. However, relatively few studies among older adults exist compared with middle-aged and younger adults. Further, the majority of current research consists of cross-sectional designs or short prospective exercise trials among motivated volunteers that may lack external validity. Future research utilising longitudinal and prospective designs with representative samples of older adults will provide a better understanding of significant causal associations between individual factors and regular exercise behaviour.

A prospective study of the impact of floods on the mental and physical health of older adults.

PubMed

Bei, Bei; Bryant, Christina; Gilson, Kim-Michelle; Koh, Juliana; Gibson, Penelope; Komiti, Angela; Jackson, Henry; Judd, Fiona

2013-01-01

With a longitudinal prospective design, we examined the impact of floods on the mental and physical health of older adults and explored risk and protective factors. Two hundred and seventy four older adults (age ≥60) completed surveys before and after a flood event. Both the surveys included measures of anxiety, depression, self-reported health, and satisfaction with life; the post-flood survey also included questionnaires on flood experience, symptoms of post-traumatic stress disorder (PTSD), stoicism, and psychological coping with floods. Compared to those not personally affected (78.8%), personally affected individuals (21.2%) reported significantly higher PTSD symptoms, with about one in six reporting PTSD symptoms that might require clinical attention. Personally affected individuals also reported a greater increase in anxiety post-flood, but changes in their depressive symptoms and self-reported health were not significantly different from those not personally affected. Greater flood exposure and the lack of social support were the risk factors for poorer mental and physical health. Higher stoicism was associated with higher post-flood depression and poorer self-reported mental health. The use of maladaptive coping, such as venting and distraction, was associated with greater deterioration in mental health after floods, whilst emotion-focused coping such as acceptance, positive reframing, and humour, was protective against such deterioration. Floods had adverse psychological impacts on some older adults who were personally affected. Despite the evidence of resilience, a small proportion of older adults experienced significant difficulties after the floods. The findings in this study help understand older adults' psychological responses to disasters and have practical implications for service planning and delivery.

Does public transport use prevent declines in walking speed among older adults living in England? A prospective cohort study

PubMed Central

Rouxel, Patrick; Webb, Elizabeth; Chandola, Tarani

2017-01-01

Objectives Although there is some evidence that public transport use confers public health benefits, the evidence is limited by cross-sectional study designs and health-related confounding factors. This study examines the effect of public transport use on changes in walking speed among older adults living in England, comparing frequent users of public transport to their peers who did not use public transport because of structural barriers (poor public transport infrastructure) or through choice. Design Prospective cohort study. Setting England, UK. Participants Older adults aged ≥60 years eligible for the walking speed test. 6246 individuals at wave 2 (2004–2005); 5909 individuals at wave 3 (2006–2007); 7321 individuals at wave 4 (2008–2009); 7535 individuals at wave 5 (2010–2011) and 7664 individuals at wave 6 (2012–2013) of the English Longitudinal Study of Ageing. Main outcome measure The walking speed was estimated from the time taken to walk 2.4 m. Fixed effects models and growth curve models were used to examine the associations between public transport use and walking speed. Results Older adults who did not use public transport through choice or because of structural reasons had slower walking speeds (−0.02 m/s (95% CI −0.03 to –0.003) and −0.02 m/s (95% CI −0.03 to –0.01), respectively) and took an extra 0.07 s to walk 2.4 m compared with their peers who used public transport frequently. The age-related trajectories of decline in walking speed were slower for frequent users of public transport compared with non-users. Conclusions Frequent use of public transport may prevent age-related decline in physical capability by promoting physical activity and lower limb muscle strength among older adults. The association between public transport use and slower decline in walking speed among older adults is unlikely to be confounded by health-related selection factors. Improving access to good quality public transport could improve the

Deaf Adults' Reasons for Genetic Testing Depend on Cultural Affiliation: Results from a Prospective, Longitudinal Genetic Counseling and Testing Study

ERIC Educational Resources Information Center

Boudreault, Patrick; Baldwin, Erin E.; Fox, Michelle; Dutton, Loriel; Tullis, LeeElle; Linden, Joyce; Kobayashi, Yoko; Zhou, Jin; Sinsheimer, Janet S.; Sininger, Yvonne; Grody, Wayne W.; Palmer, Christina G. S.

2010-01-01

This article examines the relationship between cultural affiliation and deaf adults' motivations for genetic testing for deafness in the first prospective, longitudinal study to examine the impact of genetic counseling and genetic testing on deaf adults and the deaf community. Participants (n = 256), classified as affiliating with hearing, Deaf,…

A room for design: Through participatory design young adults with schizophrenia become strong collaborators.

PubMed

Terp, Malene; Laursen, Birgitte Schantz; Jørgensen, Rikke; Mainz, Jan; Bjørnes, Charlotte D

2016-12-01

Smartphone technology is being increasingly viewed as key to engaging young adults with schizophrenia in their own mental health care. In an attempt to use smartphones as an engagement tool, we conducted a participatory design process, where young adults with schizophrenia (n = 4), healthcare providers (n = 7), software designers (n = 3), graphic designer (n = 1), graphic recorder (n = 1), and team leader (n = 1) co-designed a smartphone application for use in early phase schizophrenia care. This paper reports the co-design process. Based on a variety of written data-sources, the paper describes if, and how, participatory design can help construct a physical and relational environment that enables young adults with schizophrenia to become active participants in the design of a more participatory mental health practice. Guided by Etienne Wenger's construct of Community of Practice, three major categories of characteristics and construction of a physical and relational environment supporting and inspiring participation and engagement were identified: (i) a pre-narrative about a community of practice, (ii) the room for design is a community of practice and (iii) the community of practice as a practice of special qualities. It is concluded that participatory design can support and inspire participation and engagement in the development of mental health care with young adults with schizophrenia, given that the environment in which participatory design unfolds is transparent, flexible, secure and informal. © 2016 Australian College of Mental Health Nurses Inc.

Development of Metacognitive Skills: Designing Problem-Based Experiment with Prospective Science Teachers in Biology Laboratory

ERIC Educational Resources Information Center

Denis Çeliker, Huriye

2015-01-01

The purpose of this study is to investigate the effect of designing problem-based experiments (DPBE) on the level of metacognitive skills of prospective science teachers. For this purpose, pre test-post test design, without control group, was used in the research. The research group of the study comprised 113 second-grade prospective science…

Childhood poverty and adult psychological well-being

PubMed Central

Evans, Gary W.

2016-01-01

Childhood disadvantage has repeatedly been linked to adult physical morbidity and mortality. We show in a prospective, longitudinal design that childhood poverty predicts multimethodological indices of adult (24 y of age) psychological well-being while holding constant similar childhood outcomes assessed at age 9. Adults from low-income families manifest more allostatic load, an index of chronic physiological stress, higher levels of externalizing symptoms (e.g., aggression) but not internalizing symptoms (e.g., depression), and more helplessness behaviors. In addition, childhood poverty predicts deficits in adult short-term spatial memory. PMID:27956615

The Role of Shifting, Updating, and Inhibition in Prospective Memory Performance in Young and Older Adults

ERIC Educational Resources Information Center

Schnitzspahn, Katharina M.; Stahl, Christoph; Zeintl, Melanie; Kaller, Christoph P.; Kliegel, Matthias

2013-01-01

Prospective memory performance shows a decline in late adulthood. The present article examines the role of 3 main executive function facets (i.e., shifting, updating, and inhibition) as possible developmental mechanisms associated with these age effects. One hundred seventy-five young and 110 older adults performed a battery of cognitive tests…

A comparison of laboratory, clinical, and self-report measures of prospective memory in healthy adults and individuals with brain injury.

PubMed

Raskin, Sarah A; Shum, David H K; Ellis, Judi; Pereira, Antonia; Mills, Ginger

2018-06-01

Individuals with traumatic brain injury (TBI) have demonstrated deficits in prospective memory (PM) functioning when compared to healthy adults. These deficits have been measured using laboratory measures, clinical measures, and self-report questionnaires. However, PM has been shown to involve multiple cognitive processes and have a variety of stages. Thus, it is not known whether these measures all assess the same aspects of PM. Thus, this study was designed to measure the convergent validity of the three types of PM measures in both healthy adults and individuals with TBI. We aimed to investigate the convergent validity of the three types of tasks in two ways. First, we sought to investigate whether the PM deficits experienced by people with TBI are consistent across tasks. Second, we sought to examine the relationship between the three types of tasks. Results demonstrated that while all three types of measures were sensitive to PM deficits in TBI, there were differences in the aspects/processes of PM being measured. Data from the laboratory measure suggested a specific difficulty with detecting the correct cue. Data from the clinical measure suggested that TBI has a greater effect on time-based cues than event-based cues and that the primary deficit is a prospective intention retrieval deficit rather than the retrospective memory component. In addition, those with TBI did not differ from healthy adults when the time delay was short enough, suggesting that PM is not universally impaired. Data from the self-report questionnaire suggested that those with TBI are more sensitive to difficulties with basic activities of daily living rather than instrumental activities on daily living. These results are discussed in terms of rehabilitation techniques that could focus first on cue detection and use basic activities of daily living as outcome measures.

Associations between vertebral fractures, increased thoracic kyphosis, a flexed posture and falls in older adults: a prospective cohort study.

PubMed

van der Jagt-Willems, Hanna C; de Groot, Maartje H; van Campen, Jos P C M; Lamoth, Claudine J C; Lems, Willem F

2015-03-28

Vertebral fractures, an increased thoracic kyphosis and a flexed posture are associated with falls. However, this was not confirmed in prospective studies. We performed a prospective cohort study to investigate the association between vertebral fractures, increased thoracic kyphosis and/or flexed posture with future fall incidents in older adults within the next year. Patients were recruited at a geriatric outpatient clinic. Vertebral fractures were evaluated on lateral radiographs of the spine with the semi-quantitative method of Genant; the degree of thoracic kyphosis was assessed with the Cobb angle. The occiput-to-wall distance was used to determine a flexed posture. Self-reported falls were prospectively registered by monthly phone contact for the duration of 12 months. Fifty-one older adults were included; mean age was 79 years (SD = 4.8). An increased thoracic kyphosis was independently associated with future falls (OR 2.13; 95% CI 1.10-4.51). Prevalent vertebral fractures had a trend towards significancy (OR 3.67; 95% CI 0.85-15.9). A flexed posture was not significantly associated with future falls. Older adults with an increased thoracic kyphosis are more likely to fall within the next year. We suggest clinical attention for underlying causes. Because patients with increased thoracic curvature of the spine might have underlying osteoporotic vertebral fractures, clinicians should be aware of the risk of a new fracture.

Novel use of the Wii Balance Board to prospectively predict falls in community-dwelling older adults.

PubMed

Kwok, Boon-Chong; Clark, Ross A; Pua, Yong-Hao

2015-06-01

The Wii Balance Board has received increasing attention as a balance measurement tool; however its ability to prospectively predict falls is unknown. This exploratory study investigated the use of the Wii Balance Board and other clinical-based measures for prospectively predicting falls among community-dwelling older adults. Seventy-three community-dwelling men and women, aged 60-85years were followed-up over a year for falls. Standing balance was indexed by sway velocities measured using the Wii Balance Board interfaced with a laptop. Clinical-based measures included Short Physical Performance Battery, gait speed and Timed-Up-and-Go test. Multivariable regression analyses were used to assess the ability of the Wii Balance Board measure to complement the TUG test in fall screening. Individually, the study found Wii Balance Board anteroposterior (odds ratio 1.98, 95% CI 1.16 to 3.40, P=0.01) and mediolateral (odds ratio 2.80, 95% CI 1.10 to 7.13, p=0.03) sway velocity measures predictive of prospective falls. However, when each velocity measure was adjusted with body mass index and Timed-Up-and-Go, only anteroposterior sway velocity was predictive of prospective falls (odds ratio 2.21, 95% CI 1.18 to 4.14). A faster anteroposterior velocity was associated with increased odds of falling. Area-under-the-curves for Wii Balance Board sway velocities were 0.67 and 0.71 for anteroposterior and mediolateral respectively. The Wii Balance Board-derived anteroposterior sway velocity measure could complement existing clinical-based measures in predicting future falls among community-dwelling older adults. Australian New Zealand Clinical Trials Registry number: ACTRN12610001099011. Copyright © 2015 Elsevier Ltd. All rights reserved.

PROSPECTIVE PREGNANCY STUDY DESIGNS FOR ASSESSING REPRODUCTIVE AND DEVELOPMENTAL TOXICANTS

EPA Science Inventory

Prospective Pregnancy Study Designs for Assessing Reproductive and Developmental Toxicants
Germaine M. Buck,1 Courtney D. Johnson,1 Joseph Stanford,2 Anne Sweeney,3 Laura Schieve,4 John Rockett,5 Sherry G. Selevan,6 Steve Schrader 7

Abstract
The origin of successfu...

Computer use and stress, sleep disturbances, and symptoms of depression among young adults--a prospective cohort study.

PubMed

Thomée, Sara; Härenstam, Annika; Hagberg, Mats

2012-10-22

We have previously studied prospective associations between computer use and mental health symptoms in a selected young adult population. The purpose of this study was to investigate if high computer use is a prospective risk factor for developing mental health symptoms in a population-based sample of young adults. The study group was a cohort of young adults (n = 4163), 20-24 years old, who responded to a questionnaire at baseline and 1-year follow-up. Exposure variables included time spent on computer use (CU) in general, email/chat use, computer gaming, CU without breaks, and CU at night causing lost sleep. Mental health outcomes included perceived stress, sleep disturbances, symptoms of depression, and reduced performance due to stress, depressed mood, or tiredness. Prevalence ratios (PRs) were calculated for prospective associations between exposure variables at baseline and mental health outcomes (new cases) at 1-year follow-up for the men and women separately. Both high and medium computer use compared to low computer use at baseline were associated with sleep disturbances in the men at follow-up. High email/chat use was negatively associated with perceived stress, but positively associated with reported sleep disturbances for the men. For the women, high email/chat use was (positively) associated with several mental health outcomes, while medium computer gaming was associated with symptoms of depression, and CU without breaks with most mental health outcomes. CU causing lost sleep was associated with mental health outcomes for both men and women. Time spent on general computer use was prospectively associated with sleep disturbances and reduced performance for the men. For the women, using the computer without breaks was a risk factor for several mental health outcomes. Some associations were enhanced in interaction with mobile phone use. Using the computer at night and consequently losing sleep was associated with most mental health outcomes for both men

Architectural Design Propaedeutics in Russia: History and Prospects

NASA Astrophysics Data System (ADS)

Lee, I. S.

2017-11-01

Architectural design propaedeutics is the introductory course of the composition basics which largely determines the process of professional training of an architect and a designer and the result of their work in the form of artistically meaningful artificial human environment. The article gives a brief overview of the history of propedeutics development in Russia, the experience of application and the prospects of development of the methods used to teach the basics of composition to future professionals. The article considered the main direction of the VKHUTEMAS development, Moscow Architectural Institute. Further, the paper identifies he connection of propedeutics with the architectural and design practice of the corresponding period. The article addresses to the author’s personal experiences related to the composition basics learning at Moscow Architectural Institute in the 70-ies of the last century. Besides, it presents the examples of the works made by the students from South Ural State University at the Chair of Design and Fine Arts.

Mortality from treatable illnesses in marginally housed adults: a prospective cohort study

PubMed Central

Jones, Andrea A; Vila-Rodriguez, Fidel; Leonova, Olga; Langheimer, Verena; Lang, Donna J; Barr, Alasdair M; Procyshyn, Ric M; Smith, Geoffrey N; Schultz, Krista; Buchanan, Tari; Krausz, Michael; Montaner, Julio S; MacEwan, G William; Rauscher, Alexander; Panenka, William J; Thornton, Allen E; Honer, William G

2015-01-01

Objectives Socially disadvantaged people experience greater risk for illnesses that may contribute to premature death. This study aimed to evaluate the impact of treatable illnesses on mortality among adults living in precarious housing. Design A prospective cohort based in a community sample. Setting A socially disadvantaged neighbourhood in Vancouver, Canada. Participants Adults (N=371) living in single room occupancy hotels or recruited from the Downtown Community Court and followed for median 3.8 years. Main outcome measures Participants were assessed for physical and mental illnesses for which treatment is currently available. We compared cohort mortality rates with 2009 Canadian rates. Left-truncated Cox proportional hazards modelling with age as the time scale was used to assess risk factors for earlier mortality. Results During 1269 person-years of observation, 31/371 (8%) of participants died. Compared with age-matched and sex-matched Canadians, the standardised mortality ratio was 8.29 (95% CI 5.83 to 11.79). Compared with those that had cleared the virus, active hepatitis C infection was a significant predictor for hepatic fibrosis adjusting for alcohol dependence and age (OR=2.96, CI 1.37 to 7.08). Among participants <55 years of age, psychosis (HR=8.12, CI 1.55 to 42.47) and hepatic fibrosis (HR=13.01, CI 3.56 to 47.57) were associated with earlier mortality. Treatment rates for these illnesses were low (psychosis: 32%, hepatitis C virus: 0%) compared with other common disorders (HIV: 57%, opioid dependence: 61%) in this population. Conclusions Hepatic fibrosis and psychosis are associated with increased mortality in people living in marginal conditions. Timely diagnosis and intervention could reduce the high mortality in marginalised inner city populations. PMID:26297373

Designing an over-the-counter consumer decision-making tool for older adults.

PubMed

Martin-Hammond, Aqueasha M; Abegaz, Tamirat; Gilbert, Juan E

2015-10-01

Older adults are at increased risk of adverse drug events due to medication. Older adults tend to take more medication and are at higher risk of chronic illness. Over-the-counter (OTC) medication does not require healthcare provider oversight and understanding OTC information is heavily dependent on a consumer's ability to understand and use the medication appropriately. Coupling health technology with effective communication is one approach to address the challenge of communicating health and improving health related tasks. However, the success of many health technologies also depends on how well the technology is designed and how well it addresses users needs. This is especially true for the older adult population. This paper describes (1) a formative study performed to understand how to design novel health technology to assist older adults with OTC medication information, and (2) how a user-centered design process helped to refine the initial assumptions of user needs and help to conceptualize the technology. An iterative design process was used. The process included two brainstorming and review sessions with human-computer interaction researchers and design sessions with older adults in the form of semi-structured interviews. Methods and principles of user-centered research and design were used to inform the research design. Two researchers with expertise in human-computer interaction performed expert reviews of early system prototypes. After initial prototypes were developed, seven older adults were engaged in semi-structured interviews to understand usability concerns and features and functionality older adults may find useful for selecting appropriate OTC medication. Eight usability concerns were discovered and addressed in the two rounds of expert review, and nine additional usability concerns were discovered in design sessions with older adults. Five themes emerged from the interview transcripts as recommendations for design. These recommendations

Increased prospective health service use for depression among adults with childhood onset bipolar disorder.

PubMed

Sala, Regina; Goldstein, Benjamin I; Wang, Shuai; Flórez-Salamanca, Ludwing; Iza, Miren; Blanco, Carlos

2013-11-01

To examine the prospective relationship between age of onset of bipolar disorder and the demographic and clinical characteristics, treatment, new onset of psychiatric comorbidity, and psychosocial functioning among adults with bipolar disorder. As part of the National Epidemiologic Survey on Alcohol and Related Conditions, 1600 adults who met lifetime Statistical Manual of Mental Disorders, 4th edition criteria for bipolar disorder-I (n = 1172) and bipolar disorder-II (n = 428) were included. Individuals were evaluated using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV version for Diagnostic and Statistical Manual of Mental Disorders, 4th edition, and data were analyzed from Waves 1 and 2, approximately 3 years apart. Individuals with bipolar disorder were divided into three age at onset groups: childhood (<13 years old, n = 115), adolescence (13-18 years old, n = 396), and adulthood (>19 year old, n = 1017). After adjusting for confounding factors, adults with childhood-onset bipolar disorder were more likely to see a counselor, have been hospitalized, and have received emergency room treatment for depression compared with those with adulthood-onset bipolar disorder. By contrast, there were no differences in the severity of mania or hypomania, new onset of comorbidity, and psychosocial functioning by age of bipolar disorder onset. Childhood-onset bipolar disorder is prospectively associated with seeking treatment for depression, an important proxy for depressive severity. Longitudinal studies are needed in order to determine whether prompt identification, accurate diagnosis, and early intervention can serve to mitigate the burden of childhood onset on the long-term depressive burden of bipolar disorder. Copyright © 2013 Mosby, Inc. All rights reserved.

Incidence rate of community-acquired pneumonia in adults: a population-based prospective active surveillance study in three cities in South America

PubMed Central

Lopardo, Gustavo Daniel; Fridman, Diego; Raimondo, Enrique; Albornoz, Henry; Lopardo, Ana; Bagnulo, Homero; Goleniuk, Daniel; Sanabria, Manuelita; Stamboulian, Daniel

2018-01-01

Objective To determine the incidence rate and mortality of community-acquired pneumonia (CAP) in adults in three cities in Latin America during a 3-year period. Design Prospective population-based surveillance study. Setting Healthcare facilities (outpatient centres and hospitals) in the cities of General Roca (Argentina), Rivera (Uruguay) and Concepción (Paraguay). Participants 2302 adults aged 18 years and older with CAP were prospectively enrolled between January 2012 and March 2015. Main outcome measures Incidence rates of CAP in adults, predisposing conditions for disease, mortality at 14 days and at 1 year were estimated. Incidence rate of CAP, within each age group, was calculated by dividing the number of cases by the person-years of disease-free exposure time based on the last census; incidence rates were expressed per 1000 person-years. Results Median age of participants was 66 years, 46.44% were men, 68% were hospitalised. Annual incidence rate was 7.03 (95% CI 6.64 to 7.44) per 1000 person-years in General Roca, 6.33 (95% CI 5.92 to 6.78) per 1000 person-years in Rivera and 1.76 (95% CI 1.55 to 2.00) per 1000 person-years in Concepción. Incidence rates were highest in participants aged over 65 years. 82.4% had at least one predisposing condition and 48% had two or more (multimorbidity). Chronic heart disease (43.6%) and smoking (37.3%) were the most common risk factors. 14-day mortality rate was 12.1% and 1-year mortality was 24.9%. Multimorbidity was associated with an increased risk of death at 14 days (OR 2.91; 95% CI 2.23 to 3.80) and at 1 year (OR 3.00; 95% CI 2.44 to 3.70). Conclusions We found a high incidence rate of CAP in adults, ranging from 1.76 to 7.03 per 1000 person-years, in three cities in South America, disclosing the high burden of disease in the region. Efforts to improve prevention strategies are needed. PMID:29643153

Prevalence, diagnosis, and disease course of pertussis in adults with acute cough: a prospective, observational study in primary care

PubMed Central

Teepe, Jolien; Broekhuizen, Berna DL; Ieven, Margareta; Loens, Katherine; Huygen, Kris; Kretzschmar, Mirjam; de Melker, Hester; Butler, Chris C; Little, Paul; Stuart, Beth; Coenen, Samuel; Goossens, Herman; Verheij, Theo JM

2015-01-01

Background Most cases of adult pertussis probably remain undiagnosed. Aim To explore the prevalence, diagnosis, and disease course of acute pertussis infection in adult patients presenting with acute cough. Design and setting Prospective observational study between 2007 and 2010 in primary care in 12 European countries. Method Adults presenting with acute cough (duration of ≤28 days) were included. Bordetella pertussis infection was determined by polymerase chain reaction (from nasopharyngeal flocked swabs and sputa) and by measurement of immunoglobulin G antibodies to pertussis toxin (PT) in venous blood at day 28. An antibody titre to PT of ≥125 IU/ml or PCR positive result in a respiratory sample defined recent infection. Patients completed a symptom diary for 28 days. Results Serum and/or respiratory samples were obtained in 3074 patients. Three per cent (93/3074) had recent B. pertussis infection. Prior cough duration >2 weeks discriminated to some extent between those with and without pertussis (adjusted odds ratio 1.89, 95% confidence interval = 1.17 to 3.07; P = 0.010). Median cough duration after presentation was 17 and 12 days in patients with and without pertussis, respectively (P = 0.008). Patients with pertussis had longer duration of phlegm production (P = 0.010), shortness of breath (P = 0.037), disturbed sleep (P = 0.013) and interference with normal activities or work (P = 0.033) after presentation. Conclusion Pertussis infection plays a limited role among adults presenting with acute cough in primary care, but GPs should acknowledge the possibility of pertussis in uncomplicated lower respiratory tract infection. As in children, pertussis also causes prolonged symptoms in adults. However, pertussis is difficult to discern from other acute cough syndromes in adults at first presentation. PMID:26412843

Malaria among adult inpatients in two Tanzanian referral hospitals: a prospective study.

PubMed

Kilonzo, Semvua B; Kamugisha, Erasmus; Downs, Jennifer A; Kataraihya, Johannes; Onesmo, Rwakyendela; Mheta, Koy; Jeong, Jiyeon M; Verweij, Jaco J; Fitzgerald, Daniel W; Peck, Robert N

2014-06-01

Most malaria research in sub-Saharan Africa has focused on children and pregnant women, but malaria among hospitalized adults in this region is poorly characterized. In this prospective study, we assessed the prevalence and clinical characteristics of malaria among the inpatient adults in two hospitals in Tanzania. We enrolled adults admitted with suspected malaria and performed routine thick blood smear (BS) and malaria rapid diagnostic tests (RDT). We also assessed malaria parasite clearance rates. We considered malaria status 'confirmed' or 'excluded' only in patients with two concordant tests. Malaria polymerase chain reaction (PCR) was performed in a subset of patients with discordant BS and RDT. After BS and RDT were performed on 579 adults with suspected malaria, malaria was excluded in 458/579 (79.1%) and confirmed in 16/579 (2.8%). One hundred and five out of 579 (18.1%) had discordant results. The prevalences of positive BS and positive RDT were 102/579 (17.6%) and 35/579 (6.0%), respectively, with only fair agreement (Kappa=0.354, p<0.0001). PCR results agreed with RDT in 35/35 (100%) of patients with a negative RDT but positive BS. PCR results also agreed with RDT in 9/13 (69.2%) of cases with a positive RDT but negative BS. Clinical correlates of malaria by multivariable analysis included subjective fever (OR 3.6 [1.0-12.3], p=0.04), headache (OR 3.1 [1.2-8.0], p=0.02) and vomiting (OR 2.7 [1.2-6.4], p=0.02). Malaria parasite clearance was significantly delayed in the HIV-infected group. Our study demonstrated only fair agreement between RDT and BS malaria tests among Tanzanian adult inpatients with suspected malaria. PCR generally agreed with RDT results. HIV was associated with delayed parasite clearance in adults with malaria. We recommend the routine use of RDTs for malaria diagnosis among adults admitted to hospitals in sub-Saharan Africa. Copyright © 2014 Elsevier B.V. All rights reserved.

Computer use and stress, sleep disturbances, and symptoms of depression among young adults – a prospective cohort study

PubMed Central

2012-01-01

Background We have previously studied prospective associations between computer use and mental health symptoms in a selected young adult population. The purpose of this study was to investigate if high computer use is a prospective risk factor for developing mental health symptoms in a population-based sample of young adults. Methods The study group was a cohort of young adults (n = 4163), 20–24 years old, who responded to a questionnaire at baseline and 1-year follow-up. Exposure variables included time spent on computer use (CU) in general, email/chat use, computer gaming, CU without breaks, and CU at night causing lost sleep. Mental health outcomes included perceived stress, sleep disturbances, symptoms of depression, and reduced performance due to stress, depressed mood, or tiredness. Prevalence ratios (PRs) were calculated for prospective associations between exposure variables at baseline and mental health outcomes (new cases) at 1-year follow-up for the men and women separately. Results Both high and medium computer use compared to low computer use at baseline were associated with sleep disturbances in the men at follow-up. High email/chat use was negatively associated with perceived stress, but positively associated with reported sleep disturbances for the men. For the women, high email/chat use was (positively) associated with several mental health outcomes, while medium computer gaming was associated with symptoms of depression, and CU without breaks with most mental health outcomes. CU causing lost sleep was associated with mental health outcomes for both men and women. Conclusions Time spent on general computer use was prospectively associated with sleep disturbances and reduced performance for the men. For the women, using the computer without breaks was a risk factor for several mental health outcomes. Some associations were enhanced in interaction with mobile phone use. Using the computer at night and consequently losing sleep was associated

Childhood abuse and neglect and adult intimate relationships: a prospective study.

PubMed

Colman, Rebecca A; Widom, Cathy Spatz

2004-11-01

The present study extends prior research on childhood maltreatment and social functioning by examining the impact of early childhood physical abuse, sexual abuse, and neglect on rates of involvement in adult intimate relationships and relationship functioning. Substantiated cases of child abuse and neglect from 1967 to 1971 were matched on gender, age, race, and approximate family class with non-abused and non-neglected children and followed prospectively into adulthood. Between 1989 and 1995, 1,196 participants (676 abused and neglected and 520 controls) were administered a 2-hour in-person interview, including a psychiatric assessment and a variety of standardized rating scales. Male and female abuse and neglect victims reported higher rates of cohabitation, walking out, and divorce than controls. Abused and neglected females were also less likely than female controls to have positive perceptions of current romantic partners and to be sexually faithful. Although previous research on childhood maltreatment and adult intimate relationships has emphasized outcomes for female victims of childhood sexual abuse, present findings suggest that other forms of early maltreatment (physical abuse and neglect) also have a negative effect on both males' and females' ability to establish and maintain healthy intimate relationships in adulthood.

The influence of housing characteristics on leisure-time sitting. A prospective cohort study in Danish adults.

PubMed

Saidj, Madina; Jørgensen, Torben; Jacobsen, Rikke Kart; Linneberg, Allan; Aadahl, Mette

2015-12-01

Built environmental attributes have been studied in relation to domestic time spent sedentary. An indoor behaviour has thus been linked to an outdoor setting. Yet, attributes of the actual domestic environment may also influence the time spent sedentary at home. Therefore, the aim was to examine if housing characteristics were cross-sectionally and prospectively related to leisure-time sitting in adults. In the Danish Health2006 cohort, 2308 adults were followed for 5 years. At baseline, subjects self-reported housing characteristics (habitat type, habitat surface area and household size), moderate-to-vigorous physical activity (MVPA) and socio-demographic factors. Leisure-time sitting was self-reported at baseline and 5-year follow-up. Multiple linear regression was used to assess cross-sectional and prospective associations. At baseline habitat surface area and household size were inversely associated with leisure-time sitting (p<0.01). Living in an apartment was associated with higher leisure-time sitting compared to living in a house (p<0.01). Household size was a predictor of 5-year leisure-time sitting (p<0.01), after adjustment for confounders and the other housing characteristics. Habitat type, habitat surface area and household size were associated with leisure-time sitting in adults, while especially household size was a predictor of leisure-time sitting five years later. The findings highlight the importance of home-environmental attributes when targeting a reduction in sedentary behaviours. Copyright © 2015 Elsevier Inc. All rights reserved.

Mobile phone use and stress, sleep disturbances, and symptoms of depression among young adults - a prospective cohort study

PubMed Central

2011-01-01

Background Because of the quick development and widespread use of mobile phones, and their vast effect on communication and interactions, it is important to study possible negative health effects of mobile phone exposure. The overall aim of this study was to investigate whether there are associations between psychosocial aspects of mobile phone use and mental health symptoms in a prospective cohort of young adults. Methods The study group consisted of young adults 20-24 years old (n = 4156), who responded to a questionnaire at baseline and 1-year follow-up. Mobile phone exposure variables included frequency of use, but also more qualitative variables: demands on availability, perceived stressfulness of accessibility, being awakened at night by the mobile phone, and personal overuse of the mobile phone. Mental health outcomes included current stress, sleep disorders, and symptoms of depression. Prevalence ratios (PRs) were calculated for cross-sectional and prospective associations between exposure variables and mental health outcomes for men and women separately. Results There were cross-sectional associations between high compared to low mobile phone use and stress, sleep disturbances, and symptoms of depression for the men and women. When excluding respondents reporting mental health symptoms at baseline, high mobile phone use was associated with sleep disturbances and symptoms of depression for the men and symptoms of depression for the women at 1-year follow-up. All qualitative variables had cross-sectional associations with mental health outcomes. In prospective analysis, overuse was associated with stress and sleep disturbances for women, and high accessibility stress was associated with stress, sleep disturbances, and symptoms of depression for both men and women. Conclusions High frequency of mobile phone use at baseline was a risk factor for mental health outcomes at 1-year follow-up among the young adults. The risk for reporting mental health symptoms at

Mobile phone use and stress, sleep disturbances, and symptoms of depression among young adults--a prospective cohort study.

PubMed

Thomée, Sara; Härenstam, Annika; Hagberg, Mats

2011-01-31

Because of the quick development and widespread use of mobile phones, and their vast effect on communication and interactions, it is important to study possible negative health effects of mobile phone exposure. The overall aim of this study was to investigate whether there are associations between psychosocial aspects of mobile phone use and mental health symptoms in a prospective cohort of young adults. The study group consisted of young adults 20-24 years old (n = 4156), who responded to a questionnaire at baseline and 1-year follow-up. Mobile phone exposure variables included frequency of use, but also more qualitative variables: demands on availability, perceived stressfulness of accessibility, being awakened at night by the mobile phone, and personal overuse of the mobile phone. Mental health outcomes included current stress, sleep disorders, and symptoms of depression. Prevalence ratios (PRs) were calculated for cross-sectional and prospective associations between exposure variables and mental health outcomes for men and women separately. There were cross-sectional associations between high compared to low mobile phone use and stress, sleep disturbances, and symptoms of depression for the men and women. When excluding respondents reporting mental health symptoms at baseline, high mobile phone use was associated with sleep disturbances and symptoms of depression for the men and symptoms of depression for the women at 1-year follow-up. All qualitative variables had cross-sectional associations with mental health outcomes. In prospective analysis, overuse was associated with stress and sleep disturbances for women, and high accessibility stress was associated with stress, sleep disturbances, and symptoms of depression for both men and women. High frequency of mobile phone use at baseline was a risk factor for mental health outcomes at 1-year follow-up among the young adults. The risk for reporting mental health symptoms at follow-up was greatest among those who

Freshman Year Alcohol and Marijuana Use Prospectively Predict Time to College Graduation and Subsequent Adult Roles and Independence

ERIC Educational Resources Information Center

Wilhite, Emily R.; Ashenhurst, James R.; Marino, Elise N.; Fromme, Kim

2017-01-01

Objective: This study examined how freshman year substance use prospectively predicted time to college graduation, and whether delayed graduation predicted postponed adoption of adult roles and future substance use. Participants: Participants were part of a longitudinal study that began in 2004. The first analyses focused on freshman year (N =…

Adolescents and young adults with acute lymphoblastic leukemia.

PubMed

Stock, Wendy

2010-01-01

During the last decade, increasing attention has been paid to a unique group of patients with acute lymphoblastic leukemia (ALL) who lie at the crossroad of therapeutic care by pediatric and adult hematologists/oncologists. ALL is a disease that affects infants, children, adolescents, and adult patients. With current therapies, the vast majority of children with ALL are now long-term survivors; unfortunately, the same good results have not yet been obtained for adults with ALL. This review will describe current controversies surrounding the treatment of adolescents and young adults with ALL--a group who finds themselves in the transition from "pediatric" to "adult" treatment approaches. The review focuses on recent insights into disease biology, prognostic factors, and treatment outcomes that have led to a series of prospective clinical trials specifically designed for adolescents and younger adults (AYAs) with ALL. These trials have been designed to provide important new clinical, psychosocial, and biological insights, and to further improve the survival of this challenging and unique group of patients.

Who Provides Care? A Prospective Study of Caregiving Among Adult Siblings

PubMed Central

Pillemer, Karl; Suitor, J. Jill

2014-01-01

Purpose: We use data from a longitudinal, within-family study to identify factors that predict which adult siblings assumed caregiving responsibilities to older mothers over a 7-year period. Design and Methods: Data for the study were collected from 139 older mothers at 2 points 7 years apart regarding their expectations and experiences of care from 537 adult children. Results: Children whom mothers identified at T1 as their expected future caregivers were much more likely to provide care when a serious illness occurred. Caregiving offspring were also more likely at T1 to have shared their mothers’ values, lived in proximity, and to be daughters. Implications: The findings indicate the degree to which a mother’s expectations for care predict actual caregiving by that child. Practitioners working with older adults should explore parents’ expectations for future care that involves their adult children. PMID:23840019

Designing a Pediatric Study for an Antimalarial Drug by Using Information from Adults

PubMed Central

Jullien, Vincent; Samson, Adeline; Guedj, Jérémie; Kiechel, Jean-René; Zohar, Sarah; Comets, Emmanuelle

2015-01-01

The objectives of this study were to design a pharmacokinetic (PK) study by using information about adults and evaluate the robustness of the recommended design through a case study of mefloquine. PK data about adults and children were available from two different randomized studies of the treatment of malaria with the same artesunate-mefloquine combination regimen. A recommended design for pediatric studies of mefloquine was optimized on the basis of an extrapolated model built from adult data through the following approach. (i) An adult PK model was built, and parameters were estimated by using the stochastic approximation expectation-maximization algorithm. (ii) Pediatric PK parameters were then obtained by adding allometry and maturation to the adult model. (iii) A D-optimal design for children was obtained with PFIM by assuming the extrapolated design. Finally, the robustness of the recommended design was evaluated in terms of the relative bias and relative standard errors (RSE) of the parameters in a simulation study with four different models and was compared to the empirical design used for the pediatric study. Combining PK modeling, extrapolation, and design optimization led to a design for children with five sampling times. PK parameters were well estimated by this design with few RSE. Although the extrapolated model did not predict the observed mefloquine concentrations in children very accurately, it allowed precise and unbiased estimates across various model assumptions, contrary to the empirical design. Using information from adult studies combined with allometry and maturation can help provide robust designs for pediatric studies. PMID:26711749

Oppositional Defiant Disorder in Adults with ADHD

ERIC Educational Resources Information Center

Reimherr, Frederick W.; Marchant, Barrie K.; Olsen, John L.; Wender, Paul H.; Robison, Reid J.

2013-01-01

Objective: Oppositional defiant disorder (ODD) is the most common comorbid condition in childhood ADHD. This trial was prospectively designed to explore ODD symptoms in ADHD adults. Method: A total of 86 patients in this placebo-controlled, double-blind trial of methylphenidate transdermal system (MTS) were categorized based on the presence of ODD…

Nutrition Education among Low-Income Older Adults: A Randomized Intervention Trial in Congregate Nutrition Sites

ERIC Educational Resources Information Center

Mitchell, Roger E.; Ash, Sarah L.; McClelland, Jacquelyn W.

2006-01-01

Nutritional well-being among older adults is critical for maintaining health, increasing longevity, and decreasing the impact of chronic illness. However, few well-controlled studies have examined nutritional behavior change among low-income older adults. A prospective, controlled, randomized design examined a five session nutrition education…

Connecting Generations: Developing Co-Design Methods for Older Adults and Children

ERIC Educational Resources Information Center

Xie, Bo; Druin, Allison; Fails, Jerry; Massey, Sheri; Golub, Evan; Franckel, Sonia; Schneider, Kiki

2012-01-01

As new technologies emerge that can bring older adults together with children, little has been discussed by researchers concerning the design methods used to create these new technologies. Giving both children and older adults a voice in a shared design process comes with many challenges. This paper details an exploratory study focusing on…

Retrieval cue and delay interval influence the relationship between prospective memory and activities of daily living in older adults.

PubMed

Tierney, Savanna M; Bucks, Romola S; Weinborn, Michael; Hodgson, Erica; Woods, Steven Paul

2016-01-01

Older adults commonly experience mild declines in everyday functioning and the strategic aspects of prospective memory (PM). This study used multiprocess theory to examine whether the strategic demands of retrieval cue type (event vs. time based) and delay interval length (2 vs. 15 min) influence the relationship between PM and activities of daily living (ADLs) in older adults. Participants included 97 community-dwelling older adults recruited from the Western Australia Participant Pool. Participants were administered the Memory for Intentions Screening Test (MIST) and Prospective and Retrospective Memory Questionnaire (PRMQ) as part of a larger neurocognitive assessment. A knowledgeable informant completed the Activities of Daily Living Questionnaire (ADLQ), from which a cutpoint of ≥ 1 was used to classify participants into "ADL normal" (n = 37) or "mild ADL problems" (n = 60) groups. Repeated measures multivariate analysis of variance (MANOVA) controlling for age was conducted with ADL group as the between-subjects factor and either MIST or PRMQ cue and delay scores as the within-subjects factors. We observed a significant ADL group by PM interaction on the MIST, with pair-wise analyses showing that the mild ADL problems group performed worse than ADL normal participants on the 15-min time-based scale (p < .001, Cohen's d = 0.71). No other MIST or PRMQ cue-delay variable differed between the two ADL groups (ps > .10). Findings indicate that decrements in strategically demanding cue monitoring and detection over longer PM delays may partly explain older adults' mild problems in everyday functioning. Findings may inform neuropsychological interventions aimed at maintaining ADL independence and enhancing quality of life in older adults.

Chronic Stress in Young German Adults: Who Is Affected? A Prospective Cohort Study.

PubMed

Herrera, Ronald; Berger, Ursula; Genuneit, Jon; Gerlich, Jessica; Nowak, Dennis; Schlotz, Wolff; Vogelberg, Christian; von Mutius, Erika; Weinmayr, Gudrun; Windstetter, Doris; Weigl, Matthias; Radon, Katja

2017-10-31

We aimed to prospectively assess changes in chronic stress among young adults transitioning from high school to university or working life. A population-based cohort in Munich and Dresden (Germany) was followed from age 16-18 (2002-2003) to age 20-23 (2007-2009) ( n = 1688). Using the Trier Inventory for the Assessment of Chronic Stress, two dimensions of stress at university or work were assessed: work overload and work discontent. In the multiple ordinal generalized estimating equations, socio-demographics, stress outside the workplace, and job history were additionally considered. At follow-up, 52% of the population were university students. Work overload increased statistically significantly from first to second follow-up, while work discontent remained constant at the population level. Students, compared to employees, reported a larger increase in work overload (adjusted odds ratio (OR): 1.33; 95% confidence interval (95% CI): 1.07, 1.67), while work discontent did not differ between the groups. In conclusion, work overload increases when young adults transition from school to university/job life, with university students experiencing the largest increase.

Chronic Stress in Young German Adults: Who Is Affected? A Prospective Cohort Study

PubMed Central

Herrera, Ronald; Berger, Ursula; Gerlich, Jessica; Nowak, Dennis; Schlotz, Wolff; Vogelberg, Christian; von Mutius, Erika; Weinmayr, Gudrun; Windstetter, Doris; Weigl, Matthias; Radon, Katja

2017-01-01

We aimed to prospectively assess changes in chronic stress among young adults transitioning from high school to university or working life. A population-based cohort in Munich and Dresden (Germany) was followed from age 16–18 (2002–2003) to age 20–23 (2007–2009) (n = 1688). Using the Trier Inventory for the Assessment of Chronic Stress, two dimensions of stress at university or work were assessed: work overload and work discontent. In the multiple ordinal generalized estimating equations, socio-demographics, stress outside the workplace, and job history were additionally considered. At follow-up, 52% of the population were university students. Work overload increased statistically significantly from first to second follow-up, while work discontent remained constant at the population level. Students, compared to employees, reported a larger increase in work overload (adjusted odds ratio (OR): 1.33; 95% confidence interval (95% CI): 1.07, 1.67), while work discontent did not differ between the groups. In conclusion, work overload increases when young adults transition from school to university/job life, with university students experiencing the largest increase. PMID:29088088

Smoking behaviors and attitudes during adolescence prospectively predict support for tobacco control policies in adulthood.

PubMed

Macy, Jonathan T; Chassin, Laurie; Presson, Clark C

2012-07-01

Several cross-sectional studies have examined factors associated with support for tobacco control policies. The current study utilized a longitudinal design to test smoking status and attitude toward smoking measured in adolescence as prospective predictors of support for tobacco control policies measured in adulthood. Participants (N = 4,834) were from a longitudinal study of a Midwestern community-based sample. Hierarchical multiple regression analyses tested adolescent smoking status and attitude toward smoking as prospective predictors (after controlling for sociodemographic factors, adult smoking status, and adult attitude toward smoking) of support for regulation of smoking in public places, discussion of the dangers of smoking in public schools, prohibiting smoking in bars, eliminating smoking on television and in movies, prohibiting smoking in restaurants, and increasing taxes on cigarettes. Participants who smoked during adolescence demonstrated more support for discussion of the dangers of smoking in public schools and less support for increasing taxes on cigarettes but only among those who smoked as adults. Those with more positive attitudes toward smoking during adolescence demonstrated less support as adults for prohibiting smoking in bars and eliminating smoking on television and in movies. Moreover, a significant interaction indicated that those with more positive attitudes toward smoking as adolescents demonstrated less support as adults for prohibiting smoking in restaurants, but only if they became parents as adults. This study's findings suggest that interventions designed to deter adolescent smoking may have future benefits in increasing support for tobacco control policies.

IT-based wellness tools for older adults: Design concepts and feedback.

PubMed

Joe, Jonathan; Hall, Amanda; Chi, Nai-Ching; Thompson, Hilaire; Demiris, George

2018-03-01

To explore older adults' preferences regarding e-health applications through use of generated concepts that inform wellness tool design. The 6-8-5 method and affinity mapping were used to create e-health design ideas that were translated into storyboards and scenarios. Focus groups were conducted to obtain feedback on the prototypes and included participant sketching. A qualitative analysis of the focus groups for emerging themes was conducted, and sketches were analyzed. Forty-three older adults participated in six focus group sessions. The majority of participants found the wellness tools useful. Preferences included features that supported participants in areas of unmet needs, such as ability to find reliable health information, cognitive training, or maintaining social ties. Participants favored features such as use of voice navigation, but were concerned over cost and the need for technology skills and access. Sketches reinforced these wants, including portability, convenience, and simplicity. Several factors were found to increase the desirability of such devices including convenient access to their health and health information, a simple, accessible interface, and support for memory issues. Researchers and designers should incorporate the feedback of older adults regarding wellness tools, so that future designs meet the needs of older adults.

Relation of physical activity time to incident disability in community dwelling adults with or at risk of knee arthritis: prospective cohort study

PubMed Central

Song, Jing; Semanik, Pamela A; Sharma, Leena; Bathon, Joan M; Eaton, Charles B; Hochberg, Marc C; Jackson, Rebecca D; Kwoh, C Kent; Mysiw, W Jerry; Nevitt, Michael C; Chang, Rowland W

2014-01-01

Objective To investigate whether objectively measured time spent in light intensity physical activity is related to incident disability and to disability progression. Design Prospective multisite cohort study from September 2008 to December 2012. Setting Baltimore, Maryland; Columbus, Ohio; Pittsburgh, Pennsylvania; and Pawtucket, Rhode Island, USA. Participants Disability onset cohort of 1680 community dwelling adults aged 49 years or older with knee osteoarthritis or risk factors for knee osteoarthritis; the disability progression cohort included 1814 adults. Main outcome measures Physical activity was measured by accelerometer monitoring. Disability was ascertained from limitations in instrumental and basic activities of daily living at baseline and two years. The primary outcome was incident disability. The secondary outcome was progression of disability defined by a more severe level (no limitations, limitations to instrumental activities only, 1-2 basic activities, or ≥3 basic activities) at two years compared with baseline. Results Greater time spent in light intensity activities had a significant inverse association with incident disability. Less incident disability and less disability progression were each significantly related to increasing quartile categories of daily time spent in light intensity physical activities (hazard ratios for disability onset 1.00, 0.62, 0.47, and 0.58, P for trend=0.007; hazard ratios for progression 1.00, 0.59, 0.50, and 0.53, P for trend=0.003) with control for socioeconomic factors (age, sex, race/ethnicity, education, income) and health factors (comorbidities, depressive symptoms, obesity, smoking, lower extremity pain and function, and knee assessments: osteoarthritis severity, pain, symptoms, prior injury). This finding was independent of time spent in moderate-vigorous activities. Conclusion These prospective data showed an association between greater daily time spent in light intensity physical activities and reduced

Smoking Behaviors and Attitudes During Adolescence Prospectively Predict Support for Tobacco Control Policies in Adulthood

PubMed Central

Chassin, Laurie; Presson, Clark C.

2012-01-01

Introduction: Several cross-sectional studies have examined factors associated with support for tobacco control policies. The current study utilized a longitudinal design to test smoking status and attitude toward smoking measured in adolescence as prospective predictors of support for tobacco control policies measured in adulthood. Methods: Participants (N = 4,834) were from a longitudinal study of a Midwestern community-based sample. Hierarchical multiple regression analyses tested adolescent smoking status and attitude toward smoking as prospective predictors (after controlling for sociodemographic factors, adult smoking status, and adult attitude toward smoking) of support for regulation of smoking in public places, discussion of the dangers of smoking in public schools, prohibiting smoking in bars, eliminating smoking on television and in movies, prohibiting smoking in restaurants, and increasing taxes on cigarettes. Results: Participants who smoked during adolescence demonstrated more support for discussion of the dangers of smoking in public schools and less support for increasing taxes on cigarettes but only among those who smoked as adults. Those with more positive attitudes toward smoking during adolescence demonstrated less support as adults for prohibiting smoking in bars and eliminating smoking on television and in movies. Moreover, a significant interaction indicated that those with more positive attitudes toward smoking as adolescents demonstrated less support as adults for prohibiting smoking in restaurants, but only if they became parents as adults. Conclusions: This study’s findings suggest that interventions designed to deter adolescent smoking may have future benefits in increasing support for tobacco control policies. PMID:22193576

Insurance principles and the design of prospective payment systems.

PubMed

Ellis, R P; McGuire, T G

1988-09-01

This paper applies insurance principles to the issues of optimal outlier payments and designation of peer groups in Medicare's case-based prospective payment system for hospital care. Arrow's principle that full insurance after a deductible is optimal implies that, to minimize hospital risk, outlier payments should be based on hospital average loss per case rather than, as at present, based on individual case-level losses. The principle of experience rating implies defining more homogenous peer groups for the purpose of figuring average cost. The empirical significance of these results is examined using a sample of 470,568 discharges from 469 hospitals.

Adult height and all-cause and cause-specific mortality in the Japan Public Health Center-based Prospective Study (JPHC).

PubMed

Ihira, Hikaru; Sawada, Norie; Iwasaki, Motoki; Yamaji, Taiki; Goto, Atsushi; Noda, Mitsuhiko; Iso, Hiroyasu; Tsugane, Shoichiro

2018-01-01

Adult height is determined by both genetic characteristics and environmental factors in early life. Although previous studies have suggested that adult height is associated with risk of mortality, comprehensive associations between height and all-cause and cause-specific mortality in the Japanese population are unclear. We aimed to evaluate the associations between adult height and all-cause and cause-specific mortality among Japanese men and women in a prospective cohort study. We investigated 107,794 participants (50,755 men and 57,039 women) aged 40 to 69 years who responded to the baseline questionnaire in the Japan Public Health Center-based Prospective Study. Participants were classified by quartile of adult height obtained from a self-reported questionnaire in men (<160cm, 160-163cm, 164-167cm, ≥168cm) and women (<149cm, 149-151cm, 152-155cm, ≥156cm). Hazard ratios (HR) and 95% confidence intervals (CI) for mortality from all-cause, cancer, heart disease, cerebrovascular disease, respiratory disease, and other cause mortality were calculated using Cox proportional hazards models. During follow-up, 12,320 men and 7,030 women died. Taller adult height was associated with decreased risk for mortality from cerebrovascular disease (HR <160cm vs. ≥168cm (95% CI) = 0.83 (0.69-0.99); HR for 5-cm increment (95% CI) = 0.95 (0.90-0.99)) and respiratory disease (HR <160cm vs. ≥168cm (95% CI) = 0.84 (0.69-1.03); HR for 5-cm increment (95% CI) = 0.92 (0.87-0.97)), but was also associated with increased risk for overall cancer mortality (HR <160cm vs. ≥168cm (95% CI) = 1.17 (1.07-1.28); HR for 5-cm increment (95% CI) = 1.04 (1.01-1.07)) in men. Taller adult height was also associated with decreased risk for mortality from cerebrovascular disease (HR <149cm vs. ≥156cm (95% CI) = 0.84 (0.66-1.05); HR for 5-cm increment (95% CI) = 0.92 (0.86-0.99)) in women. Our results confirmed that adult height is associated with cause-specific mortality in a Japanese

Young adults' perceptions on life prospects and gender roles as important factors to influence health behaviour: a qualitative study from Karachi, Pakistan.

PubMed

Hasnain, Syed Farid-ul; Johansson, Eva; Mogren, Ingrid; Krantz, Gunilla

2012-04-28

The purpose of this qualitative study was to explore perceptions and expectations of young males and females, in Karachi, Pakistan, regarding their life prospects and gender roles, with resulting implications for health behaviour. The main theme emerging was "Young adults' prospects in life are hampered by psychosocial and gender equality constraints". Gender inequality and the low status of women in society were described as major obstacles to the overall development. Persistent withholding of information to the younger generation on sexual and reproductive health issues was perceived to increase exposure to health risks, particularly sexually transmitted infections (STIs). The present study reveals new discourses on equality among young adults, pointing towards an increasing, sound interaction between the sexes and aspirations for more gender equal relationships. Such views and awareness among the younger generation constitutes a strong force towards change of traditional norms, including reproductive health behaviour, and calls for policy change.

Increasing the number of inter-arch contacts improves mastication in adults with Down syndrome: a prospective controlled trial.

PubMed

Hennequin, Martine; Mazille, Marie-Noëlle; Cousson, Pierre-Yves; Nicolas, Emmanuel

2015-06-01

Feeding difficulties due to their condition have been widely described for babies, children and adults with Down syndrome (DS). A previous study demonstrated that, compared with wearing a placebo appliance, wearing an occlusal appliance increased inter-arch dental contacts, improved the oral health status of adults with DS and normalised their mandibular rest position. This longitudinal prospective controlled trial aimed to evaluate whether increasing inter-arch contacts in adults with DS would lead to improved masticatory efficiency. Fourteen subjects with DS (mean age±SD: 28.5±9.3years) and twelve controls without DS (24.6±1.0years) were video recorded while chewing samples of carrot and peanuts with and without an oral appliance that was designed to equalise the number of posterior functional units (PFUs) in both groups. Three parameters were collected during mastication for 15cycles and until swallowing: food refusals, food bolus granulometry (D50) and kinematic parameters of the chewing process (number of cycles, chewing duration and cycle frequency within the chewing sequence). In the DS group, increasing the number of PFUs led to a decrease in bolus particle size, to fewer masticatory cycles needed to produce a bolus ready for swallowing and to a decrease in the occurrence of food refusal, while mean chewing frequency did not vary. In the control group, bolus granulometry and chewing time increased with appliance wear while mean chewing frequency decreased. These changes clearly indicate a functional improvement in subjects with DS. This study also demonstrated a causal relationship between the number of functional pairs of posterior teeth and improved mastication. Any evaluation of feeding behaviour in persons with DS should consider inter-arch dental contacts as an explicative variable for feeding problems and their nutritional and respiratory consequences. Copyright © 2015 Elsevier Inc. All rights reserved.

Association between Adult Height and Risk of Colorectal, Lung, and Prostate Cancer: Results from Meta-analyses of Prospective Studies and Mendelian Randomization Analyses.

PubMed

Khankari, Nikhil K; Shu, Xiao-Ou; Wen, Wanqing; Kraft, Peter; Lindström, Sara; Peters, Ulrike; Schildkraut, Joellen; Schumacher, Fredrick; Bofetta, Paolo; Risch, Angela; Bickeböller, Heike; Amos, Christopher I; Easton, Douglas; Eeles, Rosalind A; Gruber, Stephen B; Haiman, Christopher A; Hunter, David J; Chanock, Stephen J; Pierce, Brandon L; Zheng, Wei

2016-09-01

Observational studies examining associations between adult height and risk of colorectal, prostate, and lung cancers have generated mixed results. We conducted meta-analyses using data from prospective cohort studies and further carried out Mendelian randomization analyses, using height-associated genetic variants identified in a genome-wide association study (GWAS), to evaluate the association of adult height with these cancers. A systematic review of prospective studies was conducted using the PubMed, Embase, and Web of Science databases. Using meta-analyses, results obtained from 62 studies were summarized for the association of a 10-cm increase in height with cancer risk. Mendelian randomization analyses were conducted using summary statistics obtained for 423 genetic variants identified from a recent GWAS of adult height and from a cancer genetics consortium study of multiple cancers that included 47,800 cases and 81,353 controls. For a 10-cm increase in height, the summary relative risks derived from the meta-analyses of prospective studies were 1.12 (95% CI 1.10, 1.15), 1.07 (95% CI 1.05, 1.10), and 1.06 (95% CI 1.02, 1.11) for colorectal, prostate, and lung cancers, respectively. Mendelian randomization analyses showed increased risks of colorectal (odds ratio [OR] = 1.58, 95% CI 1.14, 2.18) and lung cancer (OR = 1.10, 95% CI 1.00, 1.22) associated with each 10-cm increase in genetically predicted height. No association was observed for prostate cancer (OR = 1.03, 95% CI 0.92, 1.15). Our meta-analysis was limited to published studies. The sample size for the Mendelian randomization analysis of colorectal cancer was relatively small, thus affecting the precision of the point estimate. Our study provides evidence for a potential causal association of adult height with the risk of colorectal and lung cancers and suggests that certain genetic factors and biological pathways affecting adult height may also affect the risk of these cancers.

Association between Adult Height and Risk of Colorectal, Lung, and Prostate Cancer: Results from Meta-analyses of Prospective Studies and Mendelian Randomization Analyses

PubMed Central

Khankari, Nikhil K.; Shu, Xiao-Ou; Wen, Wanqing; Kraft, Peter; Lindström, Sara; Peters, Ulrike; Schildkraut, Joellen; Schumacher, Fredrick; Bofetta, Paolo; Risch, Angela; Bickeböller, Heike; Amos, Christopher I.; Easton, Douglas; Gruber, Stephen B.; Haiman, Christopher A.; Hunter, David J.; Chanock, Stephen J.; Pierce, Brandon L.; Zheng, Wei

2016-01-01

Background Observational studies examining associations between adult height and risk of colorectal, prostate, and lung cancers have generated mixed results. We conducted meta-analyses using data from prospective cohort studies and further carried out Mendelian randomization analyses, using height-associated genetic variants identified in a genome-wide association study (GWAS), to evaluate the association of adult height with these cancers. Methods and Findings A systematic review of prospective studies was conducted using the PubMed, Embase, and Web of Science databases. Using meta-analyses, results obtained from 62 studies were summarized for the association of a 10-cm increase in height with cancer risk. Mendelian randomization analyses were conducted using summary statistics obtained for 423 genetic variants identified from a recent GWAS of adult height and from a cancer genetics consortium study of multiple cancers that included 47,800 cases and 81,353 controls. For a 10-cm increase in height, the summary relative risks derived from the meta-analyses of prospective studies were 1.12 (95% CI 1.10, 1.15), 1.07 (95% CI 1.05, 1.10), and 1.06 (95% CI 1.02, 1.11) for colorectal, prostate, and lung cancers, respectively. Mendelian randomization analyses showed increased risks of colorectal (odds ratio [OR] = 1.58, 95% CI 1.14, 2.18) and lung cancer (OR = 1.10, 95% CI 1.00, 1.22) associated with each 10-cm increase in genetically predicted height. No association was observed for prostate cancer (OR = 1.03, 95% CI 0.92, 1.15). Our meta-analysis was limited to published studies. The sample size for the Mendelian randomization analysis of colorectal cancer was relatively small, thus affecting the precision of the point estimate. Conclusions Our study provides evidence for a potential causal association of adult height with the risk of colorectal and lung cancers and suggests that certain genetic factors and biological pathways affecting adult height may also affect the

Human Centred Design Considerations for Connected Health Devices for the Older Adult

PubMed Central

Harte, Richard P.; Glynn, Liam G.; Broderick, Barry J.; Rodriguez-Molinero, Alejandro; Baker, Paul M. A.; McGuiness, Bernadette; O’Sullivan, Leonard; Diaz, Marta; Quinlan, Leo R.; ÓLaighin, Gearóid

2014-01-01

Connected health devices are generally designed for unsupervised use, by non-healthcare professionals, facilitating independent control of the individuals own healthcare. Older adults are major users of such devices and are a population significantly increasing in size. This group presents challenges due to the wide spectrum of capabilities and attitudes towards technology. The fit between capabilities of the user and demands of the device can be optimised in a process called Human Centred Design. Here we review examples of some connected health devices chosen by random selection, assess older adult known capabilities and attitudes and finally make analytical recommendations for design approaches and design specifications. PMID:25563225

Formulating a Serious-Games Design Project for Adult Offenders with the Probation Service

ERIC Educational Resources Information Center

Bates, Matthew Ian; Brown, David; Cranton, Wayne; Lewis, James

2011-01-01

This paper documents an investigation evaluating if adult offenders can benefit from a facilitated serious-games design project as part of their probation program. Research has observed a participatory design group of adult offenders working with their probation managers and a PhD researcher to create a new serious-game for use by the probation…

Adolescent delinquency and antisocial tendencies as precursors to adult violent offending: a prospective study of a representative sample of swiss men.

PubMed

Laubacher, Arja; Rossegger, Astrid; Endrass, Jérôme; Angst, Jules; Urbaniok, Frank; Vetter, Stefan

2014-05-01

Studies on adult sex and violent offenders have found high rates of adolescent delinquency, while early delinquency has been shown to be significantly associated with adult offending. The examined subsample (n = 123) of a longitudinal prospective study (n = 6,315) includes all men who at the age of 19 had an entry in the criminal records. During the observation period of 34 years, 68.3% of the sample had been reconvicted as adults, 23.6% for violent or sex offenses. The odds of adult sex or violent offending were 2.8 times higher for those who had committed a violent offense in adolescence and 1.05 times higher for any offense committed before the age of 19. The characteristics of criminal history showed the highest discriminative values (area under the curve [AUC] = 0.61-0.65). The most important finding of this study was that characteristics of adolescent delinquency predicted adult violent or sex offending, whereas socioeconomic and psychiatric characteristics did not.

Adult Day Health Center Participation and Health-Related Quality of Life

ERIC Educational Resources Information Center

Schmitt, Eva M.; Sands, Laura P.; Weiss, Sara; Dowling, Glenna; Covinsky, Kenneth

2010-01-01

Purpose: The purpose of this study was to assess the association between Adult Day Health Center (ADHC) participation and health-related quality of life. Design and Methods: Case-controlled prospective study utilizing the Medical Outcomes Survey Form 36 (SF-36) to compare newly enrolled participants from 16 ADHC programs with comparable…

Frailty and falls among adult patients undergoing chronic hemodialysis: a prospective cohort study

PubMed Central

2013-01-01

Background Patients undergoing hemodialysis are at high risk of falls, with subsequent complications including fractures, loss of independence, hospitalization, and institutionalization. Factors associated with falls are poorly understood in this population. We hypothesized that insights derived from studies of the elderly might apply to adults of all ages undergoing hemodialysis; we focused on frailty, a phenotype of physiological decline strongly associated with falls in the elderly. Methods In this prospective, longitudinal study of 95 patients undergoing hemodialysis (1/2009-3/2010), the association of frailty with future falls was explored using adjusted Poisson regression. Frailty was classified using the criteria established by Fried et al., as a combination of five components: shrinking, weakness, exhaustion, low activity, and slowed walking speed. Results Over a median 6.7-month period of longitudinal follow-up, 28.3% of study participants (25.9% of those under 65, 29.3% of those 65 and older) experienced a fall. After adjusting for age, sex, race, comorbidity, disability, number of medications, marital status, and education, frailty independently predicted a 3.09-fold (95% CI: 1.38-6.90, P=0.006) higher number of falls. This relationship between frailty and falls did not differ for younger and older adults (P=0.57). Conclusions Frailty, a validated construct in the elderly, was a strong and independent predictor of falls in adults undergoing hemodialysis, regardless of age. Our results may aid in identifying frail hemodialysis patients who could be targeted for multidimensional fall prevention strategies. PMID:24131569

Traditional Masculinity as a Risk Factor for Suicidal Ideation: Cross-Sectional and Prospective Evidence from a Study of Young Adults.

PubMed

Coleman, Daniel

2015-01-01

Traditional masculinity is hypothesized to be associated with suicidal ideation, and traditional masculinity is predicted to interact with stressors, intensifying suicidal ideation. Cross-sectional and prospective data from a study of 2,431 young adults was analyzed using hierarchical regression main effects and interaction models. Traditional masculinity was associated with suicidal ideation, second only in strength to depression, including when controlling for other risk factors. Prospective effects were substantially weaker. There was mixed evidence for traditional masculinity by stress interactions. The results provide preliminary support for the role of traditional masculinity in suicidal ideation, but the relationship should be tested in studies of suicide attempts and mortality. Implications for prevention and intervention are explored.

Frailty and type of death among older adults in China: prospective cohort study

PubMed Central

Warner, David F; Yi, Zeng

2009-01-01

Objective To examine the association between frailty and type of death among the world’s largest oldest-old population in China. Design Prospective cohort study. Setting 2002 and 2005 waves of the Chinese longitudinal healthy longevity survey carried out in 22 provinces throughout China. Participants 13 717 older adults (aged ≥65). Main outcome measures Type of death, categorised as being bedridden for fewer than 30 days with or without suffering and being bedridden for 30 or more days with or without suffering. Results Multinomial analyses showed that higher levels of frailty significantly increased the relative risk ratios of mortality for all types of death. Of those with the highest levels of frailty, men were most likely to experience 30 or more bedridden days with suffering before death (relative risk ratio 8.70, 95% confidence interval 6.31 to 12.00) and women 30 or more bedridden days with no suffering (11.53, 17.84 to 16.96). Regardless of frailty, centenarians and nonagenarians were most likely to experience fewer than 30 bedridden days with no suffering, whereas those aged 65-79 and 80-89 were more likely to experience fewer than 30 bedridden days with suffering. Adjusting for compositional differences had little impact on the link between frailty and type of death for both sexes and age groups. Conclusions The association between frailty and type of death differs by sex and age. Health scholars and clinical practitioners should consider age and sex differences in frailty to develop more effective measures to reduce preventable suffering before death. PMID:19359289

The epidemiology of polypharmacy in older adults: register-based prospective cohort study

PubMed Central

Morin, Lucas; Johnell, Kristina; Laroche, Marie-Laure; Fastbom, Johan; Wastesson, Jonas W

2018-01-01

Objective Polypharmacy is the concomitant use of several drugs by a single person, and it increases the risk of adverse drug-related events in older adults. Little is known about the epidemiology of polypharmacy at the population level. We aimed to measure the prevalence and incidence of polypharmacy and to investigate the associated factors. Methods A prospective cohort study was conducted using register data with national coverage in Sweden. A total of 1,742,336 individuals aged ≥65 years at baseline (November 1, 2010) were included and followed until death or the end of the study (December 20, 2013). Results On average, individuals were exposed to 4.6 (SD =4.0) drugs at baseline. The prevalence of polypharmacy (5+ drugs) was 44.0%, and the prevalence of excessive polypharmacy (10+ drugs) was 11.7%. The incidence rate of polypharmacy among individuals without polypharmacy at baseline was 19.9 per 100 person-years, ranging from 16.8% in individuals aged 65–74 years to 33.2% in those aged ≥95 years (adjusted hazard ratio [HR] =1.49, 95% confidence interval [CI] 1.42–1.56). The incidence rate of excessive polypharmacy was 8.0 per 100 person-years. Older adults using multi-dose dispensing were at significantly higher risk of developing incident polypharmacy compared with those receiving ordinary prescriptions (HR =1.51, 95% CI 1.47–1.55). When adjusting for confounders, living in nursing home was found to be associated with lower risks of incident polypharmacy and incident excessive polypharmacy (HR =0.79 and HR =0.86, p<0.001, respectively). Conclusion The prevalence and incidence of polypharmacy are high among older adults in Sweden. Interventions aimed at reducing the prevalence of polypharmacy should also target potential incident polypharmacy users as they are the ones who fuel future polypharmacy. PMID:29559811

Imagining a brighter future: the effect of positive imagery training on mood, prospective mental imagery and emotional bias in older adults.

PubMed

Murphy, Susannah E; Clare O'Donoghue, M; Drazich, Erin H S; Blackwell, Simon E; Christina Nobre, Anna; Holmes, Emily A

2015-11-30

Positive affect and optimism play an important role in healthy ageing and are associated with improved physical and cognitive health outcomes. This study investigated whether it is possible to boost positive affect and associated positive biases in this age group using cognitive training. The effect of computerised imagery-based cognitive bias modification on positive affect, vividness of positive prospective imagery and interpretation biases in older adults was measured. 77 older adults received 4 weeks (12 sessions) of imagery cognitive bias modification or a control condition. They were assessed at baseline, post-training and at a one-month follow-up. Both groups reported decreased negative affect and trait anxiety, and increased optimism across the three assessments. Imagery cognitive bias modification significantly increased the vividness of positive prospective imagery post-training, compared with the control training. Contrary to our hypothesis, there was no difference between the training groups in negative interpretation bias. This is a useful demonstration that it is possible to successfully engage older adults in computer-based cognitive training and to enhance the vividness of positive imagery about the future in this group. Future studies are needed to assess the longer-term consequences of such training and the impact on affect and wellbeing in more vulnerable groups. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

A scoring algorithm for predicting the presence of adult asthma: a prospective derivation study.

PubMed

Tomita, Katsuyuki; Sano, Hiroyuki; Chiba, Yasutaka; Sato, Ryuji; Sano, Akiko; Nishiyama, Osamu; Iwanaga, Takashi; Higashimoto, Yuji; Haraguchi, Ryuta; Tohda, Yuji

2013-03-01

To predict the presence of asthma in adult patients with respiratory symptoms, we developed a scoring algorithm using clinical parameters. We prospectively analysed 566 adult outpatients who visited Kinki University Hospital for the first time with complaints of nonspecific respiratory symptoms. Asthma was comprehensively diagnosed by specialists using symptoms, signs, and objective tools including bronchodilator reversibility and/or the assessment of bronchial hyperresponsiveness (BHR). Multiple logistic regression analysis was performed to categorise patients and determine the accuracy of diagnosing asthma. A scoring algorithm using the symptom-sign score was developed, based on diurnal variation of symptoms (1 point), recurrent episodes (2 points), medical history of allergic diseases (1 point), and wheeze sound (2 points). A score of >3 had 35% sensitivity and 97% specificity for discriminating between patients with and without asthma and assigned a high probability of having asthma (accuracy 90%). A score of 1 or 2 points assigned intermediate probability (accuracy 68%). After providing additional data of forced expiratory volume in 1 second/forced vital capacity (FEV(1)/FVC) ratio <0.7, the post-test probability of having asthma was increased to 93%. A score of 0 points assigned low probability (accuracy 31%). After providing additional data of positive reversibility, the post-test probability of having asthma was increased to 88%. This pragmatic diagnostic algorithm is useful for predicting the presence of adult asthma and for determining the appropriate time for consultation with a pulmonologist.

Nutrition Education Brings Behavior and Knowledge Change in Limited-Resource Older Adults

ERIC Educational Resources Information Center

McClelland, Jacquelyn W.; Jayaratne, K.S.U.; Bird, Carolyn L.

2013-01-01

A prospective, controlled, randomized, crossover design was used to examine a nutrition education curriculum's effects on knowledge and behavior of 463 limited-resource older adults in 13 counties. Counties were randomized to begin with the treatment or control curriculum and then the remaining curriculum. Participants completed a pre-test…

Design of capability measurement instruments pedagogic content knowledge (PCK) for prospective mathematics teachers

NASA Astrophysics Data System (ADS)

Aminah, N.; Wahyuni, I.

2018-05-01

The purpose of this study is to find out how the process of designing a tool of measurement Pedagogical Content Knowledge (PCK) capabilities, especially for prospective mathematics teachers are valid and practical. The design study of this measurement appliance uses modified Plomp development step, which consists of (1) initial assessment stage, (2) design stage at this stage, the researcher designs the measuring grille of PCK capability, (3) realization stage that is making measurement tool ability of PCK, (4) test phase, evaluation, and revision that is testing validation of measurement tools conducted by experts. Based on the results obtained that the design of PCK capability measurement tool is valid as indicated by the assessment of expert validator, and the design of PCK capability measurement tool, shown based on the assessment of teachers and lecturers as users of states strongly agree the design of PCK measurement tools can be used.

Metabolic Mediators of the Association Between Adult Weight Gain and Colorectal Cancer: Data From the European Prospective Investigation into Cancer and Nutrition (EPIC) Cohort

PubMed Central

Aleksandrova, Krasimira; Schlesinger, Sabrina; Fedirko, Veronika; Jenab, Mazda; Bueno-de-Mesquita, Bas; Freisling, Heinz; Romieu, Isabelle; Pischon, Tobias; Kaaks, Rudolf; Gunter, Marc J.; Dahm, Christina C.; Overvad, Kim; Rostgaard-Hansen, Agnetha Linn; Tjønneland, Anne; Trichopoulou, Antonia; Bamia, Christina; Lagiou, Pagona; Agnoli, Claudia; Mattiello, Amalia; Bradbury, Kathryn; Khaw, Kay-Tee; Riboli, Elio; Boeing, Heiner

2017-01-01

Abstract Evidence indicates that gaining weight in adult life is associated with an elevated risk of colorectal cancer; however, biological mechanisms that may explain this association remain unclear. We evaluated the mediation effect of 20 different biomarkers on the relationship between adult weight gain and colorectal cancer, using data from a prospective nested case-control study of 452 incident cases diagnosed between 1992 and 2003 and matched within risk sets to 452 controls within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The proportions of mediated effects (%) were estimated on the basis of differences in percent effect changes in conditional logistic regression models with and without additional adjustment for individual biomarkers. Greater adult weight gain (≥300 g/year vs. <300 g/year) was associated with a higher risk of colon cancer (multivariable-adjusted relative risk = 1.54, 95% confidence interval: 1.07, 2.24) but not rectal cancer (relative risk = 1.07, 95% confidence interval: 0.68, 1.66). This association was accounted for mostly by attained waist circumference (reduction of 61%) and by the biomarkers soluble leptin receptor (reduction of 43%) and glycated hemoglobin (reduction of 28%). These novel data suggest that the observed association between adult weight gain and colon cancer could be primarily explained by attained abdominal fatness and biomarkers of metabolic dysfunction. PMID:28387787

Theory of mind and switching predict prospective memory performance in adolescents.

PubMed

Altgassen, Mareike; Vetter, Nora C; Phillips, Louise H; Akgün, Canan; Kliegel, Matthias

2014-11-01

Research indicates ongoing development of prospective memory as well as theory of mind and executive functions across late childhood and adolescence. However, so far the interplay of these processes has not been investigated. Therefore, the purpose of the current study was to investigate whether theory of mind and executive control processes (specifically updating, switching, and inhibition) predict prospective memory development across adolescence. In total, 42 adolescents and 41 young adults participated in this study. Young adults outperformed adolescents on tasks of prospective memory, theory of mind, and executive functions. Switching and theory of mind predicted prospective memory performance in adolescents. Copyright © 2014 Elsevier Inc. All rights reserved.

The role of cue detection for prospective memory development across the lifespan.

PubMed

Hering, Alexandra; Wild-Wall, Nele; Gajewski, Patrick D; Falkenstein, Michael; Kliegel, Matthias; Zinke, Katharina

2016-12-01

Behavioral findings suggest an inverted U-shaped pattern of prospective memory development across the lifespan. A key mechanism underlying this development is the ability to detect cues. We examined the influence of cue detection on prospective memory, combining behavioral and electrophysiological measures, in three age groups: adolescents (12-14 years), young (19-28 years), and old adults (66-77 years). Cue detection was manipulated by varying the distinctiveness (i.e., how easy it was to detect the cue based on color) of the prospective memory cue in a semantic judgment ongoing task. Behavioral results supported the pattern of an inverted U-shape with a pronounced prospective memory decrease in old adults. Adolescents and young adults showed a prospective memory specific modulation (larger amplitudes for the cues compared to other trials) already for the N1 component. No such specific modulation was evident in old adults for the early N1 component but only at the later P3b component. Adolescents showed differential modulations of the amplitude also for irrelevant information at the P3b, suggesting less efficient processing. In terms of conceptual implications, present findings underline the importance of cue detection for prospective remembering and reveal different developmental trajectories for cue detection. Our findings suggest that cue detection is not a unitary process but consists of multiple stages corresponding to several ERP components that differentially contribute to prospective memory performance across the lifespan. In adolescents resource allocation for detecting cues seemed successful initially but less efficient at later stages; whereas we found the opposite pattern for old adults. Copyright © 2016 Elsevier Ltd. All rights reserved.

Lest we forget: comparing retrospective and prospective assessments of adverse childhood experiences in the prediction of adult health.

PubMed

Reuben, Aaron; Moffitt, Terrie E; Caspi, Avshalom; Belsky, Daniel W; Harrington, Honalee; Schroeder, Felix; Hogan, Sean; Ramrakha, Sandhya; Poulton, Richie; Danese, Andrea

2016-10-01

Adverse childhood experiences (ACEs; e.g. abuse, neglect, and parental loss) have been associated with increased risk for later-life disease and dysfunction using adults' retrospective self-reports of ACEs. Research should test whether associations between ACEs and health outcomes are the same for prospective and retrospective ACE measures. We estimated agreement between ACEs prospectively recorded throughout childhood (by Study staff at Study member ages 3, 5, 7, 9, 11, 13, and 15) and retrospectively recalled in adulthood (by Study members when they reached age 38), in the population-representative Dunedin cohort (N = 1,037). We related both retrospective and prospective ACE measures to physical, mental, cognitive, and social health at midlife measured through both objective (e.g. biomarkers and neuropsychological tests) and subjective (e.g. self-reported) means. Dunedin and U.S. Centers for Disease Control ACE distributions were similar. Retrospective and prospective measures of adversity showed moderate agreement (r = .47, p < .001; weighted Kappa = .31, 95% CI: .27-.35). Both associated with all midlife outcomes. As compared to prospective ACEs, retrospective ACEs showed stronger associations with life outcomes that were subjectively assessed, and weaker associations with life outcomes that were objectively assessed. Recalled ACEs and poor subjective outcomes were correlated regardless of whether prospectively recorded ACEs were evident. Individuals who recalled more ACEs than had been prospectively recorded were more neurotic than average, and individuals who recalled fewer ACEs than recorded were more agreeable. Prospective ACE records confirm associations between childhood adversity and negative life outcomes found previously using retrospective ACE reports. However, more agreeable and neurotic dispositions may, respectively, bias retrospective ACE measures toward underestimating the impact of adversity on objectively measured life outcomes and

Toward a Psychological Science of Advanced Technology Design for Older Adults

PubMed Central

Fisk, Arthur D.

2010-01-01

Objectives. Technology represents advances in knowledge that change the way humans perform tasks. Ideally, technology will make the task easier, more efficient, safer, or perhaps more pleasurable. Unfortunately, new technologies can sometimes make a task more difficult, slower, dangerous, or perhaps more frustrating. Older adults interact with a variety of technologies in the course of their daily activities and thus products should be designed to be used by people of varying ages. Methods. In this article, we provide an overview of what psychology has to offer to the design of technology—from understanding what people need, to identifying their preferences for design characteristics, and to defining their capabilities and limitations that will influence technology interactions. Results. We identify how research in the field of psychology and aging has advanced understanding of technology interactions and how research on technology interactions can inform theories of aging. Discussion. Design for aging involves understanding the unique capabilities and limitations of older adults; identifying their needs, preferences, and desires for technology in their lives; and involving them in the design process. PMID:20833690

Illness Representations, Treatment Beliefs, Medication Adherence, and 30-Day Hospital Readmission in Adults With Chronic Heart Failure: A Prospective Correlational Study.

PubMed

Turrise, Stephanie

2016-01-01

An estimated 5.1 million Americans have chronic heart failure, yet despite advances in its treatment, there has been no improvement in hospital readmissions among aging adult patients with chronic heart failure. The purpose of this study is to investigate the relationships among illness representations, treatment beliefs, medication adherence, and 30-day hospital readmission for heart failure exacerbation in aging adults with chronic heart failure. Using a prospective, correlational design, 96 older adults with a primary or secondary diagnosis of heart failure discharged to home from a hospital in the Southeastern United States participated in telephone surveys and follow-up telephone calls. Data analysis included correlation and logistic regression analyses. Participants were highly adherent to their medications. Individuals who did not believe their treatment was effective in controlling their HF were readmitted within 30 days of hospital discharge for HF exacerbation; that is, treatment control was inversely related to 30-day hospital readmission. In post hoc analyses, personal control was inversely related to dichotomized medication adherence and necessity-concern differential was directly related to dichotomized medication adherence. The necessity-concern differential, or the belief that medication necessity outweighed the concerns they had about their medicines, was a significant predictor of medication adherence. Nurses can use these study findings to help identify individuals who may be at risk of being nonadherent to their medications and hospital readmission. Recommendations for future research include replication with multiple sites, the addition of objective measures of medication adherence, investigation of both the cognitive and emotional pathways, and qualitative exploration of personal control in the context of medication adherence in HF.

Sleep Deprivation and Time-Based Prospective Memory.

PubMed

Esposito, Maria José; Occhionero, Miranda; Cicogna, PierCarla

2015-11-01

To evaluate the effect of sleep deprivation on time-based prospective memory performance, that is, realizing delayed intentions at an appropriate time in the future (e.g., to take a medicine in 30 minutes). Between-subjects experimental design. The experimental group underwent 24 h of total sleep deprivation, and the control group had a regular sleep-wake cycle. Participants were tested at 08:00. Laboratory. Fifty healthy young adults (mean age 22 ± 2.1, 31 female). 24 h of total sleep deprivation. Participants were monitored by wrist actigraphy for 3 days before the experimental session. The following cognitive tasks were administered: one time-based prospective memory task and 3 reasoning tasks as ongoing activity. Objective and subjective vigilance was assessed by the psychomotor vigilance task and a visual analog scale, respectively. To measure the time-based prospective memory task we assessed compliance and clock checking behavior (time monitoring). Sleep deprivation negatively affected time-based prospective memory compliance (P < 0.001), objective vigilance (mean RT: P < 0.001; slowest 10% RT: P < 0.001; lapses: P < 0.005), and subjective vigilance (P < 0.0001). Performance on reasoning tasks and time monitoring behavior did not differ between groups. The results highlight the potential dangerous effects of total sleep deprivation on human behavior, particularly the ability to perform an intended action after a few minutes. Sleep deprivation strongly compromises time-based prospective memory compliance but does not affect time check frequency. Sleep deprivation may impair the mechanism that allows the integration of information related to time monitoring with the prospective intention. © 2015 Associated Professional Sleep Societies, LLC.

Motor performance and physical activity as predictors of prospective falls in community-dwelling, older adults by frailty level: Application of wearable technology

PubMed Central

Mohler, M. Jane; Wendel, Christopher S.; Taylor-Piliae, Ruth E.; Toosizadeh, Nima; Najafi, Bijan

2016-01-01

Background Few studies of the association between prospective falls and sensor-based measures of motor performance and physical activity have evaluated subgroups of frailty status separately. Objective To evaluate wearable sensor-based measures of gait, balance, and physical activity (PA) that are predictive of future falls in community-dwelling older adults. Methods The Arizona Frailty Cohort Study in Tucson, Arizona followed community-dwelling adults aged 65 years and over (without baseline cognitive deficit, severe movement disorders, or recent stroke) for falls over six months. Baseline measures included Fried frailty criteria; in-home, and sensor-based gait (normal and fast walk), balance (bipedal eyes open and eyes closed), and spontaneous daily PA over 48 hours, measured using validated wearable technologies. Results Of the 119 participants (36% non-frail, 48% pre-frail, and 16% frail), 48 reported one or more fall (47% of non-frail, 33% of pre-frail, and 47% of frail). Although balance deficit and PA were independent fall predictors in pre-frail and frail groups, they were not sensitive to predict prospective falls in the non-frail group. Even though gait performance deteriorated as frailty increased, gait was not a predictor of prospective falls when participants were stratified based on frailty status. In pre-frail and frail participants combined, center of mass sway (OR= 5.9, 95% CI 2.6 – 13.7), PA mean walking bout duration (OR = 1.1, 95% CI 1.0 – 1.2), PA mean standing bout duration (OR = .94, 95% CI .91 - .99), and a fall in previous 6 months (OR = 7.3, 95% CI 1.5 – 36.4) were independent predictors for prospective falls (AUC: 0.882). Conclusion This study suggests that independent predictors of falls are dependent on frailty status. Among sensor-derived parameters, balance deficit, longer typical walking episodes, and shorter typical standing episodes were the most sensitive predictors of prospective falls in the combined pre-frail and frail

Injury, disability and quality of life after the 2009 earthquake in Padang, Indonesia: a prospective cohort study of adult survivors

PubMed Central

Sudaryo, Mondastri K.; Besral; Endarti, Ajeng Tias; Rivany, Ronnie; Phalkey, Revati; Marx, Michael; Guha-Sapir, Debarati

2012-01-01

Background On 30 September 2009, a 7.6 magnitude earthquake severely hit the coast of Padang city in West Sumatra, Indonesia leaving about 1,117 people dead and injuring another 3,515. Health consequences such as physical injury, co-morbidity, disability and quality of life over time are seldom reported among survivors after earthquakes. Objectives To investigate the associations between injury, disability and quality of life amongst adult survivors in Padang city after the 2009 earthquake. Design/Methods A prospective cohort study was conducted to compare adult injured (184) and adult non-injured (93) subjects over a 6-month period. Data on physical injury, co-morbidities, disability and quality of life were collected through interviews and measured quantitatively in three phases, i.e. at baseline, end of 3 and 6 months. Results Disability scores were consistently and significantly higher among injured subjects compared to non-injured, even when adjusted for co-morbidities (i.e. acute symptoms and chronic diseases). The highest disability score amongst injured subjects was attributed to ‘feeling discomfort/pain’. Quality of life attribute (QLA) scores, were significantly lower amongst injured people as compared to those non-injured even when adjusted for co-morbidities. The lowest QLA item score amongst the injured was ‘pain, depression and anxiety’. Significant and consistent negative correlations were found between disability and QLA scores in both the injured and non-injured groups. Conclusion Physical injury is significantly correlated with both higher disability and lower quality of life, while disability has significant negative correlation with quality of life. The findings suggest that, through disability, injury may contribute to decreased quality of life. It is therefore recommended to promptly and adequately treat injuries after disasters to prevent any potential for disability and hence restore quality of life. PMID:22629236

Fast-food consumption, diet quality and body weight: cross-sectional and prospective associations in a community sample of working adults

PubMed Central

Barnes, Timothy L; French, Simone A; Mitchell, Nathan R; Wolfson, Julian

2018-01-01

Objective To examine the association between fast-food consumption, diet quality and body weight in a community sample of working adults. Design Cross-sectional and prospective analysis of anthropometric, survey and dietary data from adults recruited to participate in a worksite nutrition intervention. Participants self-reported frequency of fast-food consumption per week. Nutrient intakes and diet quality, using the Healthy Eating Index-2010 (HEI-2010), were computed from dietary recalls collected at baseline and 6 months. Setting Metropolitan medical complex, Minneapolis, MN, USA. Subjects Two hundred adults, aged 18–60 years. Results Cross-sectionally, fast-food consumption was significantly associated with higher daily total energy intake (β = 72·5, P = 0·005), empty calories (β = 0·40, P = 0·006) and BMI (β = 0·73, P =0·011), and lower HEI-2010 score (β = −1·23, P =0·012), total vegetables (β = −0·14, P =0·004), whole grains (β = −0·39, P =0·005), fibre (β = −0·83, P =0·002), Mg (β = −6·99, P =0·019) and K (β = −57·5, P =0·016). Over 6 months, change in fast-food consumption was not significantly associated with changes in energy intake or BMI, but was significantly inversely associated with total intake of vegetables (β = −0·14, P =0·034). Conclusions Frequency of fast-food consumption was significantly associated with higher energy intake and poorer diet quality cross-sectionally. Six-month change in fast-food intake was small, and not significantly associated with overall diet quality or BMI. PMID:26074150

Negative Prospective Memory in Alzheimer's Disease: "Do Not Perform That Action".

PubMed

El Haj, Mohamad; Coello, Yann; Kapogiannis, Dimitrios; Gallouj, Karim; Antoine, Pascal

2018-01-01

Relatively to "standard" prospective memory, i.e., remembering to perform a future action, little is known about negative prospective memory, i.e., remembering not to perform a future action. This study investigated the latter ability in Alzheimer's disease (AD). AD participants and healthy older adults were asked to click on the keyboard or not to click on it when a cue word was encountered. Results showed more omissions (i.e., forgetting to click the keyboard when the instruction was to do so) in AD participants than in healthy older adults, suggesting a prospective memory deficit. Interestingly, more commissions (i.e., clicking the keyboard when the instruction was not to do so) were also observed in AD participants than in healthy older adults. Similar levels of commissions and omissions were observed in AD participants and in healthy older adults. Also, commissions and omissions were correlated with performance on an inhibition assessment task. Our findings reveal that AD is characterized by not only difficulty in the retrieval of recent information, but also difficulty to inhibit no-longer appropriate stimulus-response associations previously learned, suggesting a specific deficit of negative prospective memory in AD.

Designing a Weight Gain Prevention Trial for Young Adults: The CHOICES Study

ERIC Educational Resources Information Center

Lytle, Leslie A.; Moe, Stacey G.; Nanney, M. Susie; Laska, Melissa N.; Linde, Jennifer A.; Petrich, Christine A.; Sevcik, Sarah M.

2014-01-01

Background: Young adults are at risk for weight gain. Little is known about how to design weight control programs to meet the needs of young adults and few theory-based interventions have been evaluated in a randomized control trial. The Choosing Healthy Options in College Environments and Settings (CHOICES) study was funded to create a…

Alcohol and mortality in Russia: prospective observational study of 151 000 adults

PubMed Central

Zaridze, David; Lewington, Sarah; Boroda, Alexander; Scélo, Ghislaine; Karpov, Rostislav; Lazarev, Alexander; Konobeevskaya, Irina; Igitov, Vladimir; Terechova, Tatiyana; Boffetta, Paolo; Sherliker, Paul; Kong, Xiangling; Whitlock, Gary; Boreham, Jillian; Brennan, Paul; Peto, Richard

2014-01-01

Summary Background Russian adults have extraordinarily high rates of premature death. Retrospective enquiries to the families of about 50 000 deceased Russians had found excess vodka use among those dying from external causes (accident, suicide, violence) and eight particular disease groupings. We now seek prospective evidence of these associations. Methods In three Russian cities (Barnaul, Byisk, and Tomsk), we interviewed 200 000 adults during 1999–2008 (with 12 000 re-interviewed some years later) and followed them until 2010 for cause-specific mortality. In 151 000 with no previous disease and some follow-up at ages 35–74 years, Poisson regression (adjusted for age at risk, amount smoked, education, and city) was used to calculate the relative risks associating vodka consumption with mortality. We have combined these relative risks with age-specific death rates to get 20-year absolute risks. Findings Among 57 361 male smokers with no previous disease, the estimated 20-year risks of death at ages 35–54 years were 16% (95% CI 15–17) for those who reported consuming less than a bottle of vodka per week at baseline, 20% (18–22) for those consuming 1–2·9 bottles per week, and 35% (31–39) for those consuming three or more bottles per week; trend p<0·0001. The corresponding risks of death at ages 55–74 years were 50% (48–52) for those who reported consuming less than a bottle of vodka per week at baseline, 54% (51–57) for those consuming 1–2·9 bottles per week, and 64% (59–69) for those consuming three or more bottles per week; trend p<0·0001. In both age ranges most of the excess mortality in heavier drinkers was from external causes or the eight disease groupings strongly associated with alcohol in the retrospective enquiries. Self-reported drinking fluctuated; of the men who reported drinking three or more bottles of vodka per week who were reinterviewed a few years later, about half (185 of 321) then reported drinking less

Freshman year alcohol and marijuana use prospectively predict time to college graduation and subsequent adult roles and independence.

PubMed

Wilhite, Emily R; Ashenhurst, James R; Marino, Elise N; Fromme, Kim

2017-01-01

This study examined how freshman year substance use prospectively predicted time to college graduation, and whether delayed graduation predicted postponed adoption of adult roles and future substance use. Participants were part of a longitudinal study that began in 2004. The first analyses focused on freshman year (N = 2,050). The second analyses corresponded to a subset of participants at age 27 (N = 575). Measures included self-reported substance use, adult role adoption, and university reported graduation dates. Results indicated that frequent binge drinking and marijuana use during freshman year predicted delayed college graduation. Those who took longer to graduate were more likely to have lower incomes and were less likely to obtain a graduate degree. Taking 5-6 years to graduate was associated with greater likelihood of alcohol-related problems. Findings support the importance of interventions during freshman year of college to decrease substance use and promote timely graduation.

Sibling support and the educational prospects of young adults in Malawi

PubMed Central

Trinitapoli, Jenny; Yeatman, Sara; Fledderjohann, Jasmine

2014-01-01

BACKGROUND Extended kin networks are an important social and economic resource in Africa. Existing research has focused primarily on intergenerational ties, but much less is known about “lateral” ties, such as those between siblings. In contexts of high adult mortality (i.e., fewer parents and grandparents) sibling interdependencies may assume heightened importance, especially during the transition to adulthood. OBJECTIVE In this paper, we extend the resource dilution perspective that dominates research on sibling relationships in early childhood and propose an alternate framework in which siblings represent a source of economic support that contributes positively to educational outcomes at later stages of the life course. METHODS We draw upon longitudinal data from young adults (age 15–18) in southern Malawi to assess the scope and magnitude of economic transfers among sibship sets. We then explore the relationships between sibship size, net economic transfers between siblings, and four measures of educational progress. RESULTS First, exchanges of economic support between siblings are pervasive in the Malawian context and patterned, especially by birth order. Second, economic support from siblings is positively associated with educational attainment, as well as with the odds of being at grade level in school, both contemporaneously and prospectively. CONCLUSIONS During young-adulthood, economic support from siblings acts as a buffer against the negative association between sibship size and schooling outcomes that has been documented at earlier ages. COMMENTS We question the established notion that siblings unilaterally subtract from resource pools, and argue that sibling support may be consequential for a wide range of demographic outcomes in a variety of cultural contexts. Our findings point to the need for additional research on the importance of lateral kinship ties across cultural settings and throughout the life course. PMID:24855450

Impact of fear of falling and fall history on disability incidence among older adults: Prospective cohort study.

PubMed

Makino, Keitaro; Makizako, Hyuma; Doi, Takehiko; Tsutsumimoto, Kota; Hotta, Ryo; Nakakubo, Sho; Suzuki, Takao; Shimada, Hiroyuki

2018-04-01

Fear of falling (FOF) is a major health problem for older adults, present not just in fallers, but also nonfallers. This study examined the impact of FOF and fall history on disability incidence among community-dwelling older adults from a prospective cohort study. A total of 5104 older adults living in community settings participated in baseline assessment and were followed up for about 4 years (median 52 mo, range 49-55 mo). At baseline, participants were assessed the presence of FOF and their fall history, and divided into 4 groups: Fall (-) FOF (-), Fall (+) FOF (-), Fall (-) FOF (+), and Fall (+) FOF (+). Disability incidence was defined as national long-term care insurance certification for personal support or care. During the follow-up period, 429 participants (9.9%) were newly certified as having a disability and needing personal support for long-term care insurance. Fall (-) FOF (+) group and Fall (+) FOF (+) group showed a significantly higher risk of disability incidence than Fall (-) FOF (-) group even after adjusting for covariates (Fall (-) FOF (+): hazard ratio 1.28, 95% confidence interval, 1.01-1.62, Fall (+) FOF (+): hazard ratio 1.44, 95% confidence interval, 1.05-1.98). Fear of falling could be a simple and useful predictor of disability incidence in community-dwelling older adults. Identifying and decreasing fall risk factors may prevent fall-related injuries, but excessive FOF may be associated with increased risk of disability incidence. Copyright © 2017 John Wiley & Sons, Ltd.

Community-acquired bacterial meningitis in adults in the Netherlands, 2006-14: a prospective cohort study.

PubMed

Bijlsma, Merijn W; Brouwer, Matthijs C; Kasanmoentalib, E Soemirien; Kloek, Anne T; Lucas, Marjolein J; Tanck, Michael W; van der Ende, Arie; van de Beek, Diederik

2016-03-01

We studied causative pathogens, clinical characteristics, and outcome of adult community-acquired bacterial meningitis after the introduction of adjunctive dexamethasone treatment and nationwide implementation of paediatric conjugate vaccines. In this cohort study, we prospectively assessed adults (age >16 years) with community-acquired bacterial meningitis in the Netherlands, identified through the National Reference Laboratory for Bacterial Meningitis or individual physicians between Jan 1, 2006, and July 1, 2014. We identified independent predictors of an unfavourable outcome (Glasgow Outcome Scale score 1-4) by logistic regression. We assessed 1412 episodes of community-acquired bacterial meningitis. Incidence declined from 1·72 cases per 100,000 adults per year in 2007-08, to 0·94 per 100,000 per year in 2013-14. Streptococcus pneumoniae caused 1017 (72%) of 1412 episodes. Rates of adult bacterial meningitis decreased most sharply among pneumococcal serotypes included in paediatric conjugate vaccine, and in meningococcal meningitis. We found no evidence of serotype or serogroup replacement. The overall case fatality rate was 244 (17%) of 1412 episodes and unfavourable outcome occurred in 531 (38%) of 1412 episodes. Predictors of unfavourable outcome were advanced age, absence of otitis or sinusitis, alcoholism, tachycardia, lower score on the Glasgow Coma Scale, cranial nerve palsy, a cerebrospinal fluid white-cell count lower than 1000 cells per μL, a positive blood culture, and a high serum C-reactive protein concentration. Adjunctive dexamethasone was administered for 1234 (89%) of 1384 assessed episodes. The multivariable adjusted odds ratio of dexamethasone treatment for unfavourable outcome was 0·54 (95% CI 0·39-0·73). The incidence of adult bacterial meningitis has decreased substantially, which is partly explained by herd protection by paediatric conjugate vaccines. Adjunctive dexamethasone treatment was associated with substantially improved

Research on reform plan of civil engineering adult education graduation design

NASA Astrophysics Data System (ADS)

Su, Zhibin; Sun, Shengnan; Cui, Shicai

2017-12-01

As for civil engineering adult education graduation design, reform program is put forward combined with our school. The main points of reform include the following aspects. New pattern of graduation design which is consisted of basic training of engineering design, technical application and engineering innovation training is formed. Integration model of graduation design and employment is carried out. Multiple professional guidance graduation design pattern is put forward. Subject of graduation design is chosen based on the school actual circumstance. A “three stage” quality monitoring system is established. Performance evaluation pattern that concludes two oral examinations of the dissertation is strictly carried out.

Patterns of alcohol consumption and risk of falls in older adults: a prospective cohort study.

PubMed

Ortolá, R; García-Esquinas, E; Galán, I; Guallar-Castillón, P; López-García, E; Banegas, J R; Rodríguez-Artalejo, F

2017-11-01

Falls are a major health problem in older adults, but their relationship with alcohol consumption in this population remains unclear. In a cohort with 2170 older adults followed up for 3.3 years, both moderate drinking and the Mediterranean drinking pattern were associated with a lower risk of falls and injurious falls. This study aims to examine the association between certain patterns of alcohol consumption, including the Mediterranean drinking pattern (MDP), and the risk of falls in older adults. A prospective cohort with 2170 community-dwelling individuals aged ≥60 years was recruited in Spain in 2008-2010 and followed up through 2012. At baseline, participants reported alcohol consumption and, at the end of follow-up, their falls during the previous year. The MDP was defined as moderate alcohol consumption (threshold between moderate and heavy intake was 40 g/day for men and 24 g/day for women) with preference for wine and drinking only with meals. Analyses were conducted with negative binomial or logistic regression, as appropriate, and adjusted for the main confounders. Compared with never drinkers, the number of falls was lower in moderate drinkers (incidence rate ratio (95% confidence interval), 0.79 (0.63-0.99)) and drinkers with MDP (0.73 (0.56-0.96)). Also, moderate drinkers and those with MDP showed a lower risk of ≥2 falls (odds ratio (95% confidence interval), 0.58 (0.38-0.88) and 0.56 (0.34-0.93), respectively) and of falls requiring medical care (0.67 (0.46-0.96) and 0.61 (0.39-0.96), respectively). Both moderate drinking and the MDP were associated with a lower risk of falls and injurious falls in older adults. However, sound advice on alcohol consumption should balance risks and benefits.

Infant milk feeding influences adult bone health: a prospective study from birth to 32 years.

PubMed

Pirilä, Satu; Taskinen, Mervi; Viljakainen, Heli; Kajosaari, Merja; Turanlahti, Maila; Saarinen-Pihkala, Ulla M; Mäkitie, Outi

2011-04-27

Peak bone mass, attained by early adulthood, is influenced by genetic and life-style factors. Early infant feeding and duration of breastfeeding in particular, associate with several health-related parameters in childhood. The aim of this study was to examine whether the effects of early infant feeding extend to peak bone mass and other bone health characteristics at adult age. A cohort of 158 adults (76 males) born in Helsinki, Finland, 1975, prospectively followed up from birth, underwent physical examination and bone densitometry to study bone area, bone mineral content (BMC), and bone mineral density (BMD) at 32 years of age. Life-style factors relevant for bone health were recorded. For data analysis the cohort was divided into three equal-size groups according to the total duration of breastfeeding (BF): Short (≤3 months), Intermediate and Prolonged (≥7 months) BF groups. In males short BF is associated with higher bone area, BMC, and BMD compared to longer BF. Males in the Short BF group had on average 4.7% higher whole body BMD than males in the Prolonged BF group. In multivariate analysis, after controlling for multiple confounding factors, the influence of BF duration on adult bone characteristics persisted in males. Differences between the three feeding groups were observed in lumbar spine bone area and BMC, and whole body BMD (MANCOVA; p = 0.025, p = 0.013, and p = 0.048, respectively), favoring the Short BF group. In women no differences were observed. In men, early infant milk feeding may have a significant impact on adult bone health. A potential explanation is that the calcium and phosphate contents were strikingly higher in formula milk and commercial cow milk/cow milk dilutions as opposed to human milk. Our novel finding merits further studies to determine means to ensure optimal bone mass development in infants with prolonged breastfeeding.

Executive Control Deficits as a Prodrome to Falls in Healthy Older Adults: A Prospective Study Linking Thinking, Walking, and Falling

PubMed Central

Herman, Talia; Mirelman, Anat; Giladi, Nir; Schweiger, Avraham

2010-01-01

Background. Executive function (EF) deficits may increase fall risk, even among older adults with no overt cognitive impairment. Indeed, the effects of dual tasking (DT) on gait, a challenge to executive control, are more exaggerated in persons with a history of falls. Prospective evidence is, however, lacking. Methods. We prospectively evaluated whether EF predicts falls over a 2-year period among 262 community-living, healthy, and well-functioning older adults, focusing on the 201 who reported no falls during the previous year. At baseline, participants completed a computerized cognitive battery that generated an index of EF and other cognitive domains. Gait was assessed using performance-based tests and by quantifying walking during single- and dual-task conditions. Results. The 262 participants (mean age: 76.3 ± 4.3 years, 60.3% women) had intact cognitive function on testing, a low comorbidity index, and good mobility. The EF index predicted future falls. Among those who reported no previous falls, participants in the worst EF quartile were three times more likely to fall during the 2 years of follow-up, and they were more likely to transition from nonfaller to faller sooner. DT gait variability also predicted future falls and multiple falls, whereas other measures of cognitive function, gait, and mobility did not. Conclusions. Among healthy older adults, individuals with poorer EF are more prone to falls. Higher-level cognitive functions such as those regulated by the frontal lobes are apparently needed for safe everyday navigation that demands multitasking. Optimal screening, early detection, and treatment of falls should, apparently, also target this cognitive domain. PMID:20484336

Prospective Associations of Actual and Perceived Descriptive Norms with Drinking Among Emerging Adults.

PubMed

Simons-Morton, Bruce; Haynie, Denise; Bible, Joe; Liu, Danping

2018-02-05

Descriptive norms are commonly associated with participant drinking. However, study participants may incorrectly perceive that their peers drink about the same amount as they do, which would bias estimates of drinking homogeneity. This research examined the magnitude of associations between emerging adults' reports of their own drinking and peer drinking measured the previous year by measures of (1) participants' perceptions of friends' drinking; and (2) actual drinking reported by nominated peers. The data are from annual surveys conducted in 2014 and 2015, Waves 4 and 5 (the first 2 years after high school) of 7 annual assessments as part of the NEXT Generation Health Study (n = 323). Associations of participant alcohol use with perceived friend use (five closest, closest male, and closest female friends), and with actual peer use. Logistic regression analyses estimated the magnitudes of prospective associations between each measure of peer drinking at W4 and participant drinking at W5.

Two decades (1993-2012) of adult intensive care unit design: a comparative study of the physical design features of the best practice examples.

PubMed

Rashid, Mahbub

2014-01-01

In 2006, Critical Care Nursing Quarterly published a study of the physical design features of a set of best practice example adult intensive care units (ICUs). These adult ICUs were awarded between 1993 and 2003 by the Society of Critical Care Medicine (SCCM), the American Association of Critical-Care Nurses, and the American Institute of Architects/Academy of Architecture for Health for their efforts to promote the critical care unit environment through design. Since 2003, several more adult ICUs were awarded by the same organizations for similar efforts. This study includes these newer ICUs along with those of the previous study to cover a period of 2 decades from 1993 to 2012. Like the 2006 study, this study conducts a systematic content analysis of the materials submitted by the award-winning adult ICUs. On the basis of the analysis, the study compares the 1993-2002 and 2003-2012 adult ICUs in relation to construction type, unit specialty, unit layout, unit size, patient room size and design, support and service area layout, and family space design. The study also compares its findings with the 2010 Guidelines for Design and Construction of Health Care Facilities of the Facility Guidelines Institute and the 2012 Guidelines for Intensive Care Unit Design of the SCCM. The study indicates that the award-winning ICUs of both decades used several design features that were associated with positive outcomes in research studies. The study also indicates that the award-winning ICUs of the second decade used more evidence-based design features than those of the first decades. In most cases, these ICUs exceeded the requirements of the Facility Guidelines Institute Guidelines to meet those of the SCCM Guidelines. Yet, the award-winning ICUs of both decades also used several features that had very little or no supporting research evidence. Since they all were able to create an optimal critical care environment for which they were awarded, having knowledge of the physical

Are two youth-focused interventions sufficient to empower youth with chronic health conditions in their transition to adult healthcare: a mixed-methods longitudinal prospective cohort study

PubMed Central

Gorter, Jan Willem; Stewart, Deb; Cohen, Eyal; Hlyva, Oksana; Morrison, Andrea; Galuppi, Barb; Nguyen, Tram; Amaria, Khush; Punthakee, Zubin

2015-01-01

Objectives To assess use, utility and impact of transition interventions designed to support and empower self-management in youth with chronic health conditions during transition into adult healthcare. Design A 4-year mixed-method prospective cohort study. Setting 2 academic paediatric hospitals (13 clinics) in Canada. Participants 50 adolescents (42% male; mean age 17.9±0.9 years; 20 underlying diagnoses) with transfer to adult care planned within 1 year. Interventions The Youth KIT (an organisational tool that includes goal setting activities); an online transition mentor. Main outcome measures Frequency of use, utility and impact of the transition interventions; goal achievement; post-transfer qualitative interviews with youth. Results 50 participants were enrolled during their last year of paediatric care; 36 (72%) were followed into adult care. All participants had access to the transition interventions from enrolment until the end of the study (exposure time: 12–47 months). Most youth (85%) reported using the medical/health section of the Youth KIT at least once; 20 (40%) participants engaged in chats with the mentor. The overall perceived utility of both interventions was modest; the Youth KIT received the highest ratings for ‘help with goal setting’: (mean (SD): 4.2 (2.3)) on a 7-point Likert scale. 45 (90%) participants set 294 transition goals. Goal achievement performance and satisfaction increased over time (p≤0.001). The qualitative evidence revealed reasons behind the variability in use and utility of the interventions, the interconnectedness of life-course and healthcare transitions, and the need for stronger partnerships between paediatric and adult healthcare systems. Conclusions Participants’ perceptions about the utility of the Youth KIT and the online mentor were modest. Transition supports need to be carefully tailored, timed and integrated into healthcare systems. Individualised goal setting may be an important �

Chamomile Consumption and Mortality: A Prospective Study of Mexican Origin Older Adults

PubMed Central

Howrey, Bret T.; Peek, M. Kristen; McKee, Juliet M.; Raji, Mukaila A.; Ottenbacher, Kenneth J.; Markides, Kyriakos S.

2016-01-01

Purpose: Approximately 20% of adults use some kind of herbal; however, little data exists from population-based study or clinical trials to support effectiveness of most herbal products. Chamomile is a commonly used herb among older adults of Mexican origin. We examined the effects of herbal chamomile consumption on mortality among older adults of Mexican origin. Methods and Design. A sample from the Hispanic Established Populations for Epidemiologic Study of the Elderly, a population-based study of noninstitutionalized Mexican Americans aged 65 and older from five Southwestern states (Texas, California, New Mexico, Colorado, and Arizona). We included all men and women from 2000 to 2007 (n = 1,677). Results. Chamomile was used by 14% of the sample. Cox proportional hazards regression analyses showed that chamomile was associated with a decreased risk of mortality in the total sample (hazard ratio [HR] 0.71, 95% confidence interval [CI] 0.55–0.92) and for women (HR 0.67, 95% CI 0.49–0.92) but not for men. In models adjusted for sociodemographic variables, health behaviors, and chronic conditions, chamomile remained significantly associated with reduced mortality in women (HR 0.72, 95% CI 0.53–0.98). Implications. The use of chamomile shows protective effects against mortality in this sample of older adults of Mexican origin for women. Further research is warranted in other populations to determine if these effects are consistent. PMID:26035879

Early childhood behavioral inhibition, adult psychopathology and the buffering effects of adolescent social networks: a twenty-year prospective study.

PubMed

Frenkel, Tahl I; Fox, Nathan A; Pine, Daniel S; Walker, Olga L; Degnan, Kathryn A; Chronis-Tuscano, Andrea

2015-10-01

We examined whether the temperament of behavioral inhibition is a significant marker for psychopathology in early adulthood and whether such risk is buffered by peer social networks. Participants (N = 165) were from a prospective study spanning the first two decades of life. Temperament was characterized during infancy and early childhood. Extent of involvement in peer social networks was measured during adolescence, and psychopathology was assessed in early adulthood. Latent Class Analyses generated comprehensive variables at each of three study time-points. Regressions assessed (a) the direct effect of early behavioral inhibition on adult psychopathology (b) the moderating effect of adolescent involvement in social peer networks on the link between temperamental risk and adult psychopathology. Stable behavioral inhibition in early childhood was negatively associated with adult mental health (R(2 ) = .07, p = .005, β = -.26), specifically increasing risk for adult anxiety disorders (R(2) = .04, p = .037, β = .19). These temperament-pathology relations were significantly moderated by adolescent peer group social involvement and network size (Total R(2) = .13, p = .027, β = -.22). Temperament predicted heightened risk for adult anxiety when adolescent social involvement was low (p = .002, β = .43), but not when adolescent social involvement was high. Stable behavioral inhibition throughout early childhood is a risk factor for adult anxiety disorders and interacts with adolescent social involvement to moderate risk. This is the first study to demonstrate the critical role of adolescent involvement in socially active networks in moderating long-lasting temperamental risk over the course of two decades, thus informing prevention/intervention approaches. © 2015 Association for Child and Adolescent Mental Health.

A Model for Designing Instructional Narratives for Adult Learners: Connecting the Dots

ERIC Educational Resources Information Center

Smith, Debra M.

2013-01-01

The purpose of this study was to develop a research-based model for designing and deploying instructional narratives based on principles derived from narrative theory, development theory, communication theory, learning theory and instructional design theory to enable adult learning and retention and the effective transfer of that retained learning…

Acute poisonings treated in hospitals in Oslo: a one-year prospective study (I): pattern of poisoning.

PubMed

Hovda, K E; Bjornaas, M A; Skog, K; Opdahl, A; Drottning, P; Ekeberg, O; Jacobsen, D

2008-01-01

Prospective design is mandatory to study pattern of poisoning and suicidal intention of patients. Prospective cross-sectional multi-center study of all patients contacting health care services because of acute poisoning during one year in Oslo, irrespective of intention. Data on the adult hospitalized patients (> or = 16 years) are presented here. Of a total of 3,775 such adult contacts (3,025 episodes), there were 947 (31 %) hospitalizations; annual incidence 1.9 (per 1,000) in males and 2.1 in females. Median age was 36 years (range 16-89); 54% females. Benzodiazepines (18%), ethanol (17%), paracetamol (12%), opioids (7%), and gamma hydroxybutyric acid (GHB) (7%) were most frequently taken. Patients stated suicidal intention in 29% of the admissions; physicians in 10%. Benzodiazepines and ethanol were the most common agents, but newer illicit drugs were frequent, especially GHB. Males often took ethanol and drugs of abuse; females often used prescription drugs with suicidal intention.

A prospective cohort study of depression course, functional disability, and NEET status in help-seeking young adults.

PubMed

O'Dea, Bridianne; Lee, Rico S C; McGorry, Patrick D; Hickie, Ian B; Scott, Jan; Hermens, Daniel F; Mykletun, Arnstein; Purcell, Rosemary; Killackey, Eoin; Pantelis, Christos; Amminger, G Paul; Glozier, Nicholas

2016-10-01

To examine the associations between depression course, functional disability, and Not in Education or Training (NEET) status in a clinical sample of young adults with mental health problems. Young adults aged 15-25 years seeking help from four primary mental health services were invited to participate in a prospective cohort study evaluating the course of psychiatric disorders in youth. Demographic and clinical characteristics, including depressive symptomatology and functioning, were evaluated through clinical interview and self-report at baseline and 12 month follow-up. A total of 448 young adults participated (70 % female; M: 20.05 years, SD = 2.85). A significant interaction effect for time and depression course was found, such that those who became depressed reported an increase in functional disability and those whose depression remitted reported a significant reduction in functional disability. Developing depression was not a significant predictor of becoming NEET and vice versa: remitted depression did not make a person more likely to reengage in employment or education. This is the first study to examine the course of depression, functional disability, and NEET rates among help-seeking young adults. This study confirms the importance of symptom reduction for improved functioning; however, functional disability remained greater than that seen in young people in the community and there was no association between a change in depression and a change in NEET status. These results argue that services need to address functional outcomes and reengagement with education and employment in addition to symptom reduction.

Self-perceived gait stability modulates the effect of daily life gait quality on prospective falls in older adults.

PubMed

Weijer, R H A; Hoozemans, M J M; van Dieën, J H; Pijnappels, M

2018-05-01

Quality of gait during daily life activities and perceived gait stability are both independent risk factors for future falls in older adults. We investigated whether perceived gait stability modulates the association between gait quality and falling in older adults. In this prospective cohort study, we used one-week daily-life trunk acceleration data of 272 adults over 65 years of age. Sample entropy (SE) of the 3D acceleration signals was calculated to quantify daily life gait quality. To quantify perceived gait stability, the level of concern about falling was assessed using the Falls Efficacy Scale international (FES-I) questionnaire and step length, estimated from the accelerometer data. A fall calendar was used to record fall incidence during a six-month follow up period. Logistic regression analyses were performed to study the association between falling and SE, step length or FES-I score, and their interactions. High (i.e., poor) SE in vertical direction was significantly associated with falling. FES-I scores significantly modulated this association, whereas step length did not. Subgroup analyses based on FES-I scores showed that high SE in the vertical direction was a risk factor for falls only in older adults who had a high (i.e. poor) FES-I score. In conclusion, perceived gait stability modulates the association between gait quality and falls in older adults such that an association between gait quality and falling is only present when perceived gait stability is poor. The results of the present study indicate that the effectiveness of interventions for fall prevention, aimed at improving gait quality, may be affected by a modulating effect of perceived gait stability. Results indicate that interventions to reduce falls in older adults might sort most effectiveness in populations with both a poor physiological and psychological status. Copyright © 2018 Elsevier B.V. All rights reserved.

A Teacher's Guide to Metrics. A Series of In-Service Booklets Designed for Adult Educators.

ERIC Educational Resources Information Center

Wendel, Robert, Ed.; And Others

This series of seven booklets is designed to train teachers of adults in metrication, as a prerequisite to offering metrics in adult basic education and general educational development programs. The seven booklets provide a guide representing an integration of metric teaching methods and metric materials to place the adult in an active learning…

Risk factors for generally reduced productivity--a prospective cohort study of young adults with neck or upper-extremity musculoskeletal symptoms.

PubMed

Boström, Maria; Dellve, Lotta; Thomée, Sara; Hagberg, Mats

2008-04-01

This study prospectively assessed the importance of individual conditions and computer use during school or work and leisure time as risk factors for self-reported generally reduced productivity due to musculoskeletal complaints among young adults with musculoskeletal symptoms in the neck or upper extremities. A cohort of 2914 young adults (18-25 years, vocational school and college or university students) responded to an internet-based questionnaire concerning musculoskeletal symptoms related to individual conditions and computer use during school or work and leisure time that possibly affected general productivity. Prevalence ratios (PR) were used to assess prospective risk factors for generally reduced productivity. The selected study sample (N=1051) had reported neck or upper-extremity symptoms. At baseline, 280 of them reported reduced productivity. A follow-up of the 771 who reported no reduced productivity was carried out after 1 year. Risk factors for self-reported generally reduced productivity for those followed-up were symptoms in two or three locations or dimensions for the upper back or neck and the shoulders, arms, wrists, or hands [PR 2.30, 95% confidence interval (95% CI) 1.40-3.78], symptoms persisting longer than 90 days in the shoulders, arms, wrists, or hands (PR 2.50, 95% CI 1.12-5.58), current symptoms in the shoulders, arms, wrists, or hands (PR 1.78, 95% CI 1.10-2.90) and computer use 8-14 hours/week during leisure time (PR 2.32, 95% CI 1.20-4.47). A stronger relationship was found if three or four risk factors were present. For women, a relationship was found between generally reduced productivity and widespread and current symptoms in the upper extremities. The main risk factors for generally reduced productivity due to musculoskeletal symptoms among young adults in this study were chronic symptoms in the upper extremities and widespread symptoms in the neck and upper extremities.

Modified automatic teller machine prototype for older adults: a case study of participative approach to inclusive design.

PubMed

Chan, Chetwyn C H; Wong, Alex W K; Lee, Tatia M C; Chi, Iris

2009-03-01

The goal of this study was to enhance an existing automated teller machine (ATM) human-machine interface in order to accommodate the needs of older adults. Older adults were involved in the design and field test of the modified ATM prototype. The design of the user interface and functionality took the cognitive and physical abilities of older adults into account. The modified ATM system included only "cash withdrawal" and "transfer" functions based on the task demands and needs for services of older adults. One hundred and forty-one older adults (aged 60 or above) participated in the field test by operating modified or existing ATM systems. Those who operated the modified system were found to have significantly higher success rates than those who operated the existing system. The enhancement was most significant among older adults who had lower ATM-related abilities, a lower level of education, and no prior experience of using ATMs. This study demonstrates the usefulness of using a universal design and participatory approach to modify the existing ATM system for use by older adults. However, it also leads to a reduction in functionality of the enhanced system. Future studies should explore ways to develop a universal design ATM system which can satisfy the abilities and needs of all users in the entire population.

Predictors of physical activity change among adults using observational designs.

PubMed

Rhodes, Ryan E; Quinlan, Alison

2015-03-01

Regular physical activity (PA) is foundational to human health, yet most people are inactive. A sound understanding of the determinants of PA may be instructive for building interventions and/or identifying critical target groups to promote PA. Most research on PA correlates has been biased by cross-sectional or passive prospective designs that fail to examine within-person analysis of PA change. The purpose of this review was to collect and appraise the available literature on the predictors of PA change conceived broadly in terms of increases/decreases from baseline assessment as well as specifically in terms of adoption and maintenance. Eligible studies were from English, peer-reviewed published articles that examined predictors of natural change of PA over 3 months + using observational (non-experimental) data in adult samples. Searches were performed from June 2012 to January 2014 in eight databases. Sixty-seven independent data-sets, from 12 countries, primarily of medium quality/risk of bias, were identified with 26 correlates spanning demographic, behavioral, intra-individual, inter-individual, and environmental categories. Only intention and the onset of motherhood could reliably predict overall PA change. Among datasets configured to predict PA adoption, affective judgments and behavioral processes of change were the only reliable predictors, although both only have a small number of available studies. There were no reliable predictors of maintenance when compared to PA relapse. The results underscore the importance of individual-level motivation and behavioral regulation in PA change, but also denote critical social variables. These findings, however, are constrained by PA measurement bias and limited studies that employed time-varying covariation between predictor variables and PA.

Prospective memory across adolescence: the effects of age and cue focality.

PubMed

Wang, Lijuan; Altgassen, Mareike; Liu, Wei; Xiong, Weirui; Akgün, Canan; Kliegel, Matthias

2011-01-01

The present study examined the role of controlled attention in age differences in event-based prospective memory performance across adolescence. The researchers tested whether presenting the prospective memory cue in or out of focal awareness of the ongoing task (resulting in low versus high demands for controlled attention, respectively) might affect age-related prospective memory performance. In total, 119 Chinese participants ages 13 to 20 took part in this study (60 adolescents: age M = 13.26 years, SD = 0.50; 23 boys; 59 young adults: age M = 19.70 years, SD = 0.87; 19 men). Findings demonstrated a significant interaction, F(1, 114) = 6.41, p < .05. No effect of age on prospective memory performance was revealed when a focal cue was used (F < 1), whereas there was a reliable age effect between adolescents and young adults when nonfocal prospective memory cues were presented, F(1, 59) = 16.13, p < .01. This pattern of results suggests that the interplay of both available resources of controlled attention and working memory, along with specific task demands, may contribute to possible age differences in prospective memory performance across adolescence. Results are discussed in the context of the multiprocess theory of prospective memory.

Effects of prospective-user factors and sign design features on guessability of pharmaceutical pictograms.

PubMed

Chan, Alan H S; Chan, Ken W L

2013-02-01

To examine the associations between the guessing performance of 25 pharmaceutical pictograms and five sign features for naïve participants. The effect of prospective-user factors on guessing performance was also investigated. A total of 160 Hong Kong Chinese people, drawn largely from a young student population, guessed the meanings of 25 pharmaceutical pictograms that were generally not familiar to them. Participants then completed a questionnaire about their drug buying and drug label reading habits, and their demographics and medication history. Finally they rated five features (familiarity, concreteness, complexity, meaningfulness, and semantic distance) of the pharmaceutical pictograms using 0-100 scales. For all pharmaceutical pictograms, mean and standard deviation of guessability score were 64.8 and 17.1, respectively. Prospective-user factors of 'occupation', 'age' and 'education level' significantly affected guessing performance. For sign features, semantic closeness was the best predictor of guessability score, followed by simplicity, concreteness, meaningfulness and familiarity. User characteristics and sign features are critical for pharmaceutical pictograms. To be effective, pharmaceutical pictograms should have obvious and direct connections with familiar things and it is recommended that pharmaceutical pictograms should be designed with consideration of the five sign features investigated here. This study provides useful information and recommendations to assist interface designers to create and evaluate icons for pharmaceutical products and to design more user-friendly pharmaceutical pictograms. However, further work is needed to see how older people respond to such pharmaceutical pictograms. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Naturalistic Assessment of Executive Function and Everyday Multitasking in Healthy Older Adults

PubMed Central

McAlister, Courtney; Schmitter-Edgecombe, Maureen

2013-01-01

Everyday multitasking and its cognitive correlates were investigated in an older adult population using a naturalistic task, the Day Out Task. Fifty older adults and 50 younger adults prioritized, organized, initiated and completed a number of subtasks in a campus apartment to prepare for a day out (e.g., gather ingredients for a recipe, collect change for a bus ride). Participants also completed tests assessing cognitive constructs important in multitasking. Compared to younger adults, the older adults took longer to complete the everyday tasks and more poorly sequenced the subtasks. Although they initiated, completed, and interweaved a similar number of subtasks, the older adults demonstrated poorer task quality and accuracy, completing more subtasks inefficiently. For the older adults, reduced prospective memory abilities were predictive of poorer task sequencing, while executive processes and prospective memory were predictive of inefficiently completed subtasks. The findings suggest that executive dysfunction and prospective memory difficulties may contribute to the age-related decline of everyday multitasking abilities in healthy older adults. PMID:23557096

Design and operation of the Survey of Adult Transition and Health, 2007.

PubMed

O'Connor, Kathleen S; Brooks, Keeshawna S; Nysse-Carris, Kari L; Skalland, Benjamin J; Sipulski, Edward T; Costanzo, Daniel M

2011-03-01

This report documents the survey design and operating procedures for the 2007 Survey of Adult Transition and Health (SATH). Sponsored by the Maternal and Child Health Bureau of the Health Resources and Services Administration, SATH was conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics as a module of the State and Local Area Integrated Telephone Survey program. A follow-back survey design was used to attempt to locate and contact 10,933 eligible cases originally identified in the 2001 National Survey of Children with Special Health Care Needs (NS-CSHCN). These data examine the transition experience of adolescents as they switched from pediatric health care providers to those that treat adults only. Eligible persons were aged 14-17 years as of 2001, had at least one special health care need, and lived in English-speaking households. In 2007, these cases involved young adults aged 19-23. State estimates cannot be obtained from SATH. Telephone numbers sampled in 2001 were dialed to locate the 2001 NS-CSHCN respondent. This person was asked for current contact information for the eligible SATH young adult to be contacted directly. Data were collected from June 12 through August 26, 2007. Although we were unable to contact 7409 (68%) of the 2001 parent/guardian respondents, almost all of the young adults we were able to contact participated (98%). The SATH public-use microdata file contains interview data collected in 2007 from 1,865 young adults, along with variables from the 2001 NS-CSHCN public-use file. The unweighted interview completion rate was 17.5%.

Prospective memory and aging: evidence for preserved spontaneous retrieval with exact but not related cues.

PubMed

Mullet, Hillary G; Scullin, Michael K; Hess, Theodore J; Scullin, Rachel B; Arnold, Kathleen M; Einstein, Gilles O

2013-12-01

We examined whether normal aging spares or compromises cue-driven spontaneous retrieval processes that support prospective remembering. In Experiment 1, young and older adults performed prospective-memory tasks that required either strategic monitoring processes for retrieval (nonfocal) or for which participants relied on spontaneous retrieval processes (focal). We found age differences for nonfocal, but not focal, prospective-memory performance. Experiments 2 and 3 used an intention-interference paradigm in which participants were asked to perform a prospective-memory task (e.g., press "Q" when the word money appears) in the context of an image-rating task and were then told to suspend their prospective-memory intention until after completing an intervening lexical-decision task. During the lexical-decision task, we presented the exact prospective-memory cue (e.g., money; Experiments 2 and 3) or a semantically related lure (e.g., wallet; Experiment 3), and we inferred spontaneous retrieval from slowed lexical-decision responses to these items relative to matched control items. Young and older adults showed significant slowing when the exact prospective-memory cue was presented. Only young adults, however, showed significant slowing to the semantically related lure items. Collectively, these results partially support the multiprocess theory prediction that aging spares spontaneous retrieval processes. Spontaneous retrieval processes may become less sensitive with aging, such that older adults are less likely to respond to cues that do not exactly match their encoded targets. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Depression in adolescents and young adults with cancer

PubMed Central

Park, Eliza M.; Rosenstein, Donald L.

2015-01-01

Adolescents and young adults (AYAs) with cancer are at risk for depression due to disruptions in their developmental trajectory, greater physical symptom burden, and increased likelihood of developing aggressive disease. Rates of depression and other psychological disorders are substantially higher in AYAs with cancer when compared with older adults. Psychiatrists caring for these patients must consider the age-appropriate developmental context of these patients along with familial and medical factors that may influence the presentation and treatment of depression. Previous research suggests that psychosocial interventions specifically designed for AYA patients are promising, but studies of psychopharmacology treatments for depression are lacking. There is a pressing need for prospective studies and controlled clinical trials that evaluate the optimal strategies for treating depression in this patient group. PMID:26246791

A prospective evaluation of the impact of allopurinol in pediatric and adult IBD patients with preferential metabolism of 6-mercaptopurine to 6-methylmercaptopurine.

PubMed

Gerich, Mark E; Quiros, J Antonio; Marcin, James P; Tennyson, Linda; Henthorn, Maria; Prindiville, Thomas P

2010-11-01

6-mercaptopurine (6-MP) is used for the induction and maintenance of remission of inflammatory bowel disease (IBD). 6-MP is converted into 6-methylmercaptopurine (6-MMP) or 6-thioguanine nucleotides (6-TGN) intracellularly. Treatment response in IBD patients correlates with 6-TGN levels. This study prospectively evaluated the effect of allopurinol on 6-MP metabolites in adult and pediatric IBD patients. Additionally, we quantified the prevalence of preferential metabolism towards 6-MMP through a retrospective analysis of IBD patients. Twenty patients (10 adult; 10 pediatric) with evidence of preferential metabolism towards 6-MMP, (6-TGN<250 pmol/8×10⁸ RBCs and 6-MMP>5000 pmol/8×10⁸ RBCs) were prospectively treated with allopurinol 100 mg daily and up to 100 mg of 6-MP. 6-MP dose was adjusted after a 3-week metabolite measurement. The median dose of 6-MP for adults decreased from 100mg daily (range: 37.5-150 mg) to 25mg daily (range: 12.5-50 mg). The median dose of 6-MP for pediatric patients decreased from 50 mg (range: 25-50 mg) to 10.7 mg (range: 10.7 to 21.4 mg). Mean 6-TGN levels in all subjects increased from 197.4 (± 59) to 284.8 (± 107) pmol/8×10⁸ RBCs (p=0.0005). Mean 6-MMP levels in all subjects decreased from a mean of 7719.8 (± 4716) to 404.8 (± 332) pmol/8×10⁸ RBCs (p=0.0004). There were no complications associated with allopurinol therapy. Eighty-eight (30.9%) of 285 IBD patients had evidence of preferential metabolism towards 6-MMP. The proportion of preferential metabolism was equal in adults and pediatric patients. Our results indicate that the addition of allopurinol safely shifts metabolite production in both adult and pediatric IBD patients and that there is a high prevalence of preferential metabolism towards 6-MMP among IBD patients. Published by Elsevier B.V.

Falls in older adults with major depressive disorder (MDD): a systematic review and exploratory meta-analysis of prospective studies.

PubMed

Stubbs, Brendon; Stubbs, Jean; Gnanaraj, Solomon Donald; Soundy, Andrew

2016-01-01

Depressive symptomology is now widely recognized as a key risk factor for falls. The evidence regarding the impact of major depressive disorder (MDD) on falls is unclear. A systematic review and exploratory meta-analysis was undertaken to explore the relationship between MDD and falls. Major electronic database were searched from inception till April 2015. Studies that defined MDD and measured falls prospectively in older adults (≥60 years) were included. Studies relying on depressive symptomology alone were excluded. The methodological quality of included articles was assessed and study findings were synthesized using an exploratory meta-analysis. From a potential of 415 articles, only three studies met the inclusion criteria. This included 976 unique older adults with a range of mean age from ≥65 to 83 years. The methodological quality of included studies was satisfactory. None of the included studies' primary aim was to investigate the relationship between MDD and falls. The exploratory meta-analysis demonstrated older adults with MDD are at increased risk of falling compared to non-depressed older adults (odds ratio (OR) 4.0, 95% CI 2.0-8.1, I(2) = 60%, n = 976). There is a paucity of research considering falls in older adults with MDD. Our results demonstrate that the odds of falling appear to be greater among people with MDD (OR 4.0) than in previous meta-analyses that have only considered subthreshold depressive symptoms. Given the distinct nature and challenges with MDD, more research is required to better understand the falls risk in this group.

Review of physical activity measurement using accelerometers in older adults: considerations for research design and conduct.

PubMed

Murphy, Susan L

2009-02-01

Accelerometers are being increasingly used in studies of physical activity (PA) among older adults, however the use of these monitors requires some specialized knowledge and up-to-date information on technological innovations. The purpose of this review article is to provide researchers with a guide to some commonly-used accelerometers in order to better design and conduct PA research with older adults. A literature search was conducted to obtain all available literature on commonly-used accelerometers in older adult samples with specific attention to articles discussing research design. The use of accelerometers in older adults requires a basic understanding of the type being used, rationale for their placement, and attention to calibration when needed. The updated technology in some monitors should make study conduct less difficult, however comparison studies of the newer versus the older generation models will be needed. Careful considerations for design and conduct of accelerometer research as outlined in this review should help to enhance the quality and comparability of future research studies.

Development of a Wheelchair Skills Home Program for Older Adults Using a Participatory Action Design Approach

PubMed Central

Giesbrecht, Edward M.; Miller, William C.; Mitchell, Ian M.; Woodgate, Roberta L.

2014-01-01

Restricted mobility is the most common impairment among older adults and a manual wheelchair is often prescribed to address these limitations. However, limited access to rehabilitation services results in older adults typically receiving little or no mobility training when they receive a wheelchair. As an alternative and novel approach, we developed a therapist-monitored wheelchair skills home training program delivered via a computer tablet. To optimize efficacy and adherence, principles of self-efficacy and adult learning theory were foundational in the program design. A participatory action design approach was used to engage older adult wheelchair users, care providers, and prescribing clinicians in an iterative design and development process. A series of prototypes were fabricated and revised, based on feedback from eight stakeholder focus groups, until a final version was ready for evaluation in a clinical trial. Stakeholder contributions affirmed and enhanced the foundational theoretical principles and provided validation of the final product for the target population. PMID:25276768

Perceived Weight Discrimination Mediates the Prospective Relation Between Obesity and Depressive Symptoms in U.S. and U.K. Adults

PubMed Central

2016-01-01

Objective: Obesity has been shown to increase risk of depression. Persons with obesity experience discrimination because of their body weight. Across 3 studies, we tested for the first time whether experiencing (perceived) weight-based discrimination explains why obesity is prospectively associated with increases in depressive symptoms. Method: Data from 3 studies, including the English Longitudinal Study of Ageing (2008/2009–2012/2013), the Health and Retirement Study (2006/2008–2010/2012), and Midlife in the United States (1995/1996–2004/2005), were used to examine associations between obesity, perceived weight discrimination, and depressive symptoms among 20,286 U.S. and U.K. adults. Results: Across all 3 studies, Class II and III obesity were reliably associated with increases in depressive symptoms from baseline to follow-up. Perceived weight-based discrimination predicted increases in depressive symptoms over time and mediated the prospective association between obesity and depressive symptoms in all 3 studies. Persons with Class II and III obesity were more likely to report experiencing weight-based discrimination, and this explained approximately 31% of the obesity-related increase in depressive symptoms on average across the 3 studies. Conclusion: In U.S. and U.K. samples, the prospective association between obesity (defined using body mass index) and increases in depressive symptoms in adulthood may in part be explained by perceived weight discrimination. PMID:27748611

In severely suicidal young adults, hopelessness, depressive symptoms, and suicidal ideation constitute a single syndrome.

PubMed

Shahar, Golan; Bareket, Liad; Rudd, M David; Joiner, Thomas E

2006-07-01

Despite voluminous research on the role of hopelessness and depression in suicidality, a systematic examination of various causal models pertaining to these variables is conspicuous in its absence. The directions of relationships between the three variables were examined by means of a prospective-longitudinal, cross-lagged, three-wave design in a severely suicidal young adults. Structural Equation Modeling (SEM) analyses revealed synchronous, but not longitudinal, associations between hopelessness, depressive symptoms, and suicidal ideation. In severely suicidal young adults, the three clinical constructs appear to constitute a single depressive syndrome.

Prevalence, diagnosis, and disease course of pertussis in adults with acute cough: a prospective, observational study in primary care.

PubMed

Teepe, Jolien; Broekhuizen, Berna D L; Ieven, Margareta; Loens, Katherine; Huygen, Kris; Kretzschmar, Mirjam; de Melker, Hester; Butler, Chris C; Little, Paul; Stuart, Beth; Coenen, Samuel; Goossens, Herman; Verheij, Theo J M

2015-10-01

Most cases of adult pertussis probably remain undiagnosed. To explore the prevalence, diagnosis, and disease course of acute pertussis infection in adult patients presenting with acute cough. Prospective observational study between 2007 and 2010 in primary care in 12 European countries. Adults presenting with acute cough (duration of ≤28 days) were included. Bordetella pertussis infection was determined by polymerase chain reaction (from nasopharyngeal flocked swabs and sputa) and by measurement of immunoglobulin G antibodies to pertussis toxin (PT) in venous blood at day 28. An antibody titre to PT of ≥125 IU/ml or PCR positive result in a respiratory sample defined recent infection. Patients completed a symptom diary for 28 days. Serum and/or respiratory samples were obtained in 3074 patients. Three per cent (93/3074) had recent B. pertussis infection. Prior cough duration >2 weeks discriminated to some extent between those with and without pertussis (adjusted odds ratio 1.89, 95% confidence interval = 1.17 to 3.07; P = 0.010). Median cough duration after presentation was 17 and 12 days in patients with and without pertussis, respectively (P = 0.008). Patients with pertussis had longer duration of phlegm production (P = 0.010), shortness of breath (P = 0.037), disturbed sleep (P = 0.013) and interference with normal activities or work (P = 0.033) after presentation. Pertussis infection plays a limited role among adults presenting with acute cough in primary care, but GPs should acknowledge the possibility of pertussis in uncomplicated lower respiratory tract infection. As in children, pertussis also causes prolonged symptoms in adults. However, pertussis is difficult to discern from other acute cough syndromes in adults at first presentation. © British Journal of General Practice 2015.

Assessing Acculturation Over Time: A Four-year Prospective Study of Asian American Young Adults

PubMed Central

Murray, Kate E.; Klonoff, Elizabeth A.; Garcini, Luz M.; Ullman, Jodie B.; Wall, Tamara L.; Myers, Mark G.

2014-01-01

Acculturation is commonly defined as a dynamic and multidimensional process in which individuals and groups change over time when coming into contact with another culture. Despite the emphasis on acculturation as a process of change over time, few researchers have directly assessed this hypothesis. The current study first identifies and then examines “stable” and “dynamic” dimensions of acculturation within a 4-year prospective study of 433 first- and second-generation Chinese- and Korean-American college students. Separate growth model analyses revealed significant linear change for first-generation students toward greater U.S. acculturation. In comparison, tests of linear and quadratic change for second-generation students were not significant. When stratifying by gender, acculturation increased for women but there was no significant change in acculturation for men. While all students reported increases in alcohol consumption over the study period, changes in acculturation predicted changes in alcohol consumption only for women. Chinese men showed greater increases in alcohol consumption than Korean men but there was no effect for ethnicity among women. There was significant individual variability in the models, which underscores the importance of examining change prospectively through within and between person analyses. The findings highlight the importance of examining acculturation changes over time for different migrant groups with implications for further development of acculturation measures, research methodologies, and health interventions. More prospective research designs of acculturation are needed to examine changes in health behavior and overall adaptation across migrant groups at varying stages of development. PMID:25558310

Condom use and sexuality communication with adults: a study among high school students in South Africa and Tanzania

PubMed Central

2013-01-01

Background Fostering adolescents’ communication on sexuality issues with their parents and other significant adults is often assumed to be an important component of intervention programmes aimed at promoting healthy adolescent sexual practices. However, there are few studies describing the relationship between such communication and sexual practices, particularly in sub-Saharan Africa. This study examined the relationships between adolescents’ communication with significant adults and their condom use in three sites in this region. Methods Data stem from a multi-site randomized controlled trial of a school-based HIV prevention intervention implemented in Cape Town and Mankweng, South Africa and Dar es Salaam, Tanzania. Only data from comparison schools were used. The design is therefore a prospective panel study with three waves of data collections. Data were collected in 2004 from 6,251 participants in 40 schools. Associations between adolescents’ communication with adults about sexuality issues and their use of condoms were analysed cross-sectionally using analysis of variance, as well as prospectively using multiple ordinal logistic regression analysis. Results Cross-sectional analyses showed that consistent condom users had significantly higher mean scores on communication (across topics and communication partners) than both occasional users and never-users, who had the lowest scores. After controlling for condom use at the first data collection occasion in each model as well as for possible confounders, communication scores significantly predicted consistent condom use prospectively in all three ordinal logistic regression models (Model R2 = .23 to .31). Conclusion The findings are consistent with the assertion that communication on sexuality issues between adolescents and significant adults results in safer sexual practices, as reflected by condom use, among in-school adolescents. The associations between communication variables and condom use might

Designing a personal health application for older adults to manage medications: a comprehensive case study.

PubMed

Siek, Katie A; Khan, Danish U; Ross, Stephen E; Haverhals, Leah M; Meyers, Jane; Cali, Steven R

2011-10-01

Older adults with multiple chronic conditions often go through care transitions where they move between care facilities or providers during their treatment. These transitions are often uncoordinated and can imperil patients by omitted, duplicative, or contradictory care plans. Older adults sometimes feel overwhelmed with the new responsibility of coordinating the care plan with providers and changing their medication regimes. In response, we developed a Lesser General Public License (LGPL) open source, web-based Personal Health Application (PHA) using an iterative participatory design process that provided older adults and their caregivers the ability to manage their personal health information. In this paper, we document the PHA design process from low-fidelity prototypes to high-fidelity prototypes over the course of six user studies. Our findings establish the imperative need for interdisciplinary research and collaboration among all stakeholders to create effective PHAs. We conclude with design guidelines that encourage researchers to gradually increase functionality as users become more proficient.

Incidence and cost of medication harm in older adults following hospital discharge: A multicentre prospective study in the UK.

PubMed

Parekh, Nikesh; Ali, Khalid; Stevenson, Jennifer M; Graham Davies, J; Schiff, Rebekah; Van der Cammen, Tischa; Harchowal, Jatinder; Raftery, James; Rajkumar, Chakravarthi

2018-05-22

Polypharmacy is increasingly common in older adults, placing them at risk of medication-related harm (MRH). Patients are particularly vulnerable to problems with their medications in the period following hospital discharge due to medication changes, and poor information transfer between hospital and primary care. The aim of this study was to investigate the incidence, severity, preventability and cost of medication-related harm (MRH) in older adults in England post-discharge. An observational multicentre prospective cohort study recruited 1280 older adults (median age 82 years) from five teaching hospitals in Southern England, UK. Participants were followed up for eight weeks by senior pharmacists, using 3 data sources (hospital readmission review, participant telephone interview and primary care records), to identify MRH and associated health service utilisation. Four hundred and thirteen participants (37%) experienced MRH (556 MRH events per 1000 discharges). Three hundred and thirty-six (81%) cases were serious, and 214 (52%) potentially preventable. Four participants experienced fatal MRH. The most common MRH events were gastrointestinal (n=158, 25%) and neurological (n=111, 18%). Medicine classes associated with the highest risk of MRH were opiates, antibiotics, and benzodiazepines. Three hundred and twenty-eight (79%) participants with MRH sought healthcare over the eight-week follow-up. The incidence of MRH associated hospital readmission was 78 per 1000 discharges. Post-discharge MRH in older adults is estimated to cost the National Health Service £396 million annually, of which £243 million is potentially preventable. MRH is common in older adults following hospital discharge, and results in substantial use of healthcare resources. This article is protected by copyright. All rights reserved.

Effects of different amounts of exercise on preventing depressive symptoms in community-dwelling older adults: a prospective cohort study in Taiwan

PubMed Central

Chang, Yu-Chen; Lu, Mei-Chun; Hu, I-Han; Wu, Wan-Chi Ida

2017-01-01

Objectives To compare the effects of four different amounts of exercise for preventing depressive symptoms in community-dwelling older adults. Design Prospective cohort study. Setting A nationally representative sample in Taiwan. Participants Four waves of the survey ‘Taiwan Longitudinal Study on Aging (TLSA)’ from 1996 to 2007 were analysed. A total of 2673 older adults aged 65 years and over were recruited. Primary and secondary outcome measures Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CESD). Four different types/amounts of exercise were examined including: (1) 3 times/week, 15 min/time; (2) 3 times/week, 30 min/time; (3) 6 times/week, 15 min/time; and (4) 6 times/week, 30 min/time. All exercise types were required to have at least moderate intensity. The impacts of different amounts of exercise on depressive symptoms were analysed using generalised linear mixed models. Results More than one-fifth of the elder individuals under consideration had depressive symptoms (CESD ≥10). About 38.6% of older adults met the lowest criteria for exercise type 1, and fewer (28.0%) met the highest criteria for type 4. Only exercise type 4 in the current survey was initially related to lower depressive symptoms (OR=0.8, 95% CI 0.66 to 0.95). However, after considering the interaction between time and changes in exercise patterns, the results showed that all persistent exercise models, even if a very low amount (3 times/week, 15 min/time), had significantly preventive effects on depressive symptoms (OR=0.56~0.67). Conclusion Consistent exercise with at least 15 min per time, three times a week of moderate intensity is significantly associated with lower risk of depressive symptoms. This low amount of exercise may be easier to promote at the community and population level than other alternatives. Trial registration Registry number 104040 of the Institutional Ethics Committee of Chia-Yi Christian Hospital. PMID

Young adults' recreational social environment as a predictor of ecstasy use initiation: findings of a population-based prospective study.

PubMed

Smirnov, Andrew; Najman, Jake M; Hayatbakhsh, Reza; Wells, Helene; Legosz, Margot; Kemp, Robert

2013-10-01

To examine prospectively the contribution of the recreational social environment to ecstasy initiation. Population-based retrospective/prospective cohort study. Data from screening an Australian young adult population to obtain samples of users and non-users of ecstasy. A sample of 204 ecstasy-naive participants aged 19-23 years was obtained, and a 6-month follow-up identified those who initiated ecstasy use. We assessed a range of predictors of ecstasy initiation, including elements of participants' social environment, such as ecstasy-using social contacts and involvement in recreational settings. More than 40% of ecstasy-naive young adults reported ever receiving ecstasy offers. Ecstasy initiation after 6 months was predicted independently by having, at recruitment, many ecstasy-using social contacts [adjusted relative risk (ARR) 3.15, 95% confidence interval (CI): 1.57, 6.34], attending electronic/dance music events (ARR 6.97, 95% CI: 1.99, 24.37), receiving an ecstasy offer (ARR 4.02, 95% CI: 1.23, 13.10), early cannabis use (ARR 4.04, 95% CI: 1.78, 9.17) and psychological distress (ARR 5.34, 95% CI: 2.31, 12.33). Adjusted population-attributable fractions were highest for ecstasy-using social contacts (17.7%) and event attendance (15.1%). In Australia, ecstasy initiation in early adulthood is associated predominantly with social environmental factors, including ecstasy-using social contacts and attendance at dance music events, and is associated less commonly with psychological distress and early cannabis use, respectively. A combination of universal and targeted education programmes may be appropriate for reducing rates of ecstasy initiation and associated harms. © 2013 Society for the Study of Addiction.

Sex-based differences in adults with community-acquired bacterial meningitis: a prospective cohort study.

PubMed

Dias, S P; Brouwer, M C; Bijlsma, M W; van der Ende, A; van de Beek, D

2017-02-01

To investigate sex-based differences in clinical features, causative pathogens, outcome and treatment of adult community-acquired meningitis. From January 2006 to July 2014, we prospectively investigated sex-based differences in clinical features, causative pathogens, outcome and treatment of adult community-acquired meningitis in a nationwide cohort study in the Netherlands. Sex was analysed along with known predictors of unfavourable outcome using logistic regression. We evaluated 1412 episodes of meningitis, 707 (50%) in men. Men more often presented with a history of remote head injury (41/667 (6%) versus 14/658 (2%) women, p 0.0002) or alcoholism (61/652 (9%) versus 21/660 (3%) women, p <0.0001). Neck stiffness was less common in men (453/651 (70%) versus 524/671 (78%) women, p 0.0004). Despite greater illness severity, women were less likely to receive treatment in an intensive care unit (odds ratio (OR) 0.72, 95% CI 0.58-0.89, p 0.003) or mechanical ventilation (OR 0.67, 95% CI 0.54-0.85, p 0.001). Women exhibited higher serum inflammatory parameters than men (median C-reactive protein 211 versus 171, p 0.0001; median erythrocyte sedimentation rate 48 versus 33, p <0.0001). Corticosteroids improved prognosis in both sexes, but absolute risk reduction was higher in women (20% versus 15%, p 0.001), although we found no significant interaction between sex and dexamethasone (p 0.38). In the multivariable analysis, male sex was an independent predictor of unfavourable outcome (OR 1.34, 95% CI 1.03-1.75, p 0.03) and death (OR 1.47, 95% CI 1.04-2.07, p 0.03). Our findings show sex-based differences in adults with community-acquired bacterial meningitis. Male sex is an independent risk factor for adverse outcome. It is possible that sex-based differences in immune reaction could determine a distinct response to corticosteroids. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Cannabis Withdrawal, Posttreatment Abstinence, and Days to First Cannabis Use Among Emerging Adults in Substance Use Treatment: A Prospective Study

PubMed Central

Davis, Jordan P.; Smith, Douglas C.; Morphew, Jason W.; Lei, Xinrong; Zhang, Saijun

2015-01-01

Very little prospective research investigates how cannabis withdrawal is associated with treatment outcomes, and this work has not used the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) thresholds for cannabis withdrawal. The sample included 110 emerging adults entering outpatient substance use treatment who were heavy cannabis users with no other drug use and limited alcohol use. We used survival analyses to predict days to first use of cannabis and logistic regression to predict whether participants were abstinent and living in the community at 3 months. Those meeting criteria for cannabis withdrawal were more likely to return to use sooner than those not meeting criteria for cannabis withdrawal. However, the presence of cannabis withdrawal was not a significant predictor of 3-month abstinence. Emerging adults with DSM-5 cannabis withdrawal may have difficulty initiating abstinence in the days following their intake assessment, implying the need for strategies to mitigate their more rapid return to cannabis use. PMID:26877548

Post-Traumatic Stress Disorder among Older Adults Experiencing Motor Vehicle Collision: A Multicenter Prospective Cohort Study.

PubMed

Platts-Mills, Timothy F; Nebolisa, Bo C; Flannigan, Sean A; Richmond, Natalie L; Domeier, Robert M; Swor, Robert A; Hendry, Phyllis L; Peak, David A; Rathlev, Niels K; Jones, Jeffrey S; Lee, David C; Jones, Christopher W; McLean, Samuel A

2017-09-01

To characterize risk factors for and consequences of post-traumatic stress disorder (PTSD) among older adults evaluated in the emergency department (ED) following motor vehicle collision (MVC). Prospective multicenter longitudinal study (2011-2015). 9 EDs across the United States. Adults aged 65 years and older who presented to an ED after MVC without severe injuries. PTSD symptoms were assessed 6 months after the ED visit using the Impact of Event Scale-Revised. Of 223 patients, clinically significant PTSD symptoms at 6 months were observed in 21% (95% CI 16%-26%). PTSD symptoms were more common in patients who did not have a college degree, had depressive symptoms prior to the MVC, perceived the MVC as life-threatening, had severe ED pain, and expected their physical or emotional recovery time to be greater than 30 days. Three factors (ED pain severity [0-10 scale], perceived life-threatening MVC [0-10 scale], and pre-MVC depressive symptoms [yes to either of two questions]), predicted 6-month PTSD symptoms with an area under the curve of 0.76. Compared to patients without PTSD symptoms, those with PTSD symptoms were at higher risk for persistent pain (72% versus 30%), functional decline (67% versus 42%), and new disability (49% versus 18%). Among older adults treated in the ED following MVC, clinically significant PTSD symptoms at 6 months were present in 21% of patients and were associated with adverse health outcomes. Increased risk for PTSD development can be identified with moderate accuracy using information readily available in the ED. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

A prospective study of overeating, binge eating, and depressive symptoms among adolescent and young-adult women

PubMed Central

Skinner, Hayley H.; Haines, Jess; Austin, S. Bryn; Field, Alison E.

2011-01-01

Purpose To investigate the temporal relationship between depressive symptoms, overeating and binge eating among adolescent and young-adult females in the United States. Methods We investigated incident overeating, binge eating, and depressive symptoms among 4,798 females in the Growing Up Today Study (GUTS), a prospective cohort study of adolescents and young adults throughout the United States. Participants who reported at least monthly episodes during the past year of eating a very large amount of food in a short of amount of time, but not experiencing a loss of control, were classified as overeaters. Those who did report a loss of control while overeating were classified as binge eaters. Depressive symptoms were assessed with the McKnight Risk Factor Survey. Participants were followed from 1999 until 2003. Generalized estimating equations were used for lagged-analysis with time-varying covariates. Analyses were adjusted for age, age at menarche, body mass index (BMI), and follow-up time. Results Females reporting depressive symptoms at baseline were two times more likely than their peers to start overeating (odds ratio (OR)=1.9; 95% confidence interval (CI): 1.4, 2.5) and binge eating (OR=2.3; 95% CI: 1.7, 3.0) during the follow-up. Similarly, females engaging in overeating (OR=1.9, 95% CI: 1.1, 3.4) or binge eaters (OR=1.9, 95% CI: 1.2, 2.9) at baseline, were two times more likely than their peers to develop depressive symptoms during the follow-up. Conclusions These results indicates that it is important to consider depressive symptoms in overeating and binge eating prevention and treatment initiatives targeting adolescent and young adult females. PMID:22525111

Adult Education in Asia. Courier No. 38.

ERIC Educational Resources Information Center

ASPBAE Courier, 1986

1986-01-01

This journal issue contains a series of papers concerned with exploring the role that adult education can play in developing communities. The first paper, "Major Challenges and Prospect of Adult Education for the Year 2000" (T. M. Sakya), provides an overview of adult education in Asia and the Pacific, emphasizing the vastness of the…

Design and patient characteristics of ESHOL study, a Catalonian prospective randomized study.

PubMed

Maduell, Francisco; Moreso, Francesc; Pons, Mercedes; Ramos, Rosa; Mora-Macià, Josep; Foraster, Andreu; Soler, Jordi; Galceran, Josep M; Martinez-Castelao, Alberto

2011-01-01

Retrospective studies showed that online hemodiafiltration (OL-HDF) is associated with a risk reduction of mortality over standard hemodialysis (HD) in patients with end-stage renal disease. Until now, no information was available from prospective randomized clinical trials. A prospective, randomized, multicenter, open study was designed to be conducted in HD units from Catalonia (Spain). The aim of the study is to compare 3-year survival in prevalent end-stage renal disease patients randomized to OL-HDF or to continue on standard HD. The minimum sample size was calculated according to Catalonian mortality of patients on dialysis and assuming a risk reduction associated with OL-HDF of 35% (1-sided p<0.05 and a statistical power of 0.8) and a rate of dropout due to renal transplantation or loss to follow-up of 30%. From May 2007 to September 2008, 906 patients were included and randomized to OL-HDF (n=456) or standard HD (n=450). Demographics and analytical data at the time of randomization were not different between both groups of patients. Patients will be followed during a 3-year period. The present study will contribute to evaluating the benefit for patient survival of OL-HDF over standard HD.

Four-Week Strategy-Based Training to Enhance Prospective Memory in Older Adults: Targeting Intention Retention Is More Beneficial than Targeting Intention Formation.

PubMed

Ihle, Andreas; Albiński, Rafal; Gurynowicz, Kamila; Kliegel, Matthias

2018-01-01

So far, training of prospective memory (PM) focused on very short instances (single sessions) and targeted the intention-formation phase only. We aimed to compare the effectiveness of 2 different 4-week strategy-based PM training types, namely imagery training (targeting the encoding of the PM intention in the intention-formation phase) versus rehearsal training (targeting the maintenance of the PM intention in the intention-retention phase) in older adults. We used a 4-week training protocol (8 sessions in total, 2 sessions per week). From the 44 participants, 21 were randomly assigned to the imagery training (vividly imagining a mental picture to memorize the connection between the PM cue words and related actions during intention formation) and 23 to the rehearsal training (rehearsing the PM cue words during intention retention). The criterion PM task was assessed before and after the training. Comparing the effectiveness of both training types, we found a significant time by training type interaction on PM accuracy in terms of PM cue detection, F(1, 42) = 6.07, p = 0.018, η2p = 0.13. Subsequent analyses revealed that the rehearsal training was more effective in enhancing PM accuracy in terms of PM cue detection than the imagery training. Strategy-based PM training in older adults targeting the maintenance of the PM intention in the intention-retention phase may be more effective in enhancing PM accuracy in terms of PM cue detection than the strategy targeting the encoding of the PM intention in the intention-formation phase. This suggests that for successful prospective remembering, older adults may need more support to keep the PM cues active in memory while working on the ongoing task than to initially encode the PM intention. © 2018 S. Karger AG, Basel.

The Economic Benefits of Adult Learning to Low-Qualified Young Adults: Do Participation and Qualification Decrease the Risk of Unemployment?

ERIC Educational Resources Information Center

Knipprath, Heidi; De Rick, Katleen

2014-01-01

Policymakers worldwide consider participation in adult learning beneficial for employability, in particular for specific target groups. However, still little is known about the effect of adult learning pursued by low-qualified young adults on their employment prospects. On the basis of a Flemish longitudinal database, we study the determinants and…

Complicated malaria in children and adults from three settings of the Colombian Pacific Coast: A prospective study.

PubMed

Arévalo-Herrera, Myriam; Rengifo, Lina; Lopez-Perez, Mary; Arce-Plata, Maria I; García, Jhon; Herrera, Sócrates

2017-01-01

Complicated malaria remains an important public health problem, particularly in endemic settings where access to health services is limited and consequently malaria fatal outcomes occur. Few publications describing the clinical course and outcomes of complicated malaria in Latin America are found in the literature. This prospective study approached the clinical and laboratory characteristics of hospitalized patients with complicated malaria in different endemic areas of the Colombian Pacific Coast with the aim to provide epidemiological knowledge and guide to further reducing malaria severity and mortality. A prospective, descriptive hospital-based study was conducted in 323 complicated malaria patients (median age 20 years) enrolled in Quibdó, Tumaco and Cali between 2014 and 2016. Clinical evaluation was performed and laboratory parameters were assessed during hospitalization. Plasmodium falciparum was the most common parasite species (70%), followed by P. vivax (28%), and mixed malaria (Pf/Pv; 1.9%). Overall, predominant laboratory complications were severe thrombocytopenia (43%), hepatic dysfunction (40%), and severe anaemia (34%). Severe thrombocytopenia was more common in adults (52%) regardless of parasite species. Severe anaemia was the most frequent complication in children ≤10 years (72%) and was most commonly related to P. vivax infection (p < 0.001); whereas liver dysfunction was more frequent in older patients (54%) with P. falciparum (p < 0.001). Two deaths due to P. vivax and P. falciparum each were registered. Treatment provision before recruitment hindered qPCR confirmation of parasite species in some cases. The study identified a high prevalence of complicated malaria in the Pacific Coast, together with more frequent severe anaemia in children infected by P. vivax and hepatic dysfunction in adults with P. falciparum. Results indicated the need for earlier diagnosis and treatment to prevent complications development as well as more effective

Innovation in Doctoral Degrees Designed for Adult Learners: A Hybrid Model in Personal Financial Planning

ERIC Educational Resources Information Center

Grable, John E.

2011-01-01

Innovation in doctoral degree program development and delivery provides an effective counterpoint to the expert-apprentice model established in the Middle Ages. The author outlines the importance of innovation in reaching adult learners and describes an innovative hybrid PhD program designed to allow aspiring doctoral adult-age students to pursue…

Current Trends in Adult Degree Programs: How Public Universities Respond to the Needs of Adult Learners

ERIC Educational Resources Information Center

Gast, Angela

2013-01-01

Although many adult students turn to online degree programs due to their flexibility and convenience, a majority of prospective adult learners prefer to take classes on traditional brick-and-mortar campuses. This chapter examines how public research universities create pathways to degree attainment and boost degree completion rates among adult…

Volunteering is Prospectively Associated with Health Care Use Among Older Adults

PubMed Central

Kim, Eric S.; Konrath, Sara H.

2015-01-01

Rationale Although observational and experimental studies have shown that volunteering is linked with better mental health, physical health, and health behaviors, no studies have examined whether volunteering is associated with patterns of health care use. Objective The purpose of this study was to prospectively examine whether volunteering was associated with a greater use of preventive health care services, but fewer doctor visits and nights spent in the hospital. Methods Participants (n=7,168) were drawn from the 2006 wave of the Health and Retirement Study, a nationally representative panel study of American adults over the age of 51, and tracked for one wave (2 years). Logistic regression and generalized linear models were used for analyses. Results. In analyses that adjusted for sociodemographic factors and baseline health, volunteers were 30% more likely to receive flu shots (OR=1.30, 95% CI=1.16–1.47), 47% more likely to receive cholesterol tests (OR=1.47, 95% CI=1.24–1.74); female volunteers were 53% more likely to receive mammograms/x-rays (OR=1.53, 95% CI=1.28–1.83) and 21% more likely to receive Pap smears (OR=1.21, 95% CI=1.03–1.41); male volunteers were 59% more likely to receive prostate exams (OR=1.59, 95% CI=1.29–1.95). In a model that adjusted for sociodemographic factors, volunteers spent 38% fewer nights in the hospital (RR=0.62, 95% CI=0.52–0.76), however volunteering was not associated with frequency of doctor visits (RR=0.94, 95% CI=0.87–1.02). The association between volunteering and number of nights spent in the hospital was minimally affected after adjusting for potential confounding (baseline health) and explanatory variables (health behaviors, social integration, stress, positive psychological factors, personality). Conclusion This is the first known study to examine the association between volunteering and health care use. If future studies replicate these findings, the results may be used to inform the development of new

Volunteering is prospectively associated with health care use among older adults.

PubMed

Kim, Eric S; Konrath, Sara H

2016-01-01

Although observational and experimental studies have shown that volunteering is linked with better mental health, physical health, and health behaviors, no studies have examined whether volunteering is associated with patterns of health care use. The purpose of this study was to prospectively examine whether volunteering was associated with a greater use of preventive health care services, but fewer doctor visits and nights spent in the hospital. Participants (n = 7168) were drawn from the 2006 wave of the Health and Retirement Study, a nationally representative panel study of American adults over the age of 51, and tracked for one wave (2 years). Logistic regression and generalized linear models were used for analyses. In analyses that adjusted for sociodemographic factors and baseline health, volunteers were 30% more likely to receive flu shots (OR = 1.30, 95% CI = 1.16-1.47), 47% more likely to receive cholesterol tests (OR = 1.47, 95% CI = 1.24-1.74); female volunteers were 53% more likely to receive mammograms/x-rays (OR = 1.53, 95% CI = 1.28-1.83) and 21% more likely to receive Pap smears (OR = 1.21, 95% CI = 1.03-1.41); male volunteers were 59% more likely to receive prostate exams (OR = 1.59, 95% CI = 1.29-1.95). In a model that adjusted for sociodemographic factors, volunteers spent 38% fewer nights in the hospital (RR = 0.62, 95% CI = 0.52-0.76), however volunteering was not associated with frequency of doctor visits (RR = 0.94, 95% CI = 0.87-1.02). The association between volunteering and number of nights spent in the hospital was minimally affected after adjusting for potential confounding (baseline health) and explanatory variables (health behaviors, social integration, stress, positive psychological factors, personality). This is the first known study to examine the association between volunteering and health care use. If future studies replicate these findings, the results may be used to inform the development of new

Prospective regularization design in prior-image-based reconstruction

NASA Astrophysics Data System (ADS)

Dang, Hao; Siewerdsen, Jeffrey H.; Webster Stayman, J.

2015-12-01

phantoms where the optimal parameters vary spatially by an order of magnitude or more. In a series of studies designed to explore potential unknowns associated with accurate PIBR, optimal prior image strength was found to vary with attenuation differences associated with anatomical change but exhibited only small variations as a function of the shape and size of the change. The results suggest that, given a target change attenuation, prospective patient-, change-, and data-specific customization of the prior image strength can be performed to ensure reliable reconstruction of specific anatomical changes.

Occurrence of refeeding syndrome in adults started on artificial nutrition support: prospective cohort study

PubMed Central

Rio, Alan; Whelan, Kevin; Goff, Louise; Reidlinger, Dianne Patricia; Smeeton, Nigel

2013-01-01

Background Refeeding syndrome is a potentially life-threatening condition characterised by severe intracellular electrolyte shifts, acute circulatory fluid overload and organ failure. The initial symptoms are non-specific but early clinical features are severely low-serum electrolyte concentrations of potassium, phosphate or magnesium. Risk factors for the syndrome include starvation, chronic alcoholism, anorexia nervosa and surgical interventions that require lengthy periods of fasting. The causes of the refeeding syndrome are excess or unbalanced enteral, parenteral or oral nutritional intake. Prevention of the syndrome includes identification of individuals at risk, controlled hypocaloric nutritional intake and supplementary electrolyte replacement. Objective To determine the occurrence of refeeding syndrome in adults commenced on artificial nutrition support. Design Prospective cohort study. Setting Large, single site university teaching hospital. Recruitment period 2007–2009. Participants 243 adults started on artificial nutrition support for the first time during that admission recruited from wards and intensive care. Main outcome measures Primary outcome: occurrence of the refeeding syndrome. Secondary outcome: analysis of the risk factors which predict the refeeding syndrome. Tertiary outcome: mortality due to refeeding syndrome and all-cause mortality. Results 133 participants had one or more of the following risk factors: body mass index <16–18.5≥(kg/m2), unintentional weight loss >15% in the preceding 3–6 months, very little or no nutritional intake >10 days, history of alcohol or drug abuse and low baseline levels of serum potassium, phosphate or magnesium prior to recruitment. Poor nutritional intake for more than 10 days, weight loss >15% prior to recruitment and low-serum magnesium level at baseline predicted the refeeding syndrome with a sensitivity of 66.7%: specificity was >80% apart from weight loss of >15% which was 59.1%. Baseline

Qualification Paths of Adult Educators in Sweden and Denmark

ERIC Educational Resources Information Center

Andersson, Per; Kopsen, Susanne; Larson, Anne; Milana, Marcella

2013-01-01

The qualification of adult educators is a central aspect of the quality of adult education. However, within current policy discourses and adult education research on the professional development of prospective adult educators, little attention is paid to teacher qualification when compared to other fields of education and training. In this study,…

Falls efficacy, postural balance, and risk for falls in older adults with falls-related emergency department visits: prospective cohort study.

PubMed

Pua, Yong-Hao; Ong, Peck-Hoon; Clark, Ross Allan; Matcher, David B; Lim, Edwin Choon-Wyn

2017-12-21

Risk for falls in older adults has been associated with falls efficacy (self-perceived confidence in performing daily physical activities) and postural balance, but available evidence is limited and mixed. We examined the interaction between falls efficacy and postural balance and its association with future falls. We also investigated the association between falls efficacy and gait decline. Falls efficacy, measured by the Modified Falls Efficacy Scale (MFES), and standing postural balance, measured using computerized posturography on a balance board, were obtained from 247 older adults with a falls-related emergency department visit. Six-month prospective fall rate and habitual gait speed at 6 months post baseline assessment were also measured. In multivariable proportional odds analyses adjusted for potential confounders, falls efficacy modified the association between postural balance and fall risk (interaction P = 0.014): increasing falls efficacy accentuated the increased fall risk related to poor postural balance. Low baseline falls efficacy was strongly predictive of worse gait speed (0.11 m/s [0.06 to 0.16] slower gait speed per IQR decrease in MFES; P < 0.001). Older adults with high falls efficacy but poor postural balance were at greater risk for falls than those with low falls efficacy; however, low baseline falls efficacy was strongly associated with worse gait function at follow-up. Further research into these subgroups of older adults is warranted. ClinicalTrials.gov identifier: NCT01713543 .

Translating Behavior Change Principles Into a Blended Exercise Intervention for Older Adults: Design Study.

PubMed

Mehra, Sumit; Visser, Bart; Dadema, Tessa; van den Helder, Jantine; Engelbert, Raoul Hh; Weijs, Peter Jm; Kröse, Ben Ja

2018-05-02

Physical activity can prevent or delay age-related impairments and prolong the ability of older adults to live independently. Community-based programs typically offer classes where older adults can exercise only once a week under the guidance of an instructor. The health benefits of such programs vary. Exercise frequency and the duration of the program play a key role in realizing effectiveness. An auxiliary home-based exercise program can provide older adults the opportunity to exercise more regularly over a prolonged period of time in the convenience of their own homes. Furthermore, mobile electronic devices can be used to motivate and remotely guide older adults to exercise in a safe manner. Such a blended intervention, where technology is combined with personal guidance, needs to incorporate behavior change principles to ensure effectiveness. The aim of this study was to identify theory-based components of a blended intervention that supports older adults to exercise at home. The Medical Research Council framework was used to develop the blended intervention. Insights from focus group, expert panels, and literature were combined into leading design considerations. A client-server system had been developed that combined a tablet app with a database in the cloud and a Web-based dashboard that can be used by a personal coach to remotely monitor and guide older adults. The app contains several components that facilitate behavior change-an interactive module for goal setting, the ability to draw up a personal training schedule from a library containing over 50 exercise videos, progress monitoring, and possibilities to receive remote feedback and guidance of a personal coach. An evidence-based blended intervention was designed to promote physical activity among older adults. The underlying design choices were underpinned by behavior change techniques that are rooted in self-regulation. Key components of the tablet-supported intervention were a tailored program that

Do Adults with Autism Spectrum Disorders Compensate in Naturalistic Prospective Memory Tasks?

ERIC Educational Resources Information Center

Altgassen, Mareike; Koban, Nancy; Kliegel, Matthias

2012-01-01

The present study is the first to directly compare event- and time-based prospective memory in Autism Spectrum Disorders (ASD) using a contextual task mirroring real life demands of prospective memory. Twenty-five individuals with ASD and 25 age- and ability-matched controls completed the Dresden Breakfast task which required participants to…

Prenatal alcohol exposure, adaptive function, and entry into adult roles in a prospective study of young adults.

PubMed

Lynch, Mary Ellen; Kable, Julie A; Coles, Claire D

2015-01-01

Although many studies have demonstrated effects of prenatal alcohol exposure (PAE) on physical, cognitive, and behavioral development in children, few have focused on the long term effects on adults. In this study, data are presented on adaptive function and entry into adult roles in a community sample of young adults with PAE. The expectation was that prenatally exposed adults would show lower adaptive functioning and more difficulty with entry into adult roles than the non-exposed control group and that these effects would be related to the severity of PAE effects. The predominantly African-American, low income sample included adults with a wide range of prenatal exposure (n = 123) as well as control groups for socioeconomic (SES) (n =5 9) and disability (n = 54) status. The mothers of the alcohol-exposed and SES-control group participants were recruited before birth and offspring have been followed up periodically. The disability control group was recruited in adolescence. The adults were interviewed about adaptive function in day-to-day life and adult role entry. Collateral adults who were well-acquainted with each participant were interviewed concerning adaptive function. Results showed that adults who were dysmorphic and/or cognitively affected by PAE had difficulty with adaptive function and entry into adult roles. Males showing cognitive effects with no physical effects were the most severely affected. Results for exposed adults not showing physical or cognitive effects were similar to or more positive than those of the control group for most outcomes. PAE has long-term effects on adaptive outcomes in early adulthood. Additional research should focus on possible interventions at this transition and on factors contributing to the adjustment of the exposed, but unaffected participants. Copyright © 2015 Elsevier Inc. All rights reserved.

An 8 Year Follow-Up of a Specialist Supported Employment Service for High-Ability Adults with Autism or Asperger Syndrome

ERIC Educational Resources Information Center

Howlin, Patricia; Alcock, Jennifer; Burkin, Catherine

2005-01-01

Few supported employment programmes have been specifically designed for people with autism, especially those who are more able. This study examines the outcome of a supported employment service (NAS Prospects) for adults with autism or Asperger syndrome (IQ 60+) over an 8 year period. Approximately 68 percent of clients found employment. Of the…

A Prospective Open-Label Trial of Memantine Hydrochloride for the Treatment of Social Deficits in Intellectually Capable Adults With Autism Spectrum Disorder.

PubMed

Joshi, Gagan; Wozniak, Janet; Faraone, Stephen V; Fried, Ronna; Chan, James; Furtak, Stephannie; Grimsley, Emily; Conroy, Kristina; Kilcullen, J Ryan; Woodworth, K Yvonne; Biederman, Joseph

2016-06-01

This prospective 12-week open-label trial evaluates the tolerability and efficacy of memantine hydrochloride for the treatment of core social and cognitive deficits in adults with high-functioning autism spectrum disorder (ASD). Measures for assessment of therapeutic response included the Social Responsiveness Scale-Adult Research Version (SRS-A), disorder-specific Clinical Global Impression scales, Behavior Rating Inventory of Executive Functioning-Adult Self-Report, Diagnostic Analysis of Nonverbal Accuracy Scale, and Cambridge Neuropsychological Test Automated Battery. Eighteen adults (mean age, 28 ± 9.5 years) with high-functioning ASD (SRS-A raw score, 99 ± 17) were treated with memantine (mean dose, 19.7 ± 1.2 mg/d; range, 15-20 mg), and 17 (94%) completed the trial. Treatment with memantine was associated with significant reduction on informant-rated (SRS-A, -28 ± 25; P < 0.001) and clinician-rated (Clinical Global Impression-Improvement subscale ≤2, 83%) measures of autism severity. In addition, memantine treatment was associated with significant improvement in ADHD and anxiety symptom severity. Significant improvement was noted in nonverbal communication on the Diagnostic Analysis of Nonverbal Accuracy Scale test and in executive function per self-report (Behavior Rating Inventory of Executive Functioning-Adult Self-Report Global Executive Composite, -6 ± 8.8; P < 0.015) and neuropsychological assessments (Cambridge Neuropsychological Test Automated Battery). Memantine treatment was generally well tolerated and was not associated with any serious adverse events. Treatment with memantine appears to be beneficial for the treatment of ASD and associated psychopathology and cognitive dysfunction in intellectually capable adults. Future placebo-controlled trials are warranted.

A prospective study of overeating, binge eating, and depressive symptoms among adolescent and young adult women.

PubMed

Skinner, Hayley H; Haines, Jess; Austin, S Bryn; Field, Alison E

2012-05-01

To investigate the temporal relationship between depressive symptoms and overeating and binge eating among adolescent and young adult females in the United States. We investigated incident overeating, binge eating, and depressive symptoms among 4,798 females in the Growing Up Today Study, a prospective cohort study of adolescents and young adults throughout the United States. Participants who reported at least monthly episodes of eating a very large amount of food in a short amount of time in the past year, but not experiencing a loss of control, were classified as overeaters. Those who reported a loss of control while overeating were classified as binge eaters. Depressive symptoms were assessed with the McKnight Risk Factor Survey. Participants were followed between 1999 and 2003. Generalized estimating equations were used for lagged analysis with time-varying covariates. Analyses were adjusted for age, age at menarche, body mass index, and follow-up time. Females reporting depressive symptoms at baseline were two times more likely than their peers to start overeating (odds ratio [OR] = 1.9; 95% confidence interval [CI] = 1.4, 2.5) and binge eating (OR = 2.3; 95% CI = 1.7, 3.0) during the follow-up. Similarly, females engaging in overeating (OR = 1.9; 95% CI = 1.1, 3.4) or binge eating (OR = 1.9; 95% CI = 1.2, 2.9) at baseline were two times more likely than their peers to develop depressive symptoms during the follow-up. These results indicate that it is important to consider depressive symptoms in overeating and binge eating prevention and treatment initiatives targeting adolescent and young adult females. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Juvenile-Onset OCD: Clinical Features in Children, Adolescents and Adults

PubMed Central

Mancebo, Maria C.; Garcia, Abbe M.; Pinto, Anthony; Freeman, Jennifer B.; Przeworski, Amy; Stout, Robert; Kane, Joshua S.; Eisen, Jane L.; Rasmussen, Steven A.

2009-01-01

Objective To examine clinical correlates of juvenile-onset OCD across the lifespan. Method Intake data collected from 257 consecutive participants with a juvenile-onset of OCD (20 children, 44 adolescents, and 193 adults) in a naturalistic study of the clinical course of OCD were examined. Participants and parents of juvenile participants completed a structured diagnostic interview, rater-administered severity measures, and self-report questionnaires. Results Children and adolescents (i.e. juveniles) shared similar features with the exception of age at onset and OCD symptom expression. Clinically meaningful differences between juvenile and adult participants were also found. Compared to adults, juveniles were more likely to be male, recall an earlier age at OCD onset, and have different lifetime comorbidity patterns. Conclusion Juvenile-onset OCD symptom expression is remarkably similar across the lifespan. However, findings also suggest clinically meaningful differences between juveniles and adults. Future work using a prospective design will improve our understanding of course patterns of juvenile-onset OCD. Significant Outcomes •Children were less likely than either adolescent or adults to report aggressive obsessions and mental rituals. •Males were overrepresented in the juvenile sample but gender was equally distributed in the adult sample •Compared to lifetime comorbidity patterns of adults, juveniles showed elevated rates of ADHD and lower rates of mood, substance use and eating disorders Limitations •The cross-sectional design with retrospective recall regarding course prior to study entry limits conclusions about the course of OCD. •The adult sample is limited to adults whose symptoms persisted into adulthood and therefore results cannot be generalized to all individuals with a juvenile-onset. •The small number of very young children (under age 10) may have limited power to detect differences among children and adolescents. PMID:18699949

Do children born to teenage parents have lower adult intelligence? A prospective birth cohort study.

PubMed

Khatun, Mohsina; Al Mamun, Abdullah; Scott, James; William, Gail M; Clavarino, Alexandra; Najman, Jake M

2017-01-01

Teenage motherhood has been associated with a wide variety of negative offspring outcomes including poorer cognitive development. In the context of limitations of previous research, this paper assesses the contemporary relevance of this finding. In this study we investigate the long-term cognitive status (IQ) among 21 year adult offspring born to teenage parents using the Mater University Study of Pregnancy- a prospective birth cohort study, which recruited all pregnant mothers attending a large obstetrical hospital in Brisbane, Australia, from 1981 to 1983. The analyses were restricted to a sub-sample of 2643 mother-offspring pair. Offspring IQ was measured using the Peabody Picture Vocabulary Test at 21 year. Parental age was reported at first clinic visit. Offspring born to teenage mothers (<20 years) have -3.0 (95% Confidence Interval (CI): -4.3, -1.8) points lower IQ compared to children born to mothers ≥20 years and were more likely to have a low IQ (Odds Ratio (OR) 1.7; 95% CI: 1.3, 2.3). Adjustment for a range of confounding and mediating factors including parental socioeconomic status, maternal IQ, maternal smoking and binge drinking in pregnancy, birthweight, breastfeeding and parenting style attenuates the association, though the effect remains statistically significant (-1.4 IQ points; 95% CI: -2.8,-0.1). Similarly the risk of offspring having low IQ remained marginally significantly higher in those born to teenage mothers (OR 1.3; 95% CI: 1.0, 1.9). In contrast, teenage fatherhood is not associated with adult offspring IQ, when adjusted for maternal age. Although the reduction in IQ is quantitatively small, it is indicative of neurodevelopmental disadvantage experienced by the young adult offspring of teenage mothers. Our results suggest that public policy initiatives should be targeted not only at delaying childbearing in the population but also at supporting early life condition of children born to teenage mothers to minimize the risk for

Understanding the Relationship between Type 2 Diabetes Mellitus and Falls in Older Adults: A Prospective Cohort Study

PubMed Central

Roman de Mettelinge, Tine; Cambier, Dirk; Calders, Patrick; Van Den Noortgate, Nele; Delbaere, Kim

2013-01-01

Background Older adults with type 2 Diabetes Mellitus are at increased risk of falling. The current study aims to identify risk factors that mediate the relationship between diabetes and falls. Methods 199 older adults (104 with diabetes and 95 healthy controls) underwent a medical screening. Gait (GAITRite®), balance (AccuGait® force plate), grip strength (Jamar®), and cognitive status (Mini-Mental State Examination and Clock Drawing Test) were assessed. Falls were prospectively recorded during a 12-month follow-up period using monthly calendars. Results Compared to controls, diabetes participants scored worse on all physical and cognitive measures. Sixty-four participants (42 diabetes vs. 22 controls) reported at least one injurious fall or two non-injurious falls (“fallers”). Univariate logistic regression identified diabetes as a risk factor for future falls (Odds Ratio 2.25, 95%CI 1.21–4.15, p = 0.010). Stepwise multiple regressions defined diabetes and poor balance as independent risk factors for falling. Taking more medications, slower walking speed, shorter stride length and poor cognitive performance were mediators that reduced the Odds Ratio of the relationship between diabetes and faller status relationship the most followed by reduced grip strength and increased stride length variability. Conclusions Diabetes is a major risk factor for falling, even after controlling for poor balance. Taking more medications, poorer walking performance and reduced cognitive functioning were mediators of the relationship between diabetes and falls. Tailored preventive programs including systematic medication reviews, specific balance exercises and cognitive training might be beneficial in reducing fall risk in older adults suffering from diabetes. PMID:23825617

Prospective Elemantary Science Teachers' Epistemological Beliefs

ERIC Educational Resources Information Center

Macaroglu Akgul, Esra; Oztuna Kaplan, Aysun

2009-01-01

This research study examined "prospective elementary science teachers' epistemological beliefs". Forty-nine prospective elementary science teachers participated into research. The research was designed in both quantitative and qualitative manner, within the context of "Special Methods in Science Teaching I" course.…

Psychometric Properties of the Shipley Block Design Task: A Study with Jamaican Young Adults

ERIC Educational Resources Information Center

Beaujean, A. Alexander; Hull, Darrell M.; Sheng, Yanyan; Worrell, Frank C.; Bolen, Judy; Verdisco, Aimee E.

2017-01-01

We examined the structure of the new "Block Patterns" (BP) test from the Shipley Institute of Living Scale-Second Edition in a sample of Jamaican young adults. To date, very little has been published on the properties of this subtest's items and scores. The BP test is similar in design to the Block Design subtest found in many cognitive…

Multidisciplinary design and analytic approaches to advance prospective research on the multilevel determinants of child health.

PubMed

Johnson, Sara B; Little, Todd D; Masyn, Katherine; Mehta, Paras D; Ghazarian, Sharon R

2017-06-01

Characterizing the determinants of child health and development over time, and identifying the mechanisms by which these determinants operate, is a research priority. The growth of precision medicine has increased awareness and refinement of conceptual frameworks, data management systems, and analytic methods for multilevel data. This article reviews key methodological challenges in cohort studies designed to investigate multilevel influences on child health and strategies to address them. We review and summarize methodological challenges that could undermine prospective studies of the multilevel determinants of child health and ways to address them, borrowing approaches from the social and behavioral sciences. Nested data, variation in intervals of data collection and assessment, missing data, construct measurement across development and reporters, and unobserved population heterogeneity pose challenges in prospective multilevel cohort studies with children. We discuss innovations in missing data, innovations in person-oriented analyses, and innovations in multilevel modeling to address these challenges. Study design and analytic approaches that facilitate the integration across multiple levels, and that account for changes in people and the multiple, dynamic, nested systems in which they participate over time, are crucial to fully realize the promise of precision medicine for children and adolescents. Copyright © 2017 Elsevier Inc. All rights reserved.

Designing Opportunities for Prospective Teachers to Facilitate Mathematics Discussions in Classrooms

ERIC Educational Resources Information Center

Hunter, Roberta; Anthony, Glenda

2012-01-01

How prospective teachers can best be prepared to teach effectively in mathematics classrooms is a topic of current concern. In this paper, we describe our exploration of ways in which prospective teachers were supported to translate what they learnt in mathematics methods classes into pedagogical practice. We illustrate how the use of discourse…

An Evaluation of Wellness Assessment Visualizations for Older Adults

PubMed Central

Reeder, Blaine; Yoo, Daisy; Aziz, Rafae; Thompson, Hilaire J.; Demiris, George

2015-01-01

Abstract Background Smart home technologies provide a valuable resource to unobtrusively monitor health and wellness within an older adult population. However, the breadth and density of data available along with aging associated decreases in working memory, prospective memory, spatial cognition, and processing speed can make it challenging to comprehend for older adults. We developed visualizations of smart home health data integrated into a framework of wellness. We evaluated the visualizations through focus groups with older adults and identified recommendations to guide the future development of visualizations. Materials and Methods We conducted four focus groups with older adult participants (n=31) at an independent retirement community. Participants were presented with three different visualizations from a wellness pilot study. A qualitative descriptive analysis was conducted to identify thematic content. Results We identified three themes related to processing and application of visualizations: (1) values of visualizations for wellness assessment, (2) cognitive processing approaches to visualizations, and (3) integration of health data for visualization. In addition, the focus groups highlighted key design considerations of visualizations important towards supporting decision-making and evaluation assessments within integrated health displays. Conclusions Participants found inherent value in having visualizations available to proactively engage with their healthcare provider. Integrating the visualizations into a wellness framework helped reduce the complexity of raw smart home data. There has been limited work on health visualizations from a consumer perspective, in particular for an older adult population. Creating appropriately designed visualizations is valuable towards promoting consumer involvement within the shared decision-making process of care. PMID:25401414

Impact of Genetic Counseling and Connexin-26 and Connexin-30 Testing on Deaf Identity and Comprehension of Genetic Test Results in a Sample of Deaf Adults: A Prospective, Longitudinal Study

PubMed Central

Palmer, Christina G. S.; Boudreault, Patrick; Baldwin, Erin E.; Sinsheimer, Janet S.

2014-01-01

Using a prospective, longitudinal study design, this paper addresses the impact of genetic counseling and testing for deafness on deaf adults and the Deaf community. This study specifically evaluated the effect of genetic counseling and Connexin-26 and Connexin-30 genetic test results on participants' deaf identity and understanding of their genetic test results. Connexin-26 and Connexin-30 genetic testing was offered to participants in the context of linguistically and culturally appropriate genetic counseling. Questionnaire data collected from 209 deaf adults at four time points (baseline, immediately following pre-test genetic counseling, 1-month following genetic test result disclosure, and 6-months after result disclosure) were analyzed. Four deaf identity orientations (hearing, marginal, immersion, bicultural) were evaluated using subscales of the Deaf Identity Development Scale-Revised. We found evidence that participants understood their specific genetic test results following genetic counseling, but found no evidence of change in deaf identity based on genetic counseling or their genetic test results. This study demonstrated that culturally and linguistically appropriate genetic counseling can improve deaf clients' understanding of genetic test results, and the formation of deaf identity was not directly related to genetic counseling or Connexin-26 and Connexin-30 genetic test results. PMID:25375116

Impact of genetic counseling and Connexin-26 and Connexin-30 testing on deaf identity and comprehension of genetic test results in a sample of deaf adults: a prospective, longitudinal study.

PubMed

Palmer, Christina G S; Boudreault, Patrick; Baldwin, Erin E; Sinsheimer, Janet S

2014-01-01

Using a prospective, longitudinal study design, this paper addresses the impact of genetic counseling and testing for deafness on deaf adults and the Deaf community. This study specifically evaluated the effect of genetic counseling and Connexin-26 and Connexin-30 genetic test results on participants' deaf identity and understanding of their genetic test results. Connexin-26 and Connexin-30 genetic testing was offered to participants in the context of linguistically and culturally appropriate genetic counseling. Questionnaire data collected from 209 deaf adults at four time points (baseline, immediately following pre-test genetic counseling, 1-month following genetic test result disclosure, and 6-months after result disclosure) were analyzed. Four deaf identity orientations (hearing, marginal, immersion, bicultural) were evaluated using subscales of the Deaf Identity Development Scale-Revised. We found evidence that participants understood their specific genetic test results following genetic counseling, but found no evidence of change in deaf identity based on genetic counseling or their genetic test results. This study demonstrated that culturally and linguistically appropriate genetic counseling can improve deaf clients' understanding of genetic test results, and the formation of deaf identity was not directly related to genetic counseling or Connexin-26 and Connexin-30 genetic test results.

Are two youth-focused interventions sufficient to empower youth with chronic health conditions in their transition to adult healthcare: a mixed-methods longitudinal prospective cohort study.

PubMed

Gorter, Jan Willem; Stewart, Deb; Cohen, Eyal; Hlyva, Oksana; Morrison, Andrea; Galuppi, Barb; Nguyen, Tram; Amaria, Khush; Punthakee, Zubin

2015-05-06

To assess use, utility and impact of transition interventions designed to support and empower self-management in youth with chronic health conditions during transition into adult healthcare. A 4-year mixed-method prospective cohort study. 2 academic paediatric hospitals (13 clinics) in Canada. 50 adolescents (42% male; mean age 17.9±0.9 years; 20 underlying diagnoses) with transfer to adult care planned within 1 year. The Youth KIT (an organisational tool that includes goal setting activities); an online transition mentor. Frequency of use, utility and impact of the transition interventions; goal achievement; post-transfer qualitative interviews with youth. 50 participants were enrolled during their last year of paediatric care; 36 (72%) were followed into adult care. All participants had access to the transition interventions from enrolment until the end of the study (exposure time: 12-47 months). Most youth (85%) reported using the medical/health section of the Youth KIT at least once; 20 (40%) participants engaged in chats with the mentor. The overall perceived utility of both interventions was modest; the Youth KIT received the highest ratings for 'help with goal setting': (mean (SD): 4.2 (2.3)) on a 7-point Likert scale. 45 (90%) participants set 294 transition goals. Goal achievement performance and satisfaction increased over time (p≤0.001). The qualitative evidence revealed reasons behind the variability in use and utility of the interventions, the interconnectedness of life-course and healthcare transitions, and the need for stronger partnerships between paediatric and adult healthcare systems. Participants' perceptions about the utility of the Youth KIT and the online mentor were modest. Transition supports need to be carefully tailored, timed and integrated into healthcare systems. Individualised goal setting may be an important 'active ingredient' in optimising transition supports and outcomes. Interventions that focus on youth only are

A prospective analysis of unplanned patient-initiated contacts in an adult cystic fibrosis centre.

PubMed

Burnet, Espérie; Hubert, Dominique; Champreux, Juliette; Honoré, Isabelle; Kanaan, Reem; Panzo, Rosewilta; Burgel, Pierre-Régis

2018-05-07

Timely response should be provided when patients contact the cystic fibrosis (CF) centre in between scheduled visits. Little data exist on unplanned patient-initiated contacts in CF adults. A two-stage prospective study was undertaken from 1 January to 31 December 2015 at Cochin Hospital, Paris (France). The first stage included all adults (≥18 years) who initiated unplanned contacts to the CF centre over four months. Four physicians and three nurses systematically recorded unplanned patient-initiated contacts. The data was analysed to determine why and how patients contacted the CF centre and time spent responding to their request(s). The second stage (one physician, three nurses) lasted twelve months and explored whether high contact frequency was associated with disease severity, using multivariate logistic regression. In the first stage, 259 of 410 patients (63%) initiated at least one unplanned contact, corresponding to 1067 contacts over 4 months. Patients favoured email with physicians (61% of contacts) and telephone with nurses (87% of contacts). Total time spent by the 7 caregivers on providing responses was 8 h/work week. Reasons for contacting the CF centre varied greatly, but <20% of contacts were directly related to symptom management. In the second stage, 180 of 212 patients (85%) initiated 1876 contacts over 12 months. Factors associated with ≥5 contacts/year were female sex, FEV 1  ≤ 30% predicted, ≥5 physician visits/year, and ≥ 1 hospital admission/year. Answering unplanned patient-initiated contacts represented a significant workload for CF caregivers. Increased disease severity was associated with high contact frequency. Copyright © 2018 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

Social and Financial Outcomes of Living Liver Donation: A Prospective Investigation Within the Adult-to-Adult Living Donor Liver Transplantation Cohort Study 2 (A2ALL-2).

PubMed

DiMartini, A; Dew, M A; Liu, Q; Simpson, M A; Ladner, D P; Smith, A R; Zee, J; Abbey, S; Gillespie, B W; Weinrieb, R; Mandell, M S; Fisher, R A; Emond, J C; Freise, C E; Sherker, A H; Butt, Z

2017-04-01

Because results from single-center (mostly kidney) donor studies demonstrate interpersonal relationship and financial strains for some donors, we conducted a liver donor study involving nine centers within the Adult-to-Adult Living Donor Liver Transplantation Cohort Study 2 (A2ALL-2) consortium. Among other initiatives, A2ALL-2 examined the nature of these outcomes following donation. Using validated measures, donors were prospectively surveyed before donation and at 3, 6, 12, and 24 mo after donation. Repeated-measures regression models were used to examine social relationship and financial outcomes over time and to identify relevant predictors. Of 297 eligible donors, 271 (91%) consented and were interviewed at least once. Relationship changes were positive overall across postdonation time points, with nearly one-third reporting improved donor family and spousal or partner relationships and >50% reporting improved recipient relationships. The majority of donors, however, reported cumulative out-of-pocket medical and nonmedical expenses, which were judged burdensome by 44% of donors. Lower income predicted burdensome donation costs. Those who anticipated financial concerns and who held nonprofessional positions before donation were more likely to experience adverse financial outcomes. These data support the need for initiatives to reduce financial burden. © 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

Prospective memory training in older adults and its relevance for successful aging.

PubMed

Hering, Alexandra; Rendell, Peter G; Rose, Nathan S; Schnitzspahn, Katharina M; Kliegel, Matthias

2014-11-01

In research on cognitive plasticity, two training approaches have been established: (1) training of strategies to improve performance in a given task (e.g., encoding strategies to improve episodic memory performance) and (2) training of basic cognitive processes (e.g., working memory, inhibition) that underlie a range of more complex cognitive tasks (e.g., planning) to improve both the training target and the complex transfer tasks. Strategy training aims to compensate or circumvent limitations in underlying processes, while process training attempts to augment or to restore these processes. Although research on both approaches has produced some promising findings, results are still heterogeneous and the impact of most training regimes for everyday life is unknown. We, therefore, discuss recent proposals of training regimes aiming to improve prospective memory (i.e., forming and realizing delayed intentions) as this type of complex cognition is highly relevant for independent living. Furthermore, prospective memory is associated with working memory and executive functions and age-related decline is widely reported. We review initial evidence suggesting that both training regimes (i.e., strategy and/or process training) can successfully be applied to improve prospective memory. Conceptual and methodological implications of the findings for research on age-related prospective memory and for training research in general are discussed.

Relation of physical activity time to incident disability in community dwelling adults with or at risk of knee arthritis: prospective cohort study.

PubMed

Dunlop, Dorothy D; Song, Jing; Semanik, Pamela A; Sharma, Leena; Bathon, Joan M; Eaton, Charles B; Hochberg, Marc C; Jackson, Rebecca D; Kwoh, C Kent; Mysiw, W Jerry; Nevitt, Michael C; Chang, Rowland W

2014-04-29

To investigate whether objectively measured time spent in light intensity physical activity is related to incident disability and to disability progression. Prospective multisite cohort study from September 2008 to December 2012. Baltimore, Maryland; Columbus, Ohio; Pittsburgh, Pennsylvania; and Pawtucket, Rhode Island, USA. Disability onset cohort of 1680 community dwelling adults aged 49 years or older with knee osteoarthritis or risk factors for knee osteoarthritis; the disability progression cohort included 1814 adults. Physical activity was measured by accelerometer monitoring. Disability was ascertained from limitations in instrumental and basic activities of daily living at baseline and two years. The primary outcome was incident disability. The secondary outcome was progression of disability defined by a more severe level (no limitations, limitations to instrumental activities only, 1-2 basic activities, or ≥3 basic activities) at two years compared with baseline. Greater time spent in light intensity activities had a significant inverse association with incident disability. Less incident disability and less disability progression were each significantly related to increasing quartile categories of daily time spent in light intensity physical activities (hazard ratios for disability onset 1.00, 0.62, 0.47, and 0.58, P for trend=0.007; hazard ratios for progression 1.00, 0.59, 0.50, and 0.53, P for trend=0.003) with control for socioeconomic factors (age, sex, race/ethnicity, education, income) and health factors (comorbidities, depressive symptoms, obesity, smoking, lower extremity pain and function, and knee assessments: osteoarthritis severity, pain, symptoms, prior injury). This finding was independent of time spent in moderate-vigorous activities. These prospective data showed an association between greater daily time spent in light intensity physical activities and reduced risk of onset and progression of disability in adults with osteoarthritis of

Prospective Study of Optimal Obesity Index Cut-Off Values for Predicting Incidence of Hypertension in 18–65-Year-Old Chinese Adults

PubMed Central

Ren, Qian; Su, Chang; Wang, Huijun; Wang, Zhihong; Du, Wenwen; Zhang, Bing

2016-01-01

Background Overweight and obesity increase the risk of elevated blood pressure; most of the studies that serve as a background for the debates on the optimal obesity index cut-off values used cross-sectional samples. The aim of this study was to determine the cut-off values of anthropometric markers for detecting hypertension in Chinese adults with data from prospective cohort. Methods This study determines the best cut-off values for the obesity indices that represent elevated incidence of hypertension in 18–65-year-old Chinese adults using data from the China Health and Nutrition Survey (CHNS) 2006–2011 prospective cohort. Individual body mass index (BMI), waist circumference (WC), waist:hip ratio (WHR) and waist:stature ratio (WSR) were assessed. ROC curves for these obesity indices were plotted to estimate and compare the usefulness of these obesity indices and the corresponding values for the maximum of the Youden indices were considered the optimal cut-off values. Results Five-year cumulative incidences of hypertension were 21.5% (95% CI: 19.4–23.6) in men and 16.5% (95% CI: 14.7–18.2) in women, and there was a significant trend of increased incidence of hypertension with an increase in BMI, WC, WHR or WSR (P for trend < 0.001) in both men and women. The Youden index indicated that the optimal BMI, WC, WHR, WSR cut-off values were 23.53 kg/m2, 83.7 cm, 0.90, and 0.51 among men. The optimal BMI, WC, WHR, WSR cut-off values were 24.25 kg/m2, 79.9 cm, 0.85 and 0.52 among women. Conclusions Our study supported the hypothesis that the cut-off values for BMI and WC that were recently developed by the Working Group on Obesity in China (WGOC), the cut-off values for WHR that were developed by the World Health Organization (WHO), and a global WSR cut-off value of 0.50 may be the appropriate upper limits for Chinese adults. PMID:26934390

A Comprehensive Analysis of the SRS-Schwab Adult Spinal Deformity Classification and Confounding Variables: A Prospective, Non-US Cross-sectional Study in 292 Patients.

PubMed

Hallager, Dennis Winge; Hansen, Lars Valentin; Dragsted, Casper Rokkjær; Peytz, Nina; Gehrchen, Martin; Dahl, Benny

2016-05-01

Cross-sectional analyses on a consecutive, prospective cohort. To evaluate the ability of the Scoliosis Research Society (SRS)-Schwab Adult Spinal Deformity Classification to group patients by widely used health-related quality-of-life (HRQOL) scores and examine possible confounding variables. The SRS-Schwab Adult Spinal Deformity Classification includes sagittal modifiers considered important for HRQOL and the clinical impact of the classification has been validated in patients from the International Spine Study Group database; however, equivocal results were reported for the Pelvic Tilt modifier and potential confounding variables were not evaluated. Between March 2013 and May 2014, all adult spinal deformity patients from our outpatient clinic with sufficient radiographs were prospectively enrolled. Analyses of HRQOL variance and post hoc analyses were performed for each SRS-Schwab modifier. Age, history of spine surgery, and aetiology of spinal deformity were considered potential confounders and their influence on the association between SRS-Schwab modifiers and aggregated Oswestry Disability Index (ODI) scores was evaluated with multivariate proportional odds regressions. P values were adjusted for multiple testing. Two hundred ninety-two of 460 eligible patients were included for analyses. The SRS-Schwab Classification significantly discriminated HRQOL scores between normal and abnormal sagittal modifier classifications. Individual grade comparisons showed equivocal results; however, Pelvic Tilt grade + versus +  + did not discriminate patients according to any HRQOL score. All modifiers showed significant proportional odds for worse aggregated ODI scores with increasing grade levels and the effects were robust to confounding. However, age group and aetiology had individual significant effects. The SRS-Schwab sagittal modifiers reliably grouped patients graded 0 versus + / +  + according to the most widely used HRQOL scores and the

Challenges of conducting a prospective clinical trial for older patients: Lessons learned from NCCTG N0949 (alliance).

PubMed

McCleary, Nadine J; Hubbard, Joleen; Mahoney, Michelle R; Meyerhardt, Jeffrey A; Sargent, Daniel; Venook, Alan; Grothey, Axel

2018-01-01

While the risk of developing colorectal cancer increases with age, there are limited prospective data regarding best treatment in the older adult population. We launched a phase III trial to evaluate difference in treatment outcome for older adults (aged ≥70years) with advanced colorectal cancer. Here we review the challenges faced and reasons for poor accrual to N0949. We describe the conceptualization, development and limited results of N0949, a randomized phase III study of fluoropyrimidine/bevacizumab with or without oxaliplatin (mFOLFOX7 or XELOX) as first line chemotherapy for metastatic colorectal cancer. Fluoropyrimidine was physician choice (e.g., 5-FU/LV or capecitabine). Of the projected 380 patients, only 32 patients were enrolled between the study activation in January 2011 until its closure in September 2012. Reasons for poor accrual included eligibility criteria that were too stringent, discomfort with randomizing older patients to regimens of varying intensity without considering their physical fitness, and discomfort with the use of bevacizumab in the older patient population. Several efforts were mounted to design a rationale and age-appropriate study, consider toxicities and varying study practices, and be responsive to stakeholder feedback. Challenges were experienced in conducting the first prospective phase III study evaluating progression-free survival of older adults with advanced colorectal cancer receiving palliative chemotherapy with fluoropyrimidine/bevacizumab with or without oxaliplatin in the USA. Future efforts to evaluate treatment outcomes in the older adult population should reflect on lessons learned in this large national effort. Copyright © 2017 Elsevier Inc. All rights reserved.

The Influence of Emotional Material on Encoding and Retrieving Intentions: An ERP Study in Younger and Older Adults

PubMed Central

Hering, Alexandra; Kliegel, Matthias; Bisiacchi, Patrizia S.; Cona, Giorgia

2018-01-01

Prospective memory is a cognitive process that comprises the encoding and maintenance of an intention until the appropriate moment of its retrieval. It is of highly relevance for an independent everyday life, especially in older adults; however, there is ample evidence that prospective memory declines with increasing age. Because most studies have used neutral stimuli, it is still an open question how emotional factors influence age-related differences in prospective remembering. The aim of the study was to investigate the influence of emotional material on prospective memory encoding, monitoring, maintaining, and retrieval in younger and older adults using behavioral and electrophysiological measures. We tested 24 younger adults (M = 26.4 years) and 20 older adults (M = 68.1 years) using a picture one-back task as ongoing activity with an embedded prospective memory instruction. The experimental task consisted of three sessions. In each session, participants had to encode series of images that represented the prospective memory cues for the consecutive block. The images were either of pleasant, unpleasant, or neutral valence. The pictures used in the ongoing task were likewise of pleasant, unpleasant, or neutral valence. Event-related potentials (ERPs) were recorded to assess the neural correlates of intention encoding, maintenance, and self-initiated retrieval. We did not find age differences between younger and older adults on the behavioral level. However, the ERP results revealed an interesting pattern that suggested for both age groups elevated attentional processing of emotional cues during encoding indicated by an elevated LPP for the emotional cues. Additionally, younger adults showed increased activity for unpleasant cues. During the maintenance phase, both age groups engaged in strategic monitoring especially for pleasant cues, which led to enhanced sustained positivity. During retrieval, older adults showed increased activity of ERP components related

Allowing Brief Delays in Responding Improves Event-Based Prospective Memory for Young Adults Living with HIV Disease

PubMed Central

Loft, Shayne; Doyle, Katie L.; Naar-King, Sylvie; Outlaw, Angulique Y.; Nichols, Sharon L.; Weber, Erica; Blackstone, Kaitlin; Woods, Steven Paul

2014-01-01

Event-based prospective memory (PM) tasks require individuals to remember to perform an action when they encounter a specific cue in the environment, and have clear relevance for daily functioning for individuals with HIV. In many everyday tasks, the individual must not only maintain the intent to perform the PM task, but the PM task response also competes with the alternative and more habitual task response. The current study examined whether event-based PM can be improved by slowing down the pace of the task environment. Fifty-seven young adults living with HIV performed an ongoing lexical decision task while simultaneously performing a PM task of monitoring for a specific word (which was focal to the ongoing task of making lexical decisions) or syllable contained in a word (which was nonfocal). Participants were instructed to refrain from making task responses until after a tone was presented, which occurred at varying onsets (0–1600ms) after each stimulus appeared. Improvements in focal and non-focal PM accuracy were observed with response delays of 600ms. Furthermore, the difference in PM accuracy between the low demand focal PM task and the resource demanding non-focal PM task was reduced by half across increasingly longer delays, falling from 31% at 0ms delay to only 14% at 1600ms delay. The degree of ongoing task response slowing for the PM conditions, relative to a control condition that did not have a PM task and made lexical decisions only, also decreased with increased delay. Overall, the evidence indicates that delaying the task responses of younger HIV-infected adults increased the probability that the PM relevant features of task stimuli were adequately assessed prior to the ongoing task response, and by implication that younger HIV infected adults can more adequately achieve PM goals when the pace of the task environment is slowed down. PMID:25116075

The Building Bridges Project: Involving Older Adults in the Design of a Communication Technology to Support Peer-to-Peer Social Engagement

NASA Astrophysics Data System (ADS)

Wherton, Joseph; Prendergast, David

There are a variety of factors that can lead to social isolation and loneliness in old age, including decline in physical and mental health, as well as change to social environment. The Building Bridges project explores how communication technology can help older adults remain socially connected. This paper will first provide an overview of a prototype communication system designed to support peer-to-peer group interaction. A description of the user-centered design process will be provided to demonstrate the importance of involving older adults at the earliest stages. The implications for designing new technology for older adults are discussed.

World Perspective Case Descriptions on Educational Programs for Adults: China.

ERIC Educational Resources Information Center

Mingchuan, Dong; And Others

This document contains six case studies of Chinese adult education: (1) China's Adult Education at Present and in Prospect (Mingchuan and Zhongdan); (2) Aging Issue and Education for the Aged in China (Mingchuan and Zhongdan); (3) Adult Education in Beijing Municipality (Youren); (4) A University without Campus: Introduction to China's Higher…

Longitudinal course of disaster-related PTSD among a prospective sample of adult Chilean natural disaster survivors

PubMed Central

Vicente, Benjamin; Marshall, Brandon DL; Koenen, Karestan C; Arheart, Kristopher L; Kohn, Robert; Saldivia, Sandra; Buka, Stephen L

2017-01-01

Abstract Background: With an increasing number of individuals surviving natural disasters, it is crucial to understand who is most at risk for developing post-traumatic stress disorder (PTSD). The objective of this study was to prospectively examine the role that pre-existing psychopathology plays in developing PTSD after a disaster. Methods: This study uses data from a prospective 5-wave longitudinal cohort (years 2003-11) of Chilean adults from 10 health centres (N = 1708). At baseline, participants completed the Composite International Diagnostic Interview (CIDI), a comprehensive psychiatric diagnostic instrument. In 2010, the sixth most powerful earthquake on record struck Chile. One year later, a modified version of the PTSD module of the CIDI was administered. Marginal structural logistic regressions with inverse probability censoring weights were constructed to identify pre-disaster psychiatric predictors of post-disaster PTSD. Results: The majority of participants were female (75.9%) and had a high-school/college education (66.9%). After controlling for pre-disaster PTSD, pre-existing dysthymia [odds ratio (OR) = 2.21; 95% confidence interval (CI) = 1.39-3.52], brief psychotic disorder (OR = 2.67; 95% CI = 1.21-5.90), anxiety disorders (not including PTSD; OR = 1.49; 95% CI = 1.27-1.76), panic disorder (OR = 2.46; 95% CI = 1.37-4.42), agoraphobia (OR = 2.23; 95% CI = 1.22-4.10), social phobia (OR = 1.86; 95% CI = 1.06-3.29), specific phobia (OR = 2.07; 95% CI = 1.50-2.86) and hypochondriasis (OR = 2.10; 95% CI = 1.05-4.18) were predictors of post-disaster PTSD. After controlling for pre-disaster anxiety disorders, dysthymia, and non-affective psychotic disorders, individuals with pre-disaster PTSD (vs those without pre-disaster PTSD) had higher odds of developing post-disaster PTSD (OR = 2.53; 95% CI = 1.37-4.65). Conclusions: This is the first Chilean study to demonstrate

Longitudinal course of disaster-related PTSD among a prospective sample of adult Chilean natural disaster survivors.

PubMed

Fernandez, Cristina A; Vicente, Benjamin; Marshall, Brandon Dl; Koenen, Karestan C; Arheart, Kristopher L; Kohn, Robert; Saldivia, Sandra; Buka, Stephen L

2017-04-01

With an increasing number of individuals surviving natural disasters, it is crucial to understand who is most at risk for developing post-traumatic stress disorder (PTSD). The objective of this study was to prospectively examine the role that pre-existing psychopathology plays in developing PTSD after a disaster. This study uses data from a prospective 5-wave longitudinal cohort (years 2003-11) of Chilean adults from 10 health centres ( N  = 1708). At baseline, participants completed the Composite International Diagnostic Interview (CIDI), a comprehensive psychiatric diagnostic instrument. In 2010, the sixth most powerful earthquake on record struck Chile. One year later, a modified version of the PTSD module of the CIDI was administered. Marginal structural logistic regressions with inverse probability censoring weights were constructed to identify pre-disaster psychiatric predictors of post-disaster PTSD. The majority of participants were female (75.9%) and had a high-school/college education (66.9%). After controlling for pre-disaster PTSD, pre-existing dysthymia [odds ratio (OR) = 2.21; 95% confidence interval (CI) = 1.39-3.52], brief psychotic disorder (OR = 2.67; 95% CI = 1.21-5.90), anxiety disorders (not including PTSD; OR = 1.49; 95% CI = 1.27-1.76), panic disorder (OR = 2.46; 95% CI = 1.37-4.42), agoraphobia (OR = 2.23; 95% CI = 1.22-4.10), social phobia (OR = 1.86; 95% CI = 1.06-3.29), specific phobia (OR = 2.07; 95% CI = 1.50-2.86) and hypochondriasis (OR = 2.10; 95% CI = 1.05-4.18) were predictors of post-disaster PTSD. After controlling for pre-disaster anxiety disorders, dysthymia, and non-affective psychotic disorders, individuals with pre-disaster PTSD (vs those without pre-disaster PTSD) had higher odds of developing post-disaster PTSD (OR = 2.53; 95% CI = 1.37-4.65). This is the first Chilean study to demonstrate prospectively that pre-disaster psychiatric disorders

Wechsler Adult Intelligence Scale-Revised Block Design broken configuration errors in nonpenetrating traumatic brain injury.

PubMed

Wilde, M C; Boake, C; Sherer, M

2000-01-01

Final broken configuration errors on the Wechsler Adult Intelligence Scale-Revised (WAIS-R; Wechsler, 1981) Block Design subtest were examined in 50 moderate and severe nonpenetrating traumatically brain injured adults. Patients were divided into left (n = 15) and right hemisphere (n = 19) groups based on a history of unilateral craniotomy for treatment of an intracranial lesion and were compared to a group with diffuse or negative brain CT scan findings and no history of neurosurgery (n = 16). The percentage of final broken configuration errors was related to injury severity, Benton Visual Form Discrimination Test (VFD; Benton, Hamsher, Varney, & Spreen, 1983) total score and the number of VFD rotation and peripheral errors. The percentage of final broken configuration errors was higher in the patients with right craniotomies than in the left or no craniotomy groups, which did not differ. Broken configuration errors did not occur more frequently on designs without an embedded grid pattern. Right craniotomy patients did not show a greater percentage of broken configuration errors on nongrid designs as compared to grid designs.

Successful support of biventricular heart failure patients by new EXCOR® Adult pumps with bileaflet valves: a prospective study.

PubMed

Schmack, Bastian; Weymann, Alexander; Ruschitzka, Frank; Autschbach, Rüdiger; Raake, Philip W; Jurrmann, Nadine; Menon, Ares K; Karck, Matthias; Wilhelm, Markus J; Ruhparwar, Arjang

2018-05-01

The Berlin Heart EXCOR ® Adult biventricular assist device (BiVAD) is an approved mechanical circulatory support for patients with end-stage biventricular heart failure. In this prospective post-market clinical follow-up study, we present the first clinical experience of the new EXCOR ® Adult pump with bileaflet (BL) valves in Europe. After CE-mark approval in August 2014, a total of 12 patients were enrolled with a mean age of 44 years ± 11 (range 21-58 years). The majority of patients (n = 11) were in INTERMACS level 1 or 2. Eight patients had a median pre-operative extracorporeal life support (ECLS) of 6 days (range 1-37 days). Primary end point was survival, either to heart transplantation (HTx), recovery or alive at 12 months on device, whichever occurred first. Secondary end point was the number of adverse events throughout EXCOR ® BiVAD support. Median support time up to last follow-up on EXCOR ® BiVAD device was 248 days (range 57-381 days) and patient survival at 1 year was 92%. Half of the EXCOR ® BiVAD patients (n = 6) were transplanted and five patients were still on support at 1 year post-implantation. Complications during EXCOR ® BiVAD support were thoracic bleeding, exit site infection and ischemic cerebrovascular incidents in three cases, respectively. The new EXCOR ® Adult pump with BL provides pulsatile high cardiac output with excellent outcome and successful bridging to HTx, particularly in critically ill patients with INTERMACS level 1 or 2 at the time of implantation.

Oral disease in adults treated with hemodialysis: prevalence, predictors, and association with mortality and adverse cardiovascular events: the rationale and design of the ORAL Diseases in hemodialysis (ORAL-D) study, a prospective, multinational, longitudinal, observational, cohort study.

PubMed

Strippoli, Giovanni F M; Palmer, Suetonia C; Ruospo, Marinella; Natale, Patrizia; Saglimbene, Valeria; Craig, Jonathan C; Pellegrini, Fabio; Petruzzi, Massimo; De Benedittis, Michele; Ford, Pauline; Johnson, David W; Celia, Eduardo; Gelfman, Ruben; Leal, Miguel R; Torok, Marietta; Stroumza, Paul; Bednarek-Skublewska, Anna; Dulawa, Jan; Frantzen, Luc; Ferrari, Juan Nin; del Castillo, Domingo; Hegbrant, Jorgen; Wollheim, Charlotta; Gargano, Letitzia

2013-04-19

People with end-stage kidney disease treated with dialysis experience high rates of premature death that are at least 30-fold that of the general population, and have markedly impaired quality of life. Despite this, interventions that lower risk factors for mortality (including antiplatelet agents, epoetins, lipid lowering, vitamin D compounds, or dialysis dose) have not been shown to improve clinical outcomes for this population. Although mortality outcomes may be improving overall, additional modifiable determinants of health in people treated with dialysis need to be identified and evaluated. Oral disease is highly prevalent in the general population and represents a potential and preventable cause of poor health in dialysis patients. Oral disease may be increased in patients treated with dialysis due to their lower uptake of public dental services, as well as increased malnutrition and inflammation, although available exploratory data are limited by small sample sizes and few studies evaluating links between oral health and clinical outcomes for this group, including mortality and cardiovascular disease. Recent data suggest periodontitis may be associated with mortality in dialysis patients and well-designed, larger studies are now required. The ORAL Diseases in hemodialysis (ORAL-D) study is a multinational, prospective (minimum follow-up 12 months) study. Participants comprise consecutive adults treated with long-term in-center hemodialysis. Between July 2010 and February 2012, we recruited 4500 dialysis patients from randomly selected outpatient dialysis clinics in Europe within a collaborative network of dialysis clinics administered by a dialysis provider, Diaverum, in Europe (France, Hungary, Italy, Poland, Portugal, and Spain) and South America (Argentina). At baseline, dental surgeons with training in periodontology systematically assessed the prevalence and characteristics of oral disease (dental, periodontal, mucosal, and salivary) in all participants

Prospective Associations between Religiousness/Spirituality and Depression and Mediating Effects of Forgiveness in a Nationally Representative Sample of United States Adults.

PubMed

Toussaint, Loren L; Marschall, Justin C; Williams, David R

2012-01-01

The present investigation examines the prospective associations of religiousness/spirituality with depression and the extent to which various dimensions of forgiveness act as mediating mechanisms of these associations. Data are from a nationally representative sample of United States adults who were first interviewed in 1998 and reinterviewed six months later. Measures of religiousness/spirituality, forgiveness, and various sociodemographics were collected. Depression was assessed using the Composite International Diagnostic Interview administered by trained interviewers. Results showed that religiousness/spirituality, forgiveness of oneself and others, and feeling forgiven by God were associated, both cross-sectionally and longitudinally, with depressive status. After controlling for initial depressive status, only forgiveness of oneself and others remained statistically significant predictors of depression. Path analyses revealed that religiousness/spirituality conveyed protective effects, prospectively, on depression by way of an indirect path through forgiveness of others but not forgiveness of oneself. Hence, forgiveness of others acts as a mechanism of the salutary effect of religiousness/spirituality, but forgiveness of oneself is an independent predictor. Conclusions regarding the continued development of this type of research and for the treatment of clients with depression are offered.

Prospective Associations between Religiousness/Spirituality and Depression and Mediating Effects of Forgiveness in a Nationally Representative Sample of United States Adults

PubMed Central

Toussaint, Loren L.; Marschall, Justin C.; Williams, David R.

2012-01-01

The present investigation examines the prospective associations of religiousness/spirituality with depression and the extent to which various dimensions of forgiveness act as mediating mechanisms of these associations. Data are from a nationally representative sample of United States adults who were first interviewed in 1998 and reinterviewed six months later. Measures of religiousness/spirituality, forgiveness, and various sociodemographics were collected. Depression was assessed using the Composite International Diagnostic Interview administered by trained interviewers. Results showed that religiousness/spirituality, forgiveness of oneself and others, and feeling forgiven by God were associated, both cross-sectionally and longitudinally, with depressive status. After controlling for initial depressive status, only forgiveness of oneself and others remained statistically significant predictors of depression. Path analyses revealed that religiousness/spirituality conveyed protective effects, prospectively, on depression by way of an indirect path through forgiveness of others but not forgiveness of oneself. Hence, forgiveness of others acts as a mechanism of the salutary effect of religiousness/spirituality, but forgiveness of oneself is an independent predictor. Conclusions regarding the continued development of this type of research and for the treatment of clients with depression are offered. PMID:22675623

Older adults' personal routine at time of hospitalization.

PubMed

Zisberg, Anna; Gur-Yaish, Nurit

This study is the first to explore whether hospitalization disrupts the daily routines of dependent and independent older adults. Data were collected as part of a prospectively designed study from 330 hospitalized older adults age 70+. Patients reported prehospitalization frequency, duration, and timing of basic activities of daily living and leisure activities at hospital admission. Hospital routine was assessed on day of discharge. Results indicated that frequency and duration of most basic activities decreased during hospitalization; the sharpest decrease was in frequency of getting dressed. Showering occurred 2 h earlier in the hospital setting, and getting dressed occurred an hour and a half later. For dependent respondents, the greatest change was in duration; for independent respondents, the greatest change was in frequency. Given the importance of routine maintenance to health and well-being, understanding the dynamics of its disruption in the hospital setting is imperative. Copyright © 2016 Elsevier Inc. All rights reserved.

Impact of ambient air pollution on physical activity among adults: a systematic review and meta-analysis.

PubMed

An, Ruopeng; Zhang, Sheng; Ji, Mengmeng; Guan, Chenghua

2018-03-01

This study systematically reviewed literature regarding the impact of ambient air pollution on physical activity among children and adults. Keyword and reference search was conducted in PubMed and Web of Science to systematically identify articles meeting all of the following criteria - study designs: interventions or experiments, retrospective or prospective cohort studies, cross-sectional studies, and case-control studies; subjects: adults; exposures: specific air pollutants and overall air quality; outcomes: physical activity and sedentary behaviour; article types: peer-reviewed publications; and language: articles written in English. Meta-analysis was performed to estimate the pooled effect size of ambient PM 2.5 air pollution on physical inactivity. Seven studies met the inclusion criteria. Among them, six were conducted in the United States, and one was conducted in the United Kingdom. Six adopted a cross-sectional study design, and one used a prospective cohort design. Six had a sample size larger than 10,000. Specific air pollutants assessed included PM 2.5 , PM 10 , O 3 , and NO x , whereas two studies focused on overall air quality. All studies found air pollution level to be negatively associated with physical activity and positively associated with leisure-time physical inactivity. Study participants, and particularly those with respiratory disease, self-reported a reduction in outdoor activities to mitigate the detrimental impact of air pollution. Meta-analysis revealed a one unit (μg/m 3 ) increase in ambient PM 2.5 concentration to be associated with an increase in the odds of physical inactivity by 1.1% (odds ratio = 1.011; 95% confidence interval = 1.001, 1.021; p-value < .001) among US adults. Existing literature in general suggested that air pollution discouraged physical activity. Current literature predominantly adopted a cross-sectional design and focused on the United States. Future studies are warranted to implement a longitudinal

Sleep Quality, Sleep Duration, and the Risk of Coronary Heart Disease: A Prospective Cohort Study With 60,586 Adults

PubMed Central

Lao, Xiang Qian; Liu, Xudong; Deng, Han-Bing; Chan, Ta-Chien; Ho, Kin Fai; Wang, Feng; Vermeulen, Roel; Tam, Tony; Wong, Martin C.S.; Tse, L.A.; Chang, Ly-yun; Yeoh, Eng-Kiong

2018-01-01

Study Objectives: There is limited information on the relationship between risk of cardiovascular disease and the joint effects of sleep quality and sleep duration, especially from large, prospective, cohort studies. This study is to prospectively investigate the joint effects of sleep quality and sleep duration on the development of coronary heart disease. Methods: This study examined 60,586 adults aged 40 years or older. A self-administered questionnaire was used to collect information on sleep quality and sleep duration as well as a wide range of potential confounders. Events of coronary heart disease were self-reported in subsequent medical examinations. Two types of Sleep Score (multiplicative and additive) were constructed to reflect the participants' sleep profiles, considering both sleep quality and sleep duration. The Cox regression model was used to estimate the hazard ratio (HR) and the 95% confidence interval (CI). Results: A total of 2,740 participants (4.5%) reported new events of coronary heart disease at follow-up. For sleep duration, participants in the group of < 6 h/d was significantly associated with an increased risk of coronary heart disease (HR: 1.13, 95% CI: 1.04–1.23). However, the association in the participants with long sleep duration (> 8 h/d) did not reach statistical significance (HR: 1.11, 95% CI: 0.98–1.26). For sleep quality, both dreamy sleep (HR: 1.21, 95% CI: 1.10–1.32) and difficult to fall asleep/use of sleeping pills or drugs (HR: 1.40, 95% CI: 1.25–1.56) were associated with an increased risk of the disease. Participants in the lowest quartile of multiplicative Sleep Score (HR: 1.31, 95% CI: 1.16–1.47) and of additive sleep score (HR: 1.31, 95% CI: 1.16–1.47) were associated with increased risk of coronary heart disease compared with those in the highest quartile. Conclusions: Both short sleep duration and poor sleep quality are associated with the risk of coronary heart disease. The association for long sleep

Cigarette pack design and perceptions of risk among UK adults and youth.

PubMed

Hammond, David; Dockrell, Martin; Arnott, Deborah; Lee, Alex; McNeill, Ann

2009-12-01

It is illegal in the EU for tobacco packaging to suggest that some cigarettes are safer than others. This study examined consumer perceptions of cigarette packs in the UK, including perceptions of 'plain packaging', in which colour and other design elements are removed, whilst retaining the brand name. 516 adult smokers and 806 youth aged 11-17 participated in an online survey. Participants were asked to compare pairs of cigarette packs on five measures: taste, tar delivery, health risk, attractiveness and either ease of quitting (adult smokers) or brand they would choose if trying smoking (youth). Adults and youth were significantly more likely to rate packs with the terms 'smooth', 'silver' and 'gold' as lower tar, lower health risk and either easier to quit smoking (adults) or their choice of pack if trying smoking (youth). For example, more than half of adults and youth reported that brands labelled as 'smooth' were less harmful compared with the 'regular' variety. The colour of packs was also associated with perceptions of risk and brand appeal: compared with Marlboro packs with a red logo, Marlboro packs with a gold logo were rated as lower health risk by 53% and easier to quit by 31% of adult smokers. Plain packs significantly reduced false beliefs about health risk and ease of quitting, and were rated as significantly less attractive and appealing to youth for trying smoking. Current regulations have failed to remove potentially misleading information from tobacco packaging. Removing colours from packs (plain packaging), as well as terms such as 'smooth' 'gold' and 'silver' would significantly reduce false beliefs and increase compliance with existing legislation.

Risk of deep venous thrombosis in elective neurosurgical procedures: a prospective, Doppler ultrasound-based study in children 12 years of age or younger.

PubMed

Scherer, Andrea G; White, Ian K; Shaikh, Kashif A; Smith, Jodi L; Ackerman, Laurie L; Fulkerson, Daniel H

2017-07-01

prospective study, no DVTs were found in 91 patients evaluated by ultrasound and 9 patients followed clinically. While the study is underpowered to give a definitive incidence, the data suggest that the risk of DVT and VTE is very low in children undergoing elective neurosurgical procedures. Prophylactic protocols designed for adults may not apply to pediatric patients. Clinical trial registration no.: NCT02037607 (clinicaltrials.gov).

How do homeless adults change their lives after completing an intensive job-skills program? A prospective study.

PubMed

Gray, Heather M; Nelson, Sarah E; Shaffer, Howard J; Stebbins, Patricia; Farina, Andrea Ryan

2017-09-01

Among people experiencing homelessness, difficulty securing housing is often compounded by concurrent challenges including unemployment, chronic illness, criminal justice involvement, and victimization. The Moving Ahead Program (MAP) is a vocational rehabilitation program that seeks to help adults facing these challenges to secure competitive employment. We prospectively studied how MAP graduates (N = 97) changed from the beginning of MAP to about six months after graduation. We observed a variety of positive outcomes not just in employment and housing but also in health, substance use, and criminal justice involvement. However, these gains were not universal; for instance, participants were less likely to report positive outcomes at follow-up if they started MAP with a serious mental illness, made relatively small gains in work skills, or did not seek mental health treatment during the six months after they completed MAP. These findings might encourage program staff to devote additional resources toward supporting at-risk students.

Effects of prenatal alcohol exposure in a prospective sample of young adults: Mental health, substance use, and difficulties with the legal system.

PubMed

Lynch, Mary Ellen; Kable, Julie A; Coles, Claire D

2017-11-01

Few studies have focused on the transition to adulthood in adults with prenatal alcohol exposure (PAE). In this study, we examine the occurrence of problem behavior at this transition, including mental health problems, substance use, and difficulties with the legal system. The sample is prospective and provides an opportunity to examine effects of a wide range of prenatal exposure. Adults with PAE were expected to show more problem behavior; the impact of level of exposure was examined as well. The sample was drawn from a predominantly low-income, African-American population. Mothers of the alcohol-exposed participants (n=123) and those in the non-exposed SES-Control group (CONT) (n=59) were recruited at a prenatal visit when information on alcohol and drug use during pregnancy was collected. A disability contrast group (n=54) was recruited at adolescence. The adults with PAE were assigned to three groups varying in physical and cognitive effects of exposure. This report is based on the adults' responses to interviews or questionnaires on problem behavior and laboratory tests related to substance use. Adults with PAE showed more problem behavior in all three areas than adults from the CONT group. For mental health problems, the exposed group showing cognitive, but not physical effects, had the highest scores; their scores were similar, however, to those of the disability contrast group on several scales. Results for outcomes on substance use and legal difficulties were less consistent, but, when significant effects occurred, the group that was exposed, but neither physically nor cognitively affected, was more likely to show negative outcomes. Males in this group were most involved in these behaviors. Effects of PAE continue into early adulthood and affect mental health problems, substance use, and interactions with the legal system. Adults who are exposed, but less physically affected, seem to be the most involved in problem behavior. More research is necessary to

The Design of Adult Acute Care Units in U.S. Hospitals

PubMed Central

Catrambone, Cathy; Johnson, Mary E.; Mion, Lorraine C.; Minnick, Ann F.

2010-01-01

Purpose To describe the current state of design characteristics determined to be desirable by the Agency for Health Research and Quality (AHRQ) in U.S. adult medical, surgical, and intensive care units (ICUs). Design Descriptive study of patient visibility; distance to hygiene, toileting, charting, and supplies; unit configuration; percentage of private rooms; and presence or absence of carpeting in 56 ICUs and 81 medical-surgical units in six metropolitan areas. Methods Data were collected via observation, measurement, and interviews. Unit configurations were classified via an iterative process. Descriptive data were analyzed according to ICU and non-ICU status using SPSS (Version 15). Findings Analysis of unit configurations indicated eight unit designs. Statistical analysis showed inter- and intrahospital variation in unit configurations, percentage private rooms, carpeting, visibility, and distance to supplies and charting. Few units met the AHRQ designated design elements studied. Conclusions A wide gap exists between desirable characteristics in ICUs and medical-surgical units. Future research is needed to explore operationalization of unit design elements as risk adjustments, how design elements contribute to patient outcomes, and how design elements influence one another. Clinical Relevance There is room for improvement on almost every design variable, particularly on medical-surgical units. Future planning should take into consideration the interaction of bed capacity and unit configuration. PMID:19335681

The contribution of community and family contexts to African American young adults' romantic relationship health: a prospective analysis.

PubMed

Kogan, Steven M; Lei, Man-Kit; Grange, Christina R; Simons, Ronald L; Brody, Gene H; Gibbons, Frederick X; Chen, Yi-Fu

2013-06-01

Accumulating evidence suggests that African American men and women experience unique challenges in developing and maintaining stable, satisfying romantic relationships. Extant studies have linked relationship quality among African American couples to contemporaneous risk factors such as economic hardship and racial discrimination. Little research, however, has examined the contextual and intrapersonal processes in late childhood and adolescence that influence romantic relationship health among African American adults. We investigated competence-promoting parenting practices and exposure to community-related stressors in late childhood, and negative relational schemas in adolescence, as predictors of young adult romantic relationship health. Participants were 318 African American young adults (59.4% female) who had provided data at four time points from ages 10-22 years. Structural equation modeling indicated that exposure to community-related stressors and low levels of competence-promoting parenting contributed to negative relational schemas, which were proximal predictors of young adult relationship health. Relational schemas mediated the associations of competence-promoting parenting practices and exposure to community stressors in late childhood with romantic relationship health during young adulthood. Results suggest that enhancing caregiving practices, limiting youths' exposure to community stressors, and modifying relational schemas are important processes to be targeted for interventions designed to enhance African American adults' romantic relationships.

Is bilingualism associated with a lower risk of dementia in community-living older adults? Cross-sectional and prospective analyses.

PubMed

Yeung, Caleb M; St John, Philip D; Menec, Verena; Tyas, Suzanne L

2014-01-01

The aim of this study was to determine whether bilingualism is associated with dementia in cross-sectional or prospective analyses of older adults. In 1991, 1616 community-living older adults were assessed and were followed 5 years later. Measures included age, sex, education, subjective memory loss (SML), and the modified Mini-mental State Examination (3MS). Dementia was determined by clinical examination in those who scored below the cut point on the 3MS. Language status was categorized based upon self-report into 3 groups: English as a first language (monolingual English, bilingual English) and English as a Second Language (ESL). The ESL category had lower education, lower 3MS scores, more SML, and were more likely to be diagnosed with cognitive impairment, no dementia at both time 1 and time 2 compared with those speaking English as a first language. There was no association between being bilingual (ESL and bilingual English vs. monolingual) and having dementia at time 1 in bivariate or multivariate analyses. In those who were cognitively intact at time 1, there was no association between being bilingual and having dementia at time 2 in bivariate or multivariate analyses. We did not find any association between speaking >1 language and dementia.

A prospective registration study to determine feasibility of hematopoietic SCT in adults with acute leukemia: planning, expectations and reality.

PubMed

Labopin, M; Gorin, N-C; Polge, E; Socié, G; Gurman, G; Gluckman, E; Jindra, P; Poiré, X; Schäfer-Eckart, K; Ruutu, T; Milone, G; Arcese, W; Mohty, M; Rocha, V

2014-03-01

For adults with acute leukemia, it is important to know whether the therapeutic schemes initially planned were actually implemented. The European Group for Blood and Marrow transplantation Acute Leukemia Working Party prospectively followed 695 consecutive patients who were registered at the time of HLA typing. Of 304 patients with an available matched sibling donor (MSD), SCT was planned in 264, chemotherapy in 33 and autografting in 7. For the rest, an unrelated donor (UD) search was initiated in 198. Among these, 117 were transplanted, 114 received chemotherapy and 77 underwent autografting. Probabilities of receiving a planned treatment were 60 and 65% at 1 and 2 years, respectively. Patients scheduled to receive MSD SCT had an 82% probability, whereas those scheduled to undergo UD SCT had a 57% probability, of receiving their transplant at 1 year. The only factor associated with a lower probability of MSD SCT in first remission was delayed HLA typing (HR=0.82; P=0.03). One year after enrollment, 40% of patients did not follow their initial treatment plan. Because OS was 50% only at 3 years and only 57% of the patients without a MSD underwent SCT, this suggests room for improvement in outcomes for adults with acute leukemia.

Designing Therapeutic Clinical Trials for Older and Frail Adults With Cancer: U13 Conference Recommendations

PubMed Central

Hurria, Arti; Dale, William; Mooney, Margaret; Rowland, Julia H.; Ballman, Karla V.; Cohen, Harvey J.; Muss, Hyman B.; Schilsky, Richard L.; Ferrell, Betty; Extermann, Martine; Schmader, Kenneth E.; Mohile, Supriya G.

2014-01-01

A majority of cancer diagnoses and deaths occur in patients age ≥ 65 years. With the aging of the US population, the number of older adults with cancer will grow. Although the coming wave of older patients with cancer was anticipated in the early 1980s, when the need for more research on the cancer-aging interface was recognized, many knowledge gaps remain when it comes to treating older and/or frailer patients with cancer. Relatively little is known about the best way to balance the risks and benefits of existing cancer therapies in older patients; however, these patients continue to be underrepresented in clinical trials. Furthermore, the available clinical trials often do not include end points pertinent to the older adult population, such as preservation of function, cognition, and independence. As part of its ongoing effort to advance research in the field of geriatric oncology, the Cancer and Aging Research Group held a conference in November 2012 in collaboration with the National Cancer Institute, the National Institute on Aging, and the Alliance for Clinical Trials in Oncology. The goal was to develop recommendations and establish research guidelines for the design and implementation of therapeutic clinical trials for older and/or frail adults. The conference sought to identify knowledge gaps in cancer clinical trials for older adults and propose clinical trial designs to fill these gaps. The ultimate goal of this conference series is to develop research that will lead to evidence-based care for older and/or frail adults with cancer. PMID:25071116

Future thinking instructions improve prospective memory performance in adolescents.

PubMed

Altgassen, Mareike; Kretschmer, Anett; Schnitzspahn, Katharina Marlene

2017-07-01

Studies on prospective memory (PM) development in adolescents point to age-related increases through to adulthood. The goal of the present study was to examine whether instructing adolescents to engage in an episodic prospection of themselves executing future actions (i.e., future thinking) when forming an intention would improve their PM performance and reduce age-related differences. Further, we set out to explore whether future thinking instructions result in stronger memory traces and/or stronger cue-context associations by evaluating retrospective memory for the PM cues after task completion and monitoring costs during PM task processing. Adolescents and young adults were allocated to either the future thinking, repeated-encoding or standard condition. As expected, adolescents had fewer correct PM responses than young adults. Across age groups, PM performance in the standard condition was lower than in the other encoding conditions. Importantly, the results indicate a significant interaction of age by encoding condition. While adolescents benefited most from future thinking instructions, young adults performed best in the repeated-encoding condition. The results also indicate that the beneficial effects of future thinking may result from deeper intention-encoding through the simulation of future task performance.

Associations between liking for fat, sweet or salt and obesity risk in French adults: a prospective cohort study.

PubMed

Lampuré, Aurélie; Castetbon, Katia; Deglaire, Amélie; Schlich, Pascal; Péneau, Sandrine; Hercberg, Serge; Méjean, Caroline

2016-07-04

Individual sensory liking appears to be an important determinant of dietary intake and may consequently influence weight status. Cross-sectional studies have shown positive association between fat liking and weight status and equivocal results regarding salt and sweet liking. Moreover, the contribution of dietary intake to explain this relationship has not been studied yet. We investigated the prospective association between sensory liking for fat, sweet or salt and the onset of obesity over 5 years in adults, and the mediating effect of dietary intake. We prospectively examine the risk of obesity among 24,776 French adults participating in the NutriNet-Santé cohort study. Liking scores and dietary data were assessed at baseline using a validated web-based questionnaire and 24 h records, respectively. Self-reported anthropometric data were collected using web-based questionnaire, each year during 5 years. Associations between quartiles of liking for fat, sweet or salt and obesity risk, and the mediating effect of diet were assessed by multivariate Cox proportional hazards models stratified by gender, adjusted for sociodemographic and lifestyle factors. In both genders, sensory liking for fat was associated with an increased risk of obesity (hazard ratios for quartile 4 compared to quartile 1, men: HR(Q4vs.Q1) = 2.39 (95% CI 1.39,4.11) P-trend = 0.0005, women: HR(Q4vs.Q1) = 2.02 (1.51,2.71) P-trend = <0.0001). Dietary intake explained 32% in men and 52% in women of the overall variation of liking for fat in obesity. Sensory liking for sweet was associated with a decreased risk of obesity (men: HR(Q4vs.Q1) = 0.51 (0.31,0.83) P-trend = 0.01, women: HR(Q4vs.Q1) = 0.72 (0.54,0.96) P-trend = 0.035). No significant association between salt liking and the risk of obesity was found. Unlike sweet and salt liking, higher liking for fat appears to be a major risk factor of obesity, largely explained by dietary intake. Our findings emphasize the

Modeling the Oldest Old: Personas to Design Technology-Based Solutions for Older Adults

PubMed Central

Reeder, Blaine; Zaslavksy, Oleg; Wilamowska, Katarzyna M.; Demiris, George; Thompson, Hilaire J

2011-01-01

There is a recognized need to develop information technology for the delivery of care services to older adults. However, little attention has been paid to the design of information technology for the oldest old demographic. We made novel use of data from observations, focus groups and cluster analysis of oldest old participant characteristics from a pilot study in a community setting to iteratively construct personas for the design of information technology for the oldest old. The resulting two personas, “Hazel” and “Rose”, capture different abilities of members of the oldest old demographic group. In addition, we provide a list of eleven design recommendations to guide the design of technology that supports the abilities of people like Hazel and Rose. The resulting personas, design recommendations and persona construction method can be useful tools for informaticians and designers of new systems for the oldest old. PMID:22195177

A prospective cohort and extended comprehensive-cohort design provided insights about the generalizability of a pragmatic trial: the ProtecT prostate cancer trial.

PubMed

Donovan, Jenny L; Young, Grace J; Walsh, Eleanor I; Metcalfe, Chris; Lane, J Athene; Martin, Richard M; Tazewell, Marta K; Davis, Michael; Peters, Tim J; Turner, Emma L; Mills, Nicola; Khazragui, Hanan; Khera, Tarnjit K; Neal, David E; Hamdy, Freddie C

2018-04-01

Randomized controlled trials (RCTs) deliver robust internally valid evidence but generalizability is often neglected. Design features built into the Prostate testing for cancer and Treatment (ProtecT) RCT of treatments for localized prostate cancer (PCa) provided insights into its generalizability. Population-based cluster randomization created a prospective study of prostate-specific antigen (PSA) testing and a comprehensive-cohort study including groups choosing treatment or excluded from the RCT, as well as those randomized. Baseline information assessed selection and response during RCT conduct. The prospective study (82,430 PSA-tested men) represented healthy men likely to respond to a screening invitation. The extended comprehensive cohort comprised 1,643 randomized, 997 choosing treatment, and 557 excluded with advanced cancer/comorbidities. Men choosing treatment were very similar to randomized men except for having more professional/managerial occupations. Excluded men were similar to the randomized socio-demographically but different clinically, representing less healthy men with more advanced PCa. The design features of the ProtecT RCT provided data to assess the representativeness of the prospective cohort and generalizability of the findings of the RCT. Greater attention to collecting data at the design stage of pragmatic trials would better support later judgments by clinicians/policy-makers about the generalizability of RCT findings in clinical practice. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Using Data Collection Apps and Single-Case Designs to Research Transformative Learning in Adults

ERIC Educational Resources Information Center

Roessger, Kevin M.; Greenleaf, Arie; Hoggan, Chad

2017-01-01

To overcome situational hurdles when researching transformative learning in adults, we outline a research approach using single-case research designs and smartphone data collection apps. This approach allows researchers to better understand learners' current lived experiences and determine the effects of transformative learning interventions on…

Academic Achievement in Adults with a History of Childhood Attention-Deficit/Hyperactivity Disorder: A Population-Based Prospective Study.

PubMed

Voigt, Robert G; Katusic, Slavica K; Colligan, Robert C; Killian, Jill M; Weaver, Amy L; Barbaresi, William J

2017-01-01

Previous research on the developmental course of attention-deficit/hyperactivity disorder (ADHD) is limited by biased clinic-referred samples and other methodological problems. Thus, questions about adult academic outcomes associated with childhood ADHD remain unanswered. Thus, the objective of this study was to describe academic outcomes in adulthood among incident cases of research-identified childhood ADHD versus non-ADHD referents from a population-based birth cohort. Young adults with research-identified childhood ADHD (N = 232; mean age 27.0 yr; 72.0% men) and referents (N = 335; mean age 28.6 yr; 62.7% men) from a 1976 to 1982 birth cohort (N = 5699) were invited to participate in a followup study and were administered an academic achievement battery consisting of the basic reading component of the Woodcock-Johnson III Tests of Achievement (WJ-III) and the arithmetic subtest of the Wide Range Achievement Test-Third Edition (WRAT-3). Outcomes were compared between the 2 groups using linear regression models, adjusted for age, sex, and comorbid learning disability status. Childhood ADHD cases scored from 3 to 5 grade equivalents lower on all academic tests compared with referents, with mean (SD) standard scores of 95.7 (8.4) versus 101.8 (8.1) in basic reading; 95.0 (9.3) versus 101.9 (8.5) in letterword identification; 98.2 (8.6) versus 103.2 (9.2) in passage comprehension; 95.7 (9.1) versus 100.9 (9.0) in word attack; and 87.8 (12.9) versus 98.0 (12.0) in arithmetic. This is the first prospective, population-based study of adult academic outcomes of childhood ADHD. Our data provide evidence that childhood onset ADHD is associated with long-term underachievement in reading and math that may negatively impact ultimate educational attainment and occupational functioning in adulthood.

Decision Making Among Older Adults at the End of Life: A Theoretical Perspective.

PubMed

Romo, Rafael D; Dawson-Rose, Carol S; Mayo, Ann M; Wallhagen, Margaret I

Understanding changes in decision making among older adults across time is important for health care providers. We examined how older adults with a limited prognosis used their perception of prognosis and health in their decision-making processes and related these findings to prospect theory. The theme of decision making in the context of ambiguity emerged, reflecting how participants used both prognosis and health to value choices, a behavior not fully captured by prospect theory. We propose an extension of the theory that can be used to better visualize decision making at this unique time of life among older adults.

Designing an intervention to prevent suicide: PROSPECT (Prevention of Suicide in Primary Care Elderly: Collaborative Trial)

PubMed Central

Bruce, Martha L.; Pearson, Jane L.

1999-01-01

Suicide is a major public health problem with greatest risk in the very old. This paper describes an approach to reducing the risk of suicide by intervening on depression in elderly primary care patients. Depression is an appropriate target for an intervention as it is highly prevalent in primary care, is a strong risk factor for suicide, and is more often than not inadequately treated. PROSPECT (Prevention of Suicide in Primary Care Elderly: Collaborative Trial) is a National institute of Mental Health (NIMH)-funded collaborative study that is testing this approach to suicide risk prevention in 18 primary care practices in the United States. PROSPECT'S intervention of “guideline management” introduces a health specialist into the primary care setting to help physicians provide “on-time, on-target” treatment and long-term management of late-life depression following structured clinical guidelines. The effectiveness of the intervention in reducing suicidal risk and depression is evaluated by following a representative sample of older patients identified using a 2-stage design. PMID:22033641

A Differential Deficit in Time- versus Event-based Prospective Memory in Parkinson's Disease

PubMed Central

Raskin, Sarah A.; Woods, Steven Paul; Poquette, Amelia J.; McTaggart, April B.; Sethna, Jim; Williams, Rebecca C.; Tröster, Alexander I.

2010-01-01

Objective The aim of the current study was to clarify the nature and extent of impairment in time- versus event-based prospective memory in Parkinson's disease (PD). Prospective memory is thought to involve cognitive processes that are mediated by prefrontal systems and are executive in nature. Given that individuals with PD frequently show executive dysfunction, it is important to determine whether these individuals may have deficits in prospective memory that could impact daily functions, such as taking medications. Although it has been reported that individuals with PD evidence impairment in prospective memory, it is still unclear whether they show a greater deficit for time- versus event-based cues. Method Fifty-four individuals with PD and 34 demographically similar healthy adults were administered a standardized measure of prospective memory that allows for a direct comparison of time-based and event-based cues. In addition, participants were administered a series of standardized measures of retrospective memory and executive functions. Results Individuals with PD demonstrated impaired prospective memory performance compared to the healthy adults, with a greater impairment demonstrated for the time-based tasks. Time-based prospective memory performance was moderately correlated with measures of executive functioning, but only the Stroop Neuropsychological Screening Test emerged as a unique predictor in a linear regression. Conclusions Findings are interpreted within the context of McDaniel and Einstein's (2000) multi-process theory to suggest that individuals with PD experience particular difficulty executing a future intention when the cue to execute the prescribed intention requires higher levels of executive control. PMID:21090895

Prospective, Multicentre, Nationwide Clinical Data from 600 Cases of Acute Pancreatitis

PubMed Central

Párniczky, Andrea; Kui, Balázs; Szentesi, Andrea; Balázs, Anita; Szűcs, Ákos; Mosztbacher, Dóra; Czimmer, József; Sarlós, Patrícia; Bajor, Judit; Gódi, Szilárd; Vincze, Áron; Illés, Anita; Szabó, Imre; Pár, Gabriella; Takács, Tamás; Czakó, László; Szepes, Zoltán; Rakonczay, Zoltán; Izbéki, Ferenc; Gervain, Judit; Halász, Adrienn; Novák, János; Crai, Stefan; Hritz, István; Góg, Csaba; Sümegi, János; Golovics, Petra; Varga, Márta; Bod, Barnabás; Hamvas, József; Varga-Müller, Mónika; Papp, Zsuzsanna; Sahin-Tóth, Miklós; Hegyi, Péter

2016-01-01

Objective The aim of this study was to analyse the clinical characteristics of acute pancreatitis (AP) in a prospectively collected, large, multicentre cohort and to validate the major recommendations in the IAP/APA evidence-based guidelines for the management of AP. Design Eighty-six different clinical parameters were collected using an electronic clinical research form designed by the Hungarian Pancreatic Study Group. Patients 600 adult patients diagnosed with AP were prospectively enrolled from 17 Hungarian centres over a two-year period from 1 January 2013. Main Results With respect to aetiology, biliary and alcoholic pancreatitis represented the two most common forms of AP. The prevalence of biliary AP was higher in women, whereas alcoholic AP was more common in men. Hyperlipidaemia was a risk factor for severity, lack of serum enzyme elevation posed a risk for severe AP, and lack of abdominal pain at admission demonstrated a risk for mortality. Abdominal tenderness developed in all the patients with severe AP, while lack of abdominal tenderness was a favourable sign for mortality. Importantly, lung injury at admission was associated with mortality. With regard to laboratory parameters, white blood cell count and CRP were the two most sensitive indicators for severe AP. The most common local complication was peripancreatic fluid, whereas the most common distant organ failure in severe AP was lung injury. Deviation from the recommendations in the IAP/APA evidence-based guidelines on fluid replacement, enteral nutrition and timing of interventions increased severity and mortality. Conclusions Analysis of a large, nationwide, prospective cohort of AP cases allowed for the identification of important determinants of severity and mortality. Evidence-based guidelines should be observed rigorously to improve outcomes in AP. PMID:27798670

An Annotated Bibliography of Materials Designed and Organized for Adult Use in Discussion Groups.

ERIC Educational Resources Information Center

Ellison, John W.

This first annotated bibliography of materials designed and organized for adult use in disucssion groups includes both book and nonbook material. Areas dealt with are: art, censorship, change, child guidance, communication, crime, democracy, economics, education, evolution, food, foreign affairs, forgetting, generation gap, gold, good and evil,…

Long-term consequences of child abuse and neglect on adult economic well-being.

PubMed

Currie, Janet; Widom, Cathy Spatz

2010-05-01

Child abuse and neglect represent major threats to child health and well-being; however, little is known about consequences for adult economic outcomes. Using a prospective cohort design, court substantiated cases of childhood physical and sexual abuse and neglect during 1967-1971 were matched with nonabused and nonneglected children and followed into adulthood (mean age 41). Outcome measures of economic status and productivity were assessed in 2003-2004 (N 1/4 807). Results indicate that adults with documented histories of childhood abuse and/or neglect have lower levels of education, employment, earnings, and fewer assets as adults, compared to matched control children. There is a 14% gap between individuals with histories of abuse/neglect and controls in the probability of employment in middle age, controlling for background characteristics. Maltreatment appears to affect men and women differently, with larger effects for women than men. These new findings demonstrate that abused and neglected children experience large and enduring economic consequences.

Long-Term Consequences of Child Abuse and Neglect on Adult Economic Well-Being

PubMed Central

Currie, Janet; Widom, Cathy Spatz

2013-01-01

Child abuse and neglect represent major threats to child health and well-being; however, little is known about consequences for adult economic outcomes. Using a prospective cohort design, court substantiated cases of childhood physical and sexual abuse and neglect during 1967–1971 were matched with nonabused and nonneglected children and followed into adulthood (mean age 41). Outcome measures of economic status and productivity were assessed in 2003–2004 (N = 807). Results indicate that adults with documented histories of childhood abuse and/or neglect have lower levels of education, employment, earnings, and fewer assets as adults, compared to matched control children. There is a 14% gap between individuals with histories of abuse/neglect and controls in the probability of employment in middle age, controlling for background characteristics. Maltreatment appears to affect men and women differently, with larger effects for women than men. These new findings demonstrate that abused and neglected children experience large and enduring economic consequences. PMID:20425881

Adults with developmental dyslexia show selective impairments in time-based and self-initiated prospective memory: Self-report and clinical evidence.

PubMed

Smith-Spark, James H; Zięcik, Adam P; Sterling, Christopher

2017-03-01

Prospective memory (PM; memory for delayed intentions) would seem to be impaired in dyslexia but evidence is currently limited in scope. There is a need, therefore, firstly, to explore PM under controlled conditions using a broader range of PM tasks than used previously and, secondly, to determine whether objectively measured and self-reported PM problems can be found in the same individuals with dyslexia. The responses of 30 adults with dyslexia were compared with those of 30 IQ-matched adults without dyslexia on a self-report and a clinical measure of PM. Dyslexia-related deficits were shown on the clinical measure overall and, more particularly, when PM responses had to be made to cues based on time rather than environmental events. Adults with dyslexia were also more likely to forget to carry out an intention under naturalistic conditions 24h later. On the self-report questionnaire, the group with dyslexia reported significantly more frequent problems with PM overall, despite using more techniques to aid their memory. In particular, problems were identified with longer-term PM tasks and PM which had to be self-initiated. Dyslexia-related PM deficits were found under both laboratory and everyday conditions in the same participants; the first time that this has been demonstrated. These findings support previous experimental research which has highlighted dyslexia-related deficits in PM when the enacting of intentions is based on time cues and/or has to be self-initiated rather than being in prompted by environmental events. Copyright © 2017 Elsevier Ltd. All rights reserved.

An internal pilot design for prospective cancer screening trials with unknown disease prevalence.

PubMed

Brinton, John T; Ringham, Brandy M; Glueck, Deborah H

2015-10-13

For studies that compare the diagnostic accuracy of two screening tests, the sample size depends on the prevalence of disease in the study population, and on the variance of the outcome. Both parameters may be unknown during the design stage, which makes finding an accurate sample size difficult. To solve this problem, we propose adapting an internal pilot design. In this adapted design, researchers will accrue some percentage of the planned sample size, then estimate both the disease prevalence and the variances of the screening tests. The updated estimates of the disease prevalence and variance are used to conduct a more accurate power and sample size calculation. We demonstrate that in large samples, the adapted internal pilot design produces no Type I inflation. For small samples (N less than 50), we introduce a novel adjustment of the critical value to control the Type I error rate. We apply the method to two proposed prospective cancer screening studies: 1) a small oral cancer screening study in individuals with Fanconi anemia and 2) a large oral cancer screening trial. Conducting an internal pilot study without adjusting the critical value can cause Type I error rate inflation in small samples, but not in large samples. An internal pilot approach usually achieves goal power and, for most studies with sample size greater than 50, requires no Type I error correction. Further, we have provided a flexible and accurate approach to bound Type I error below a goal level for studies with small sample size.

Trajectory of Development in Adolescents and Adults with Autism

ERIC Educational Resources Information Center

Seltzer, Marsha Mailick; Shattuck, Paul; Abbeduto, Leonard; Greenberg, Jan S.

2004-01-01

This article seeks to elucidate the trajectory of development in adolescents and adults with autism. Prospective, retrospective, and cross-sectional studies are reviewed to reveal the manifestation of and changes in the core symptoms of autism in adolescence and adulthood. Comparing children with adolescents and adults, modest degrees of symptom…

Childhood Trauma Questionnaire (CTQ) correlations with prospective violence assessment in a longitudinal cohort.

PubMed

Liebschutz, Jane M; Buchanan-Howland, Kathryn; Chen, Clara A; Frank, Deborah A; Richardson, Mark A; Heeren, Timothy C; Cabral, Howard J; Rose-Jacobs, Ruth

2018-06-01

Retrospective recall-based measures administered to adults, like the Childhood Trauma Questionnaire (CTQ), are commonly used to determine experiences of childhood trauma in the home. However, the CTQ has not been compared with prospective measures of childhood violence exposure, whether at home or in the community. We evaluated the relationships between young adults' responses to the CTQ and their prospective self-reports of exposure to violence in childhood and adolescence. Participants were 127 (93% African American, 47% male) urban young adults in a longitudinal birth cohort study examining effects of prenatal substance exposure and environmental factors on development. Participants completed the Violence Exposure Scale for Children-Revised (VEX-R), a 21-item self-report measure of experience of/witness to interpersonal violence, administered face to face at 9, 10, and 11 years using cartoon pictures, and via audio-computer assisted self-interview at 12, 14, and 16 years. Participants also completed the CTQ, a 28-item, 5-scale screening measure, during a young-adult follow-up (ages 18-23). Using Pearson Correlation coefficients, VEX-R total scores significantly correlated with the sum of CTQ scales, r = .33, p < .01, and 3 (physical, emotional, and sexual abuse) of the 5 CTQ subscales, showing a moderate linear association. This study suggests that the CTQ serves as a reasonable retrospective assessment of prospectively ascertained childhood trauma exposure. The differences may be accounted for by disparities in domains assessed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Prospective memory function in late adulthood: affect at encoding and resource allocation costs.

PubMed

Henry, Julie D; Joeffry, Sebastian; Terrett, Gill; Ballhausen, Nicola; Kliegel, Matthias; Rendell, Peter G

2015-01-01

Some studies have found that prospective memory (PM) cues which are emotionally valenced influence age effects in prospective remembering, but it remains unclear whether this effect reflects the operation of processes implemented at encoding or retrieval. In addition, none of the prior ageing studies of valence on PM function have examined potential costs of engaging in different valence conditions, or resource allocation trade-offs between the PM and the ongoing task. In the present study, younger, young-old and old-old adults completed a PM task in which the valence of the cues varied systematically (positive, negative or neutral) at encoding, but was kept constant (neutral) at retrieval. The results indicated that PM accuracy did not vary as a function of affect at encoding, and that this effect did not interact with age group. There was also no main or interaction effect of valence on PM reaction time in PM cue trials, indicating that valence costs across the three encoding conditions were equivalent. Old-old adults' PM accuracy was reduced relative to both young-old and younger adults. Prospective remembering incurred dual-task costs for all three groups. Analyses of reaction time data suggested that for both young-old and old-old, these costs were greater, implying differential resource allocation cost trade-offs. However, when reaction time data were expressed as a proportional change that adjusted for the general slowing of the older adults, costs did not differ as a function of group.

Childhood intelligence and adult obesity.

PubMed

Kanazawa, Satoshi

2013-03-01

Recent studies conclude childhood intelligence has no direct effect on adult obesity net of education, but evolutionary psychological theories suggest otherwise. A population (n = 17,419) of British babies has been followed since birth in 1958 in a prospectively longitudinal study. Childhood general intelligence is measured at 7, 11, and 16, and adult BMI and obesity are measured at 51. Childhood general intelligence has a direct effect on adult BMI, obesity, and weight gain, net of education, earnings, mother's BMI, father's BMI, childhood social class, and sex. More intelligent children grow up to eat more healthy foods and exercise more frequently as adults. Childhood intelligence has a direct effect on adult obesity unmediated by education or earnings. General intelligence decreases BMI only in adulthood when individuals have complete control over what they eat. Copyright © 2012 The Obesity Society.

The impact of virus infections on pneumonia mortality is complex in adults: a prospective multicentre observational study.

PubMed

Katsurada, Naoko; Suzuki, Motoi; Aoshima, Masahiro; Yaegashi, Makito; Ishifuji, Tomoko; Asoh, Norichika; Hamashige, Naohisa; Abe, Masahiko; Ariyoshi, Koya; Morimoto, Konosuke

2017-12-06

Various viruses are known to be associated with pneumonia. However, the impact of viral infections on adult pneumonia mortality remains unclear. This study aimed to clarify the effect of virus infection on pneumonia mortality among adults stratified by virus type and patient comorbidities. This multicentre prospective study enrolled pneumonia patients aged ≥15 years from September 2011 to August 2014. Sputum samples were tested by in-house multiplex polymerase chain reaction assays to identify 13 respiratory viruses. Viral infection status and its effect on in-hospital mortality were examined by age group and comorbidity status. A total of 2617 patients were enrolled in the study and 77.8% was aged ≥65 years. 574 (21.9%) did not have comorbidities, 790 (30.2%) had chronic respiratory disease, and 1253 (47.9%) had other comorbidities. Viruses were detected in 605 (23.1%) patients. Human rhinovirus (9.8%) was the most frequently identified virus, followed by influenza A (3.9%) and respiratory syncytial virus (3.9%). Respiratory syncytial virus was more frequently identified in patients with chronic respiratory disease (4.7%) than those with other comorbidities (4.2%) and without comorbidities (2.1%) (p = 0.037). The frequencies of other viruses were almost identical between the three groups. Virus detection overall was not associated with increased mortality (adjusted risk ratio (ARR) 0.76, 95% CI 0.53-1.09). However, influenza virus A and B were associated with three-fold higher mortality in patients with chronic respiratory disease but not with other comorbidities (ARR 3.38, 95% CI 1.54-7.42). Intriguingly, paramyxoviruses were associated with dramatically lower mortality in patients with other comorbidities (ARR 0.10, 95% CI 0.01-0.70) but not with chronic respiratory disease. These effects were not affected by age group. The impact of virus infections on pneumonia mortality varies by virus type and comorbidity status in adults.

Novel and conventional serum biomarkers predicting acute kidney injury in adult cardiac surgery--a prospective cohort study.

PubMed

Haase-Fielitz, Anja; Bellomo, Rinaldo; Devarajan, Prasad; Story, David; Matalanis, George; Dragun, Duska; Haase, Michael

2009-02-01

To compare the value of novel with conventional serum biomarkers in the prediction of acute kidney injury (AKI) in adult cardiac surgical patients according to preoperative renal function. Single-center, prospective observational study. Tertiary hospital. One hundred adult cardiac surgical patients. We measured concentrations of plasma neutrophil gelatinase-associated lipocalin (NGAL), and serum cystatin C, and creatinine and urea at baseline, on arrival in the intensive care unit (ICU) and at 24 hours postoperatively. We assessed such biomarkers in relation to the development of AKI (>50% increase in creatinine from baseline) and to a composite end point (need for renal replacement therapy and in-hospital mortality). We defined an area under the receiver operating characteristic curve of 0.60-0.69 as poor, 0.70-0.79 as fair, 0.80-0.89 as good, and 0.90-1.00 as excellent in terms of predictive value. On arrival in ICU, plasma NGAL and serum cystatin C were of good predictive value, but creatinine and urea were of poor predictive value. After exclusion of patients with preoperative renal impairment (estimated glomerular filtration rate <60 mL/min), the predictive performance for AKI of all renal biomarkers on arrival in ICU remained unchanged except for cystatin C, which was of fair value in such patients. At 24 hours postoperatively, all renal biomarkers were of good predictive value. On arrival in ICU, novel biomarkers were superior to conventional biomarkers (p < 0.05). Plasma NGAL (p = 0.015) and serum cystatin C (p = 0.007) were independent predictors of AKI and of excellent value in the prediction of the composite end point. Early postoperative measurement of plasma NGAL was of good value in identifying patients who developed AKI after adult cardiac surgery. Plasma NGAL and serum cystatin C were superior to conventional biomarkers in the prediction of AKI and were also of prognostic value in this setting.

Stiffness Control of Balance during Dual Task and Prospective Falls in Older Adults: The MOBILIZE Boston Study

PubMed Central

Kang, Hyun Gu; Quach, Lien; Li, Wenjun; Lipsitz, Lewis A.

2013-01-01

Outdoor fallers differ from indoor fallers substantially in demographics, lifestyle, health condition and physical function. Biomechanical predictors of outdoor falls have not been well characterized. Current validated measures of postural deficits, which describe only the overall postural behavior, are predictive of indoor falls but not outdoor falls. We hypothesized that a model-based description of postural muscle tone and reflexes, particularly during dual tasking, would predict outdoor falls. We tested whether postural stiffness and damping from an inverted pendulum model were predictive of future indoor and outdoor falls among older adults from the MOBILIZE Boston Study. The center of pressure data during standing were obtained from 717 participants aged 77.9±5.3 years. Participants stood barefoot with eyes open for 30 seconds per trial, in two sets of five standing trials. One set included a serial subtractions task. Postural stiffness and damping values were determined from the postural sway data. After the postural measurements, falls were monitored prospectively using a monthly mail-in calendar over 6-36 months. Associations of postural measures with fall rates were determined using negative binomial regressions. After covariate adjustments, postural stiffness (p=0.02-0.05) and damping (p=0.007-0.1) were associated with lower outdoor falls risk, but not with indoor falls. Results were invariant by direction (anteroposterior versus mediolateral) or by condition (quiet standing versus dual task). Outdoor fall risk may be tied to postural control more so than indoor falls. Dual tasking is likely related to fall risk among older and sicker older adults, but not those relatively healthy. PMID:23623606

Effects of childhood abuse on adult obesity: a systematic review and meta-analysis.

PubMed

Hemmingsson, E; Johansson, K; Reynisdottir, S

2014-11-01

Controversy exists surrounding the role of childhood abuse in obesity development. This is a meta-analysis of observational studies on the role of childhood abuse in adult obesity. Systematic searches of PubMed, PsycInfo, Medline and CINAHL resulted in 23 cohort studies (4 prospective, 19 retrospective) with n=112,708 participants, containing four abuse types (physical, emotional, sexual, general). Four studies reported dose-response effects. A random effects model was used to quantify effect sizes, meta-regression/subgroup analysis for identifying potential moderating variables and Egger's test for publication bias. Adults who reported childhood abuse were significantly more likely to be obese (odds ratio [OR]: 1.34, 95% confidence interval [CI]: 1.24-1.45, P<0.001). All four types of abuse were significantly associated with adult obesity: physical (OR: 1.28, 95% CI: 1.13-1.46), emotional (OR: 1.36, 95% CI: 1.08-1.71), sexual (OR: 1.31, 95% CI: 1.13-1.53) and general abuse (OR: 1.45, 95% CI: 1.25-1.69). Severe abuse (OR: 1.50, 95% CI: 1.27-1.77) was significantly more associated with adult obesity (P=0.043) compared with light/moderate abuse (OR: 1.13, 95% CI: 0.91-1.41). We found no significant effects of study design (prospective vs. retrospective, P=0.07), age (P=0.96) or gender (P=0.92). Publication bias was evident (Egger's test P=0.007), but effect sizes remained statistically significant in sensitivity analyses. Childhood abuse was clearly associated with being obese as an adult, including a positive dose-response association. This suggests that adverse life experiences during childhood plays a major role in obesity development, potentially by inducing mental and emotional perturbations, maladaptive coping responses, stress, inflammation and metabolic disturbances. © 2014 World Obesity.

Dietary acrylamide intake of adults in the European Prospective Investigation into Cancer and Nutrition differs greatly according to geographical region.

PubMed

Freisling, Heinz; Moskal, Aurelie; Ferrari, Pietro; Nicolas, Geneviève; Knaze, Viktoria; Clavel-Chapelon, Françoise; Boutron-Ruault, Marie-Christine; Nailler, Laura; Teucher, Birgit; Grote, Verena A; Boeing, Heiner; Clemens, Matthias; Tjønneland, Anne; Olsen, Anja; Overvad, Kim; Quirós, J Ramón; Duell, Eric J; Sánchez, María-José; Amiano, Pilar; Chirlaque, Maria-Dolores; Barricarte, Aurelio; Khaw, Kay-Tee; Wareham, Nicholas J; Crowe, Francesca L; Gallo, Valentina; Oikonomou, Eleni; Naska, Androniki; Trichopoulou, Antonia; Palli, Domenico; Agnoli, Claudia; Tumino, Rosario; Polidoro, Silvia; Mattiello, Amalia; Bueno-de-Mesquita, H Bas; Ocké, Marga C; Peeters, Petra H M; Wirfält, Elisabet; Ericson, Ulrika; Bergdahl, Ingvar A; Johansson, Ingegerd; Hjartåker, Anette; Engeset, Dagrun; Skeie, Guri; Riboli, Elio; Slimani, Nadia

2013-06-01

Methodological differences in assessing dietary acrylamide (AA) often hamper comparisons of intake across populations. Our aim was to describe the mean dietary AA intake in 27 centers of 10 European countries according to selected lifestyle characteristics and its contributing food sources in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. In this cross-sectional analysis, 36 994 men and women, aged 35-74 years completed a single, standardized 24-hour dietary recall using EPIC-Soft. Food consumption data were matched to a harmonized AA database. Intake was computed by gender and center, and across categories of habitual alcohol consumption, smoking status, physical activity, education, and body mass index (BMI). Adjustment was made for participants' age, height, weight, and energy intake using linear regression models. Adjusted mean AA intake across centers ranged from 13 to 47 μg/day in men and from 12 to 39 μg/day in women; intakes were higher in northern European centers. In most centers, intake in women was significantly higher among alcohol drinkers compared with abstainers. There were no associations between AA intake and physical activity, BMI, or education. At least 50 % of AA intake across centers came from two food groups "bread, crisp bread, rusks" and "coffee." The third main contributing food group was "potatoes". Dietary AA intake differs greatly among European adults residing in different geographical regions. This observed heterogeneity in AA intake deserves consideration in the design and interpretation of population-based studies of dietary AA intake and health outcomes.

Serum reference interval of ARCHITECT alpha-fetoprotein in healthy Chinese Han adults: Sub-analysis of a prospective multi-center study.

PubMed

Yan, Cunling; Yang, Jia; Wei, Lianhua; Hu, Jian; Song, Jiaqi; Wang, Xiaoqin; Han, Ruilin; Huang, Ying; Zhang, Wei; Soh, Andrew; Beshiri, Agim; Fan, Zhuping; Zheng, Yijie; Chen, Wei

2018-02-01

Alpha-fetoprotein (AFP) has been widely used in clinical practice for decades. However, large-scale survey of serum reference interval for ARCHITECT AFP is still absent in Chinese population. This study aimed to measure serum AFP levels in healthy Chinese Han subjects, which is a sub-analysis of an ongoing prospective, cross-sectional, multi-center study (ClinicalTrials.gov Identifier: NCT03047603). This analysis included a total of 530 participants (41.43±12.14years of age on average, 48.49% males), enrolled from 5 regional centers. Serum AFP level was measured by ARCHITECT immunoassay. Statistical analysis was performed using SAS 9.4 and R software. AFP distribution did not show significant correlation with age or sex. The overall median and interquartile range of AFP was 2.87 (2.09, 3.83) ng/mL. AFP level did not show a trend of increasing with age. The new reference interval was 2.0-7.07ng/mL (LOQ- 97.5th percentiles). The reference interval for ARCHITECT AFP is updated with the data of adequate number of healthy Han adults. This new reference interval is more practical and applicable in Chinese adults. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Prospective and retrospective time perception are related to mental time travel: evidence from Alzheimer's disease.

PubMed

El Haj, Mohamad; Moroni, Christine; Samson, Séverine; Fasotti, Luciano; Allain, Philippe

2013-10-01

Unlike prospective time perception paradigms, in which participants are aware that they have to estimate forthcoming time, little is known about retrospective time perception in normal aging and Alzheimer's disease (AD). Our paper addresses this shortcoming by comparing prospective and retrospective time estimation in younger adults, older adults, and AD patients. In four prospective tasks (lasting 30s, 60s, 90s, or 120s) participants were asked to read a series of numbers and to provide a verbal estimation of the reading time. In four other retrospective tasks, they were not informed about time judgment until they were asked to provide a verbal estimation of four elapsed time intervals (lasting 30s, 60s, 90s, or 120s). AD participants gave shorter verbal time estimations than older adults and younger participants did, suggesting that time is perceived to pass quickly in these patients. For all participants, the duration of the retrospective tasks was underestimated as compared to the prospective tasks and both estimations were shorter than the real time interval. Prospective time estimation was further correlated with mental time travel, as measured with the Remember/Know paradigm. Mental time travel was even higher correlated with retrospective time estimation. Our findings shed light on the relationship between time perception and the ability to mentally project oneself into time, two skills contributing to human memory functioning. Finally, time perception deficits, as observed in AD patients, can be interpreted in terms of dramatic changes occurring in frontal lobes and hippocampus. Copyright © 2013 Elsevier Inc. All rights reserved.

Family Caregiver Knowledge, Patient Illness Characteristics, and Unplanned Hospital Admissions in Older Adults With Cancer.

PubMed

Geddie, Patricia I; Wochna Loerzel, Victoria; Norris, Anne E

2016-07-01

To explore factors related to unplanned hospital admissions and determine if one or more factors are predictive of unplanned hospital admissions for older adults with cancer.
. A prospective longitudinal design and a retrospective chart review.
. Adult oncology outpatient infusion centers and inpatient units at Orlando Regional Medical Center in Florida.
. A convenience sample of 129 dyads of older adults with cancer and their family caregivers. 
. Family caregiver demographic and side effect knowledge data were collected prospectively during interviews with family caregivers using a newly developed tool, the Nurse Assessment of Family Caregiver Knowledge and Action Tool. Patient demographic and clinical data were obtained through a retrospective chart review. Descriptive statistics and logistic regression analyses were used to evaluate data and examine relationships among variables.
. Patient illness characteristics; impaired function; side effects, such as infection, fever, vomiting, and diarrhea; family caregiver knowledge; and unplanned hospital admissions.
. Unplanned hospital admissions were more likely to occur when older adults had impaired function and side effects, such as infection, fever, vomiting, and diarrhea. Impaired function and family caregiver knowledge did not moderate the effects of these side effects on unplanned hospital admissions. 
. Findings suggest that the presence of impaired function and side effects, such as infection, fever, vomiting, and diarrhea, predict unplanned hospital admissions in older adults with cancer during the active treatment phase. Side effects may or may not be related to chemotherapy and may be related to preexisting comorbidities. 
. Nurses can conduct targeted assessments to identify older adults and their family caregivers who will need additional follow-up and support during the cancer treatment trajectory. Information gained from these assessments will assist nurses to provide practical and

A prospective evaluation of a pressure ulcer prevention and management E-Learning Program for adults with spinal cord injury.

PubMed

Brace, Jacalyn A; Schubart, Jane R

2010-08-01

Pressure ulcers are a common complication of spinal cord injury (SCI). Pressure ulcer education programs for spinal cord injured individuals have been found to have a positive effect on care protocol adherence. A prospective study was conducted among hospitalized spinal cord-injured men and women to determine if viewing the Pressure Ulcer Prevention and Management Education for Adults with Spinal Cord Injury: E-Learning Program affects their knowledge scores. A 20-question multiple-choice pre-/post learning test was developed and validated by 12 rehabilitation nurses. Twenty (20) patients (13 men, seven women; mean age 49 years, [SD: 18.26] with injuries to the cervical [seven], thoracic [six], and lumbar [six] regions) volunteered. Most (42%) had completed high school and time since SCI ranged from 2 weeks to 27 years. Eighteen (18) participants completed both the pre- and post test. Of those, 16 showed improvement in pressure ulcer knowledge scores. The median scores improved from 65 (range 25 to 100) pre-program to 92.5 (range 75 to 100) post-program. Descriptive statistics, Student's t-test, and analysis of variance (ANOVA) were used to analyze the data. The results suggest that a single viewing of this e-learning program could improve pressure ulcer knowledge of hospitalized adults with SCI. Research to ascertain the effects of this and other educational programs on pressure ulcer rates is needed.

Is prospective memory enhanced by cue-action semantic relatedness and enactment at encoding?

PubMed

Pereira, Antonina; Ellis, Judi; Freeman, Jayne

2012-09-01

Benefits and costs on prospective memory performance, of enactment at encoding and a semantic association between a cue-action word pair, were investigated in two experiments. Findings revealed superior performance for both younger and older adults following enactment, in contrast to verbal encoding, and when cue-action semantic relatedness was high. Although younger adults outperformed older adults, age did not moderate benefits of cue-action relatedness or enactment. Findings from a second experiment revealed that the inclusion of an instruction to perform a prospective memory task led to increments in response latency to items from the ongoing activity in which that task was embedded, relative to latencies when the ongoing task only was performed. However, this task interference 'cost' did not differ as a function of either cue-action relatedness or enactment. We argue that the high number of cue-action pairs employed here influenced meta-cognitive consciousness, hence determining attention allocation, in all experimental conditions. Copyright © 2012 Elsevier Inc. All rights reserved.

Association of major depression and diabetes in medically indigent Puerto Rican adults.

PubMed

Disdier-Flores, Orville M

2010-03-01

Studies have found that major depression and diabetes mellitus are strongly associated. The main goal of this study was to evaluate the association between major depression and diabetes in a large medically indigent population of Puerto Rican adults living on the island. A secondary database analysis through a cross-sectional design was used for this study. Participants were selected from the Puerto Rico Commonwealth Health Plan database, beneficiaries of the public health sector. Adult's subjects with at least one claim during 2002 were included. The final sample consisted of 1,026,625 adult insured. The International Classification of Diseases (ICD-9) was used for disease classifications. The prevalence of diabetes was 14.6% in subjects with major depression and 9.7% for those without major depression (POR 1.59, p < 0.001). The strength of this association remained after adjusting for obesity and sex. Prevalence of diabetes appears to be significantly higher in Puerto Rican adults with major depression compared to those without this psychiatric disorder. Longitudinal prospective studies and randomized controlled trials are needed to shed light on the temporal or causal relationship and to test whether effective prevention and treatment can reduce the risk of developing diabetes.

Diagnostic accuracy of a point-of-care urine test for tuberculosis screening among newly-diagnosed HIV-infected adults: a prospective, clinic-based study.

PubMed

Drain, Paul K; Losina, Elena; Coleman, Sharon M; Giddy, Janet; Ross, Douglas; Katz, Jeffrey N; Walensky, Rochelle P; Freedberg, Kenneth A; Bassett, Ingrid V

2014-02-26

A rapid diagnostic test for active tuberculosis (TB) at the clinical point-of-care could expedite case detection and accelerate TB treatment initiation. We assessed the diagnostic accuracy of a rapid urine lipoarabinomannan (LAM) test for TB screening among HIV-infected adults in a TB-endemic setting. We prospectively enrolled newly-diagnosed HIV-infected adults (≥18 years) at 4 outpatient clinics in Durban from Oct 2011-May 2012, excluding those on TB therapy. A physician evaluated all participants and offered CD4 cell count testing. Trained study nurses collected a sputum sample for acid-fast bacilli smear microscopy (AFB) and mycobacterial culture, and performed urine LAM testing using Determine™ TB LAM in the clinic. The presence of a band regardless of intensity on the urine LAM test was considered positive. We defined as the gold standard for active pulmonary TB a positive sputum culture for Mycobacterium tuberculosis. Diagnostic accuracy of urine LAM was assessed, alone and in combination with smear microscopy, and stratified by CD4 cell count. Among 342 newly-diagnosed HIV-infected participants, 190 (56%) were male, mean age was 35.6 years, and median CD4 was 182/mm3. Sixty participants had culture-positive pulmonary TB, resulting in an estimated prevalence of 17.5% (95% CI 13.7-22.0%). Forty-five (13.2%) participants were urine LAM positive. Mean time from urine specimen collection to LAM test result was 40 minutes (95% CI 34-46 minutes). Urine LAM test sensitivity was 28.3% (95% CI 17.5-41.4) overall, and 37.5% (95% CI 21.1-56.3) for those with CD4 count <100/mm3, while specificity was 90.1% (95% CI 86.0-93.3) overall, and 86.9% (95% CI 75.8-94.2) for those with CD4 < 100/mm3. When combined with sputum AFB (either test positive), sensitivity increased to 38.3% (95% CI 26.0-51.8), but specificity decreased to 85.8% (95% CI 81.1-89.7). In this prospective, clinic-based study with trained nurses, a rapid urine LAM test had low sensitivity for TB

Prospective Elementary School Teachers' Views about Socioscientific Issues: A Concurrent Parallel Design Study

ERIC Educational Resources Information Center

Özden, Muhammet

2015-01-01

The purpose of this research is to examine the prospective elementary school teachers' perceptions on socioscientific issues. The research was conducted on prospective elementary school teachers studying at a university located in western Turkey. The researcher first taught the subjects of global warming and nuclear power plants from a perspective…

The relation between risk perceptions and physical activity among older adults: a prospective study.

PubMed

Stephan, Yannick; Boiche, Julie; Trouilloud, David; Deroche, Thomas; Sarrazin, Philippe

2011-07-01

Past studies have found that risk perceptions of suffering from diseases play an important role in the development of intentions to perform physical activity (PA). According to the behaviour motivation hypothesis, perceived risk could be positively and directly related to PA, but this possibility has been ignored and/or underestimated. Accounting for recent methodological developments on the importance of study design and risk perception assessment, the purpose of the present study was to examine the risk-perceptions-PA relationship among older adults. Participants (N=143) aged from 61 to 70 years initially underwent measurement of risk perceptions, baseline PA, socio-demographic and health factors. Six months later, they were asked about their PA participation. Multiple regression analyses revealed that perceived risk of suffering from diseases and conditions without regular PA participation was an independent positive predictor of later PA, over and beyond baseline behaviour, socio-demographic and health variables. This study fills a gap in the existing literature on the PAs of older adults and reveals that risk perceptions are directly linked to their participation. In addition, it extends existing knowledge in health psychology on the behaviour motivation hypothesis, and emphasises the necessity of methodological adjustments when assessing the risk-perception-behaviour relationship. © 2011 Taylor & Francis

Fast-food consumption, diet quality and body weight: cross-sectional and prospective associations in a community sample of working adults.

PubMed

Barnes, Timothy L; French, Simone A; Mitchell, Nathan R; Wolfson, Julian

2016-04-01

To examine the association between fast-food consumption, diet quality and body weight in a community sample of working adults. Cross-sectional and prospective analysis of anthropometric, survey and dietary data from adults recruited to participate in a worksite nutrition intervention. Participants self-reported frequency of fast-food consumption per week. Nutrient intakes and diet quality, using the Healthy Eating Index-2010 (HEI-2010), were computed from dietary recalls collected at baseline and 6 months. Metropolitan medical complex, Minneapolis, MN, USA. Two hundred adults, aged 18-60 years. Cross-sectionally, fast-food consumption was significantly associated with higher daily total energy intake (β=72·5, P=0·005), empty calories (β=0·40, P=0·006) and BMI (β=0·73, P=0·011), and lower HEI-2010 score (β=-1·23, P=0·012), total vegetables (β=-0·14, P=0·004), whole grains (β=-0·39, P=0·005), fibre (β=-0·83, P=0·002), Mg (β=-6·99, P=0·019) and K (β=-57·5, P=0·016). Over 6 months, change in fast-food consumption was not significantly associated with changes in energy intake or BMI, but was significantly inversely associated with total intake of vegetables (β=-0·14, P=0·034). Frequency of fast-food consumption was significantly associated with higher energy intake and poorer diet quality cross-sectionally. Six-month change in fast-food intake was small, and not significantly associated with overall diet quality or BMI.

Investing in Prospective Cohorts for Etiologic Study of Occupational Exposures

PubMed Central

Blair, A.; Hines, C.J.; Thomas, K.W.; Alavanja, M.C.R.; Beane Freeman, L.E.; Hoppin, J.A.; Kamel, F.; Lynch, C.F.; Lubin, J.H.; Silverman, D.T.; Whelan, E.; Zahm, S. H.; Sandler, D. P.

2015-01-01

Prospective cohorts have played a major role in understanding the contribution of diet, physical activity, medical conditions, and genes to the development of many diseases, but have not been widely used for occupational exposures. Studies in agriculture are an exception. We draw upon our experience using this design to study agricultural workers to identify conditions that might foster use of prospective cohorts to study other occupational settings. Prospective cohort studies are perceived by many as the strongest epidemiologic design. It allows updating of information on exposure and other factors, collection of biologic samples before disease diagnosis for biomarker studies, assessment of effect modification by genes, lifestyle, and other occupational exposures, and evaluation of a wide range of health outcomes. Increased use of prospective cohorts would be beneficial in identifying hazardous exposures in the workplace. Occupational epidemiologists should seek opportunities to initiate prospective cohorts to investigate high priority, occupational exposures. PMID:25603935

Executive Function and Falls in Older Adults: New Findings from a Five-Year Prospective Study Link Fall Risk to Cognition

PubMed Central

Mirelman, Anat; Herman, Talia; Brozgol, Marina; Dorfman, Moran; Sprecher, Elliot; Schweiger, Avraham; Giladi, Nir; Hausdorff, Jeffrey M.

2012-01-01

Background Recent findings suggest that executive function (EF) plays a critical role in the regulation of gait in older adults, especially under complex and challenging conditions, and that EF deficits may, therefore, contribute to fall risk. The objective of this study was to evaluate if reduced EF is a risk factor for future falls over the course of 5 years of follow-up. Secondary objectives were to assess whether single and dual task walking abilities, an alternative window into EF, were associated with fall risk. Methodology/Main Results We longitudinally followed 256 community-living older adults (age: 76.4±4.5 yrs; 61% women) who were dementia free and had good mobility upon entrance into the study. At baseline, a computerized cognitive battery generated an index of EF, attention, a closely related construct, and other cognitive domains. Gait was assessed during single and dual task conditions. Falls data were collected prospectively using monthly calendars. Negative binomial regression quantified risk ratios (RR). After adjusting for age, gender and the number of falls in the year prior to the study, only the EF index (RR: .85; CI: .74–.98, p = .021), the attention index (RR: .84; CI: .75–.94, p = .002) and dual tasking gait variability (RR: 1.11; CI: 1.01–1.23; p = .027) were associated with future fall risk. Other cognitive function measures were not related to falls. Survival analyses indicated that subjects with the lowest EF scores were more likely to fall sooner and more likely to experience multiple falls during the 66 months of follow-up (p<0.02). Conclusions/Significance These findings demonstrate that among community-living older adults, the risk of future falls was predicted by performance on EF and attention tests conducted 5 years earlier. The present results link falls among older adults to cognition, indicating that screening EF will likely enhance fall risk assessment, and that treatment of EF may reduce fall risk. PMID

Executive function and falls in older adults: new findings from a five-year prospective study link fall risk to cognition.

PubMed

Mirelman, Anat; Herman, Talia; Brozgol, Marina; Dorfman, Moran; Sprecher, Elliot; Schweiger, Avraham; Giladi, Nir; Hausdorff, Jeffrey M

2012-01-01

Recent findings suggest that executive function (EF) plays a critical role in the regulation of gait in older adults, especially under complex and challenging conditions, and that EF deficits may, therefore, contribute to fall risk. The objective of this study was to evaluate if reduced EF is a risk factor for future falls over the course of 5 years of follow-up. Secondary objectives were to assess whether single and dual task walking abilities, an alternative window into EF, were associated with fall risk. We longitudinally followed 256 community-living older adults (age: 76.4±4.5 yrs; 61% women) who were dementia free and had good mobility upon entrance into the study. At baseline, a computerized cognitive battery generated an index of EF, attention, a closely related construct, and other cognitive domains. Gait was assessed during single and dual task conditions. Falls data were collected prospectively using monthly calendars. Negative binomial regression quantified risk ratios (RR). After adjusting for age, gender and the number of falls in the year prior to the study, only the EF index (RR: .85; CI: .74-.98, p = .021), the attention index (RR: .84; CI: .75-.94, p = .002) and dual tasking gait variability (RR: 1.11; CI: 1.01-1.23; p = .027) were associated with future fall risk. Other cognitive function measures were not related to falls. Survival analyses indicated that subjects with the lowest EF scores were more likely to fall sooner and more likely to experience multiple falls during the 66 months of follow-up (p<0.02). These findings demonstrate that among community-living older adults, the risk of future falls was predicted by performance on EF and attention tests conducted 5 years earlier. The present results link falls among older adults to cognition, indicating that screening EF will likely enhance fall risk assessment, and that treatment of EF may reduce fall risk.

Sexually transmitted diseases among adults who had been abused and neglected as children: a 30-year prospective study.

PubMed

Wilson, Helen W; Widom, Cathy S

2009-04-01

We examined associations between childhood abuse and neglect and the risk in adulthood for sexually transmitted diseases. In a prospective cohort design, we matched children aged 0 to 11 years with documented cases of abuse or neglect during 1967 to 1971 with a control group of children who had not been maltreated (754 participants in all) and followed them into adulthood. Information about lifetime history of sexually transmitted diseases was collected as part of a medical status examination when participants were approximately 41 years old. Childhood sexual abuse increased risk for any sexually transmitted disease (odds ratio [OR] = 1.94; 95% confidence interval [CI] = 1.00, 3.77; P = .05) and more than 1 type of sexually transmitted disease (OR = 3.33; 95% CI = 1.33, 8.22; P = .01). Physical abuse increased risk for more than 1 type of sexually transmitted disease (OR = 3.61; 95% CI = 1.39, 9.38; P = .009). Our results provided the first prospective evidence that child physical and sexual abuse increases risk for sexually transmitted diseases. Early screening and interventions are needed to identify and prevent sexually transmitted diseases among child abuse victims.

Metabolic costs of daily activity in older adults (Chores XL) study: design and methods.

PubMed

Corbett, Duane B; Wanigatunga, Amal A; Valiani, Vincenzo; Handberg, Eileen M; Buford, Thomas W; Brumback, Babette; Casanova, Ramon; Janelle, Christopher M; Manini, Todd M

2017-06-01

For over 20 years, normative data has guided the prescription of physical activity. This data has since been applied to research and used to plan interventions. While this data seemingly provides accurate estimates of the metabolic cost of daily activities in young adults, the accuracy of use among older adults is less clear. As such, a thorough evaluation of the metabolic cost of daily activities in community dwelling adults across the lifespan is needed. The Metabolic Costs of Daily Activity in Older Adults Study is a cross-sectional study designed to compare the metabolic cost of daily activities in 250 community dwelling adults across the lifespan. Participants (20+ years) performed 38 common daily activities while expiratory gases were measured using a portable indirect calorimeter (Cosmed K4b2). The metabolic cost was examined as a metabolic equivalent value (O 2 uptake relative to 3.5 milliliter• min-1•kg-1), a function of work rate - metabolic economy, and a relative value of resting and peak oxygen uptake. The primary objective is to determine age-related differences in the metabolic cost of common lifestyle and exercise activities. Secondary objectives include (a) investigating the effect of functional impairment on the metabolic cost of daily activities, (b) evaluating the validity of perception-based measurement of exertion across the lifespan, and (c) validating activity sensors for estimating the type and intensity of physical activity. Results of this study are expected to improve the effectiveness by which physical activity and nutrition is recommended for adults across the lifespan.

Stiffness control of balance during dual task and prospective falls in older adults: the MOBILIZE Boston Study.

PubMed

Kang, Hyun Gu; Quach, Lien; Li, Wenjun; Lipsitz, Lewis A

2013-09-01

Outdoor fallers differ from indoor fallers substantially in demographics, lifestyle, health condition and physical function. Biomechanical predictors of outdoor falls have not been well characterized. Current validated measures of postural deficits, which describe only the overall postural behavior, are predictive of indoor falls but not outdoor falls. We hypothesized that a model-based description of postural muscle tone and reflexes, particularly during dual tasking, would predict outdoor falls. We tested whether postural stiffness and damping from an inverted pendulum model were predictive of future indoor and outdoor falls among older adults from the MOBILIZE Boston Study. The center of pressure data during standing were obtained from 717 participants aged 77.9±5.3 years. Participants stood barefoot with eyes open for 30s per trial, in two sets of five standing trials. One set included a serial subtractions task. Postural stiffness and damping values were determined from the postural sway data. After the postural measurements, falls were monitored prospectively using a monthly mail-in calendar over 6-36 months. Associations of postural measures with fall rates were determined using negative binomial regressions. After covariate adjustments, postural stiffness (p=0.02-0.05) and damping (p=0.007-0.1) were associated with lower outdoor falls risk, but not with indoor falls. Results were invariant by direction (anteroposterior versus mediolateral) or by condition (quiet standing versus dual task). Outdoor fall risk may be tied to postural control more so than indoor falls. Dual tasking is likely related to fall risk among older and sicker older adults, but not those relatively healthy. Copyright © 2013 Elsevier B.V. All rights reserved.

Isometric and swallowing tongue strength in healthy adults.

PubMed

Todd, J Tee; Lintzenich, Catherine Rees; Butler, Susan G

2013-10-01

The tongue contributes to a safe swallow. It facilitates bolus control during mastication, maintains a bolus in the oral cavity to prevent premature entry of the bolus into the hypopharynx, and helps generate pressure in the hypopharynx during swallowing. This study examined isometric tongue strength and tongue pressure measured during swallowing in healthy young and older adults. Prospective group design. One hundred twenty-six healthy individuals who were recruited as part of a larger study on swallowing participated in this study. Participants were divided into three age groups: 20 to 40 years, 41 to 60 years, and ≥61 years. A KayPentax Digital Swallowing Workstation with an air-filled bulb array was placed on the tongue of each participant (anterior to posterior). Participants completed three isometric tongue presses and three swallows. Repeated measures analyses of variance revealed a significant main effect of age (P = .01) and gender by tongue bulb location interaction (P = .02) for isometric tongue strength. That is, older adults had lower isometric tongue strength than young adults, and females had a greater difference between anterior and posterior tongue strength than males. Tongue strength during swallowing yielded significantly greater anterior versus posterior tongue pressure. This study comprises one of the largest in terms of number of healthy participants reported to date and confirms previous findings that isometric tongue strength decreases with age. Furthermore, given young and older adults generate similar swallowing pressures, swallowing is a submaximal strength activity, yet older adults have less functional reserve. 4. Copyright © 2013 The American Laryngological, Rhinological, and Otological Society, Inc.

Adult physical, sexual, and emotional abuse and postpartum depression, a population based, prospective study of 53,065 women in the Norwegian Mother and Child Cohort Study.

PubMed

Sørbø, Marie Flem; Grimstad, Hilde; Bjørngaard, Johan Håkon; Lukasse, Mirjam; Schei, Berit

2014-09-08

Postpartum depression (PPD) has detrimental consequences to the women, their infants and families. The aim of the present study was to assess the association between adult abuse and PPD. This study was based on data from 53,065 pregnant women in the Norwegian Mother and Child Cohort Study (MoBa), conducted by the Norwegian Institute of Public Health. Women were recruited through a postal invitation in relation to a routine ultra-sound invitation at week 18 of gestation. Exposure to adult emotional, sexual, physical abuse was based on self-report at week 30, also differentiating if the perpetrator was known or a stranger, and whether the abuse was recent or not (<12 month since abuse). PPD was measured with a four items version of the Edinburgh Postnatal Depression Scale (EDS) at six months postpartum. The associations between different types of adult abuse and PPD were performed with logistic regression, adjusting for age, parity, civil status, education, child abuse, social support, and depression prior to pregnancy. Altogether, 11% had PPD, and 19% had been exposed to adult abuse. Women reporting adult abuse had an 80% increased fully adjusted odds of PPD (OR 1.8 95% CI 1.7-1.9) compared to non-abused women. There was a tendency towards higher odds of PPD for women reporting combinations of adult abuse (emotional, sexual and physical), as compared with those reporting sexual, emotional or physical abuse only. Exposure from known perpetrator was more strongly associated with PPD than exposure from an unknown perpetrator. Compared with women without adult abuse, the fully adjusted odds of PPD was 2.6 (95% CI 2.4-2.9) higher for women with any recent adult abuse and 1.5 (95% CI 1.5-1.7) higher for women with any adult abuse, but not recent. The results from this large prospective population-based cohort study support initiatives aiming to assess and adequately address abuse when counseling and treating women of PPD.

Prospects for a civil/military transport aircraft

NASA Technical Reports Server (NTRS)

Jobe, C. E.; Noggle, L. W.; Whitehead, A. H., Jr.

1978-01-01

The similarities and disparities between commercial and military payloads, design features, missions, and transport aircraft are enumerated. Two matrices of civil/military transport aircraft designs were evaluated to determine the most cost effective payloads for a projected commercial route structure and air freight market. The probability of this market developing and the prospects for alternate route structures and freight markets are evaluated along with the possible impact on the aircraft designs. Proposals to stimulate the market and increase the viability of the common aircraft concept are reviewed and the possible impact of higher cargo demand on prospects for common civil/military freighters is postulated. The implications of planned advanced technology developments on the aircraft performance and cost are also considered.

Prospective patients rate practice factors: development of a questionnaire.

PubMed

St Louis, Brian Lingg; Firestone, Allen R; Johnston, William; Shanker, Shiva; Vig, Katherine W L

2011-02-01

The importance that prospective patients place on practice characteristics when choosing an orthodontic practice has not been extensively reported. The objective of this research was to develop a valid and reliable questionnaire to address the relative importance of orthodontic office and doctor characteristics for prospective patients or parents of child patients during the initial orthodontic office consultation. An initial questionnaire, based on published literature, was field-tested on 16 subjects to assess its validity. Based on the field test, the questionnaire was modified and tested for reliability by using a test-retest method. The questionnaire covered the following areas: doctor, office, staff, and finances. The reliability study included 2 groups of subjects: 12 consecutive prospective adult patients and 41 consecutive parents of prospective child patients. The questionnaires consisted of 43 and 50 questions for the adult patients and the parents of patients, respectively. The subjects rated the importance of practice characteristics in their selection of an orthodontic practice using a 100-mm visual analog scale anchored at "not important at all" and "most important." Reliability was analyzed by using the intraclass correlation coefficient (ICC). Summary scores of all 53 subjects showed excellent reliability (ICC, 0.88; range, 0.61-1.0). Summary scores of all 50 questions showed acceptable reliability (ICC, 0.70; range, 0.45-0.88). Twenty-one questions had excellent reliability (ICC, >.75), and 29 questions had fair-to-good reliability (ICC, 0.41-0.75). No questions showed poor reliability (ICC, <0.4). The pilot study data indicated that the overall reliability of the questionnaire is acceptable. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Association of serum uric acid and risk of hypertension in adults: a prospective study of Kailuan Corporation cohort.

PubMed

Cui, Liu-Fu; Shi, Hui-Jing; Wu, Shou-Ling; Shu, Rong; Liu, Na; Wang, Guan-Ying; Zhou, Bin; Sun, Kai; Yu, Ping; Wang, Jian; Song, Hai-Cheng; Yang, Wen-Hao; Wang, Jie-Rui; Han, Yi-Xuan; Mu, Rong

2017-05-01

Whether hyperuricemia is an independent risk factor for hypertension in adults is still under debate. To determine the association between serum uric acid and risk of hypertension in the Chinese population, we conducted a prospective study using the "Kailuan Corporation cohort." A total of 39,233 adult subjects with available data on serum uric acid were enrolled from 2006 to 2007. Subjects with established hypertension were excluded and were then grouped based on the gender and baseline quartile serum uric acid into F1-4 for women and M1-4 for men with F1 and M1 being the lowest quartiles. Incidence of newly described primary hypertension was reevaluated in 2010-2011. The median (interquantile range) baseline uric acid (UA) was 290 (243-344) μmol/L in men and 230 (194-274) μmol/L in women. During a 4-year follow-up period, 12,844 subjects (31.31 %) were newly diagnosed with hypertension. The incidence of hypertension was 14.36, 16.57, 19.06, and 22.35 % in F1 to F4 and 33.64, 33.97, 36.54, and 40.74 % in M1 to M4, respectively. Multiple logistic regression analysis showed that the odds ratios (ORs) of incident hypertension were 1.17 [95 % confidence interval (CI) 1.00-1.37, P = 0.055], 1.24 (95 % CI 1.06-1.45, P = 0.009), and 1.20 (95 % CI 1.02-1.41, P = 0.027) in F2 to F4 compared to the F1 and 0.98 (95 % CI 0.91-1.05, P = 0.534), 1.05 (95 % CI 0.98-1.13, P = 0.190), and 1.13 (95 % CI 1.05-1.22, P = 0.002) in M2 to M4 compared to the M1. Elevated level of serum uric acid is associated with an increased risk of hypertension in adults.

Clinical features and predictors for disease natural progression in adults with Pompe disease: a nationwide prospective observational study

PubMed Central

2012-01-01

Background Due partly to physicians’ unawareness, many adults with Pompe disease are diagnosed with great delay. Besides, it is not well known which factors influence the rate of disease progression, and thus disease outcome. We delineated the specific clinical features of Pompe disease in adults, and mapped out the distribution and severity of muscle weakness, and the sequence of involvement of the individual muscle groups. Furthermore, we defined the natural disease course and identified prognostic factors for disease progression. Methods We conducted a single-center, prospective, observational study. Muscle strength (manual muscle testing, and hand-held dynamometry), muscle function (quick motor function test), and pulmonary function (forced vital capacity in sitting and supine positions) were assessed every 3–6 months and analyzed using repeated-measures ANOVA. Results Between October 2004 and August 2009, 94 patients aged between 25 and 75 years were included in the study. Although skeletal muscle weakness was typically distributed in a limb-girdle pattern, many patients had unfamiliar features such as ptosis (23%), bulbar weakness (28%), and scapular winging (33%). During follow-up (average 1.6 years, range 0.5-4.2 years), skeletal muscle strength deteriorated significantly (mean declines of −1.3% point/year for manual muscle testing and of −2.6% points/year for hand-held dynamometry; both p<0.001). Longer disease duration (>15 years) and pulmonary involvement (forced vital capacity in sitting position <80%) at study entry predicted faster decline. On average, forced vital capacity in supine position deteriorated by 1.3% points per year (p=0.02). Decline in pulmonary function was consistent across subgroups. Ten percent of patients declined unexpectedly fast. Conclusions Recognizing patterns of common and less familiar characteristics in adults with Pompe disease facilitates timely diagnosis. Longer disease duration and reduced pulmonary function

Research on Adult Learning and Memory: Retrospect and Prospect.

ERIC Educational Resources Information Center

Hultsch, David F.; Pentz, C. A.

1980-01-01

Descriptions of cognitive development are determined by the metamodel on which theories and data are based. The associative and information processing approaches have generated much of the research on adult learning and memory. A contextual approach, emphasizing perceiving, comprehending, and remembering, is emerging in the present historical…

Hacking the hospital environment: young adults designing youth-friendly hospital rooms together with young people with cancer experiences.

PubMed

Boisen, Kirsten A; Boisen, Anne; Thomsen, Stine Legarth; Matthiesen, Simon Meggers; Hjerming, Maiken; Hertz, Pernille Grarup

2015-12-09

There is a need for youth-friendly hospital environments as the ward environment may affect both patient satisfaction and health outcomes. To involve young people in designing youth-friendly ward environment. We arranged a design competition lasting 42 h (Hackathon). Students in architecture, design, engineering, communication and anthropology participated (27 young adults) - forming eight groups. Adolescents and young adults (AYA) with current or former cancer experience participated as sparring partners. We provided workspace and food during the weekend. The groups presented their products to a jury and relevant stakeholders. The groups created eight unique design concepts. The young designers were extremely flexible listening to ideas and experiences from the young patients, which led to common features including individual and flexible design, privacy in two-bed wardrooms and social contact with other hospitalized AYA. The winning project included an integrated concept for both wardrooms and the AYA day room, including logos and names for the rooms and an 'energy wall' in the day room. A hackathon event was an effective mode of youth participation. The design concepts and ideas were in line with current evidence regarding pleasing hospital environment and youth-friendly inpatient facilities and may be applicable to other young patients.

Adult Day Care

MedlinePlus

... Page Resize Text Printer Friendly Online Chat Adult Day Care Adult Day Care Centers are designed to provide care and ... adults who need assistance or supervision during the day. Programs offer relief to family members and caregivers, ...

Impact of Human Immunodeficiency Virus on the Burden and Severity of Influenza Illness in Malawian Adults: A Prospective Cohort and Parallel Case-Control Study

PubMed Central

Ho, Antonia; Aston, Stephen J; Jary, Hannah; Mitchell, Tamara; Alaerts, Maaike; Menyere, Mavis; Mallewa, Jane; Nyirenda, Mulinda; Everett, Dean; Heyderman, Robert S; French, Neil

2018-01-01

Abstract Background The impact of human immunodeficiency virus (HIV) infection on influenza incidence and severity in adults in sub-Saharan Africa is unclear. Seasonal influenza vaccination is recommended for HIV-infected persons in developed settings but is rarely implemented in Africa. Methods We conducted a prospective cohort study to compare the incidence of laboratory-confirmed influenza illness between HIV-infected and HIV-uninfected adults in Blantyre, Malawi. In a parallel case-control study, we explored risk factors for severe influenza presentation of severe (hospitalized) lower respiratory tract infection, and mild influenza (influenza-like illness [ILI]). Results The cohort study enrolled 608 adults, of whom 360 (59%) were HIV infected. Between April 2013 and March 2015, 24 of 229 ILI episodes (10.5%) in HIV-infected and 5 of 119 (4.2%) in HIV-uninfected adults were positive for influenza by means of polymerase chain reaction (incidence rate, 46.0 vs 14.5 per 1000 person-years; incidence rate ratio, 2.75; 95% confidence interval, 1.02–7.44; P = .03; adjusted for age, sex, household crowding, and food security). In the case-control study, influenza was identified in 56 of 518 patients (10.8%) with hospitalized lower respiratory tract infection, and 88 or 642 (13.7%) with ILI. The HIV prevalence was 69.6% and 29.6%, respectively, among influenza-positive case patients and controls. HIV was a significant risk factor for severe influenza (odds ratio, 4.98; 95% confidence interval, 2.09–11.88; P < .001; population-attributable fraction, 57%; adjusted for season, sanitation facility, and food security). Conclusions HIV is an important risk factor for influenza-associated ILI and severe presentation in this high–HIV prevalence African setting. Targeted influenza vaccination of HIV-infected African adults should be reevaluated, and the optimal mechanism for vaccine introduction in overstretched health systems needs to be determined. PMID:29045699

The PROSPECT physics program

DOE PAGES

Ashenfelter, J.; Balantekin, A. B.; Band, H. R.; ...

2016-10-17

The precision reactor oscillation and spectrum experiment, PROSPECT, is designed to make a precise measurement of the antineutrino spectrum from a highly-enriched uranium reactor and probe eV-scale sterile neutrinos by searching for neutrino oscillations over a distance of several meters. The subject of this paper, PROSPECT, is conceived as a 2-phase experiment utilizing segmented 6Li-doped liquid scintillator detectors for both efficient detection of reactor antineutrinos through the inverse beta decay reaction and excellent background discrimination. PROSPECT Phase I consists of a movable 3 ton antineutrino detector at distances of 7–12 m from the reactor core. It will probe the best-fitmore » point of the ν e disappearance experiments at 4σ in 1 year and the favored region of the sterile neutrino parameter space at > 3σ in 3 years. With a second antineutrino detector at 15–19 m from the reactor, Phase II of PROSPECT can probe the entire allowed parameter space below 10 eV 2 at 5σ in 3 additional years. Finally, the measurement of the reactor antineutrino spectrum and the search for short-baseline oscillations with PROSPECT will test the origin of the spectral deviations observed in recent θ 13 experiments, search for sterile neutrinos, and conclusively address the hypothesis of sterile neutrinos as an explanation of the reactor anomaly.« less

The PROSPECT physics program

NASA Astrophysics Data System (ADS)

Ashenfelter, J.; Balantekin, A. B.; Band, H. R.; Barclay, G.; Bass, C. D.; Berish, D.; Bignell, L.; Bowden, N. S.; Bowes, A.; Brodsky, J. P.; Bryan, C. D.; Cherwinka, J. J.; Chu, R.; Classen, T.; Commeford, K.; Conant, A. J.; Davee, D.; Dean, D.; Deichert, G.; Diwan, M. V.; Dolinski, M. J.; Dolph, J.; DuVernois, M.; Erikson, A. S.; Febbraro, M. T.; Gaison, J. K.; Galindo-Uribarri, A.; Gilje, K.; Glenn, A.; Goddard, B. W.; Green, M.; Hackett, B. T.; Han, K.; Hans, S.; Heeger, K. M.; Heffron, B.; Insler, J.; Jaffe, D. E.; Jones, D.; Langford, T. J.; Littlejohn, B. R.; Martinez Caicedo, D. A.; Matta, J. T.; McKeown, R. D.; Mendenhall, M. P.; Mueller, P. E.; Mumm, H. P.; Napolitano, J.; Neilson, R.; Nikkel, J. A.; Norcini, D.; Pushin, D.; Qian, X.; Romero, E.; Rosero, R.; Seilhan, B. S.; Sharma, R.; Sheets, S.; Surukuchi, P. T.; Trinh, C.; Varner, R. L.; Viren, B.; Wang, W.; White, B.; White, C.; Wilhelmi, J.; Williams, C.; Wise, T.; Yao, H.; Yeh, M.; Yen, Y.-R.; Zangakis, G. Z.; Zhang, C.; Zhang, X.; PROSPECT Collaboration

2016-11-01

The precision reactor oscillation and spectrum experiment, PROSPECT, is designed to make a precise measurement of the antineutrino spectrum from a highly-enriched uranium reactor and probe eV-scale sterile neutrinos by searching for neutrino oscillations over a distance of several meters. PROSPECT is conceived as a 2-phase experiment utilizing segmented 6Li-doped liquid scintillator detectors for both efficient detection of reactor antineutrinos through the inverse beta decay reaction and excellent background discrimination. PROSPECT Phase I consists of a movable 3 ton antineutrino detector at distances of 7-12 m from the reactor core. It will probe the best-fit point of the {ν }e disappearance experiments at 4σ in 1 year and the favored region of the sterile neutrino parameter space at \\gt 3σ in 3 years. With a second antineutrino detector at 15-19 m from the reactor, Phase II of PROSPECT can probe the entire allowed parameter space below 10 eV2 at 5σ in 3 additional years. The measurement of the reactor antineutrino spectrum and the search for short-baseline oscillations with PROSPECT will test the origin of the spectral deviations observed in recent {θ }13 experiments, search for sterile neutrinos, and conclusively address the hypothesis of sterile neutrinos as an explanation of the reactor anomaly.

Mild cognitive impairment and prospective memory: translating the evidence into neuropsychological practice.

PubMed

Kinsella, Glynda J; Pike, Kerryn E; Cavuoto, Marina G; Lee, Stephen D

2018-04-30

There has been a recent rapid development of research characterizing prospective memory performance in mild cognitive impairment (MCI) in older age. However, this body of literature remains largely separated from routine clinical practice in neuropsychology. Furthermore, there is emerging evidence of effective interventions to improve prospective memory performance. Therefore, our objective in this article was to offer a clinical neuropsychological perspective on the existing research in order to facilitate the translation of the evidence-base into clinical practice. By conducting a critical review of the existing research related to prospective memory and MCI, we highlight how this data can be introduced into clinical practice, either within diagnostic assessment or clinical management. Prospective memory is impaired in older adults with MCI, with a pattern of performance that helps with differential diagnosis from healthy aging. Clinical neuropsychologists are encouraged to add prospective memory assessment to their toolbox for diagnostic evaluation of clients with MCI. Preliminary findings of prospective memory interventions in MCI are promising, but more work is required to determine how different approaches translate to increasing independence in everyday life.

Recruitment and Retention Challenges in a Technology-Based Study with Older Adults Discharged from a Geriatric Rehabilitation Unit.

PubMed

McCloskey, Rose; Jarrett, Pamela; Stewart, Connie; Keeping-Burke, Lisa

2015-01-01

Technology has the potential to offer support to older adults after being discharged from geriatric rehabilitation. This article highlights recruitment and retention challenges in a study examining an interactive voice response telephone system designed to monitor and support older adults and their informal caregivers following discharge from a geriatric rehabilitation unit. A prospective longitudinal study was planned to examine the feasibility of an interactive voice telephone system in facilitating the transition from rehabilitation to home for older adults and their family caregivers. Patient participants were required to make daily calls into the system. Using standardized instruments, data was to be collected at baseline and during home visits. Older adults and their caregivers may not be willing to learn how to use new technology at the time of hospital discharge. Poor recruitment and retention rates prevented analysis of findings. The importance of recruitment and retention in any study should never be underestimated. Target users of any intervention need to be included in both the design of the intervention and the study examining its benefit. Identifying the issues associated with introducing technology with a group of older rehabilitation patients should assist others who are interested in exploring the role of technology in facilitating hospital discharge. © 2014 Association of Rehabilitation Nurses.

A decade of adult intensive care unit design: a study of the physical design features of the best-practice examples.

PubMed

Rashid, Mahbub

2006-01-01

This article reports a study of the physical design characteristics of a set of adult intensive care units (ICUs), built between 1993 and 2003. These ICUs were recognized as the best-practice examples by the Society of Critical Care Medicine, the American Association of Critical Care Nurses, and the American Institute of Architects. This study is based on a systematic analysis of the materials found on these ICUs in the booklet and videos jointly published by the above organizations in 2005. The study finds that most of these examples of best-practice adult ICUs have the following negative characteristics: (1) they are built as renovation projects with more health and safety hazards during construction; (2) most of them are mixed-service units with more safety and staffing problems; (3) the overall layout and the layout of staff work areas in these ICUs do not have any common design solutions for improved patient and staff outcomes; and (4) in these ICUs, family space is often located outside the unit, and family access to the patient room is restricted, even though family presence at the bedside may be important for improved patient outcomes. Some of these negative characteristics are offset by the following positive characteristics in most ICUs: (1) they have only private patient rooms for improved patient care, safety, privacy, and comfort; (2) most patient beds are freestanding for easy access to patients from all sides; (3) they have handwashing sinks and waste disposal facilities in the patient room for improved safety; and (4) most patient rooms have natural light to help patients with circadian rhythms. The article discusses, in detail, the implications of its findings, and the role of the ICU design community in a very complicated design context.

Weather, day length and physical activity in older adults: Cross-sectional results from the European Prospective Investigation into Cancer and Nutrition (EPIC) Norfolk Cohort

PubMed Central

Wu, Yu-Tzu; Luben, Robert; Wareham, Nicholas; Griffin, Simon; Jones, Andy P.

2017-01-01

Background A wide range of environmental factors have been related to active ageing, but few studies have explored the impact of weather and day length on physical activity in older adults. We investigate the cross-sectional association between weather conditions, day length and activity in older adults using a population-based cohort in England, the European Prospective Investigation into Cancer and Nutrition (EPIC) Norfolk study. Methods Physical activity was measured objectively over 7 days using an accelerometer and this was used to calculate daily total physical activity (counts per minute), daily minutes of sedentary behaviour and light, moderate and vigorous physical activity (LMVPA). Day length and two types of weather conditions, precipitation and temperature, were obtained from a local weather station. The association between these variables and physical activity was examined by multilevel first-order autoregressive modelling. Results After adjusting for individual factors, short day length and poor weather conditions, including high precipitation and low temperatures, were associated with up to 10% lower average physical activity (p<0.01) and 8 minutes less time spent in LMVPA but 15 minutes more sedentary time, compared to the best conditions. Conclusion Day length and weather conditions appear to be an important factor related to active ageing. Future work should focus on developing potential interventions to reduce their impact on physical activity behaviours in older adults. PMID:28562613

Weather, day length and physical activity in older adults: Cross-sectional results from the European Prospective Investigation into Cancer and Nutrition (EPIC) Norfolk Cohort.

PubMed

Wu, Yu-Tzu; Luben, Robert; Wareham, Nicholas; Griffin, Simon; Jones, Andy P

2017-01-01

A wide range of environmental factors have been related to active ageing, but few studies have explored the impact of weather and day length on physical activity in older adults. We investigate the cross-sectional association between weather conditions, day length and activity in older adults using a population-based cohort in England, the European Prospective Investigation into Cancer and Nutrition (EPIC) Norfolk study. Physical activity was measured objectively over 7 days using an accelerometer and this was used to calculate daily total physical activity (counts per minute), daily minutes of sedentary behaviour and light, moderate and vigorous physical activity (LMVPA). Day length and two types of weather conditions, precipitation and temperature, were obtained from a local weather station. The association between these variables and physical activity was examined by multilevel first-order autoregressive modelling. After adjusting for individual factors, short day length and poor weather conditions, including high precipitation and low temperatures, were associated with up to 10% lower average physical activity (p<0.01) and 8 minutes less time spent in LMVPA but 15 minutes more sedentary time, compared to the best conditions. Day length and weather conditions appear to be an important factor related to active ageing. Future work should focus on developing potential interventions to reduce their impact on physical activity behaviours in older adults.

Effect of prospective reimbursement on nursing home costs.

PubMed Central

Coburn, A F; Fortinsky, R; McGuire, C; McDonald, T P

1993-01-01

OBJECTIVE. This study evaluates the effect of Maine's Medicaid nursing home prospective payment system on nursing home costs and access to care for public patients. DATA SOURCES/STUDY SETTING. The implementation of a facility-specific prospective payment system for nursing homes provided the opportunity for longitudinal study of the effect of that system. Data sources included audited Medicaid nursing home cost reports, quality-of-care data from state facility survey and licensure files, and facility case-mix information from random, stratified samples of homes and residents. Data were obtained for six years (1979-1985) covering the three-year period before and after implementation of the prospective payment system. STUDY DESIGN. This study used a pre-post, longitudinal analytical design in which interrupted, time-series regression models were estimated to test the effects of prospective payment and other factors, e.g., facility characteristics, nursing home market factors, facility case mix, and quality of care, on nursing home costs. PRINCIPAL FINDINGS. Prospective payment contributed to an estimated $3.03 decrease in total variable costs in the third year from what would have been expected under the previous retrospective cost-based payment system. Responsiveness to payment system efficiency incentives declined over the study period, however, indicating a growing problem in achieving further cost reductions. Some evidence suggested that cost reductions might have reduced access for public patients. CONCLUSIONS. Study findings are consistent with the results of other studies that have demonstrated the effectiveness of prospective payment systems in restraining nursing home costs. Potential policy trade-offs among cost containment, access, and quality assurance deserve further consideration, particularly by researchers and policymakers designing the new generation of case mix-based and other nursing home payment systems. PMID:8463109

Efficacy of Eight Months of Nightly Zolpidem: A Prospective Placebo-Controlled Study

PubMed Central

Randall, Surilla; Roehrs, Timothy A.; Roth, Thomas

2012-01-01

Study Objectives: To evaluate the long-term (8 months) efficacy of zolpidem in adults with chronic primary insomnia using polysomnography. Design: Randomized, double-blind, placebo-controlled clinical trial. Setting: Sleep disorders and research center. Participants: Healthy participants (n = 91), ages 23-70, meeting DSM-IV-TR criteria for primary insomnia. Interventions: Nightly zolpidem, 10 mg (5 mg for patients > 60 yrs) or placebo 30 minutes before bedtime for 8 months. Measurements and Results: Polysomnographic sleep parameters and morning subject assessments of sleep on 2 nights in months 1 and 8. Relative to placebo, zolpidem significantly increased overall total sleep time and sleep efficiency, reduced sleep latency and wake after sleep onset when assessed at months 1 and 8. Overall, subjective evaluations of efficacy were not shown among treatment groups. Conclusions: In adults with primary insomnia, nightly zolpidem administration remained efficacious across 8 months of nightly use. Clinical Trial Information: ClinicalTrials.gov Identifier: NCT01006525; Trial Name: Safety and Efficacy of Chronic Hypnotic Use; http://clinicaltrials.gov/ct2/show/NCT01006525. Citation: Randall S; Roehrs TA; Roth T. Efficacy of eight months of nightly zolpidem: a prospective placebo-controlled study. SLEEP 2012;35(11):1551-1557. PMID:23115404

Evaluation of the Effectiveness of a Web-Based Learning Design for Adult Computer Science Courses

ERIC Educational Resources Information Center

Antonis, Konstantinos; Daradoumis, Thanasis; Papadakis, Spyros; Simos, Christos

2011-01-01

This paper reports on work undertaken within a pilot study concerned with the design, development, and evaluation of online computer science training courses. Drawing on recent developments in e-learning technology, these courses were structured around the principles of a learner-oriented approach for use with adult learners. The paper describes a…

Clinical Research That Matters: Designing Outcome-Based Research for Older Adults to Qualify for Systematic Reviews and Meta-Analyses.

PubMed

Lee, Jeannie K; Fosnight, Susan M; Estus, Erica L; Evans, Paula J; Pho, Victoria B; Reidt, Shannon; Reist, Jeffrey C; Ruby, Christine M; Sibicky, Stephanie L; Wheeler, Janel B

2018-01-01

Though older adults are more sensitive to the effects of medications than their younger counterparts, they are often excluded from manufacturer-based clinical studies. Practice-based research is a practical method to identify medication-related effects in older patients. This research also highlights the role of a pharmacist in improving care in this population. A single study rarely has strong enough evidence to change geriatric practice, unless it is a large-scale, multisite, randomized controlled trial that specifically targets older adults. It is important to design studies that may be used in systematic reviews or meta-analyses that build a stronger evidence base. Recent literature has documented a gap in advanced pharmacist training pertaining to research skills. In this paper, we hope to fill some of the educational gaps related to research in older adults. We define best practices when deciding on the type of study, inclusion and exclusion criteria, design of the intervention, how outcomes are measured, and how results are reported. Well-designed studies increase the pool of available data to further document the important role that pharmacists have in optimizing care of older patients.

Where Now for Adult Learning?

ERIC Educational Resources Information Center

Keep, Ewart; Rogers, David; Hunt, Sally; Walden, Christopher; Fryer, Bob; Gorard, Stephen; Williams, Ceri; Jones, Wendy; Hartley, Ralph

2010-01-01

With 6 billion British pounds of public spending reductions already on the table, and far deeper cuts inevitable, what are the prospects for adult learning in the new Parliament? Some of the regular contributors of this journal were asked what they expected and what they would like to see. Ewart Keep warns that the coalition parties' commitments…

Application of a fall screening algorithm stratified fall risk but missed preventive opportunities in community-dwelling older adults: a prospective study.

PubMed

Muir, Susan W; Berg, Katherine; Chesworth, Bert; Klar, Neil; Speechley, Mark

2010-01-01

Evaluate the ability of the American and British Geriatrics Society fall prevention guideline's screening algorithm to identify and stratify future fall risk in community-dwelling older adults. Prospective cohort of community-dwelling older adults (n = 117) aged 65 to 90 years. Fall history, balance, and gait measured during a comprehensive geriatric assessment at baseline. Falls data were collected monthly for 1 year. The outcomes of any fall and any injurious fall were evaluated. The algorithm stratified participants into 4 hierarchal risk categories. Fall risk was 33% and 68% for the "no intervention" and "comprehensive fall evaluation required" groups respectively. The relative risk estimate for falling comparing participants in the 2 intervention groups was 2.08 (95% CI 1.42-3.05) for any fall and 2.60 (95% Cl 1.53-4.42) for any injurious fall. Prognostic accuracy values were: sensitivity of 0.50 (95% Cl 0.36-0.64) and specificity of 0.82 (95% CI 0.70-0.90) for any fall; and sensitivity of 0.56 (95% CI 0.38-0.72) and specificity of 0.78 (95% Cl 0.67-0.86) for any injurious fall. The algorithm was able to identify and stratify fall risk for each fall outcome, though the values of prognostic accuracy demonstrate moderate clinical utility. The recommendations of fall evaluation for individuals in the highest risk groups appear supported though the recommendation of no intervention in the lowest risk groups may not address their needs for fall prevention interventions. Further evaluation of the algorithm is recommended to refine the identification of fall risk in community-dwelling older adults.

Improving Medication Knowledge among Older Adults with Heart Failure: A Patient-Centered Approach to Instruction Design

ERIC Educational Resources Information Center

Morrow, Daniel G.; Weiner, Michael; Young, James; Steinley, Douglas; Deer, Melissa; Murray, Michael D.

2005-01-01

Purpose: We investigated whether patient-centered instructions for chronic heart failure medications increase comprehension and memory for medication information in older adults diagnosed with chronic heart failure. Design and Methods: Patient-centered instructions for familiar and unfamiliar medications were compared with instructions for the…

Prospective study of one million deaths in India: rationale, design, and validation results.

PubMed

Jha, Prabhat; Gajalakshmi, Vendhan; Gupta, Prakash C; Kumar, Rajesh; Mony, Prem; Dhingra, Neeraj; Peto, Richard

2006-02-01

Over 75% of the annual estimated 9.5 million deaths in India occur in the home, and the large majority of these do not have a certified cause. India and other developing countries urgently need reliable quantification of the causes of death. They also need better epidemiological evidence about the relevance of physical (such as blood pressure and obesity), behavioral (such as smoking, alcohol, HIV-1 risk taking, and immunization history), and biological (such as blood lipids and gene polymorphisms) measurements to the development of disease in individuals or disease rates in populations. We report here on the rationale, design, and implementation of the world's largest prospective study of the causes and correlates of mortality. We will monitor nearly 14 million people in 2.4 million nationally representative Indian households (6.3 million people in 1.1 million households in the 1998-2003 sample frame and 7.6 million people in 1.3 million households in the 2004-2014 sample frame) for vital status and, if dead, the causes of death through a well-validated verbal autopsy (VA) instrument. About 300,000 deaths from 1998-2003 and some 700,000 deaths from 2004-2014 are expected; of these about 850,000 will be coded by two physicians to provide causes of death by gender, age, socioeconomic status, and geographical region. Pilot studies will evaluate the addition of physical and biological measurements, specifically dried blood spots. Preliminary results from over 35,000 deaths suggest that VA can ascertain the leading causes of death, reduce the misclassification of causes, and derive the probable underlying cause of death when it has not been reported. VA yields broad classification of the underlying causes in about 90% of deaths before age 70. In old age, however, the proportion of classifiable deaths is lower. By tracking underlying demographic denominators, the study permits quantification of absolute mortality rates. Household case-control, proportional mortality

Prospective Study of Adenosine on Atrioventricular Nodal Conduction in Pediatric and Young Adult Patients After Heart Transplantation.

PubMed

Flyer, Jonathan N; Zuckerman, Warren A; Richmond, Marc E; Anderson, Brett R; Mendelsberg, Tamar G; McAllister, Jennie M; Liberman, Leonardo; Addonizio, Linda J; Silver, Eric S

2017-06-20

Supraventricular tachycardia is common after heart transplantation. Adenosine, the standard therapy for treating supraventricular tachycardia in children and adults without transplantation, is relatively contraindicated after transplantation because of a presumed risk of prolonged atrioventricular block in denervated hearts. This study tested whether adenosine caused prolonged asystole after transplantation and if it was effective in blocking atrioventricular nodal conduction in these patients. This was a single-center prospective clinical study including healthy heart transplant recipients 6 months to 25 years of age presenting for routine cardiac catheterization during 2015 to 2016. After catheterization, a transvenous pacing catheter was placed and adenosine was given following a dose-escalation protocol until atrioventricular block was achieved. The incidence of clinically significant asystole (≥12 seconds after adenosine) was quantified. The effects of patient characteristics on adenosine dose required to produce atrioventricular block and duration of effect were also measured. Eighty patients completed adenosine testing. No patient (0%; 95% confidence interval, 0-3) required rescue ventricular pacing. Atrioventricular block was observed in 77 patients (96%; 95% confidence interval, 89-99). The median longest atrioventricular block was 1.9 seconds (interquartile range, 1.4-3.2 seconds), with a mean duration of adenosine effect of 4.3±2.0 seconds. No patient characteristic significantly predicted the adenosine dose to produce atrioventricular block or duration of effect. Results were similar across patient weight categories. Adenosine induces atrioventricular block in healthy pediatric and young adult heart transplant recipients with minimal risk when low initial doses are used (25 μg/kg; 1.5 mg if ≥60 kg) and therapy is gradually escalated. URL: http://www.clinicaltrials.gov. Unique identifier: NCT02462941. © 2017 American Heart Association, Inc.

Fruit and Vegetable Consumption and Changes in Anthropometric Variables in Adult Populations: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

PubMed Central

Schwingshackl, Lukas; Hoffmann, Georg; Kalle-Uhlmann, Tamara; Arregui, Maria; Buijsse, Brian; Boeing, Heiner

2015-01-01

Background Randomized controlled trials provide conflicting results on the effects of increased fruit and vegetable consumption on changes in body weight. We aimed to perform a systematic review and meta-analysis of prospective cohort studies on fruit and vegetable consumption in relation to changes in anthropometric measures. Methods PubMed and EMBASE were searched up to July 2015 for prospective studies reporting on habitual fruit and/or vegetable consumption in relation to changes in body weight or waist circumference or to risk of weight gain/overweight/obesity in adults. Random-effects meta-analysis was applied to pool results across studies. Findings Seventeen cohort studies (from 20 reports) including 563,277 participants met our inclusion criteria. Higher intake of fruits was inversely associated with weight change (decrease) (beta-coefficient per 100-g increment, -13.68 g/year; 95% CI, -22.97 to -4.40). No significant changes could be observed for combined fruit and vegetable consumption or vegetable consumption. Increased intake of fruits was inversely associated with changes (decrease) in waist circumference (beta: -0.04 cm/year; 95% CI, -0.05 to -0.02). Comparing the highest combined fruit & vegetable, fruit, and vegetable intake categories were associated with a 9%, 17%, and 17% reduced risk of adiposity (odds ratio [OR]: 0.91, 95% CI, 0.84 to 0.99), (OR: 0.83, 95% CI, 0.71 to 0.99), and (OR: 0.83, 95% CI, 0.70 to 0.99), respectively. Conclusion This meta-analysis showed several inverse associations between fruit and vegetable intake and prospective improvements in anthropometric parameters, and risk of adiposity. The present meta-analysis seems to be limited by low study quality. Nevertheless, when combined with evolutionary nutrition and epidemiological modeling studies, these findings have public health relevance and support all initiatives to increase fruit and vegetable intake. PMID:26474158

An analysis of retrospective and repeat prospective reports of adverse childhood experiences from the South African Birth to Twenty Plus cohort

PubMed Central

Norris, Shane A.; Mabaso, Musawenkosi; Richter, Linda M.

2017-01-01

Most studies rely on cross-sectional retrospective reports from adult samples to collect information about adverse childhood experiences (ACEs) to examine relationships with adult outcomes. The problems associated with these reports have long been debated, with only a few studies determining their reliability and validity and fewer still reaching consensus on the matter. This paper uses repeat prospective and retrospective reports of adverse childhood experiences from two respondent sources in the South African Birth to Twenty Plus (Bt20+) cohort to explore agreement and concordance in the prospective reporting of ACEs by caregivers and respective children as adolescents and then as young adults. The findings demonstrate little overall agreement between prospective and retrospective accounts of childhood experiences, with 80% of kappa values below the moderate agreement cutoff (k = .41). The highest levels of agreement were found between prospective and retrospective reporting on parental and household death (kappas ranging from .519 to .944). Comparisons between prospective caregiver reports and retrospective young adult reports yielded high concordance rates on sexual and physical abuse and exposure to intimate partner violence (91.0%, 87.7% and 80.2%, respectively). The prevalence of reported ACEs varied with the age of the respondent, with adolescents reporting much higher rates of exposure to violence, physical and sexual abuse than are reported retrospectively or by caregivers. This variation may partly reflect actual changes in circumstances with maturation, but may be influenced by developmental stage and issues of memory, cognition and emotional state more than has been considered in previous analyses. More research, across disciplines, is needed to understand these processes and their effect on recall. Long-term prospective studies are critical for this purpose. In conclusion, methodological research that uses a range of information sources to establish

Outside the Golden Gate: Prospects and Comparisons in Finnish Adult Higher Education.

ERIC Educational Resources Information Center

Parjanen, Matti, Ed.; And Others

This book contains four articles on adult higher education (AHE) in Finland. In the preface, Matti Parjanen outlines the development of AHE in Finland and discusses the rationale for the book. In "Adult Education and Universities in the Era of Economic Depression," Osmo Kivinen and Risto Rinne examine the dilemma between the mission of…

Prospective Memory Function in Late Adulthood: Affect at Encoding and Resource Allocation Costs

PubMed Central

Henry, Julie D.; Joeffry, Sebastian; Terrett, Gill; Ballhausen, Nicola; Kliegel, Matthias; Rendell, Peter G.

2015-01-01

Some studies have found that prospective memory (PM) cues which are emotionally valenced influence age effects in prospective remembering, but it remains unclear whether this effect reflects the operation of processes implemented at encoding or retrieval. In addition, none of the prior ageing studies of valence on PM function have examined potential costs of engaging in different valence conditions, or resource allocation trade-offs between the PM and the ongoing task. In the present study, younger, young-old and old-old adults completed a PM task in which the valence of the cues varied systematically (positive, negative or neutral) at encoding, but was kept constant (neutral) at retrieval. The results indicated that PM accuracy did not vary as a function of affect at encoding, and that this effect did not interact with age group. There was also no main or interaction effect of valence on PM reaction time in PM cue trials, indicating that valence costs across the three encoding conditions were equivalent. Old-old adults’ PM accuracy was reduced relative to both young-old and younger adults. Prospective remembering incurred dual-task costs for all three groups. Analyses of reaction time data suggested that for both young-old and old-old, these costs were greater, implying differential resource allocation cost trade-offs. However, when reaction time data were expressed as a proportional change that adjusted for the general slowing of the older adults, costs did not differ as a function of group. PMID:25893540

Physical Activity and Heart Rate Variability in Older Adults: The Cardiovascular Health Study

PubMed Central

Soares-Miranda, Luisa; Sattelmair, Jacob; Chaves, Paulo; Duncan, Glen; Siscovick, David S; Stein, Phyllis K; Mozaffarian, Dariush

2014-01-01

Background Cardiac mortality and electrophysiologic dysfunction both increase with age. Heart rate variability (HRV) provides indices of autonomic function and electrophysiology that are associated with cardiac risk. How habitual physical activity (PA) among older adults prospectively relates to HRV, including nonlinear indices of erratic sinus patterns, is not established. We hypothesized that increasing levels of both total leisure-time activity and walking would be prospectively associated with more favorable time-domain, frequency-domain, and nonlinear HRV measures in older adults. Methods and Results We evaluated serial longitudinal measures of both PA and 24-hour Holter HRV over 5 years among 985 older US adults in the community-based Cardiovascular Health Study. After multivariable adjustment, greater total leisure-time activity, walking distance, and walking pace were each prospectively associated with specific, more favorable HRV indices, including higher 24-hour standard-deviation-of-all-normal-to-normal-intervals (SDNN, p-trend=0.009, 0.02, 0.06, respectively) and ultra-low-frequency-power (p-trend=0.02, 0.008, 0.16, respectively). Greater walking pace was also associated with higher short-term-fractal-scaling-exponent (p-trend=0.003) and lower Poincare ratio (p-trend=0.02), markers of less erratic sinus patterns. Conclusions Greater total leisure-time activity, as well as walking alone, were prospectively associated with more favorable and specific indices of autonomic function in older adults, including several suggestive of more normal circadian fluctuations and less erratic sinoatrial firing. Our results suggest potential mechanisms that might contribute to lower cardiovascular mortality with habitual PA later in life. PMID:24799513

PROSPECT - A Precision Oscillation and Spectrum Experiment

NASA Astrophysics Data System (ADS)

Zhang, Xianyi; Prospect Collaboration

2017-01-01

PROSPECT, the PRecision Oscillation and SPECTrum Experiment, is a multi-phased short baseline reactor antineutrino experiment that aims to precisely measure the U-235 antineutrino spectrum and prob for oscillation effects involving a possible Δm2 1 eV2 scale sterile neutrino. In PROSPECT Phase-I, an optically segmented Li-6 loaded liquid scintillator detector will be deployed at at the baseline of 7-12m from the High Flux Isotope Reactor at the Oak Ridge National Laboratory. PROSPECT will measure the spectrum of U-235 to aid in resolving the unexplained inconsistency between predictive spectral models and recent experimental measurements using LEU cores, while the oscillation measurement will probe the best fit region suggested by global fitting studies within 1-year data taking. This talk will introduce the design of PROSPECT Phase-I, the discovery potential of the experiment, and the progress the collaboration has made toward realizing PROSPECT Phase-I. Department of Energy

The role of environmental factors for the onset of restricted mobility outside the home among older adults with osteoarthritis: a prospective cohort study

PubMed Central

Rantakokko, Merja; Wilkie, Ross

2017-01-01

Objectives The study examines how environmental factors contribute to the onset of restricted mobility outside the home among older adults with osteoarthritis. Methods This is a prospective cohort study of adults aged 50 years and older with osteoarthritis (n=1802). Logistic regression tested the association between the onset of restricted mobility outside the home and health, sociodemographic and perceived environmental barriers (hills and steep slopes, inaccessible public buildings, poor pavement condition, lack of access to public parks or sport facilities, heavy traffic or speeding cars and poor weather). The potential moderating role of environmental barriers on the association between health factors and onset was examined using interaction terms and stratified analysis. Results Of 1802 participants, 13.5% (n=243) reported the onset of restricted mobility outside the home at 3-year follow-up. Walking disability, anxiety, depression, cognitive impairment and obesity and all environmental barriers were associated with onset after adjustment for confounders. Environmental barriers had an added contribution to the effect of the health conditions on onset of restricted mobility, which was attenuated when adjusted for confounders. The added contribution remained only for walking disability and the presence of hills and steep slopes; in the presence of both, the association with onset of restricted mobility was stronger (OR 7.66, 95% CI 4.64 to 12.64) than in the presence of walking disability (3.60, 2.43 to 5.32) or the presence of hills and steep slopes alone (4.55, 2.89 to 7.16). Conclusion For older adults with osteoarthritis, environmental barriers are associated and add a contribution to that of morbidities and walking disability on the onset of restricted mobility outside the home. Awareness of environmental barriers is important when aiming to maintain mobility and activities outside the home despite health conditions in older adults. PMID:28667194

Adolescent Insomnia as a Risk Factor for Early Adult Depression and Substance Abuse

PubMed Central

Roane, Brandy M.; Taylor, Daniel J.

2008-01-01

Study Objective: To evaluate the association between adolescent insomnia and mental health during adolescence and young adulthood. Design: Cross-sectional and prospective study. Settings: School and in home. Participants: Nationally based population sample of 4494 adolescents, 12 to 18 years old at baseline (mean = 15.83 years), with 3582 young adults, 18 to 25 years old (mean = 21.25 years) at 6- to 7-year follow-up. Measures: Self-report measures of mental health. Results: Insomnia symptoms were reported by 9.4% of the adolescents. Cross-sectionally, adolescent insomnia symptoms were associated with use of alcohol, cannabis, and drugs other than cannabis; depression; suicide ideation; and suicide attempts (all P values < 0.01) after controlling for sex. Prospectively, insomnia symptoms during adolescence were a significant risk factor for depression diagnosis (odds ratio = 2.3) in young adulthood after controlling for sex and baseline depression. Conclusion: This study is the first to longitudinally evaluate insomnia symptoms during adolescence as a risk factor for mental health problems in young adulthood. The findings indicate that insomnia is a prevalent problem for adolescents and argue for future treatment-outcome studies to evaluate the efficacy and effectiveness of various insomnia interventions in this age group. Citation: Roane BM; Taylor DJ. Adolescent insomnia as a risk factor for early adult depression and substance abuse. SLEEP 2008;31(10):1351–1356. PMID:18853932

The Funding and Organization of Adult Continuing Education Research in Britain: Trends and Prospects.

ERIC Educational Resources Information Center

Field, John; Taylor, Richard

1995-01-01

A research review identified major adult/continuing education trends in Britain: vocational education/training, university-business-industry interaction, educational needs of the disadvantaged, nonformal settings, life-cycle analysis, access to education, articulation, social purpose and radical adult education, and analysis of adult education in…

Time Spent Walking and Risk of Diabetes in Japanese Adults: The Japan Public Health Center-Based Prospective Diabetes Study.

PubMed

Kabeya, Yusuke; Goto, Atsushi; Kato, Masayuki; Matsushita, Yumi; Takahashi, Yoshihiko; Isogawa, Akihiro; Inoue, Manami; Mizoue, Tetsuya; Tsugane, Shoichiro; Kadowaki, Takashi; Noda, Mitsuhiko

2016-01-01

The association between time spent walking and risk of diabetes was investigated in a Japanese population-based cohort. Data from the Japan Public Health Center-based Prospective Diabetes cohort were analyzed. The surveys of diabetes were performed at baseline and at the 5-year follow-up. Time spent walking per day was assessed using a self-reported questionnaire (<30 minutes, 30 minutes to <1 hour, 1 to <2 hours, or ≥2 hours). A cross-sectional analysis was performed among 26 488 adults in the baseline survey. Logistic regression was used to examine the association between time spent walking and the presence of unrecognized diabetes. We then performed a longitudinal analysis that was restricted to 11 101 non-diabetic adults who participated in both the baseline and 5-year surveys. The association between time spent walking and the incidence of diabetes during the 5 years was examined. In the cross-sectional analysis, 1058 participants had unrecognized diabetes. Those with time spent walking of <30 minutes per day had increased odds of having diabetes in relation to those with time spent walking of ≥2 hours (adjusted odds ratio [OR] 1.23; 95% CI, 1.02-1.48). In the longitudinal analysis, 612 participants developed diabetes during the 5 years of follow-up. However, a significant association between time spent walking and the incidence of diabetes was not observed. Increased risk of diabetes was implied in those with time spent walking of <30 minutes per day, although the longitudinal analysis failed to show a significant result.

Time Spent Walking and Risk of Diabetes in Japanese Adults: The Japan Public Health Center-Based Prospective Diabetes Study

PubMed Central

Kabeya, Yusuke; Goto, Atsushi; Kato, Masayuki; Matsushita, Yumi; Takahashi, Yoshihiko; Isogawa, Akihiro; Inoue, Manami; Mizoue, Tetsuya; Tsugane, Shoichiro; Kadowaki, Takashi; Noda, Mitsuhiko

2016-01-01

Background The association between time spent walking and risk of diabetes was investigated in a Japanese population-based cohort. Methods Data from the Japan Public Health Center-based Prospective Diabetes cohort were analyzed. The surveys of diabetes were performed at baseline and at the 5-year follow-up. Time spent walking per day was assessed using a self-reported questionnaire (<30 minutes, 30 minutes to <1 hour, 1 to <2 hours, or ≥2 hours). A cross-sectional analysis was performed among 26 488 adults in the baseline survey. Logistic regression was used to examine the association between time spent walking and the presence of unrecognized diabetes. We then performed a longitudinal analysis that was restricted to 11 101 non-diabetic adults who participated in both the baseline and 5-year surveys. The association between time spent walking and the incidence of diabetes during the 5 years was examined. Results In the cross-sectional analysis, 1058 participants had unrecognized diabetes. Those with time spent walking of <30 minutes per day had increased odds of having diabetes in relation to those with time spent walking of ≥2 hours (adjusted odds ratio [OR] 1.23; 95% CI, 1.02–1.48). In the longitudinal analysis, 612 participants developed diabetes during the 5 years of follow-up. However, a significant association between time spent walking and the incidence of diabetes was not observed. Conclusions Increased risk of diabetes was implied in those with time spent walking of <30 minutes per day, although the longitudinal analysis failed to show a significant result. PMID:26725285

Cannabis and Anxiety and Depression in Young Adults: A Large Prospective Study

ERIC Educational Resources Information Center

Hayatbakhsh, Mohammad R.; Najman, Jake M.; Jamrozik, Konrad; Mamun, Abdullah A.; Alati, Rosa; Bor, William

2007-01-01

Objective: To examine whether age of first use or frequency of use of cannabis is associated with anxiety and depression (AD) in young adults, independent of known potential confounders, including the use of other illicit drugs. Method: A cohort of 3,239 Australian young adults was followed from birth to the age of 21 when data on AD were obtained…

Designing, Implementing, and Evaluating Mobile Health Technologies for Managing Chronic Conditions in Older Adults: A Scoping Review

PubMed Central

Harris, Lauren; Ploeg, Jenny; Markle-Reid, Maureen; Valaitis, Ruta; Ibrahim, Sarah; Gafni, Amiram; Isaacs, Sandra

2016-01-01

Background The current landscape of a rapidly aging population accompanied by multiple chronic conditions presents numerous challenges to optimally support the complex needs of this group. Mobile health (mHealth) technologies have shown promise in supporting older persons to manage chronic conditions; however, there remains a dearth of evidence-informed guidance to develop such innovations. Objectives The purpose of this study was to conduct a scoping review of current practices and recommendations for designing, implementing, and evaluating mHealth technologies to support the management of chronic conditions in community-dwelling older adults. Methods A 5-stage scoping review methodology was used to map the relevant literature published between January 2005 and March 2015 as follows: (1) identified the research question, (2) identified relevant studies, (3) selected relevant studies for review, (4) charted data from selected literature, and (5) summarized and reported results. Electronic searches were conducted in 5 databases. In addition, hand searches of reference lists and a key journal were completed. Inclusion criteria were research and nonresearch papers focused on mHealth technologies designed for use by community-living older adults with at least one chronic condition, or health care providers or informal caregivers providing care in the home and community setting. Two reviewers independently identified articles for review and extracted data. Results We identified 42 articles that met the inclusion criteria. Of these, described innovations focused on older adults with specific chronic conditions (n=17), chronic conditions in general (n=6), or older adults in general or those receiving homecare services (n=18). Most of the mHealth solutions described were designed for use by both patients and health care providers or health care providers only. Thematic categories identified included the following: (1) practices and considerations when designing m

Reference ranges of handgrip strength from 125,462 healthy adults in 21 countries: a prospective urban rural epidemiologic (PURE) study.

PubMed

Leong, Darryl P; Teo, Koon K; Rangarajan, Sumathy; Kutty, V Raman; Lanas, Fernando; Hui, Chen; Quanyong, Xiang; Zhenzhen, Qian; Jinhua, Tang; Noorhassim, Ismail; AlHabib, Khalid F; Moss, Sarah J; Rosengren, Annika; Akalin, Ayse Arzu; Rahman, Omar; Chifamba, Jephat; Orlandini, Andrés; Kumar, Rajesh; Yeates, Karen; Gupta, Rajeev; Yusufali, Afzalhussein; Dans, Antonio; Avezum, Álvaro; Lopez-Jaramillo, Patricio; Poirier, Paul; Heidari, Hosein; Zatonska, Katarzyna; Iqbal, Romaina; Khatib, Rasha; Yusuf, Salim

2016-12-01

The measurement of handgrip strength (HGS) has prognostic value with respect to all-cause mortality, cardiovascular mortality and cardiovascular disease, and is an important part of the evaluation of frailty. Published reference ranges for HGS are mostly derived from Caucasian populations in high-income countries. There is a paucity of information on normative HGS values in non-Caucasian populations from low- or middle-income countries. The objective of this study was to develop reference HGS ranges for healthy adults from a broad range of ethnicities and socioeconomically diverse geographic regions. HGS was measured using a Jamar dynamometer in 125,462 healthy adults aged 35-70 years from 21 countries in the Prospective Urban Rural Epidemiology (PURE) study. HGS values differed among individuals from different geographic regions. HGS values were highest among those from Europe/North America, lowest among those from South Asia, South East Asia and Africa, and intermediate among those from China, South America, and the Middle East. Reference ranges stratified by geographic region, age, and sex are presented. These ranges varied from a median (25 th -75 th percentile) 50 kg (43-56 kg) in men <40 years from Europe/North America to 18 kg (14-20 kg) in women >60 years from South East Asia. Reference ranges by ethnicity and body-mass index are also reported. Individual HGS measurements should be interpreted using region/ethnic-specific reference ranges.

Rationale, design and baseline characteristics of a randomized controlled trial of a web-based computer-tailored physical activity intervention for adults from Quebec City.

PubMed

Boudreau, François; Walthouwer, Michel Jean Louis; de Vries, Hein; Dagenais, Gilles R; Turbide, Ginette; Bourlaud, Anne-Sophie; Moreau, Michel; Côté, José; Poirier, Paul

2015-10-09

The relationship between physical activity and cardiovascular disease (CVD) protection is well documented. Numerous factors (e.g. patient motivation, lack of facilities, physician time constraints) can contribute to poor PA adherence. Web-based computer-tailored interventions offer an innovative way to provide tailored feedback and to empower adults to engage in regular moderate- to vigorous-intensity PA. To describe the rationale, design and content of a web-based computer-tailored PA intervention for Canadian adults enrolled in a randomized controlled trial (RCT). 244 men and women aged between 35 and 70 years, without CVD or physical disability, not participating in regular moderate- to vigorous-intensity PA, and familiar with and having access to a computer at home, were recruited from the Quebec City Prospective Urban and Rural Epidemiological (PURE) study centre. Participants were randomized into two study arms: 1) an experimental group receiving the intervention and 2) a waiting list control group. The fully automated web-based computer-tailored PA intervention consists of seven 10- to 15-min sessions over an 8-week period. The theoretical underpinning of the intervention is based on the I-Change Model. The aim of the intervention was to reach a total of 150 min per week of moderate- to vigorous-intensity aerobic PA. This study will provide useful information before engaging in a large RCT to assess the long-term participation and maintenance of PA, the potential impact of regular PA on CVD risk factors and the cost-effectiveness of a web-based computer-tailored intervention. ISRCTN36353353 registered on 24/07/2014.

Metacognition for strategy selection during arithmetic problem-solving in young and older adults.

PubMed

Geurten, Marie; Lemaire, Patrick

2018-04-19

We examined participants' strategy choices and metacognitive judgments during arithmetic problem-solving. Metacognitive judgments were collected either prospectively or retrospectively. We tested whether metacognitive judgments are related to strategy choices on the current problems and on the immediately following problems, and age-related differences in relations between metacognition and strategy choices. Data showed that both young and older adults were able to make accurate retrospective, but not prospective, judgments. Moreover, the accuracy of retrospective judgments was comparable in young and older adults when participants had to select and execute the better strategy. Metacognitive accuracy was even higher in older adults when participants had to only select the better strategy. Finally, low-confidence judgments on current items were more frequently followed by better strategy selection on immediately succeeding items than high-confidence judgments in both young and older adults. Implications of these findings to further our understanding of age-related differences and similarities in adults' metacognitive monitoring and metacognitive regulation for strategy selection in the context of arithmetic problem solving are discussed.

Age-related differences in time-based prospective memory: The role of time estimation in the clock monitoring strategy.

PubMed

Vanneste, Sandrine; Baudouin, Alexia; Bouazzaoui, Badiâa; Taconnat, Laurence

2016-07-01

Time-based prospective memory (TBPM) is required when it is necessary to remember to perform an action at a specific future point in time. This type of memory has been found to be particularly sensitive to ageing, probably because it requires a self-initiated response at a specific time. In this study, we sought to examine the involvement of temporal processes in the time monitoring strategy, which has been demonstrated to be a decisive factor in TBPM efficiency. We compared the performance of young and older adults in a TBPM task in which they had to press a response button every minute while categorising words. The design allowed participants to monitor time by checking a clock whenever they decided. Participants also completed a classic time-production task and several executive tasks assessing inhibition, updating and shifting processes. Our results confirm an age-related lack of accuracy in prospective memory performance, which seems to be related to a deficient strategic use of time monitoring. This could in turn be partially explained by age-related temporal deficits, as evidenced in the duration production task. These findings suggest that studies designed to investigate the age effect in TBPM tasks should consider the contribution of temporal mechanisms.

Adult neurobehavioral outcome of hyperbilirubinemia in full term neonates-a 30 year prospective follow-up study.

PubMed

Hokkanen, Laura; Launes, Jyrki; Michelsson, Katarina

2014-01-01

.0001) and inattention (p < 0.02) were more common in HB groups, but in adulthood the symptoms were equal. The affected HB had lower scores in parameters reflecting life satisfaction, less controlled drinking, but not increased substance abuse. Discussion. Our results indicate that neonatal HB has negative consequences in adult age. A prospectively collected cohort with strict inclusion criteria enables to control most of the bias factors involved with retrospective data. The control and HB groups were remarkably similar at birth in terms of medical data, and the growth environment of the children, as well as the parents' social groups, education, size of family, type of housing at birth and at 9 years of age. Our findings bear resemblance to disorders of the fronto-striatal network, and also symptoms of the ADHD spectrum were frequent in the HB group suggesting a link of HB to other neurodevelopmental disorders.

Adult neurobehavioral outcome of hyperbilirubinemia in full term neonates—a 30 year prospective follow-up study

PubMed Central

Launes, Jyrki; Michelsson, Katarina

2014-01-01

< 0.0001) and inattention (p < 0.02) were more common in HB groups, but in adulthood the symptoms were equal. The affected HB had lower scores in parameters reflecting life satisfaction, less controlled drinking, but not increased substance abuse. Discussion. Our results indicate that neonatal HB has negative consequences in adult age. A prospectively collected cohort with strict inclusion criteria enables to control most of the bias factors involved with retrospective data. The control and HB groups were remarkably similar at birth in terms of medical data, and the growth environment of the children, as well as the parents’ social groups, education, size of family, type of housing at birth and at 9 years of age. Our findings bear resemblance to disorders of the fronto-striatal network, and also symptoms of the ADHD spectrum were frequent in the HB group suggesting a link of HB to other neurodevelopmental disorders. PMID:24688870

Keewatin Region Educational Authority Pilot Adult Education Project: Computer-Assisted Learning. Final Report.

ERIC Educational Resources Information Center

Fahy, Patrick J.

This 2-year project attempted to improve local employment prospects of young adult Inuit in seven communities in the Keewatin Region in the Canadian Northwest Territories by providing them computer-assisted instruction (CAI) in adult basic education and high school equivalency upgrading programs; business, financial, and telecommunications…

Prospective study of tricuspid valve regurgitation associated with permanent leads in patients undergoing cardiac rhythm device implantation: Background, rationale, and design

PubMed Central

Dokainish, Hisham; Elbarasi, Esam; Masiero, Simona; Van de Heyning, Caroline; Brambatti, Michela; Ghazal, Sami; AL-Maashani, Said; Capucci, Alessandro; Buikema, Lisanne; Leong, Darryl; Shivalkar, Bharati; Saenen, Johan; Miljoen, Hielko; Morillo, Carlos; Divarakarmenon, Syam; Amit, Guy; Ribas, Sebastian; Brautigam, Aaron; Baiocco, Erika; Maolo, Alessandro; Romandini, Andrea; Maffei, Simone; Connolly, Stuart; Healey, Jeff

2015-01-01

Given the increasing numbers of cardiac device implantations worldwide, it is important to determine whether permanent endocardial leads across the tricuspid valve can promote tricuspid regurgitation (TR). Virtually all current data is retrospective, and indicates a signal of TR being increased after permanent lead implantation. However, the precise incidence of moderate or greater TR post-procedure, the exact mechanisms (mechanical, traumatic, functional), and the hemodynamic burden and clinical effects of this putative increase in TR, remain uncertain. We have therefore designed a multicenter, international, prospective study of 300 consecutive patients (recruitment completed, baseline data presented) who will undergo echocardiography and clinical assessment prior to, and at 1-year post device insertion. This prospective study will help determine whether cardiac device-associated TR is real, what are its potential mechanisms, and whether it has an important clinical impact on cardiac device patients. PMID:26779517

Risk Factors Associated with Falls in Older Adults with Dementia: A Systematic Review

PubMed Central

Fernando, Eresha; Fraser, Michelle; Hendriksen, Jane; Kim, Corey H.

2017-01-01

Purpose: People with dementia fall more often than cognitively healthy older adults, but their risk factors are not well understood. A review is needed to determine a fall risk profile for this population. The objective was to critically evaluate the literature and identify the factors associated with fall risk in older adults with dementia. Methods: Articles published between January 1988 and October 2014 in EMBASE, PubMed, PsycINFO, and CINAHL were searched. Inclusion criteria were participants aged 55 years or older with dementia or cognitive impairment, prospective cohort design, detailed fall definition, falls as the primary outcome, and multi-variable regression analysis. Two authors independently reviewed and extracted data on study characteristics, quality assessment, and outcomes. Adjusted risk estimates were extracted from the articles. Results: A total of 17 studies met the inclusion criteria. Risk factors were categorized into demographic, balance, gait, vision, functional status, medications, psychosocial, severity of dementia, and other. Risk factors varied with living setting and were not consistent across all studies within a setting. Conclusion: Falls in older adults with dementia are associated with multiple intrinsic and extrinsic risk factors, some shared with older adults in general and others unique to the disease. Risk factors vary between community- and institution-dwelling samples of adults with dementia or cognitive impairment. PMID:28539696

Macronutrients Intake and Incident Frailty in Older Adults: A Prospective Cohort Study.

PubMed

Sandoval-Insausti, Helena; Pérez-Tasigchana, Raúl F; López-García, Esther; García-Esquinas, Esther; Rodríguez-Artalejo, Fernando; Guallar-Castillón, Pilar

2016-10-01

Only a few studies have assessed the association between protein intake and frailty incidence and have obtained inconsistent results. This study examined the association of protein and other macronutrient intake with the risk of frailty in older adults. A prospective cohort of 1,822 community-dwelling individuals aged 60 and older was recruited in 2008-2010 and followed-up through 2012. At baseline, food consumption was assessed with a validated, computerized face-to-face diet history. In 2012, individuals were contacted again to ascertain incident frailty, defined as the presence of at least three of the five Fried criteria: low physical activity, slowness, unintentional weight loss, muscle weakness, and exhaustion. Analyses were performed using logistic regression and adjusted for the main confounders, including total energy intake. During a mean follow-up of 3.5 years, 132 persons with incident frailty were identified. The odds ratios (95% confidence interval) of frailty across increasing quartiles of total protein were 1.00, 0.55 (0.32-0.93), 0.45 (0.26-0.78), and 0.41 (0.23-0.72); p trend: .001. The corresponding figures for animal protein intake were 1.00, 0.68 (0.40-1.17), 0.56 (0.32-0.97), and 0.48 (0.26-0.87), p trend: .011. And for intake of monounsaturated fatty acids (MUFAs), the results were 1.00, 0.66 (0.37-1.20), 0.54 (0.28-1.02), and 0.50 (0.26-0.96); p trend: .038. No association was found between intake of vegetable protein, saturated fats, long-chain ω-3 fatty acids, α-linolenic acid, linoleic acid, simple sugars, or polysaccharides and the risk of frailty. Intake of total protein, animal protein, and MUFAs was inversely associated with incident frailty. Promoting the intake of these nutrients might reduce frailty. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Mood state sub-types in adults who stutter: A prospective study.

PubMed

Tran, Yvonne; Blumgart, Elaine; Craig, Ashley

2018-06-01

Many adults who stutter have elevated negative mood states like anxiety and depressive mood. Little is known about how mood states change over time. The purpose of this study was to determine the trajectories or sub-types of mood states in adults who stutter over a 6 month period, and establish factors that contribute to these sub-types. Participants included 129 adults who stutter who completed an assessment regimen at baseline, including a measure of mood states (Symptom Checklist-90-Revised). Three mood states were assessed (interpersonal sensitivity or IS, depressive mood and anxiety) once a month over 6 months. Latent class growth mixture modeling was used to establish trajectories of change in these mood states over time. Logistic regression was then used to determine factors assessed at baseline that contribute to the IS trajectories. Three-class trajectory models were accepted as the best fit for IS, depressive mood and anxiety mood sub-types. Stable and normal mood state sub-types were found, incorporating around 60% of participants. Up to 40% belonged to sub-types comprising elevated levels of negative mood states. The logistic regression was conducted only with the IS domain, and revealed four factors that significantly contributed to IS mood sub-types. Those with low perceived control, low vitality, elevated social fears and being female were more likely to belong to elevated IS classes. This research revealed mood sub-types in adults who stutter, providing direction for the treatment of stuttering. Clarification of how much stuttering influences mood sub-types versus pre-existing mood is required. Copyright © 2017 Elsevier Inc. All rights reserved.

Examining the ethical and social issues of health technology design through the public appraisal of prospective scenarios: a study protocol describing a multimedia-based deliberative method

PubMed Central

2014-01-01

Background The design of health technologies relies on assumptions that affect how they will be implemented, such as intended use, complexity, impact on user autonomy, and appropriateness. Those who design and implement technologies make several ethical and social assumptions on behalf of users and society more broadly, but there are very few tools to examine prospectively whether such assumptions are warranted and how the public define and appraise the desirability of health innovations. This study protocol describes a three-year study that relies on a multimedia-based prospective method to support public deliberations that will enable a critical examination of the social and ethical issues of health technology design. Methods The first two steps of our mixed-method study were completed: relying on a literature review and the support of our multidisciplinary expert committee, we developed scenarios depicting social and technical changes that could unfold in three thematic areas within a 25-year timeframe; and for each thematic area, we created video clips to illustrate prospective technologies and short stories to describe their associated dilemmas. Using this multimedia material, we will: conduct four face-to-face deliberative workshops with members of the public (n = 40) who will later join additional participants (n = 25) through an asynchronous online forum; and analyze and integrate three data sources: observation, group deliberations, and a self-administered participant survey. Discussion This study protocol will be of interest to those who design and assess public involvement initiatives and to those who examine the implementation of health innovations. Our premise is that using user-friendly tools in a deliberative context that foster participants’ creativity and reflexivity in pondering potential technoscientific futures will enable our team to analyze a range of normative claims, including some that may prove problematic and others that may

Examining the ethical and social issues of health technology design through the public appraisal of prospective scenarios: a study protocol describing a multimedia-based deliberative method.

PubMed

Lehoux, Pascale; Gauthier, Philippe; Williams-Jones, Bryn; Miller, Fiona A; Fishman, Jennifer R; Hivon, Myriam; Vachon, Patrick

2014-06-21

The design of health technologies relies on assumptions that affect how they will be implemented, such as intended use, complexity, impact on user autonomy, and appropriateness. Those who design and implement technologies make several ethical and social assumptions on behalf of users and society more broadly, but there are very few tools to examine prospectively whether such assumptions are warranted and how the public define and appraise the desirability of health innovations. This study protocol describes a three-year study that relies on a multimedia-based prospective method to support public deliberations that will enable a critical examination of the social and ethical issues of health technology design. The first two steps of our mixed-method study were completed: relying on a literature review and the support of our multidisciplinary expert committee, we developed scenarios depicting social and technical changes that could unfold in three thematic areas within a 25-year timeframe; and for each thematic area, we created video clips to illustrate prospective technologies and short stories to describe their associated dilemmas. Using this multimedia material, we will: conduct four face-to-face deliberative workshops with members of the public (n=40) who will later join additional participants (n=25) through an asynchronous online forum; and analyze and integrate three data sources: observation, group deliberations, and a self-administered participant survey. This study protocol will be of interest to those who design and assess public involvement initiatives and to those who examine the implementation of health innovations. Our premise is that using user-friendly tools in a deliberative context that foster participants' creativity and reflexivity in pondering potential technoscientific futures will enable our team to analyze a range of normative claims, including some that may prove problematic and others that may shed light over potentially more valuable

Design of the Prevention of Adult Caries Study (PACS): A randomized clinical trial assessing the effect of a chlorhexidine dental coating for the prevention of adult caries

PubMed Central

2010-01-01

Background Dental caries is one of the primary causes of tooth loss among adults. It is estimated to affect a majority of Americans aged 55 and older, with a disproportionately higher burden in disadvantaged populations. Although a number of treatments are currently in use for caries prevention in adults, evidence for their efficacy and effectiveness is limited. Methods/Design The Prevention of Adult Caries Study (PACS) is a multicenter, placebo-controlled, double-blind, randomized clinical trial of the efficacy of a chlorhexidine (10% w/v) dental coating in preventing adult caries. Participants (n = 983) were recruited from four different dental delivery systems serving four diverse communities, including one American Indian population, and were randomized to receive either chlorhexidine or a placebo treatment. The primary outcome is the net caries increment (including non-cavitated lesions) from baseline to 13 months of follow-up. A cost-effectiveness analysis also will be considered. Discussion This new dental treatment, if efficacious and approved for use by the Food and Drug Administration (FDA), would become a new in-office, anti-microbial agent for the prevention of adult caries in the United States. Trial Registration Number NCT00357877 PMID:20923557

The effect of a translating research into practice intervention to promote use of evidence-based fall prevention interventions in hospitalized adults: A prospective pre-post implementation study in the U.S.

PubMed

Titler, Marita G; Conlon, Paul; Reynolds, Margaret A; Ripley, Robert; Tsodikov, Alex; Wilson, Deleise S; Montie, Mary

2016-08-01

Falls are a major public health problem internationally. Many hospitals have implemented fall risk assessment tools, but few have implemented interventions to mitigate patient-specific fall risks. Little research has been done to examine the effect of implementing evidence-based fall prevention interventions to mitigate patient-specific fall risk factors in hospitalized adults. To evaluate the impact of implementing, in 3 U.S. hospitals, evidence-based fall prevention interventions targeted to patient-specific fall risk factors (Targeted Risk Factor Fall Prevention Bundle). Fall rates, fall injury rates, types of fall injuries and adoption of the Targeted Risk Factor Fall Prevention Bundle were compared prior to and following implementation. A prospective pre-post implementation cohort design. Thirteen adult medical-surgical units from three community hospitals in the Midwest region of the U.S. Nurses who were employed at least 20hours/week, provided direct patient care, and licensed as an RN (n=157 pre; 140 post); and medical records of patients 21years of age or older, who received care on the study unit for more than 24hours during the designated data collection period (n=390 pre and post). A multi-faceted Translating Research Into Practice Intervention was used to implement the Targeted Risk Factor Fall Prevention Bundle composed of evidence-based fall prevention interventions designed to mitigate patient-specific fall risks. Dependent variables (fall rates, fall injury rates, fall injury type, use of Targeted Risk Factor Fall Prevention Bundle) were collected at baseline, and following completion of the 15month implementation phase. Nurse questionnaires included the Stage of Adoption Scale, and the Use of Research Findings in Practice Scale to measure adoption of evidence-based fall prevention practices. A Medical Record Abstract Form was used to abstract data about use of targeted risk-specific fall prevention interventions. Number of falls, and number and

Health in adults with congenital heart disease.

PubMed

Cuypers, Judith A A E; Utens, Elisabeth M W J; Roos-Hesselink, Jolien W

2016-09-01

Since the introduction of cardiac surgery, the prospects for children born with a cardiac defect have improved spectacularly. Many reach adulthood and the population of adults with congenital heart disease is increasing and ageing. However, repair of congenital heart disease does not mean cure. Many adults with congenital heart disease encounter late complications. Late morbidity can be related to the congenital heart defect itself, but may also be the consequence of the surgical or medical treatment or longstanding alterations in hemodynamics, neurodevelopment and psychosocial development. This narrative review describes the cardiac and non-cardiac long-term morbidity in the adult population with congenital heart disease. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Integrated care at home reduces unnecessary hospitalizations of community-dwelling frail older adults: a prospective controlled trial.

PubMed

Di Pollina, Laura; Guessous, Idris; Petoud, Véronique; Combescure, Christophe; Buchs, Bertrand; Schaller, Philippe; Kossovsky, Michel; Gaspoz, Jean-Michel

2017-02-14

Care of frail and dependent older adults with multiple chronic conditions is a major challenge for health care systems. The study objective was to test the efficacy of providing integrated care at home to reduce unnecessary hospitalizations, emergency room visits, institutionalization, and mortality in community dwelling frail and dependent older adults. A prospective controlled trial was conducted, in real-life clinical practice settings, in a suburban region in Geneva, Switzerland, served by two home visiting nursing service centers. Three hundred and one community-dwelling frail and dependent people over 60 years old were allocated to previously randomized nursing teams into Control (N = 179) and Intervention (N = 122) groups: Controls received usual care by their primary care physician and home visiting nursing services, the Intervention group received an additional home evaluation by a community geriatrics unit with access to a call service and coordinated follow-up. Recruitment began in July 2009, goals were obtained in July 2012, and outcomes assessed until December 2012. Length of follow-up ranged from 5 to 41 months (mean 16.3). Primary outcome measure was the number of hospitalizations. Secondary outcomes were reasons for hospitalizations, the number and reason of emergency room visits, institutionalization, death, and place of death. The number of hospitalizations did not differ between groups however, the intervention led to lower cumulative incidence for the first hospitalization after the first year of follow-up (69.8%, CI 59.9 to 79.6 versus 87 · 6%, CI 78 · 2 to 97 · 0; p = .01). Secondary outcomes showed that the intervention compared to the control group had less frequent unnecessary hospitalizations (4.1% versus 11.7%, p = .03), lower cumulative incidence for the first emergency room visit, 8.3%, CI 2.6 to 13.9 versus 23.2%, CI 13.1 to 33.3; p = .01), and death occurred more frequently at home (44.4 versus 14

Cost-effectiveness of medical nutrition therapy and therapeutically designed meals for older adults with cardiovascular disease.

PubMed

Troyer, Jennifer L; McAuley, William J; McCutcheon, Megan E

2010-12-01

Many older adults experience hyperlipidemia and hypertension, but there is little information about whether medical nutrition therapy (MNT) or therapeutic meals have independent or joint beneficial effects on older adults with these diagnoses. To assess the cost-effectiveness of MNT and therapeutic meals for older adults with hyperlipidemia and/or hypertension. A 1-year prospective four-arm controlled randomized community-based clinical trial. Participants were people ages 60 years or older residing in community settings who were medically diagnosed with either hypertension or hyperlipidemia. They were recruited through a number of venues beginning in May 2003. The 321 eligible individuals were assigned to one of four arms: (a) a literature control group, (b) a therapeutic meal group that received seven diagnosis-appropriate therapeutic meals a week, (c) an MNT group, and (d) an MNT-plus-therapeutic meal group. The outcome measure was quality-adjusted life-years (QALYs). Costs included both intervention and medical costs. Estimations of separate models of costs and QALYs facilitated the construction of incremental cost-effectiveness ratios. Net benefit analysis produced the probability that each intervention was cost-effective given different values for society's willingness to pay for a QALY. Therapeutic meals are cost-effective. Using the net benefit approach and a willingness to pay of $109,000 per QALY, the probability that the therapeutic meal delivery program is cost-effective is 95% and for MNT the probability is 90%. However, the combination of MNT and therapeutic meals did not have an independent significant effect on QALYs. Results inform the debate about extending Medicare funding for MNT to individuals with hypertension and hyperlipidemia. Future research should include more individuals who are not currently receiving medications for these diseases. Copyright © 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

An e-health intervention to support the transition of young people with long-term illnesses to adult healthcare services: Design and early use.

PubMed

Coyne, I; Prizeman, G; Sheehan, A; Malone, H; While, A E

2016-09-01

Co-design information and website to support adolescents and young adults with long-term illnesses in their transition to adult healthcare. A participatory iterative process involving a survey (n=207), twenty-one interviews, six participatory workshops, six video recordings, two advisory groups, and a co-design group to identify needs and preferences for e-health and information provision, was used to develop an appropriate intervention. Adolescents and young people expressed preferences for information that was trustworthy, empowering, colorful, easily downloaded online and written using non-patronizing language. They desired video testimonials of experiences from young adults who had transitioned to adult healthcare and wanted advice about becoming more independent, managing their condition, preparing for the transition, and information about medications and the differences between child and adult healthcare. They also wanted information about the location and configuration of adult healthcare, key hospital personnel, and frequently asked questions. The participatory iterative process led to the development of an online resource specifically tailored to the adolescents and young people's transition needs and information preferences. Preliminary feedback indicates that it is a valued resource. The www.SteppingUP.ie website has the potential to help prepare its target population group for the transition to adult healthcare. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Adult Age Differences in Dual Information Processes: Implications for the Role of Affective and Deliberative Processes in Older Adults' Decision Making.

PubMed

Peters, Ellen; Hess, Thomas M; Västfjäll, Daniel; Auman, Corinne

2007-03-01

Age differences in affective/experiential and deliberative processes have important theoretical implications for judgment and decision theory and important pragmatic implications for older-adult decision making. Age-related declines in the efficiency of deliberative processes predict poorer-quality decisions as we age. However, age-related adaptive processes, including motivated selectivity in the use of deliberative capacity, an increased focus on emotional goals, and greater experience, predict better or worse decisions for older adults depending on the situation. The aim of the current review is to examine adult age differences in affective and deliberative information processes in order to understand their potential impact on judgments and decisions. We review evidence for the role of these dual processes in judgment and decision making and then review two representative life-span perspectives (based on aging-related changes to cognitive or motivational processes) on the interplay between these processes. We present relevant predictions for older-adult decisions and make note of contradictions and gaps that currently exist in the literature. Finally, we review the sparse evidence about age differences in decision making and how theories and findings regarding dual processes could be applied to decision theory and decision aiding. In particular, we focus on prospect theory (Kahneman & Tversky, 1979) and how prospect theory and theories regarding age differences in information processing can inform one another. © 2007 Association for Psychological Science.

Designing sensor systems capable of differentiating children from adults.

PubMed

Butturini, Randy; Midgett, Jonathan

2006-01-01

Injury prevention systems intended to prevent children from entering hazardous locations (or at least alert caregivers if that occurs) often respond to every instance of a person's presence, regardless of whether the intruder is a child. This performance results in a high nuisance alarm rate that sometimes causes adults to disable or circumvent the safety system. If a child safety system can accurately identify intruders as adults or children, nuisance alarm rates can be decreased. This analysis selects three human factors (height, foot length, and cognition) amenable to adult/child differentiation and describes likely sensor strategies, advantages, and disadvantages. Preliminary testing of prototypes systems shows that simple sensor systems are capable of acquiring adequate data for adult/child differentiation. The discussion addresses requirements for discriminator systems and the effects of various sensor combinations on overall performance.

Prospective political analysis for policy design: enhancing the political viability of single-payer health reform in Vermont.

PubMed

Blanchet, Nathan J; Fox, Ashley M

2013-06-01

In 2011 the state of Vermont adopted legislation that aims to create the nation's first state-level single-payer health care system, a system that would go well beyond national reform efforts. To conduct a prospective, institutional stakeholder analysis to guide development of a politically viable, universal health care reform proposal, as commissioned by Vermont's legislature in July 2010. A total of 64 semi-structured stakeholder interviews with nearly 120 individuals, representing 60 different groups/institutions, were conducted between July and December 2010. Interviews probed stakeholders regarding five major design components: financing options, decoupling insurance from employment, organization/governance, comprehensiveness of benefits, and payment reform. There was a range of opposition and support across stakeholder groups and components, and more remarkably a diversity of views within groups often believed to be unwavering supporters or detractors of comprehensive health reform. Given the balance of conflicting views, relative power, and acceptable trade-offs, the research team proposed a single-payer health care system financed through payroll taxes, decoupled from employment, with a generous benefit package, governed by a public-private intermediary. Prospective political analysis can assist in choosing among a range of technically sound policy options to create a more politically viable health reform package. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Residential Adult Education: Trends and Prospects. Discussion Paper in Continuing Education, Number 3.

ERIC Educational Resources Information Center

Field, John, Ed.; Normie, Gerald, Ed.

These papers on the role of residential adult education were first presented at a July 1991 conference at Somerville College, Oxford University, England. After an introduction (Field), the first paper, "Residential Adult Education: History, Concept, and Evaluation" (Bron), offers an historical perspective and recommends defining…

Design and evaluation of a computer game to promote a healthy diet for young adults.

PubMed

Peng, Wei

2009-03-01

This article reports the development and evaluation of a computer game (RightWay Café) as a special medium to promote a healthy diet for young adults. Structural features of computer games, such as interactive tailoring, role playing, the element of fun, and narrative, were operationalized in the RightWay Café game to afford behavior rehearsal in a safe and entertaining way. Theories such as the health belief model, social cognitive theory, and theory of reasoned action guided the content design of the game to influence mediators of behavior change, including self-efficacy, perceived benefits, perceived barriers, and behavior change intention. A randomized controlled evaluation study with pretest, posttest, and follow-up design demonstrated that this game was effective in teaching nutrition and weight management knowledge and increasing people's self-efficacy and perceived benefits of healthy eating, as well as their intention to be on a healthy diet. Limited long-term effects were also found: participants in the game-playing group had greater self-efficacy than participants in the control group after 1 month. This study validates the computer game-based approach to health promotion for young adults. Limitations and implications are also discussed.

Adult normative data for phonatory aerodynamics in connected speech.

PubMed

Lewandowski, Ali; Gillespie, Amanda I; Kridgen, Samantha; Jeong, Kwonho; Yu, Lan; Gartner-Schmidt, Jackie

2018-04-01

To establish normative values for phonatory aerodynamic measurements in connected speech across adult ages and gender. Prospective data collection across group design. One hundred fifty adults aged >18 years without voice complaints were stratified into three equal-age groups (group 1 [ages 18-39 years]; group 2 [ages 40-59 years], and group 3 [ages 60 + years]) and two equal-gender groups (male and female) resulting in 25 participants in each category. Participants read the first four sentences of the Rainbow Passage at comfortable pitch and loudness to obtain a connected speech sample. The following dependent variables were analyzed: breath number, reading passage duration, mean phonatory airflow, inspiratory airflow duration, and expiratory airflow duration. A gender effect was found for mean phonatory airflow, with males showing significantly greater phonatory airflow than females during connected speech (P < .001). Number of breaths was significantly greater for group 3 than group 2 (P < .001) and group 1 (P < .001). Duration, and inspiratory and expiratory airflow durations were all significantly greater for group 3 (P < .001) than group 2 (P < .001) than group 1 (P < .001). This study provides normative data for phonatory aerodynamics in adult connected speech. Significant age and gender effects were observed. Laryngoscope, 128:909-914, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Examining Development of Curriculum Knowledge of Prospective Mathematics Teachers

ERIC Educational Resources Information Center

Sahin, Ömer; Soylu, Yasin

2017-01-01

Explanatory-confirmatory research design, one of the mixed methods research designs, was used in this study to investigate Curriculum Knowledge developments of prospective teachers regarding algebra. Cross-sectional study method, as a type of descriptive research and one of the non-experimental research designs, was used to collect quantitative…

Rumination and Depression in Adolescence: Investigating Symptom Specificity in a Multiwave Prospective Study

ERIC Educational Resources Information Center

Hankin, Benjamin L.

2008-01-01

A ruminative response style has been shown to predict depressive symptoms among youth and adults, but it is unclear whether rumination is associated specifically with depression compared with co-occurring symptoms of anxiety and externalizing behaviors. This prospective, multiwave study investigated whether baseline rumination predicted…

A new adult appendicitis score improves diagnostic accuracy of acute appendicitis - a prospective study

PubMed Central

2014-01-01

Background The aim of the study was to construct a new scoring system for more accurate diagnostics of acute appendicitis. Applying the new score into clinical practice could reduce the need of potentially harmful diagnostic imaging. Methods This prospective study enrolled 829 adults presenting with clinical suspicion of appendicitis, including 392 (47%) patients with appendicitis. The collected data included clinical findings and symptoms together with laboratory tests (white cell count, neutrophil count and C-reactive protein), and the timing of the onset of symptoms. The score was constructed by logistic regression analysis using multiple imputations for missing values. Performance of the constructed score in patients with complete data (n = 725) was compared with Alvarado score and Appendicitis inflammatory response score. Results 343 (47%) of patients with complete data had appendicitis. 199 (58%) patients with appendicitis had score value at least 16 and were classified as high probability group with 93% specificity.Patients with score below 11 were classified as low probability of appendicitis. Only 4% of patients with appendicitis had a score below 11, and none of them had complicated appendicitis. In contrast, 207 (54%) of non-appendicitis patients had score below 11. There were no cases with complicated appendicitis in the low probability group. The area under ROC curve was significantly larger with the new score 0.882 (95% CI 0.858 – 0.906) compared with AUC of Alvarado score 0.790 (0.758 – 0.823) and Appendicitis inflammatory response score 0.810 (0.779 – 0.840). Conclusions The new diagnostic score is fast and accurate in categorizing patients with suspected appendicitis, and roughly halves the need of diagnostic imaging. PMID:24970111

Prospective Analyses of Childhood Factors and Antisocial Behavior for Students with High-Incidence Disabilities

ERIC Educational Resources Information Center

Chen, Chin-Chih; Symons, Frank J.; Reynolds, Arthur J.

2011-01-01

This prospective longitudinal study investigated the association between childhood factors (individual, family, and school characteristics) and later antisocial behavior (official juvenile delinquency and adult crime) for students identified with high-incidence disabilities (i.e., learning disabilities, emotional disturbance). The sample consisted…

Usability Testing of the BRANCH Smartphone App Designed to Reduce Harmful Drinking in Young Adults.

PubMed

Milward, Joanna; Deluca, Paolo; Drummond, Colin; Watson, Rod; Dunne, Jacklyn; Kimergård, Andreas

2017-08-08

Electronic screening and brief intervention (eSBI) apps demonstrate potential to reduce harmful drinking. However, low user engagement rates with eSBI reduce overall effectiveness of interventions. As "Digital Natives," young adults have high expectations of app quality. Ensuring that the design, content, and functionality of an eSBI app are acceptable to young adults is an integral stage to the development process. The objective of this study was to identify usability barriers and enablers for an app, BRANCH, targeting harmful drinking in young adults. The BRANCH app contains a drinking diary, alcohol reduction goal setting functions, normative drinking feedback, and information on risks and advice for cutting down. The app includes a social feature personalized to motivate cutting down and to promote engagement with a point-based system for usage. Three focus groups were conducted with 20 users who had tested the app for 1 week. A detailed thematic analysis was undertaken. The first theme, "Functionality" referred to how users wanted an easy-to-use interface, with minimum required user-input. Poor functionality was considered a major usability barrier. The second theme, "Design" described how an aesthetic with minimum text, clearly distinguishable tabs and buttons and appealing infographics was integral to the level of usability. The final theme, "Content" described how participants wanted all aspects of the app to be automatically personalized to them, as well as providing them with opportunities to personalize the app themselves, with increased options for social connectivity. There are high demands for apps such as BRANCH that target skilled technology users including young adults. Key areas to optimize eSBI app development that emerged from testing BRANCH with representative users include high-quality functionality, appealing aesthetics, and improved personalization. ©Joanna Milward, Paolo Deluca, Colin Drummond, Rod Watson, Jacklyn Dunne, Andreas Kimerg

Effect of prospective reimbursement on nursing home costs.

PubMed

Coburn, A F; Fortinsky, R; McGuire, C; McDonald, T P

1993-04-01

This study evaluates the effect of Maine's Medicaid nursing home prospective payment system on nursing home costs and access to care for public patients. The implementation of a facility-specific prospective payment system for nursing homes provided the opportunity for longitudinal study of the effect of that system. Data sources included audited Medicaid nursing home cost reports, quality-of-care data from state facility survey and licensure files, and facility case-mix information from random, stratified samples of homes and residents. Data were obtained for six years (1979-1985) covering the three-year period before and after implementation of the prospective payment system. This study used a pre-post, longitudinal analytical design in which interrupted, time-series regression models were estimated to test the effects of prospective payment and other factors, e.g., facility characteristics, nursing home market factors, facility case mix, and quality of care, on nursing home costs. Prospective payment contributed to an estimated $3.03 decrease in total variable costs in the third year from what would have been expected under the previous retrospective cost-based payment system. Responsiveness to payment system efficiency incentives declined over the study period, however, indicating a growing problem in achieving further cost reductions. Some evidence suggested that cost reductions might have reduced access for public patients. Study findings are consistent with the results of other studies that have demonstrated the effectiveness of prospective payment systems in restraining nursing home costs. Potential policy trade-offs among cost containment, access, and quality assurance deserve further consideration, particularly by researchers and policymakers designing the new generation of case mix-based and other nursing home payment systems.

Results of a prospective multicentre myeloablative double-unit cord blood transplantation trial in adult patients with acute leukaemia and myelodysplasia.

PubMed

Barker, Juliet N; Fei, Mingwei; Karanes, Chatchada; Horwitz, Mitchell; Devine, Steven; Kindwall-Keller, Tamila L; Holter, Jennifer; Adams, Alexia; Logan, Brent; Navarro, Willis H; Riches, Marcie

2015-02-01

Double-unit cord blood (CB) grafts may improve engraftment and relapse risk in adults with haematological malignancies. We performed a prospective high-dose myeloablative double-unit CB transplantation (CBT) trial in adults with high-risk acute leukaemia or myelodysplasia (MDS) between 2007 and 2011. The primary aim was to establish the 1-year overall survival in a multi-centre setting. Fifty-six patients (31 acute myeloid leukaemia, 19 acute lymphoblastic leukaemia, 4 other acute leukaemias, 2 myelodysplastic syndrome [MDS]) were transplanted at 10 centres. The median infused total nucleated cell doses were 2·62 (larger unit) and 2·02 (smaller unit) x 10(7) /kg. The cumulative incidence of day 100 neutrophil engraftment was 89% (95% confidence interval [CI]: 80-96). Day 180 grade II-IV acute graft-versus-host disease (GVHD) incidence was 64% (95%CI: 51-76) and 36% (95%CI: 24-49) of patients had chronic GVHD by 3-years. At 3-years post-transplant, the transplant-related mortality (TRM) was 39% (95%CI: 26-52), and the 3-year relapse incidence was 11% (95%CI: 4-21). With a median 37-month (range 23-71) follow-up of survivors, the 3-year disease-free survival was 50% (95%CI: 37-63). Double-unit CBT is a viable alternative therapy for high-risk acute leukaemia/ MDS in patients lacking a matched unrelated donor. This is especially important for minority patients. The relapse incidence was low but strategies to ameliorate TRM are needed. © 2014 John Wiley & Sons Ltd.

Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis123

PubMed Central

Pan, An; Willett, Walter C; Hu, Frank B

2013-01-01

Background: The relation between sugar-sweetened beverages (SSBs) and body weight remains controversial. Objective: We conducted a systematic review and meta-analysis to summarize the evidence in children and adults. Design: We searched PubMed, EMBASE, and Cochrane databases through March 2013 for prospective cohort studies and randomized controlled trials (RCTs) that evaluated the SSB-weight relation. Separate meta-analyses were conducted in children and adults and for cohorts and RCTs by using random- and fixed-effects models. Results: Thirty-two original articles were included in our meta-analyses: 20 in children (15 cohort studies, n = 25,745; 5 trials, n = 2772) and 12 in adults (7 cohort studies, n = 174,252; 5 trials, n = 292). In cohort studies, one daily serving increment of SSBs was associated with a 0.06 (95% CI: 0.02, 0.10) and 0.05 (95% CI: 0.03, 0.07)-unit increase in BMI in children and 0.22 kg (95% CI: 0.09, 0.34 kg) and 0.12 kg (95% CI: 0.10, 0.14 kg) weight gain in adults over 1 y in random- and fixed-effects models, respectively. RCTs in children showed reductions in BMI gain when SSBs were reduced [random and fixed effects: −0.17 (95% CI: −0.39, 0.05) and −0.12 (95% CI: −0.22, −0.2)], whereas RCTs in adults showed increases in body weight when SSBs were added (random and fixed effects: 0.85 kg; 95% CI: 0.50, 1.20 kg). Sensitivity analyses of RCTs in children showed more pronounced benefits in preventing weight gain in SSB substitution trials (compared with school-based educational programs) and among overweight children (compared with normal-weight children). Conclusion: Our systematic review and meta-analysis of prospective cohort studies and RCTs provides evidence that SSB consumption promotes weight gain in children and adults. PMID:23966427

Career and Self-Construction of Emerging Adults: The Value of Life Designing

PubMed Central

Maree, Jacobus G.; Twigge, Adeline

2016-01-01

This article describes a potential way of counseling emerging adults from a life design perspective to construct a self that could enable them to be agents of both their own development and the development of others. Theoretical issues relating to a dynamic, developmental and systems framework of the understanding of wellbeing are described and the process involved is delineated. The research design was qualitative and comprised case studies. Six participants who subscribed to the definition of “emerging adults” and were comparatively representative of the ethnic diversity of South Africa, were selected purposively from a group of individuals who applied for career counseling in a private practice context. The intervention involved life design counseling and occurred over a period of 6 weeks. Information related to participants' self-construction was gathered using qualitative techniques, including the Career Interest Profile, the Career Construction Interview, a timeline, video clips, a collage, and semi-structured interviews. Following the intervention, the participants revealed heightened insights with regard to aspects of their sense of a relational-moral self. Results indicated that life design counseling could enhance elaborative personal development (enhancing self-awareness and reaping the benefits of developing an improved relational-moral self) and the promotion of an awareness of the importance to promote social justice in work-related contexts. PMID:26793152

Development and Prototyping of the PROSPECT Antineutrino Detector

NASA Astrophysics Data System (ADS)

Commeford, Kelley; Prospect Collaboration

2017-01-01

The PROSPECT experiment will make the most precise measurement of the 235U reactor antineutrino spectrum as well as search for sterile neutrinos using a segmented Li-loaded liquid scintillator neutrino detector. Several prototype detectors of increasing size, complexity, and fidelity have been constructed and tested as part of the PROSPECT detector development program. The challenges to overcome include the efficient rejection of cosmogenic background and collection of optical photons in a compact volume. Design choices regarding segment structure and layout, calibration source deployment, and optical collection methods are discussed. Results from the most recent multi-segment prototype, PROSPECT-50, will also be shown.

Regression Discontinuity in Prospective Evaluations: The Case of the FFVP Evaluation

ERIC Educational Resources Information Center

Klerman, Jacob Alex; Olsho, Lauren E. W.; Bartlett, Susan

2015-01-01

While regression discontinuity has usually been applied retrospectively to secondary data, it is even more attractive when applied prospectively. In a prospective design, data collection can be focused on cases near the discontinuity, thereby improving internal validity and substantially increasing precision. Furthermore, such prospective…

Sugar-sweetened beverages and dental caries in adults: a 4-year prospective study.

PubMed

Bernabé, Eduardo; Vehkalahti, Miira M; Sheiham, Aubrey; Aromaa, Arpo; Suominen, Anna L

2014-08-01

To explore the association between frequency of consumption of sugar-sweetened beverages (SSB) and caries increment over 4 years in adults. A second objective was to explore whether the association between frequency of SSB consumption and caries increment varied by socio-demographic characteristics and use of fluoride toothpaste. Data from 939 dentate adults who participated in both the Health 2000 Survey and the Follow-Up Study of Finnish Adults' Oral Health were analysed. At baseline, participants provided information on demographic characteristics, education and dental behaviours, including two questions on frequency of SSB consumption. The 4-year net DMFT increment was calculated using data from baseline and follow-up clinical oral examinations. The association was tested in negative binomial regression models and the moderating role of sex, age, education and use of fluoride toothpaste was examined by adding their two-way interaction with SSB consumption to the main effects model. A positive association was found between frequency of SBS consumption and 4-year net DMFT increment, regardless of participants' socio-demographic and behavioural characteristics. Adults drinking 1-2 and 3+ SSB daily had, respectively, 31% (Incidence Rate Ratio: 1.31; 95%CI: 1.02-1.67) and 33% (IRR: 1.33; 95%CI; 1.03-1.72) greater net DMFT increments than those not drinking any SSB. None of the four two-way interaction terms was significant (all p>0.05). There seems to be a dose-response relationship between frequency of SSB consumption and caries increment in adults. That association was consistent across socio-demographic characteristics, and more importantly, use of fluoride toothpaste. Drinking sugar-sweetened beverages on a daily basis is related to greater caries risk in adults. Copyright © 2014 Elsevier Ltd. All rights reserved.

Assessing older adults' perceptions of sensor data and designing visual displays for ambient environments. An exploratory study.

PubMed

Reeder, B; Chung, J; Le, T; Thompson, H; Demiris, G

2014-01-01

This article is part of the Focus Theme of Methods of Information in Medicine on "Using Data from Ambient Assisted Living and Smart Homes in Electronic Health Records". Our objectives were to: 1) characterize older adult participants' perceived usefulness of in-home sensor data and 2) develop novel visual displays for sensor data from Ambient Assisted Living environments that can become part of electronic health records. Semi-structured interviews were conducted with community-dwelling older adult participants during three and six-month visits. We engaged participants in two design iterations by soliciting feedback about display types and visual displays of simulated data related to a fall scenario. Interview transcripts were analyzed to identify themes related to perceived usefulness of sensor data. Thematic analysis identified three themes: perceived usefulness of sensor data for managing health; factors that affect perceived usefulness of sensor data and; perceived usefulness of visual displays. Visual displays were cited as potentially useful for family members and health care providers. Three novel visual displays were created based on interview results, design guidelines derived from prior AAL research, and principles of graphic design theory. Participants identified potential uses of personal activity data for monitoring health status and capturing early signs of illness. One area for future research is to determine how visual displays of AAL data might be utilized to connect family members and health care providers through shared understanding of activity levels versus a more simplified view of self-management. Connecting informal and formal caregiving networks may facilitate better communication between older adults, family members and health care providers for shared decision-making.

Which Childhood and Adolescent Psychiatric Disorders predict which Young Adult Disorders?

PubMed Central

Copeland, William E.; Shanahan, Lilly; Costello, E. Jane; Angold, Adrian

2009-01-01

Context Most adults with a psychiatric disorder first met diagnostic criteria during childhood and/or adolescence, yet specific homotypic and heterotypic patterns of prediction have not been firmly established. Objective To establish which childhood and adolescent psychiatric disorders predict particular young adult disorders when accounting for comorbidities, disaggregating similar disorders, and examining childhood and adolescent predictors separately. Design/Setting/Patients Eleven waves of data from the prospective population-based Great Smoky Mountains Study (N = 1,420) were used, covering children in the community ages 9−16, 19, and 21 years old. Outcome Common psychiatric disorders were assessed in childhood (ages 9 to 12) and adolescence (ages 13 to 16) with the Child and Adolescent Psychiatric Assessment, and in young adulthood (ages 19 and 21) with the Young Adult Psychiatric Assessment. Results Adolescent depression significantly predicted young adult depression in the bivariate analysis, but this effect was entirely accounted for by comorbidity of adolescent depression with adolescent oppositional defiant disorder, anxiety and substance disorders in adjusted analyses. Generalized anxiety and depression cross-predicted each other, and oppositional defiant disorder (but not conduct disorder) predicted later anxiety disorders and depression. Evidence of homotypic prediction was supported for substance use disorders, antisocial personality disorder (from conduct disorder) and anxiety disorders, although this effect was primary accounted for by DSM-III-R overanxious disorder. Conclusions Stringent tests of homotypic and heterotypic prediction patterns suggest a more developmentally and diagnostically nuanced picture in comparison with the previous literature. The putative link between adolescent and young adult depression was not supported. Oppositional defiant disorder was singular in being part of the developmental history of a wide range of young adult

Prospective memory and frontal lobe function.

PubMed

Neulinger, Kerryn; Oram, Joanne; Tinson, Helen; O'Gorman, John; Shum, David H K

2016-01-01

The study sought to examine the role of frontal lobe functioning in focal prospective memory (PM) performance and its relation to PM deficit in older adults. PM and working memory (WM) differences were studied in younger aged (n = 21), older aged (n = 20), and frontal injury (n = 14) groups. An event-based focal PM task was employed and three measures of WM were administered. The younger aged group differed from the other two groups in showing significantly higher scores on PM and on one of the WM measures, but there were no differences at a statistically significant level between the older aged group and the frontal injury groups on any of the memory measures. There were, however, some differences in correlations with a WM measure between groups. It is concluded that there are similarities and differences in the deficits in PM between older adults and patients with frontal lobe injury on focal as well as nonfocal PM tasks.

Health Literacy, Cognitive Ability, and Functional Health Status among Older Adults

PubMed Central

Serper, Marina; Patzer, Rachel E; Curtis, Laura M; Smith, Samuel G; O'Conor, Rachel; Baker, David W; Wolf, Michael S

2014-01-01

Objective To investigate whether previously noted associations between health literacy and functional health status might be explained by cognitive function. Data Sources/Study Setting Health Literacy and Cognition in Older Adults (“LitCog,” prospective study funded by National Institute on Aging). Data presented are from interviews conducted among 784 adults, ages 55–74 years receiving care at an academic general medicine clinic or one of four federally qualified health centers in Chicago from 2008 to 2010. Study Design Study participants completed structured, in-person interviews administered by trained research assistants. Data Collection Health literacy was measured using the Test of Functional Health Literacy in Adults, Rapid Estimate of Adult Literacy in Medicine, and Newest Vital Sign. Cognitive function was assessed using measures of long-term and working memory, processing speed, reasoning, and verbal ability. Functional health was assessed with SF-36 physical health summary scale and Patient Reported Outcomes Measurement Information System short form subscales for depression and anxiety. Principal Findings All health literacy measures were significantly correlated with all cognitive domains. In multivariable analyses, inadequate health literacy was associated with worse physical health and more depressive symptoms. After adjusting for cognitive abilities, associations between health literacy, physical health, and depressive symptoms were attenuated and no longer significant. Conclusions Cognitive function explains a significant proportion of the associations between health literacy, physical health, and depression among older adults. Interventions to reduce literacy disparities in health care should minimize the cognitive burden in behaviors patients must adopt to manage personal health. PMID:24476068

Phenobarbital Versus Valproate for Generalized Convulsive Status Epilepticus in Adults: A Prospective Randomized Controlled Trial in China.

PubMed

Su, Yingying; Liu, Gang; Tian, Fei; Ren, Guoping; Jiang, Mengdi; Chun, Brian; Zhang, Yunzhou; Zhang, Yan; Ye, Hong; Gao, Daiquan; Chen, Weibi

2016-12-01

Although generalized convulsive status epilepticus (GCSE) is a life-threatening emergency, evidence-based data to guide initial drug treatment choices are lacking in the Chinese population. We conducted this prospective, randomized, controlled trial to evaluate the relative efficacy and safety of intravenous phenobarbital and valproate in patients with GCSE. After the failure of first-line diazepam treatment, Chinese adult patients with GCSE were randomized to receive either intravenous phenobarbital (standard doses, low rate) or valproate (standard). Successful treatment was considered when clinical and electroencephalographic seizure activity ceased. Adverse events following treatment, as well as the neurological outcomes at discharge and 3 months later, were also evaluated. Overall, 73 cases were enrolled in the study. Intravenous phenobarbital was successful in 81.1% of patients, and intravenous valproate was successful in 44.4% of patients (p < 0.05). The relapse rate of status epilepticus within 24 h of receiving phenobarbital (6.7%) was significantly lower than that in patients receiving valproate (31.3%), and the total number of adverse events did not differ significantly between the two groups (p > 0.05). In the phenobarbital group, two patients (5.4%) required ventilation and two patients (5.4%) developed serious hypotension. The neurological outcomes of the phenobarbital group were generally better than those of the valproate group; however, no significant differences were observed between phenobarbital and valproate with respect to mortality (8.1 vs. 16.6%) at discharge, or mortality (16.2 vs. 30.5%) and post-symptomatic epilepsy (26.3 vs. 42.8%) at 3-month follow-up. Intravenous phenobarbital appears to be more effective than intravenous valproate for Chinese adult patients with GCSE. The occurrence of serious respiratory depression and hypotension caused by phenobarbital was reduced by decreasing the intravenous infusion rate; however, even at a

Effects of a cardiovascular risk reduction intervention with psychobehavioral strategies for Korean adults with type 2 diabetes and metabolic syndrome.

PubMed

Kim, Chun-Ja; Kim, Dae-Jung; Park, Hyung-Ran

2011-01-01

Type 2 diabetes mellitus (DM) and metabolic syndrome are associated with high risk of cardiovascular disease (CVD) and depression. Although lifestyle modifications including regular exercise and weight control are recommended as a primary approach to glycemic control and CVD risk reduction for people with DM and/or metabolic syndrome, little is known concerning the effects of CVD risk reduction interventions using psychobehavioral strategies in this population. This pilot study investigated the effects of a 16-week CVD risk reduction intervention in Korean adults with type 2 DM and metabolic syndrome. A prospective, pretest and posttest, controlled, quasi-experimental design enrolled a convenience sample of 43 Korean adults with type 2 DM and metabolic syndrome at a university hospital. The adults in the intervention group participated in a 16-week CVD risk reduction intervention consisting of 150 minutes of regular exercise per week; 200- to 300-kcal reduced daily diet for weight control; one-on-one psychobehavioral counseling based on constructs from the Transtheoretical Model such as processes of change, self-efficacy, and decisional balance; and telephone coaching for behavioral modification. Participants in the control group received a booklet with basic diabetic education as part of their routine care. Repeated-measures analysis of variance was used for analyzing the effects of the CVD risk reduction intervention on cardiometabolic risk factors including the UK Prospective Diabetes Study score for 10-year CVD risk, glycated hemoglobin (HbA1c), and depression. The intervention group showed significant reductions (P < .05) at 16 weeks, compared with the control group on the UK Prospective Diabetes Study fatal risk scale (-1.73% vs -0.04%), triglycerides (-38.5 vs -15.1 mg/dL), fasting plasma glucose (-29.24 vs +1.77 mg/dL), HbA1c (-0.37% vs +0.17%), and depression (score, -3.24 vs 1.40) measurements. This pilot study yielded evidence for the beneficial impact

A Study on the Spatial Abilities of Prospective Social Studies Teachers: A Mixed Method Research

ERIC Educational Resources Information Center

Yurt, Eyüp; Tünkler, Vural

2016-01-01

This study investigated prospective social studies teachers' spatial abilities. It was conducted with 234 prospective teachers attending Social Studies Teaching departments at Education Faculties of two universities in Central and Southern Anatolia. This study, designed according to the explanatory-sequential design, is a mixed research method,…

A prospective multicenter study of factors associated with hospital admission among adults with acute asthma.

PubMed

Weber, Ellen J; Silverman, Robert A; Callaham, Michael L; Pollack, Charles V; Woodruff, Prescott G; Clark, Sunday; Camargo, Carlos A

2002-10-01

We sought to determine patient characteristics associated with hospital admission after emergency treatment for asthma, and whether disposition guidelines are followed. We performed a prospective multicenter cohort study involving 64 emergency departments in the United States and Canada. Consecutive adult patients with asthma exacerbations were interviewed, and their charts were reviewed using standardized protocols. Telephone follow-up at 2 weeks determined relapse. Of 1805 patients, 363 (20%; 95% confidence interval [CI]: 18% to 22%) were hospitalized. Among patients with severe exacerbations (final peak flow <50% of predicted), 122 (49%; 95% CI: 43% to 55%) were hospitalized. Admission was associated with final peak flow, female sex, nonwhite race, severity of chronic illness, and severity of exacerbation. Admission predictors were similar regardless of hospital funding, region, or size. Among patients with mild or moderate exacerbations of asthma (peak flow >or=50% predicted), the likelihood of admission was associated significantly with the number of predefined risk factors for death from asthma. Of patients who were discharged from the emergency department, 62 (5%; 95% CI: 4% to 6%) relapsed within 72 hours. Relapse was not associated with final peak flow (P = 0.39). Associations between patient characteristics and disposition were similar across sites. Despite guidelines to the contrary, half of patients with final peak flow <50% were discharged. After emergency department treatment and discharge, short-term relapse was uncommon among patients with asthma, suggesting that strict peak flow cutoffs may be unnecessary if risk factors in patients with mild or moderate exacerbations are considered.

A Study of Prospective Teachers' Consumption Patterns on Special Days

ERIC Educational Resources Information Center

Saglam, Halil Ibrahim

2016-01-01

The purpose of this study was to identify prospective teachers' consumption patterns on special days. The sample was comprised of 29 prospective teachers (22 females and 7 males) who studied Primary School Teaching in the Faculty of Education at Sakarya University during the 2014-2015 Academic Year. The study was designed as a phenomenological…

Allopurinol and Cardiovascular Outcomes in Adults With Hypertension.

PubMed

MacIsaac, Rachael L; Salatzki, Janek; Higgins, Peter; Walters, Matthew R; Padmanabhan, Sandosh; Dominiczak, Anna F; Touyz, Rhian M; Dawson, Jesse

2016-03-01

Allopurinol lowers blood pressure in adolescents and has other vasoprotective effects. Whether similar benefits occur in older individuals remains unclear. We hypothesized that allopurinol is associated with improved cardiovascular outcomes in older adults with hypertension. Data from the United Kingdom Clinical Research Practice Datalink were used. Multivariate Cox-proportional hazard models were applied to estimate hazard ratios for stroke and cardiac events (defined as myocardial infarction or acute coronary syndrome) associated with allopurinol use over a 10-year period in adults aged >65 years with hypertension. A propensity-matched design was used to reduce potential for confounding. Allopurinol exposure was a time-dependent variable and was defined as any exposure and then as high (≥300 mg daily) or low-dose exposure. A total of 2032 allopurinol-exposed patients and 2032 matched nonexposed patients were studied. Allopurinol use was associated with a significantly lower risk of both stroke (hazard ratio, 0.50; 95% confidence interval, 0.32-0.80) and cardiac events (hazard ratio, 0.61; 95% confidence interval, 0.43-0.87) than nonexposed control patients. In exposed patients, high-dose treatment with allopurinol (n=1052) was associated with a significantly lower risk of both stroke (hazard ratio, 0.58; 95% confidence interval, 0.36-0.94) and cardiac events (hazard ratio, 0.65; 95% confidence interval, 0.46-0.93) than low-dose treatment (n=980). Allopurinol use is associated with lower rates of stroke and cardiac events in older adults with hypertension, particularly at higher doses. Prospective clinical trials are needed to evaluate whether allopurinol improves cardiovascular outcomes in adults with hypertension. © 2016 American Heart Association, Inc.

Childhood Predictors of Young Adult Social Functioning in 22q11.2 Deletion Syndrome

ERIC Educational Resources Information Center

Wagner, Kayla E.; Kates, Wendy R.; Fremont, Wanda; Antshel, Kevin M.

2017-01-01

The primary objectives of the current prospective longitudinal study were to (a) describe social functioning outcomes and (b) identify childhood predictors of social functioning in young adults with (22q11.2DS). Childhood predictors of young adult social functioning were examined. Family environment and parental stress in adolescence were…

Lest we forget: Comparing retrospective and prospective assessments of adverse childhood experiences in the prediction of adult health

PubMed Central

Reuben, Aaron; Moffitt, Terrie E.; Caspi, Avshalom; Belsky, Daniel W.; Harrington, Honalee; Schroeder, Felix; Hogan, Sean; Ramrakha, Sandhya; Poulton, Richie; Danese, Andrea

2017-01-01

Background Adverse childhood experiences (ACEs; e.g., abuse, neglect, parental loss, etc.) have been associated with increased risk for later-life disease and dysfunction using adults’ retrospective self-reports of ACEs. Research should test whether associations between ACEs and health outcomes are the same for prospective and retrospective ACE measures. Methods We estimated agreement between ACEs prospectively-recorded throughout childhood (by Study staff at Study member ages 3, 5, 7, 9, 11, 13, and 15) and retrospectively-recalled in adulthood (by Study members when they reached age 38), in the population-representative Dunedin cohort (N=1,037). We related both retrospective and prospective ACE measures to physical, mental, cognitive, and social health at midlife measured through both objective (e.g., biomarkers and neuropsychological tests) and subjective (e.g., self-reported) means. Results Dunedin and CDC ACE distributions were similar. Retrospective and prospective measures of adversity showed moderate agreement (r=.47, p<.001; weighted Kappa = .31, 95% CI: .27–.35). Both associated with all midlife outcomes. As compared to prospective ACEs, retrospective ACEs showed stronger associations with life outcomes that were subjectively assessed, and weaker associations with life outcomes that were objectively assessed. Recalled ACEs and poor subjective outcomes were correlated regardless of whether prospectively-recorded ACEs were evident. Individuals who recalled more ACEs than had been prospectively recorded were more neurotic than average, and individuals who recalled fewer ACEs than recorded were more agreeable. Conclusions Prospective ACE records confirm associations between childhood adversity and negative life outcomes found previously using retrospective ACE reports. However, more agreeable and neurotic dispositions may respectively bias retrospective ACE measures toward underestimating the impact of adversity on objectively-measured life outcomes and

Challenge and Change. Proceedings of the Annual Conference of the Commission of Professors of Adult Education (Nashville, Tennessee, November 4-5, 1994).

ERIC Educational Resources Information Center

Polson, Cheryl J., Ed.; Schied, Fred M., Ed.

This conference proceedings includes the following papers: "Professors of Adult Education, Colleges of Education, and the Transformation of the Research University" (Common); "The Future of Adult Education" (Wisniewski); "Adult Education's Prospects in a Post-University World" (Smith); "Whither the University--Whither Academic Adult Education?"…

Multifaceted Prospective Memory Intervention to Improve Medication Adherence.

PubMed

Insel, Kathie C; Einstein, Gilles O; Morrow, Daniel G; Koerner, Kari M; Hepworth, Joseph T

2016-03-01

To test whether a multifaceted prospective memory intervention improved adherence to antihypertensive medications and to assess whether executive function and working memory processes moderated the intervention effects. Two-group longitudinal randomized control trial. Community. Individuals aged 65 and older without signs of dementia or symptoms of severe depression who were self-managing prescribed medication. After 4 weeks of initial adherence monitoring using a medication event monitoring system, individuals with 90% or less adherence were randomly assigned to groups. The prospective memory intervention was designed to provide strategies that switch older adults from relying on executive function and working memory processes (that show effects of cognitive aging) to mostly automatic associative processes (that are relatively spared with normal aging) for remembering to take medications. Strategies included establishing a routine, establishing cues strongly associated with medication taking actions, performing the action immediately upon thinking about it, using a medication organizer, and imagining medication taking to enhance encoding and improve cuing. There was significant improvement in adherence in the intervention group (57% at baseline to 78% after the intervention), but most of these gains were lost after 5 months. The control condition started at 68% and was stable during the intervention, but dropped to 62%. Executive function and working memory moderated the intervention effect, with the intervention producing greater benefit for those with lower executive function and working memory. The intervention improved adherence, but the benefits were not sustained. Further research is needed to determine how to sustain the substantial initial benefits. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Poor Appetite and Dietary Intake in Community-Dwelling Older Adults.

PubMed

van der Meij, Barbara S; Wijnhoven, Hanneke A H; Lee, Jung S; Houston, Denise K; Hue, Trisha; Harris, Tamara B; Kritchevsky, Stephen B; Newman, Anne B; Visser, Marjolein

2017-10-01

Poor appetite in older adults leads to sub-optimal food intake and increases the risk of undernutrition. The impact of poor appetite on food intake in older adults is unknown. The aim of this study was to examine the differences in food intake among older community-dwelling adults with different reported appetite levels. Cross-sectional analysis of data from a longitudinal prospective study. Health, aging, and body composition study performed in the USA. 2,597 community-dwelling adults aged 70-79. A semi-quantitative, interviewer-administered, 108-item food frequency questionnaire designed to estimate dietary intake. Poor appetite was defined as the report of a moderate, poor, or very poor appetite in the past month and was compared with good or very good appetite. The mean age of the study sample was 74.5 ± 2.8 years; 48.2% were men, 37.7% were black, and 21.8% reported a poor appetite. After adjustment for total energy intake and potential confounders (including biting/chewing problems), participants with a poor appetite had a significantly lower consumption of protein and dietary fiber, solid foods, protein rich foods, whole grains, fruits, and vegetables, but a higher consumption of dairy foods, fats, oils, sweets, and sodas compared to participants with very good appetite. In addition, they were less likely to report consumption of significant larger portion sizes. Older adults reporting a poor appetite showed a different dietary intake pattern compared to those with (very) good appetite. Better understanding of the specific dietary intake pattern related to a poor appetite in older adults can be used for nutrition interventions to enhance food intake, diet variety, and diet quality. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Electrophysiological evidence during episodic prospection implicates medial prefrontal and bilateral middle temporal gyrus.

PubMed

Hsu, Chia-Fen; Sonuga-Barke, Edmund J S

2016-08-01

fMRI studies have implicated the medial prefrontal cortex and medial temporal lobe, components of the default mode network (DMN), in episodic prospection. This study compared quantitative EEG localized to these DMN regions during prospection and during resting and while waiting for rewards. EEG was recorded in twenty-two adults while they were asked to (i) envision future monetary episodes; (ii) wait for rewards and (iii) rest. Activation sources were localized to core DMN regions. EEG power and phase coherence were compared across conditions. Prospection, compared to resting and waiting, was associated with reduced power in the medial prefrontal gyrus and increased power in the bilateral medial temporal gyrus across frequency bands as well as greater phase synchrony between these regions in the delta band. The current quantitative EEG analysis confirms prior fMRI research suggesting that medial prefrontal and medial temporal gyrus interactions are central to the capacity for episodic prospection. Copyright © 2016 Elsevier B.V. All rights reserved.

The role of environmental factors for the onset of restricted mobility outside the home among older adults with osteoarthritis: a prospective cohort study.

PubMed

Rantakokko, Merja; Wilkie, Ross

2017-06-30

The study examines how environmental factors contribute to the onset of restricted mobility outside the home among older adults with osteoarthritis. This is a prospective cohort study of adults aged 50 years and older with osteoarthritis (n=1802). Logistic regression tested the association between the onset of restricted mobility outside the home and health, sociodemographic and perceived environmental barriers (hills and steep slopes, inaccessible public buildings, poor pavement condition, lack of access to public parks or sport facilities, heavy traffic or speeding cars and poor weather). The potential moderating role of environmental barriers on the association between health factors and onset was examined using interaction terms and stratified analysis. Of 1802 participants, 13.5% (n=243) reported the onset of restricted mobility outside the home at 3-year follow-up. Walking disability, anxiety, depression, cognitive impairment and obesity and all environmental barriers were associated with onset after adjustment for confounders. Environmental barriers had an added contribution to the effect of the health conditions on onset of restricted mobility, which was attenuated when adjusted for confounders. The added contribution remained only for walking disability and the presence of hills and steep slopes; in the presence of both, the association with onset of restricted mobility was stronger (OR 7.66, 95% CI 4.64 to 12.64) than in the presence of walking disability (3.60, 2.43 to 5.32) or the presence of hills and steep slopes alone (4.55, 2.89 to 7.16). For older adults with osteoarthritis, environmental barriers are associated and add a contribution to that of morbidities and walking disability on the onset of restricted mobility outside the home. Awareness of environmental barriers is important when aiming to maintain mobility and activities outside the home despite health conditions in older adults. © Article author(s) (or their employer(s) unless otherwise

Swallowing Changes in Community-Dwelling Older Adults.

PubMed

Mulheren, Rachel W; Azola, Alba M; Kwiatkowski, Stephanie; Karagiorgos, Eleni; Humbert, Ianessa; Palmer, Jeffrey B; González-Fernández, Marlís

2018-06-08

Older adults may evidence changes in swallowing physiology. Our goals were to identify dysphagia risk in community-dwelling older adults with no history of dysphagia, and to compare swallowing physiology and safety between older and younger adults. Thirty-two older adults with no history of dysphagia were prospectively recruited and completed the Dysphagia Handicap Index (DHI), two trials of a 3 oz. swallow screen, and videofluoroscopy (VFSS). Self-ratings of swallowing function were compared to published norms by paired t tests, and multivariate logistic regression models were generated to determine whether these ratings and VFSS analysis of swallowing function were associated with failure of one or both swallow screen trials. Archived VFSS of 33 younger adults were compared to older adults with Wilcoxon rank-sum tests. The DHI scores of older adults were higher than published non-dysphagic adults but lower than dysphagic adults. Older participants with greater Oral Residue scores were more likely to fail both swallow screen trials. Older adults received higher median MBSImP™© scores for select pharyngeal components than younger adults. The two age groups did not differ on Penetration-Aspiration Scale scores, and no aspiration was observed. Measures of swallowing in older individuals may reflect age-related sensory and motor changes in the context of functional swallowing and adequate airway protection.

Occurrence of refeeding syndrome in adults started on artificial nutrition support: prospective cohort study.

PubMed

Rio, Alan; Whelan, Kevin; Goff, Louise; Reidlinger, Dianne Patricia; Smeeton, Nigel

2013-01-11

Refeeding syndrome is a potentially life-threatening condition characterised by severe intracellular electrolyte shifts, acute circulatory fluid overload and organ failure. The initial symptoms are non-specific but early clinical features are severely low-serum electrolyte concentrations of potassium, phosphate or magnesium. Risk factors for the syndrome include starvation, chronic alcoholism, anorexia nervosa and surgical interventions that require lengthy periods of fasting. The causes of the refeeding syndrome are excess or unbalanced enteral, parenteral or oral nutritional intake. Prevention of the syndrome includes identification of individuals at risk, controlled hypocaloric nutritional intake and supplementary electrolyte replacement. To determine the occurrence of refeeding syndrome in adults commenced on artificial nutrition support. Prospective cohort study. Large, single site university teaching hospital. Recruitment period 2007-2009. 243 adults started on artificial nutrition support for the first time during that admission recruited from wards and intensive care. occurrence of the refeeding syndrome. Secondary outcome: analysis of the risk factors which predict the refeeding syndrome. Tertiary outcome: mortality due to refeeding syndrome and all-cause mortality. 133 participants had one or more of the following risk factors: body mass index <16-18.5≥(kg/m(2)), unintentional weight loss >15% in the preceding 3-6 months, very little or no nutritional intake >10 days, history of alcohol or drug abuse and low baseline levels of serum potassium, phosphate or magnesium prior to recruitment. Poor nutritional intake for more than 10 days, weight loss >15% prior to recruitment and low-serum magnesium level at baseline predicted the refeeding syndrome with a sensitivity of 66.7%: specificity was >80% apart from weight loss of >15% which was 59.1%. Baseline low-serum magnesium was an independent predictor of the refeeding syndrome (p=0.021). Three participants

Attenuated cerebrospinal fluid leukocyte count and sepsis in adults with pneumococcal meningitis: a prospective cohort study

PubMed Central

Weisfelt, Martijn; van de Beek, Diederik; Spanjaard, Lodewijk; Reitsma, Johannes B; de Gans, Jan

2006-01-01

Background A low cerebrospinal fluid (CSF) white-blood cell count (WBC) has been identified as an independent risk factor for adverse outcome in adults with bacterial meningitis. Whereas a low CSF WBC indicates the presence of sepsis with early meningitis in patients with meningococcal infections, the relation between CSF WBC and outcome in patients with pneumococcal meningitis is not understood. Methods We examined the relation between CSF WBC, bacteraemia and sepsis in a prospective cohort study that included 352 episodes of pneumococcal meningitis, confirmed by CSF culture, occurring in patients aged >16 years. Results CSF WBC was recorded in 320 of 352 episodes (91%). Median CSF WBC was 2530 per mm3 (interquartile range 531–6983 per mm3) and 104 patients (33%) had a CSF WBC <1000/mm3. Patients with a CSF WBC <1000/mm3 were more likely to have an unfavourable outcome (defined as a Glasgow Outcome Scale score of 1–4) than those with a higher WBC (74 of 104 [71%] vs. 87 of 216 [43%]; P < 0.001). CSF WBC was significantly associated with blood WBC (Spearman's test 0.29), CSF protein level (0.20), thrombocyte count (0.21), erythrocyte sedimentation rate (-0.15), and C-reactive protein levels (-0.18). Patients with a CSF WBC <1000/mm3 more often had a positive blood culture (72 of 84 [86%] vs. 138 of 196 [70%]; P = 0.01) and more often developed systemic complications (cardiorespiratory failure, sepsis) than those with a higher WBC (53 of 104 [51%] vs. 69 of 216 [32%]; P = 0.001). In a multivariate analysis, advanced age (Odds ratio per 10-year increments 1.22, 95%CI 1.02–1.45), a positive blood culture (Odds ratio 2.46, 95%CI 1.17–5.14), and a low thrombocyte count on admission (Odds ratio per 100,000/mm3 increments 0.67, 95% CI 0.47–0.97) were associated with a CSF WBC <1000/mm3. Conclusion A low CSF WBC in adults with pneumococcal meningitis is related to the presence of signs of sepsis and systemic complications. Invasive pneumococcal infections should

Prospective memory in schizophrenia: relationship to medication management skills, neurocognition, and symptoms in individuals with schizophrenia.

PubMed

Raskin, Sarah A; Maye, Jacqueline; Rogers, Alexandra; Correll, David; Zamroziewicz, Marta; Kurtz, Matthew

2014-05-01

Impaired adherence to medication regimens is a serious concern for individuals with schizophrenia linked to relapse and poorer outcomes. One possible reason for poor adherence to medication is poor ability to remember future intentions, labeled prospective memory skills. It has been demonstrated in several studies that individuals with schizophrenia have impairments in prospective memory that are linked to everyday life skills. However, there have been no studies, to our knowledge, examining the relationship of a clinical measure of prospective memory to medication management skills, a key element of successful adherence. In this Study 41 individuals with schizophrenia and 25 healthy adults were administered a standardized test battery that included measures of prospective memory, medication management skills, neurocognition, and symptoms. Individuals with schizophrenia demonstrated impairments in prospective memory (both time and event-based) relative to healthy controls. Performance on the test of prospective memory was correlated with the standardized measure of medication management in individuals with schizophrenia. Moreover, the test of prospective memory predicted skills in medication adherence even after measures of neurocognition were accounted for. This suggests that prospective memory may play a key role in medication management skills and thus should be a target of cognitive remediation programs.

Chamomile Consumption and Mortality: A Prospective Study of Mexican Origin Older Adults.

PubMed

Howrey, Bret T; Peek, M Kristen; McKee, Juliet M; Raji, Mukaila A; Ottenbacher, Kenneth J; Markides, Kyriakos S

2016-12-01

Approximately 20% of adults use some kind of herbal; however, little data exists from population-based study or clinical trials to support effectiveness of most herbal products. Chamomile is a commonly used herb among older adults of Mexican origin. We examined the effects of herbal chamomile consumption on mortality among older adults of Mexican origin. A sample from the Hispanic Established Populations for Epidemiologic Study of the Elderly, a population-based study of noninstitutionalized Mexican Americans aged 65 and older from five Southwestern states (Texas, California, New Mexico, Colorado, and Arizona). We included all men and women from 2000 to 2007 (n = 1,677). Chamomile was used by 14% of the sample. Cox proportional hazards regression analyses showed that chamomile was associated with a decreased risk of mortality in the total sample (hazard ratio [HR] 0.71, 95% confidence interval [CI] 0.55-0.92) and for women (HR 0.67, 95% CI 0.49-0.92) but not for men. In models adjusted for sociodemographic variables, health behaviors, and chronic conditions, chamomile remained significantly associated with reduced mortality in women (HR 0.72, 95% CI 0.53-0.98). The use of chamomile shows protective effects against mortality in this sample of older adults of Mexican origin for women. Further research is warranted in other populations to determine if these effects are consistent. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Shared and Distinctive Origins and Correlates of Adult Attachment Representations: The Developmental Organization of Romantic Functioning

ERIC Educational Resources Information Center

Haydon, Katherine C.; Collins, W. A.; Salvatore, Jessica E.; Simpson, Jeffry A.; Roisman, Glenn I.

2012-01-01

To test proposals regarding the hierarchical organization of adult attachment, this study examined developmental origins of generalized and romantic attachment representations and their concurrent associations with romantic functioning. Participants (N = 112) in a 35-year prospective study completed the Adult Attachment Interview (AAI) and Current…

Identifying reliable predictors of protein-energy malnutrition in hospitalized frail older adults: A prospective longitudinal study.

PubMed

Sanson, Gianfranco; Bertocchi, Luca; Dal Bo, Eugenia; Di Pasquale, Carmen Luisa; Zanetti, Michela

2018-06-01

Decreased food intake is a risk factor for relevant complications (e.g. infections, pressure ulcers), longer hospital stays, higher readmission rates, greater health care costs and increased patient mortality, particularly in frail hospitalized older adults who are malnourished or at risk of malnutrition. Nurses are called to improve this criticality, starting from accurately identifying malnourished patients at hospital admission and effectively monitoring their food intake. The primary aim was to identify reliable predictive indicators of reduced food intake at hospital admission. The secondary aims were to assess the adequacy of daily energy and protein intake and the impact of nutrient intake on patient outcomes. Prospective observational longitudinal study. Internal Medicine Ward of an Academic Teaching University Hospital. Acute older adults who were malnourished or at risk of malnutrition (Nutritional Risk Score-2002 ≥ 3, middle-upper arm circumference <23.5 cm or impaired self-feeding ability) at admission. The effective energy and protein intake was monitored during the first 5 days of hospital stay by a photographic method and compared to the daily energy and protein requirement calculated by specific equations. Data on anthropometry, inflammation/malnutrition laboratory data and body composition (phase angle calculated using bioelectrical impedance analysis) were collected. Eighty-one subjects (age 81.5 ± 11.5 years) were enrolled. Mean energy intake was 669.0 ± 573.9 kcal/day, and mean protein intake was 30.7 ± 25.8 g/day. Over 60% of patients ingested ≤50% of their calculated energy and protein requirements: these patients were older (p = 0.026), had a lower middle-upper arm circumference (p = 0.022) and total arm area (p = 0.038), a higher C-reactive protein/albumin ratio and Instant Nutritional Assessment score (p < 0.01), and experienced longer hospital stays (p ≤ 0.04) and higher in

Protection of xenon against postoperative oxygen impairment in adults undergoing Stanford Type-A acute aortic dissection surgery: Study protocol for a prospective, randomized controlled clinical trial.

PubMed

Jin, Mu; Cheng, Yi; Yang, Yanwei; Pan, Xudong; Lu, Jiakai; Cheng, Weiping

2017-08-01

The available evidence shows that hypoxemia after Stanford Type-A acute aortic dissection (AAD) surgery is a frequent cause of several adverse consequences. The pathogenesis of postoperative hypoxemia after AAD surgery is complex, and ischemia/reperfusion and inflammation are likely to be underlying risk factors. Xenon, recognized as an ideal anesthetic and anti-inflammatory treatment, might be a possible treatment for these adverse effects. The trial is a prospective, double-blind, 4-group, parallel, randomized controlled, a signal-center clinical trial. We will recruit 160 adult patients undergoing Stanford type-A AAD surgery. Patients will be allocated a study number and will be randomized on a 1:1:1:1 basis to receive 1 of the 3 treatment options (pulmonary inflated with 50% xenon, 75% xenon, or 100% xenon) or no treatment (control group, pulmonary inflated with 50% nitrogen). The aims of this study are to clarify the lung protection capability of xenon and its possible mechanisms in patients undergoing the Stanford type-A AAD surgery. This trial uses an innovative design to account for the xenon effects of postoperative oxygen impairment, and it also delineates the mechanism for any benefit from xenon. The investigational xenon group is considered a treatment intervention, as it includes 3 groups of pulmonary static inflation with 50%, 75%, and 100% xenon. It is suggested that future trials might define an appropriate concentration of xenon for the best practice intervention.

Continuities and Discontinuities in Psychopathology between Childhood and Adult Life

ERIC Educational Resources Information Center

Rutter, Michael; Kim-Cohen, Julia; Maughan, Barbara

2006-01-01

The possible mechanisms involved in continuities and discontinuities in psychopathology between childhood and adult life are considered in relation to the findings from systematic, prospective, long-term longitudinal studies. Findings on schizophrenia, neurodevelopmental disorders, emotional disturbances, antisocial behaviour and substance abuse…

Coblation versus unipolar electrocautery tonsillectomy: a prospective, randomized, single-blind study in adult patients.

PubMed

Noordzij, J Pieter; Affleck, Brian D

2006-08-01

To determine if the coblation tonsillectomy (subcapsular dissection) results in less postoperative pain, equivalent intraoperative blood loss, equivalent postoperative hemorrhage rates, and faster healing compared with tonsillectomy was performed using unipolar electrocautery in adult patients. The authors conducted a prospective clinical trial. Forty-eight patients underwent tonsillectomy and were randomly assigned to have one tonsil removed with coblation and the other with unipolar electrocautery. Outcome measures included time to remove each tonsil, intraoperative blood loss, patient-reported pain, postoperative hemorrhage, and amount of healing 2 weeks after surgery. Mean time to remove a single tonsil with coblation and electrocautery was 8.22 minutes and 6.33 minutes, respectively (P = .011). Mean intraoperative blood loss for each technique was less than 10 mL. Postoperative pain was significantly less with coblation as compared with electrocautery: 18.6% less painful during the first week of recovery. Seventy percent of blinded patients identified the coblation side as less painful during the overall 14-day convalescent period. Postoperative hemorrhage rates (2.1% for coblation and 6.2% for electrocautery) were not significantly different. No difference in tonsillar fossa healing was observed between the two techniques 2 weeks after surgery. During nine of the 48 surgeries, wires on the tip of the coblation handpiece experienced thinning to the point of discontinuity while removing a single tonsil. Coblation subcapsular tonsillectomy was less painful than electrocautery tonsillectomy in this 48-patient group. On average, intraoperative blood loss was less than 10 mL for both techniques. Postoperative hemorrhage rates and the degree of tonsillar fossa healing were similar between the two techniques. The coblation handpiece experienced degradation of vital wires in 18% of cases necessitating the use of a second, new handpiece.

Child Maltreatment and Executive Functioning in Middle Adulthood: A Prospective Examination

PubMed Central

Nikulina, Valentina; Widom, Cathy Spatz

2013-01-01

Objective There is extensive evidence of negative consequences of childhood maltreatment for IQ, academic achievement, and post-traumatic stress disorder (PTSD) and increased attention to neurobiological consequences. However, few prospective studies have assessed the long-term effects of abuse and neglect on executive functioning. The current study examines whether childhood abuse and neglect predicts components of executive functioning and nonverbal reasoning ability in middle adulthood and whether PTSD moderates this relationship. Method Using a prospective cohort design, a large sample (N = 792) of court-substantiated cases of childhood physical and sexual abuse and neglect (ages 0-11) and matched controls were followed into adulthood (mean age = 41). Executive functioning was assessed with the Trail Making B test and non-verbal reasoning with Matrix Reasoning. PTSD (DSM-III-R lifetime diagnosis) was assessed at age 29. Data were analyzed using ordinary least squares regressions, controlling for age, sex, and race and possible confounds of IQ, depression, and excessive alcohol use. Results In multivariate analyses, childhood maltreatment overall and childhood neglect predicted poorer executive functioning and non-verbal reasoning at age 41, whereas physical and sexual abuse did not. A past history of PTSD did not mediate or moderate these relations. Conclusions Childhood maltreatment and neglect specifically have a significant long-term impact on important aspects of adult neuropsychological functioning. These findings suggest the need for targeted efforts dedicated to interventions for neglected children. PMID:23876115

A Prospective Examination of Perceived Burdensomeness and Thwarted Belongingness As Risk Factors for Suicide Ideation In Adult Outpatients Receiving Cognitive-Behavioral Therapy.

PubMed

Teismann, Tobias; Glaesmer, Heide; von Brachel, Ruth; Siegmann, Paula; Forkmann, Thomas

2017-10-01

The interpersonal-psychological theory of suicidal behavior posits that 2 proximal, causal, and interactive risk factors must be present for someone to desire suicide: perceived burdensomeness and thwarted belongingness. The purpose of the present study was to evaluate the predictive power of these 2 risk factors in a prospective study. A total of 231 adult outpatients (age: mean = 38.1, standard deviation = 12.3) undergoing cognitive-behavioral therapy took part in a pretreatment and a midtreatment assessment after the 10th therapy session. Perceived burdensomeness, thwarted belongingness, and the interaction between these 2 risk factors did not add incremental variance to the prediction of midtreatment suicide ideation after controlling for age, gender, depression, hopelessness, impulsivity, lifetime suicide attempts, and pretreatment suicide ideation. The best predictor of midtreatment suicide ideation was pretreatment suicide ideation. Results offer only limited support to the assumptions of the interpersonal theory of suicide. © 2017 Wiley Periodicals, Inc.

Prospective registration trends, reasons for retrospective registration and mechanisms to increase prospective registration compliance: descriptive analysis and survey

PubMed Central

Seidler, Anna Lene; Askie, Lisa M

2018-01-01

Objectives To analyse prospective versus retrospective trial registration trends on the Australian New Zealand Clinical Trials Registry (ANZCTR) and to evaluate the reasons for non-compliance with prospective registration. Design Part 1: Descriptive analysis of trial registration trends from 2006 to 2015. Part 2: Online registrant survey. Participants Part 1: All interventional trials registered on ANZCTR from 2006 to 2015. Part 2: Random sample of those who had retrospectively registered a trial on ANZCTR between 2010 and 2015. Main outcome measures Part 1: Proportion of prospective versus retrospective clinical trial registrations (ie, registration before versus after enrolment of the first participant) on the ANZCTR overall and by various key metrics, such as sponsor, funder, recruitment country and sample size. Part 2: Reasons for non-compliance with prospective registration and perceived usefulness of various proposed mechanisms to improve prospective registration compliance. Results Part 1: Analysis of the complete dataset of 9450 trials revealed that compliance with prospective registration increased from 48% (216 out of 446 trials) in 2006 to 63% (723/1148) in 2012 and has since plateaued at around 64%. Patterns of compliance were relatively consistent across sponsor and funder types (industry vs non-industry), type of intervention (drug vs non-drug) and size of trial (n<100, 100–500, >500). However, primary sponsors from Australia/New Zealand were almost twice as likely to register prospectively (62%; 4613/7452) compared with sponsors from other countries with a WHO Network Registry (35%; 377/1084) or sponsors from countries without a WHO Registry (29%; 230/781). Part 2: The majority (56%; 84/149) of survey respondents cited lack of awareness as a reason for not registering their study prospectively. Seventy-four per cent (111/149) stated that linking registration to ethics approval would facilitate prospective registration. Conclusions Despite some

Older Adults' Perceptions of Intergenerational Support after Widowhood: How Do Men and Women Differ?

ERIC Educational Resources Information Center

Ha, Jung-Hwa; Carr, Deborah; Utz, Rebecca L.; Nesse, Randolph

2006-01-01

This study examines the ways that widowhood affects older adults' perceived exchange of support with their children, and whether exchange patterns differ by gender. Data are from the Changing Lives of Older Couples (CLOC), a prospective study of 1,532 married individuals age 65 years and older. Spousal loss increases older adults' dependence on…

Prospects of Pluripotent and Adult Stem Cells for Rare Diseases.

PubMed

García-Castro, Javier; Singeç, Ilyas

2017-01-01

Rare diseases are highly diverse and complex regarding molecular underpinning and clinical manifestation and afflict millions of patients worldwide. The lack of appropriate model systems with face and construct validity and the limited availability of live tissues and cells from patients has largely hampered the understanding of underlying disease mechanisms. As a consequence, there are no adequate treatment options available for the vast majority of rare diseases. Over the last decade, remarkable progress in pluripotent and adult stem cell biology and the advent of powerful genomic technologies opened up exciting new avenues for the investigation, diagnosis, and personalized therapy of intractable human diseases. Utilizing the entire range of available stem cell types will continue to cross-fertilize different research areas and leverage the investigation of rare diseases based on evidence-based medicine. Standardized cell engineering and manufacturing from inexhaustible stem cell sources should lay the foundation for next-generation drug discovery and cell therapies that are broadly applicable in regenerative medicine. In this chapter we discuss how patient- and disease-specific iPS cells as well as adult stem cells are changing the pace of biomedical research and the translational landscape.

Mobility predicts change in older adults' health-related quality of life: evidence from a Vancouver falls prevention prospective cohort study.

PubMed

Davis, Jennifer C; Bryan, Stirling; Best, John R; Li, Linda C; Hsu, Chun Liang; Gomez, Caitlin; Vertes, Kelly A; Liu-Ambrose, Teresa

2015-07-15

Older adults with mobility impairments are prone to reduced health related quality of life (HRQoL) is highly associated with mobility impairments. The consequences of falls have detrimental impact on mobility. Hence, ascertaining factors explaining variation among individuals' quality of life is critical for promoting healthy ageing, particularly among older fallers. Hence, the primary objective of our study was to identify key factors that explain variation in HRQoL among community dwelling older adults at risk of falls. We conducted a longitudinal analysis of a 12-month prospective cohort study at the Vancouver Falls Prevention Clinic (n = 148 to 286 depending on the analysis). We constructed linear mixed models where assessment month (0, 6, 12) was entered as a within-subjects repeated measure, the intercept was specified as a random effect, and predictors and covariates were entered as between-subjects fixed effects. We also included the predictors by sex and predictor by sex by time interaction terms in order to investigate sex differences in the relations between the predictor variable and the outcome variable, the EQ-5D. Our primary analysis demonstrated a significant mobility (assessed using the Short Performance Physical Battery and the Timed Up and Go) by time interaction (p < 0.05) and mobility by time by sex interaction (p < 0.05). The sensitivity analyses demonstrated some heterogeneity of these findings using an imputed and a complete case analysis. Mobility may be an important predictor of changes in HRQoL over time. As such, mobility is a critical factor to target for future intervention strategies aimed at maintaining or improving HRQoL in late life.

Predictors of Survival among Adult Ethiopian Patients in the National ART Program at Seven University Teaching Hospitals: A Prospective Cohort Study.

PubMed

Fekade, Daniel; Weldegebreal, Teklu; Teklu, Alula M; Damen, Melake; Abdella, Saro; Baraki, Nega; Belayhun, Bekele; Berhan, Eyoel; Kebede, Amha; Assefa, Yibeltal

2017-02-01

In Ethiopia, the publicly funded antiretroviral treatment (ART) program was started in 2005. Two hundred seventy-five thousand patients were enrolled in the national ART program by 2012. However, there is limited data on mortality and predictors of death among adult patients in the ART program. The study aimed to estimate mortality and risk factors for death among adult, ART-naïve patients, started in the national ART program from January 2009 to July 2013. Multi-site, prospective, observational cohort study of adult, age > 18 years, ART-naïve patients, started in the national ART program at seven university-affiliated hospitals from January 2009 - July 2013. Kaplan-Meier and Cox regression analyses were used to estimate survival and determine risk factors for death. A total of 976 patients, 594 females (60.9 %), were enrolled into the study. Median age of the cohort was 33years. The median CD4 count at start of ART was 144 cells/µl (interquartile range (IQR) 78-205), and 34.2% (330/965) had CD4 < 100. Sixty-three percent (536/851) had viral load greater than 5 log copies/ml (IQR 4.7-5.7) at base line. One hundred and one deaths were recorded during follow-up period, all-cause mortality rate 10.3%; 5.4 deaths/100 person years of observation, 95% confidence interval 4.4-6.5. Seventy percent of the deaths occurred within six months of starting ART. Cox regression analyses showed that the following measures independently predicted mortality: age >51 years, (Adjusted Hazard Ratio (AHR) 4.01, P=0.003), WHO stages III&IV, (AHR 1.76, p = 0.025), CD4 count, <100, (AHR 2.36, p =0.006), and viral load >5 log copies /ml (CHR 1.71, p = 0.037). There is high early on- ART mortality in patients presenting with advanced immunodeficiency. Detecting cases and initiating ART before onset of advanced immunodeficiency might improve survival.

Effects of different amounts of exercise on preventing depressive symptoms in community-dwelling older adults: a prospective cohort study in Taiwan.

PubMed

Chang, Yu-Chen; Lu, Mei-Chun; Hu, I-Han; Wu, Wan-Chi Ida; Hu, Susan C

2017-05-02

To compare the effects of four different amounts of exercise for preventing depressive symptoms in community-dwelling older adults. Prospective cohort study. A nationally representative sample in Taiwan. Four waves of the survey 'Taiwan Longitudinal Study on Aging (TLSA)' from 1996 to 2007 were analysed. A total of 2673 older adults aged 65 years and over were recruited. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CESD). Four different types/amounts of exercise were examined including: (1) 3 times/week, 15 min/time; (2) 3 times/week, 30 min/time; (3) 6 times/week, 15 min/time; and (4) 6 times/week, 30 min/time. All exercise types were required to have at least moderate intensity. The impacts of different amounts of exercise on depressive symptoms were analysed using generalised linear mixed models. More than one-fifth of the elder individuals under consideration had depressive symptoms (CESD ≥10). About 38.6% of older adults met the lowest criteria for exercise type 1, and fewer (28.0%) met the highest criteria for type 4. Only exercise type 4 in the current survey was initially related to lower depressive symptoms (OR=0.8, 95% CI 0.66 to 0.95). However, after considering the interaction between time and changes in exercise patterns, the results showed that all persistent exercise models, even if a very low amount (3 times/week, 15 min/time), had significantly preventive effects on depressive symptoms (OR=0.56~0.67). Consistent exercise with at least 15 min per time, three times a week of moderate intensity is significantly associated with lower risk of depressive symptoms. This low amount of exercise may be easier to promote at the community and population level than other alternatives. Registry number 104040 of the Institutional Ethics Committee of Chia-Yi Christian Hospital. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No

Pathways from Adolescent Deliberate Self-Poisoning to Early Adult Outcomes: A Six-Year Follow-Up

ERIC Educational Resources Information Center

Aglan, Azza; Kerfoot, Michael; Pickles, Andrew

2008-01-01

Background: Prospective studies show that the adult outcomes of adolescents who deliberately harm themselves are marked by high rates of adversity and psychiatric disorders. The goal of this study was to identify pathways linking childhood risk factors to early adult outcomes of suicidal adolescents. Methods: A clinical sample of 158 adolescents…

Prospective Primary Teachers' Beliefs about Mathematics

ERIC Educational Resources Information Center

Maasepp, Brooke; Bobis, Janette

2015-01-01

Concerns about the negative mathematical beliefs of prospective primary teachers have arisen from evidence that such beliefs detrimentally impact future teaching practices. The aim of this study was to explore factors contributing to the effectiveness of a mathematics content-focused intervention designed to nurture positive mathematical beliefs.…

Coordinating resources for prospective medication risk management of older home care clients in primary care: procedure development and RCT study design for demonstrating its effectiveness.

PubMed

Toivo, Terhi; Dimitrow, Maarit; Puustinen, Juha; Savela, Eeva; Pelkonen, Katariina; Kiuru, Valtteri; Suominen, Tuula; Kinnunen, Sirkka; Uunimäki, Mira; Kivelä, Sirkka-Liisa; Leikola, Saija; Airaksinen, Marja

2018-03-16

The magnitude of safety risks related to medications of the older adults has been evidenced by numerous studies, but less is known of how to manage and prevent these risks in different health care settings. The aim of this study was to coordinate resources for prospective medication risk management of home care clients ≥ 65 years in primary care and to develop a study design for demonstrating effectiveness of the procedure. Health care units involved in the study are from primary care in Lohja, Southern Finland: home care (191 consented clients), the public healthcare center, and a private community pharmacy. System based risk management theory and action research method was applied to construct the collaborative procedure utilizing each profession's existing resources in medication risk management of older home care clients. An inventory of clinical measures in usual clinical practice and systematic review of rigorous study designs was utilized in effectiveness study design. The new coordinated medication management model (CoMM) has the following 5 stages: 1) practical nurses are trained to identify clinically significant drug-related problems (DRPs) during home visits and report those to the clinical pharmacist. Clinical pharmacist prepares the cases for 2) an interprofessional triage meeting (50-70 cases/meeting of 2 h) where decisions are made on further action, e.g., more detailed medication reviews, 3) community pharmacists conduct necessary medication reviews and each patients' physician makes final decisions on medication changes needed. The final stages concern 4) implementation and 5) follow-up of medication changes. Randomized controlled trial (RCT) was developed to demonstrate the effectiveness of the procedure. The developed procedure is feasible for screening and reviewing medications of a high number of older home care clients to identify clients with severe DRPs and provide interventions to solve them utilizing existing primary care resources

Quality of Life and Associated Socio-Clinical Factors after Encephalitis in Children and Adults in England: A Population-Based, Prospective Cohort Study

PubMed Central

Ramanuj, Parashar Pravin; Granerød, Julia; Davies, Nicholas W. S.; Conti, Stefano; Brown, David W. G.; Crowcroft, Natasha S.

2014-01-01

Objective We sought to measure HRQoL in all-cause encephalitis survivors and assess the impact of various socio-clinical factors on outcome. Methods We used a prospective cohort study design, using the short-form 36 (SF-36) to measure the HRQoL in patients 15 years and older, and the short-form 10 (SF-10) for patients less than 15 years old. We posted questionnaires to individuals six months after discharge from hospital. All scores were normalised to the age- and sex-matched general population. We used multivariate statistical analysis to assess the relative association of clinical and socio-demographic variables on HRQoL in adults. Results Of 109 individuals followed-up, we received 61 SF-36 and twenty SF-10 questionnaires (response rate 74%). Patients scored consistently worse than the general population in all domains of the SF-36 and SF-10, although there was variation in individual scores. Infectious encephalitis was associated with the worst HRQoL in those aged 15 years and over, scoring on average 5.64 points less than immune-mediated encephalitis (95% CI −8.77– −2.89). In those aged less than 15 years the worst quality of life followed encephalitis of unknown cause. Immuno compromise, unemployment, and the 35–44 age group all had an independent negative association with HRQoL. A poor Glasgow Outcome Score was most strongly associated with a poor HRQoL. Less than half of those who had made a ‘good’ recovery on the score reported a HRQoL equivalent to the general population. Conclusions Encephalitis has adverse effects on the majority of survivors’ wellbeing and quality of life. Many of these adverse consequences could be minimised by prompt identification and treatment, and with better rehabilitation and support for survivors. PMID:25072738

Consistency between Constructivist Profiles and Instructional Practices of Prospective Physics Teachers

ERIC Educational Resources Information Center

Ates, Ozlem; Unal Coban, Gul; Kaya Sengoren, Serap

2018-01-01

This study aims to explain the extent to which prospective physics teachers' views and practices are consistent with the constructivist framework. A case study design was employed as the research approach. The study was conducted with 11 prospective physics teachers attending a state university in Turkey. Data was collected through semi-structured…

The Quality of Medication Use in Older Adults: Methods of a Longitudinal Study

PubMed Central

Roth, Mary T.; Moore, Charity G.; Ivey, Jena L.; Esserman, Denise A.; Campbell, William H.; Weinberger, Morris

2009-01-01

Background The quality of medication use in older adults is a recurring problem of substantial concern. Efforts to both measure and improve the quality of medication use often define quality too narrowly and fall short of addressing the complexity of an older adult's medication regimen. Objective In an effort to more comprehensively define the quality of medication use in older adults, we conducted a prospective cohort study to: 1) describe the quality of medication use in community-residing older adults at baseline, examining differences between Whites and African Americans; 2) examine the effect of race on medication-related problems[mtr1], and 3) assess the change in quality medication use between Whites and African Americans over time. This paper presents the research design and methods of this longitudinal study. Methods We interviewed 100 White and 100 African-American community-residing older adults three times over one year (baseline, 6, and 12 months). We oversampled African Americans so that we could estimate racial differences in the quality of medication use. We collected information on the quality of medication use, relying on a clinical pharmacist's assessment of quality and the Assessing Care of Vulnerable Elders (ACOVE) quality indicators. We also collected data on demographic characteristics, health literacy, functional status, and participant-reported drug therapy concerns. Results Two hundred older adults were enrolled into the study and completed a baseline visit. Of the 200, 92% completed the 6-month visit (n=183) and 88% completed the 12-month visit (n=176). We present baseline demographic characteristics for the 200 older adults enrolled in the study. Conclusion This longitudinal study is an initial step toward developing more comprehensive, patient-centered measures and interventions to improve the quality of medication use in older adults. PMID:19028378

Self-reported personality disorder in the children in the community sample: convergent and prospective validity in late adolescence and adulthood.

PubMed

Crawford, Thomas N; Cohen, Patricia; Johnson, Jeffrey G; Kasen, Stephanie; First, Michael B; Gordon, Kathy; Brook, Judith S

2005-02-01

Approximately 800 youths from the Children in the Community Study (Cohen & Cohen, 1996) have been assessed prospectively for over 20 years to study personality disorders (PDs) in adolescents and young adults. In this article we evaluate the Children in the Community Self-Report (CIC-SR) Scales, which were designed to assess DSM-IV PDs using self-reported prospective data from this longitudinal sample. To evaluate convergent validity, we assessed concordance between the CIC-SR Scales and the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II; First, Gibbon, Spitzer, Williams, & Benjamin, 1995) in 644 participants at mean age 33. To assess predictive validity, we used CIC-SR Scales at mean age 22 to predict subsequent CIC-SR and SCID-II Personality Questionnaire scores at mean age 33. In these analyses the CIC-SR Scales matched or exceeded benchmarks established in previous comparisons between self-report instruments and structured clinical interviews. Unlike other self-report scales, the CIC-SR did not appear to overestimate diagnoses when compared with SCID-II clinical diagnoses.

Sleep Improves Prospective Remembering by Facilitating Spontaneous-Associative Retrieval Processes

PubMed Central

Diekelmann, Susanne; Wilhelm, Ines; Wagner, Ullrich; Born, Jan

2013-01-01

Memories are of the past but for the future, enabling individuals to implement intended plans and actions at the appropriate time. Prospective memory is the specific ability to remember and execute an intended behavior at some designated point in the future. Although sleep is well-known to benefit the consolidation of memories for past events, its role for prospective memory is still not well understood. Here, we show that sleep as compared to wakefulness after prospective memory instruction enhanced the successful execution of prospective memories two days later. We further show that sleep benefited both components of prospective memory, i.e. to remember that something has to be done (prospective component) and to remember what has to be done (retrospective component). Finally, sleep enhanced prospective remembering particularly when attentional resources were reduced during task execution, suggesting that subjects after sleep were able to recruit additional spontaneous-associative retrieval processes to remember intentions successfully. Our findings indicate that sleep supports the maintenance of prospective memory over time by strengthening intentional memory representations, thus favoring the spontaneous retrieval of the intended action at the appropriate time. PMID:24143246

Physical Exercise Helped to Maintain and Restore Functioning in Chinese Older Adults With Mild Cognitive Impairment: A 5-Year Prospective Study of the Hong Kong Memory and Ageing Prospective Study (HK-MAPS).

PubMed

Ma, Duan Yang; Wong, Candy H Y; Leung, Grace T Y; Fung, Ada W T; Chan, Wai Chi; Lam, Linda C W

2017-04-01

This study investigated the potential of physical exercise habit as a lifestyle modification against cognitive and functional decline at the community level. A total of 454 community-dwelling Chinese older adults without dementia participated in the Hong Kong Memory and Ageing Prospective Study at baseline and follow-up at 5 years. Their cognitive and functional performances were assessed by the Cantonese version of the Mini-Mental State Examination (CMMSE) and the Chinese version of Disability Assessment in Dementia (DAD). Hierarchical multiple regression analyses were performed to examine whether physical exercise was a significant predictor of the follow-up CMMSE and DAD scores after controlling for the covariates. Subgroup analyses were performed with a group of 127 participants with mild cognitive impairment at baseline. Physical exercise habit was a significant predictor for both the follow-up CMMSE scores and DAD scores. Participants with exercise habits of 5 years or more showed better cognitive and functional performances at follow-up. Participants who picked up exercise habits only after the baseline assessment also demonstrated better functioning at follow-up. The same patterns were observed in the subgroup analyses with the mild cognitive impairment group. Results suggested that prolonged exercise habit is required for positive effects on cognition to emerge, but benefits on functioning can be observed when individuals take up an exercise habit later in life or even after the beginning of cognitive decline. These findings are encouraging in promoting an exercise habit among older adults living in the community. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Design and implementation of the canadian kidney disease cohort study (CKDCS): A prospective observational study of incident hemodialysis patients

PubMed Central

2011-01-01

Background Many nephrology observational studies use renal registries, which have well known limitations. The Canadian Kidney Disease Cohort Study (CKDCS) is a large prospective observational study of patients commencing hemodialysis in five Canadian centers. This study focuses on delineating potentially reversible determinants of adverse outcomes that occur in patients receiving dialysis for end-stage renal disease (ESRD). Methods/Design The CKDCS collects information on risk factors and outcomes, and stores specimens (blood, dialysate, hair and fingernails) at baseline and in long-term follow-up. Such specimens will permit measurements of biochemical markers, proteomic and genetic parameters (proteins and DNA) not measured in routine care. To avoid selection bias, all consenting incident hemodialysis patients at participating centers are enrolled, the large sample size (target of 1500 patients), large number of exposures, and high event rates will permit the exploration of multiple potential research questions. Preliminary Results Data on the baseline characteristics from the first 1074 subjects showed that the average age of patients was 62 (range; 50-73) years. The leading cause of ESRD was diabetic nephropathy (41.9%), and the majority of the patients were white (80.0%). Only 18.7% of the subjects received dialysis in a satellite unit, and over 80% lived within a 50 km radius of the nearest nephrologist's practice. Discussion The prospective design, detailed clinical information, and stored biological specimens provide a wealth of information with potential to greatly enhance our understanding of risk factors for adverse outcomes in dialysis patients. The scientific value of the stored patient tissue will grow as new genetic and biochemical markers are discovered in the future. PMID:21324196

Organ localization: Toward prospective patient-specific organ dosimetry in computed tomography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Segars, W. P., E-mail: paul.segars@duke.edu; Rybicki, K.; Norris, Hannah

2014-12-15

Purpose: With increased focus on radiation dose from medical imaging, prospective radiation dose estimates are becoming increasingly desired. Using available populations of adult and pediatric patient phantoms, radiation dose calculations can be catalogued and prospectively applied to individual patients that best match certain anatomical characteristics. In doing so, the knowledge of organ size and location is a required element. Here, the authors develop a predictive model of organ locations and volumes based on an analysis of adult and pediatric computed tomography (CT) data. Methods: Fifty eight adult and 69 pediatric CT datasets were segmented and utilized in the study. Themore » maximum and minimum points of the organs were recorded with respect to the axial distance from the tip of the sacrum. The axial width, midpoint, and volume of each organ were calculated. Linear correlations between these three organ parameters and patient age, BMI, weight, and height were determined. Results: No statistically significant correlations were found in adult patients between the axial width, midpoint, and volume of the organs versus the patient age or BMI. Slight, positive linear trends were found for organ midpoint versus patient weight (max r{sup 2} = 0.382, mean r{sup 2} = 0.236). Similar trends were found for organ midpoint versus height (max r{sup 2} = 0.439, mean r{sup 2} = 0.200) and for organ volume versus height (max r{sup 2} = 0.410, mean r{sup 2} = 0.153). Gaussian fits performed on probability density functions of the adult organs resulted in r{sup 2}-values ranging from 0.96 to 0.996. The pediatric patients showed much stronger correlations overall. Strong correlations were observed between organ axial midpoint versus age, height, and weight (max r{sup 2} = 0.842, mean r{sup 2} = 0.790; max r{sup 2} = 0.949, mean r{sup 2} = 0.894; and max r{sup 2} = 0.870, mean r{sup 2} = 0.847, respectively). Moderate linear correlations were also observed for organ axial

Adult Learning Week Planning Packet.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Office of Adult Learning Services.

Each year one week is designated by the Governor of New York as Adult Learning Week because of the growing importance of adult education to society and the economy of New York State. The major purpose of Adult Learning Week is to promote greater public awareness of the availability and variety of learning opportunities for adults. In practical…

The Accuracy of Adult Narrative Reports of Developmental Trajectories

ERIC Educational Resources Information Center

Cohen, Patricia; Kasen, Stephanie; Bifulco, Antonia; Andrews, Howard; Gordon, Kathy

2005-01-01

This methodological investigation examines the accuracy of narrative-based scaled ratings covering several post high school years. Guided narratives by young adults described developmentally relevant behaviour and context for each month between ages 17 and the mid-20s. "Prospective" narratives covered shorter time periods in three interviews…

A Case Study on Mathematical Literacy of Prospective Elementary School Teachers

ERIC Educational Resources Information Center

Suharta, I. Gusti Putu; Suarjana, I. Made

2018-01-01

The purpose of this study is to describe Mathematical Literacy (ML) of Prospective Elementary School Teachers with attention to aspects of mathematical skills and gender. The type of research is qualitative with the research design of Case Study. Respondents are assigned 12 Prospective Elementary School Teachers, consisting of 6 men and 6 women.…

Instructional Patterns for Maximizing Human Potential. A Curriculum Design for Human Development and Interpersonal Relationships: Kindergarten through Adult Education.

ERIC Educational Resources Information Center

Kern Joint Union High School District, Bakersfield, CA.

Intended for consumer and homemaking education program development in kindergarten through adult education, this curriculum design emphasizes human development and interpersonal relationships. Presented in two sections, the document covers both the curriculum development process and the resulting products. The curriculum addresses five…

An Adult ESL Curriculum.

ERIC Educational Resources Information Center

South Carolina Literacy Resource Center, Columbia.

This curriculum framework for adult literacy was written by 21 South Carolina adult English-as-a-Second-Language (ESL) instructors, as submitted to the South Carolina Literacy Resource Center. It is based on current theories in the fields of adult education and second language acquisition and is designed to be flexible so that it may be adapted to…

Assessing Knowledge and Attitudes about End of Life: Evaluation of Three Instruments Designed for Adults with Intellectual Disability

ERIC Educational Resources Information Center

Stancliffe, R. J.; Wiese, M. Y.; Read, S.; Jeltes, G.; Clayton, J. M.

2017-01-01

Background: This paper examines the development and psychometric characteristics of three instruments about end of life, designed for use with adults with intellectual disability (ID). Respectively, the instruments assess understanding of the concept of death, end-of-life planning, and fear of death. Methods: Part 1: instruments were developed or…

Design and recruitment of the Chicago Healthy Living Study: a study of health behaviors in a diverse cohort of adult childhood cancer survivors.

PubMed

Stolley, Melinda R; Sharp, Lisa K; Arroyo, Claudia; Ruffin, Cherese; Restrepo, Jacqueline; Campbell, Richard

2009-09-15

Adult childhood cancer survivors are at higher risk for developing late medical effects related to their cancer treatments. Health-promoting behaviors may reduce the risk of some late effects and the severity of others. This article describes the design and recruitment of the Chicago Healthy Living Study (CHLS), an on-going study designed to examine the health behaviors and body mass index of minority adult childhood cancer survivors compared with nonminority survivors and noncancer controls. Survivors are identified by the hospital cancer registries at 5 treating institutions in the Chicago area; then, a multilevel recruitment plan will be implemented with the objective of enrolling 450 adult survivors of childhood cancer (150 in each racial/ethnic group). Simultaneously, 375 adult African-American, Hispanic, and non-Hispanic white noncancer controls (125 in each racial/ethnic group) living in the Chicago area will be recruited by using listed, targeted digit dialing. All participants will complete a 2-hour interview of questionnaires related to diet, physical activity, smoking, and associated mediators. Height and weight also will be measured. The CHLS will provide important information on the health behaviors of adult minority childhood cancer survivors that can be used to inform the development of interventions to improve modifiable risks. Copyright (c) 2009 American Cancer Society.

The correlation between serum free thyroxine and regression of dyslipidemia in adult males: A 4.5-year prospective study.

PubMed

Wang, Haoyu; Liu, Aihua; Zhou, Yingying; Xiao, Yue; Yan, Yumeng; Zhao, Tong; Gong, Xun; Pang, Tianxiao; Fan, Chenling; Zhao, Jiajun; Teng, Weiping; Shan, Zhongyan; Lai, Yaxin

2017-09-01

Elevated free thyroxine (FT4) levels may play a protective role in development of dyslipidemia. However, few prospective studies have been performed to definite the effects of thyroid hormones on the improvement of dyslipidemia and its components. Thus, this study aims to clarify the association between thyroid hormones within normal range and reversal of dyslipidemia in the absence of intervention.A prospective analysis including 134 adult males was performed between 2010 and 2014. Anthropometric parameters, thyroid function, and lipid profile were measured at baseline and during follow-up. Logistic regression and receiver operating characteristic (ROC) analysis were conducted to identify the variables in forecasting the reversal of dyslipidemia and its components.During 4.5-year follow-up, 36.6% (49/134) patients resolved their dyslipidemia status without drug intervention. Compared with the continuous dyslipidemia group, subjects in reversal group had elevated FT4 and high-density lipoprotein cholesterol (HDL-C) levels, as well as decreased total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C) levels at baseline. Furthermore, baseline FT4 is negatively associated with the change percentages of TG (r = -0.286, P = .001), while positively associated with HDL-C (r = 0.227, P = .008). However, no correlation of lipid profile change percentages with FT3 and TSH were observed. Furthermore, the improving effects of baseline FT4 on dyslipidemia, high TG, and low HDL-C status were still observed after multivariable adjustment. In ROC analysis, areas under curve (AUCs) for FT4 in predicting the reversal of dyslipidemia, high TG, and low HDL-C were 0.666, 0.643, and 0.702, respectively (P = .001 for dyslipidemia, .018 for high TG, and .001 for low HDL-C).Higher FT4 value within normal range may ameliorate the dyslipidemia, especially high TG and low HDL-C status, in males without drug intervention. This suggests

The Paris prospective birth cohort study: which design and who participates?

PubMed

Clarisse, B; Nikasinovic, L; Poinsard, R; Just, J; Momas, I

2007-01-01

The Paris prospective birth cohort study was implemented in 2003 to assess environmental/behavioural factors associated with respiratory and allergic disorder occurrence in early childhood. This paper describes the design and sociodemographic features of eligible/enrolled families. Full-term newborns without any medical problem at birth were recruited in five Paris maternity hospitals. They resided in the Paris area and had French speaking mothers. Sample size is at least 3500 infants, and children are followed-up until their sixth birthday. Data collection is based on regular medical and environmental self-administered questionnaires to parents. Information on dwellings is gathered by means of phone questionnaires, and standardized medical examinations are carried out at 18 months and 6 years. Exposure to traffic-related pollution is modelled. At inclusion, some information concerning refusals is gathered in order to describe sociodemographic features of participating families as compared with eligible children. 4115 (63%) out of the 6493 eligible infants are now participating in this study. Participation rate is higher in parents with a high SES (socioeconomic status), for French and European parents, and for > or =25-year-old mothers, but decreases with sibship size. Similar determinants are associated with the distribution of reasons for non-participation. The participation rate in the Paris study is comparable with other similar studies. Finally, giving detailed explanation of the study aims at inclusion, establishing regular mailed and phoned contacts with families, offering free complete medical examinations for the participant child and re-sent missing questionnaires are very important to improve participation at inclusion and during follow-up.

Commission of Professors of Adult Education. Proceedings of the Annual Conference (Tulsa, Oklahoma, October 31-November 2, 1988).

ERIC Educational Resources Information Center

Oaklief, Charles R., Ed.; Zelenak, Bonnie, Ed.

The conference proceedings reported in this publication represent the deliberations, problems, and prospects associated with adult education as a field of academic inquiry. The following papers or summaries are included: "Adult Education Research: Issues and Directions" (Deshler, Hagan); "Comparative Perspectives for Research about…

Prospective memory in schizophrenia: Relationship to medication management skills, neurocognition and symptoms in individuals with schizophrenia

PubMed Central

Raskin, S.; Maye, J.; Rogers, A.; Correll, D.; Zamroziewicz, M.; Kurtz, M.

2014-01-01

Objective Impaired adherence to medication regimens is a serious concern for individuals with schizophrenia linked to relapse and poorer outcomes. One possible reason for poor adherence to medication is poor ability to remember future intentions, labeled prospective memory skills. It has been demonstrated in several studies that individuals with schizophrenia have impairments in prospective memory that are linked to everyday life skills. However, there have been no studies, to our knowledge, examining the relationship of a clinical measure of prospective memory to medication management skills, a key element of successful adherence. Methods In this study 41 individuals with schizophrenia and 25 healthy adults were administered a standardized test battery that included measures of prospective memory, medication management skills, neurocognition and symptoms. Results Individuals with schizophrenia demonstrated impairments in prospective memory (both time and event-based) relative to healthy controls. Performance on the test of prospective memory was correlated with the standardized measure of medication management in individuals with schizophrenia. Moreover, the test of prospective memory predicted skills in medication adherence even after measures of neurocognition were accounted for. Conclusions This suggests that prospective memory may play a key role in medication management skills and thus should be a target of cognitive remediation programs. PMID:24188118

The role of dissociation in revictimization across the lifespan: A 32-year prospective study.

PubMed

Zamir, Osnat; Szepsenwol, Ohad; Englund, Michelle M; Simpson, Jeffry A

2018-05-01

Exposure to childhood abuse puts women at risk for revictimization in adult intimate relationships, but knowledge about the mechanism by which it occurs is limited. The present study investigated whether dissociation mediates the effect of exposure to physical or sexual child abuse on intimate partner violence in adulthood. We tested this using prospective data collected from birth to age 32 from 80 female participants in the Minnesota Longitudinal Study of Risk and Adaptation. We found that women who experienced sexual or physical abuse during the first 17.5 years of life (n = 37) were more likely (r = 0.30, p < .01) to experience intimate partner violence in adulthood (ages 20-32). Furthermore, we found that dissociation partially mediated this effect. Specifically, exposure to childhood abuse predicted greater dissociation in late adolescence (age 19), which in turn predicted more intimate partner violence during early to mid-adulthood. The results of this study highlight the mediating role played by dissociation in the revictimization of women abused during childhood, and speak to the need to develop interventions designed to prevent intimate partner violence among abused girls or adult women with a history of abuse. Copyright © 2018 Elsevier Ltd. All rights reserved.

Advanced design for lightweight structures: Review and prospects

NASA Astrophysics Data System (ADS)

Braga, Daniel F. O.; Tavares, S. M. O.; da Silva, Lucas F. M.; Moreira, P. M. G. P.; de Castro, Paulo M. S. T.

2014-08-01

Current demand for fuel efficient aircraft has been pushing the aeronautical sector to develop ever more lightweight designs while keeping safe operation and required structural strength. Along with light-weighting, new structural design concepts have also been established in order to maintain the aircraft in service for longer periods of time, with high reliability levels. All these innovations and requirements have led to deeply optimized aeronautical structures contributing to more sustainable air transport. This article reviews the major design philosophies which have been employed in aircraft structures, including safe-life, fail-safe and damage tolerance taking into account their impact on the structural design. A brief historical review is performed in order to analyse what led to the development of each philosophy. Material properties are related to each of the design philosophies. Damage tolerant design has emerged as the main structural design philosophy in aeronautics, requiring deep knowledge on materials fatigue and corrosion strength, as well as potential failure modes and non-destructive inspection techniques, particularly minimum detectable defect and scan times. A discussion on the implementation of structural health monitoring and self-healing structures within the current panorama of structures designed according to the damage tolerant philosophy is presented. This discussion is aided by a review of research on these two subjects. These two concepts show potential for further improving safety and durability of aircraft structures.

Health responses to a new high-voltage power line route: design of a quasi-experimental prospective field study in the Netherlands

PubMed Central

2014-01-01

Background New high-voltage power transmission lines will be introduced due to increasing demand for reliable and renewable energy supplies. Some residents associate non-specific health complaints with exposure to electromagnetic fields from nearby power lines. This study protocol describes the design and rationale of a prospective study investigating whether the introduction of a new power line triggers health responses in residents living nearby. Methods/Design The study is designed as a quasi-experimental field study with two pretests during the construction of a new power line route, and two posttests after it has been put into operation. Key outcomes are self-reported non-specific somatic and cognitive health complaints, and attribution of these health complaints to a power line. The main determinant is proximity to the new power line route. One member of every household (n = 2379) residing in close proximity (0-500 meters) to the overhead parts of a new power line route in the Netherlands is invited to participate, as well as a sample of household members (n = 2382) residing farther away (500-2000 meters). Multilevel analysis will be employed to test whether an increase in key outcome measures is related to proximity to the line. Longitudinal structural equation models will be applied to test to what extent health responses are mediated by psychosocial health mechanisms and moderated by negative oriented personality traits. Discussion This is the first study to investigate health responses to a new power line route in a prospective manner. The results will provide theoretical insight into psychosocial mechanisms operating during the introduction of an environmental health risk, and may offer suggestions to policymakers and other stakeholders for minimizing adverse health responses when introducing new high-voltage power lines. PMID:24606914

HIV, prospective memory, and cerebrospinal fluid concentrations of quinolinic acid and phosphorylated Tau.

PubMed

Anderson, Albert M; Croteau, David; Ellis, Ronald J; Rosario, Debra; Potter, Michael; Guillemin, Gilles J; Brew, Bruce J; Woods, Steven Paul; Letendre, Scott L

2018-06-15

There is mounting evidence that prospective memory (PM) is impaired during HIV infection despite treatment. In this prospective study, 66 adults (43 HIV+ and 23 HIV negative) underwent PM assessment and cerebrospinal fluid (CSF) examination. HIV+ participants had significantly lower PM but significantly higher CSF concentrations of CXCL10 and quinolinic acid (QUIN). Higher CSF phosphorylated Tau (pTau) was associated with worse PM. In a secondary analysis excluding outliers, higher QUIN correlated with higher pTau. CSF QUIN is thus elevated during HIV infection despite antiretroviral therapy and could indirectly contribute to impaired PM by influencing the formation of pTau. Copyright © 2018 Elsevier B.V. All rights reserved.

Using the NIATx Model to Implement User-Centered Design of Technology for Older Adults.

PubMed

Gustafson, David H; Maus, Adam; Judkins, Julianne; Dinauer, Susan; Isham, Andrew; Johnson, Roberta; Landucci, Gina; Atwood, Amy K

2016-01-14

What models can effectively guide the creation of eHealth and mHealth technologies? This paper describes the use of the NIATx model as a framework for the user-centered design of a new technology for older adults. The NIATx model is a simple framework of process improvement based on the following principles derived from an analysis of decades of research from various industries about why some projects fail and others succeed: (1) Understand and involve the customer; (2) fix key problems; (3) pick an influential change leader; (4) get ideas from outside the field; (5) use rapid-cycle testing. This paper describes the use of these principles in technology development, the strengths and challenges of using this approach in this context, and lessons learned from the process. Overall, the NIATx model enabled us to produce a user-focused technology that the anecdotal evidence available so far suggests is engaging and useful to older adults. The first and fourth principles were especially important in developing the technology; the fourth proved the most challenging to use.

Using the NIATx Model to Implement User-Centered Design of Technology for Older Adults

PubMed Central

Maus, Adam; Judkins, Julianne; Dinauer, Susan; Isham, Andrew; Johnson, Roberta; Landucci, Gina; Atwood, Amy K

2016-01-01

What models can effectively guide the creation of eHealth and mHealth technologies? This paper describes the use of the NIATx model as a framework for the user-centered design of a new technology for older adults. The NIATx model is a simple framework of process improvement based on the following principles derived from an analysis of decades of research from various industries about why some projects fail and others succeed: (1) Understand and involve the customer; (2) fix key problems; (3) pick an influential change leader; (4) get ideas from outside the field; (5) use rapid-cycle testing. This paper describes the use of these principles in technology development, the strengths and challenges of using this approach in this context, and lessons learned from the process. Overall, the NIATx model enabled us to produce a user-focused technology that the anecdotal evidence available so far suggests is engaging and useful to older adults. The first and fourth principles were especially important in developing the technology; the fourth proved the most challenging to use. PMID:27025985

Frailty Among Elderly Adults in a Rural Area of Turkey

PubMed Central

Çakmur, Hülya

2015-01-01

Background The elderly population is growing in Turkey, as it is worldwide. The average age of residents in rural areas of Turkey is relatively high and is gradually increasing. The purpose of this study is to summarize the fitness and frailty of elderly adults living in a rural area of Turkey characterized by a relatively low level of socioeconomic development. Material/Methods This study was designed as a prospective, cross-sectional study, and was conducted in a rural area of Kars Province. A total of 168 elderly adults (≥65 years old) from 12 central villages were included in the study. The Fried Frailty Criteria was used to assess the frailty of the participants. In addition to frailty, the physical, social, and mental status of elderly adults was examined. Results The prevalence of frailty in this rural area of Turkey was 7.1%. The study group ranged in age from 65 to 96 years (mean 72.70±7.73 years), and 53.6% were female. Among the elderly adult group, 84.3% had not completed elementary school, and 43.29% had a monthly income of ≤500 Turkish liras ($200). No significant relationship was identified between gender and frailty. There was a statistically significant relationship between frailty and older age, lower education level, lower economic level, co-morbidities, polypharmacy, diabetes, chronic obstructive pulmonary disease, gastric disease, arthritis, generalized pain, benign prostatic hyperplasia, urinary incontinence, auditory impairment, impaired oral care, caregiver burden, impaired cognitive function, depression, or a lack of social support (social isolation). Conclusions It is believed that this study will contribute considerably to understanding the health status and needs of elderly adults in Turkey and the health problems of this population as well as to planning the development of public health and geriatric services based on regional needs. PMID:25925800

Prospective study evaluating the use of nasal glucagon for the treatment of moderate to severe hypoglycaemia in adults with type 1 diabetes in a real‐world setting

PubMed Central

Seaquist, Elizabeth R.; Dulude, Hélène; Rabasa‐Lhoret, Remi; Tsoukas, George M.; Conway, James R.; Weisnagel, Stanley J.; Gerety, Gregg; Woo, Vincent C.; Zhang, Shuyu; Carballo, Dolorès; Pradhan, Sheetal; Piché, Claude A.; Guzman, Cristina B.

2018-01-01

In the present multicentre, open‐label, prospective, phase III study, we evaluated the real‐world effectiveness and ease of use of nasal glucagon (NG) in the treatment of moderate/severe hypoglycaemic events (HEs) in adults with type 1 diabetes (T1D). Patients and caregivers were taught how to use NG (3 mg) to treat moderate/severe HEs, record the time taken to awaken or return to normal status, and measure blood glucose (BG) levels over time. Questionnaires were used to collect information about adverse events and ease of use of NG. In the efficacy analysis population, 69 patients experienced 157 HEs. In 95.7% patients, HEs resolved within 30 minutes of NG administration. In all the 12 severe HEs, patients awakened or returned to normal status within 15 minutes of NG administration without additional external medical help. Most caregivers reported that NG was easy to use. Most adverse events were local and of low to moderate severity. In this study, a single, 3‐mg dose of NG demonstrated real‐life effectiveness in treating moderate and severe HEs in adults with T1D. NG was well tolerated and easy to use. PMID:29504662

Open-Label, Prospective Trial of Olanzapine in Adolescents with Subaverage Intelligence and Disruptive Behavioral Disorders

ERIC Educational Resources Information Center

Handen, Benjamin L.; Hardan, Antonio Y.

2006-01-01

Objective: Olanzapine, an atypical antipsychotic, has been shown to be efficacious for treatment of psychotic and mood disorders in adults. This prospective, open-label study was conducted to examine the safety and usefulness of olanzapine in treating disruptive behavior disorders in adolescents with subaverage intelligence. Method: Sixteen…

Expanding the Scope of Adult Education Curriculum in Nigeria: A Call for Emphasis on Adult Physical Education.

ERIC Educational Resources Information Center

Ojeme, E. O.

1988-01-01

The emphasis on adult education in Nigeria is designed to eliminate illiteracy and to ensure development of adult Nigerians by making education a lifelong process. This paper focuses on the concept of adult physical education to promote understanding, ramifications, and rationale for use in adult programs. (JOW)

Adiposity and risks of colorectal and small intestine cancer in Chinese adults: a prospective study of 0.5 million people.

PubMed

Pang, Yuanjie; Kartsonaki, Christiana; Guo, Yu; Chen, Yiping; Yang, Ling; Bian, Zheng; Bragg, Fiona; Millwood, Iona Y; Mao, Enke; Li, Yilei; Shi, Liya; Chen, Junshi; Li, Liming; Holmes, Michael V; Chen, Zhengming

2018-06-06

Uncertainty remains about the associations of adiposity with intestinal cancer in China and by its anatomical subtype. The prospective China Kadoorie Biobank recorded 3024 incident cases of colorectal (CRC) and 143 cases of small intestine (SIC) cancer during a 10-year follow-up among 509 568 participants without prior cancer at baseline. Cox regression was used to estimate adjusted hazard ratios (HRs) for specific cancers associated with adiposity. Overall mean body mass index (BMI) was 23.7  kg/m 2 . BMI was positively associated with CRC (HR per SD 1.10 [95% CI 1.06-1.14]), colon (1.13 [1.07-1.18]), and rectal (1.07 [1.02-1.13]) cancer. For waist circumference, the corresponding HRs per SD were 1.14 (1.10-1.18), 1.18 (1.13-1.24), and 1.11 (1.05-1.16), respectively. The adjusted HRs were somewhat greater in men than women. Adiposity was positively, but non-significantly, associated with SIC risk. Among relatively lean Chinese adults, adiposity was associated with risks of colon and rectal cancer, with the associations somewhat stronger in men than women.

Problems and Prospects in Foreign Language Computing.

ERIC Educational Resources Information Center

Pusack, James P.

The problems and prospects of the field of foreign language computing are profiled through a survey of typical implementation, development, and research projects that language teachers may undertake. Basic concepts in instructional design, hardware, and software are first clarified. Implementation projects involving courseware evaluation, textbook…

Exploring Prospective Teachers' Reflections in the Context of Conducting Clinical Interviews

ERIC Educational Resources Information Center

Taylan, Rukiye Didem

2018-01-01

This study investigated prospective mathematics teachers' reflections on the experience of designing and conducting one-to-one clinical interviews with middle school students in the context of an elective course on use of video in teacher learning. Prospective teachers were asked to write about weaknesses and strengths in student understanding as…

Childhood Origins of Young Adult Environmental Behavior.

PubMed

Evans, Gary W; Otto, Siegmar; Kaiser, Florian G

2018-05-01

Prospective, longitudinal analyses revealed that over a 12-year period from ages 6 to 18, individuals who grew up with mothers with more proenvironmental attitudes engaged in more proenvironmental behavior as young adults. A similar marginal association was uncovered between mothers' proenvironmental behaviors and the proenvironmental behavior of their young adult offspring. Maternal educational attainment, but not political ideology, was also associated with more proenvironmental behavior as children matured. Moreover, childhood time spent outdoors was positively associated with increased environmentally responsible behavior in young adulthood. Interestingly, one's own childhood proenvironmental behavior and attitude, at least as assessed at age 6, bear little on one's eventual proenvironmental behavior as a young adult. Finally, among this set of childhood factors, maternal education and childhood time spent outdoors were independent predictors of positive changes in environmental behavior from early childhood to young adulthood.

Physical and psychosocial aspects of adolescent and young adults after allogeneic hematopoietic stem-cell transplantation: results from a prospective multicenter trial.

PubMed

Pulewka, Kristin; Wolff, Daniel; Herzberg, Philipp Y; Greinix, Hildegard; Heussner, Pia; Mumm, Friederike H A; von Harsdorf, Stephanie; Rieger, Kathrin; Hemmati, Philipp; Hochhaus, Andreas; Hilgendorf, Inken

2017-08-01

Allogeneic hematopoietic stem-cell transplantation (alloHSCT) is physically and psychosocially demanding. Among transplant recipients, adolescent and young adults (AYA) represent a special group, as disease occurs early in life, resulting in the prospect of long survival time and high burden of alloHSCT sequelae. However, data focusing on AYA undergoing alloHSCT are rare. Data resulting from a prospective multicenter trial initially focusing on graft-versus-host disease (GvHD) after alloHSCT were reused to analyse the differences between AYA and elderly patients. In total, data of 205 alloHSCT recipients were evaluated. Patients completed the FACT-BMT, HAP, SF-36, 24-AM, LOT-R, BSSS, HADS, and GvHD questionnaires. Median age of AYA and non-AYA patients was 29 and 52 years. Using 24-AM-Test, evaluating personality traits, non-AYA reported to be more conscientious (p = 0.033). However, AYA described higher quality of life regarding physical role functioning (p = 0.001), physical functioning (p = 0.002), bodily pain (p = 0.023), and emotional role function (p = 0.027) in the SF-36. General health perception, vitality, social role functioning, and mental health were comparable among both groups. On HAP scale, AYA reported higher maximum (p = 0.003) and adjusted activity scores (p = 0.002), but showed similar restrictions regarding activity, self-supply, and self-determination. AYA represent a particular group characterized by higher physical well-being and activity scores, and significantly vary from non-AYA patients in psychosocial aspects. Studies covering distinctive features of AYA undergoing alloHSCT are warranted to improve awareness of the special needs of this group.

Childhood Abuse and Neglect and Adult Intimate Relationships: A Prospective Study

ERIC Educational Resources Information Center

Colman, R.A.; Widom, C.S.

2004-01-01

Objective:: The present study extends prior research on childhood maltreatment and social functioning by examining the impact of early childhood physical abuse, sexual abuse, and neglect on rates of involvement in adult intimate relationships and relationship functioning. Method:: Substantiated cases of child abuse and neglect from 1967 to 1971…

Prospective Teachers' Cognitive Constructs Concerning Ideal Teacher Qualifications: A Phenomenological Analysis Based on Repertory Grid Technique

ERIC Educational Resources Information Center

Kozikoglu, Ishak

2017-01-01

The aim of this study is to identify cognitive constructs of prospective teachers about ideal teacher qualifications. This study was designed as phenomenological pattern which is one of the qualitative research designs. The study was conducted with 36 prospective teachers selected from Yüzüncü Yil University, Faculty of Education. The study group…

Brain Gray Matter Deficits at 33-Year Follow-Up in Adults with Attention-Deficit/Hyperactivity Disorder Established in Childhood

PubMed Central

Proal, Erika; Reiss, Philip T.; Klein, Rachel G.; Mannuzza, Salvatore; Gotimer, Kristin; Ramos-Olazagasti, Maria A.; Lerch, Jason P.; He, Yong; Zijdenbos, Alex; Kelly, Clare; Milham, Michael P.; Castellanos, F. Xavier

2013-01-01

Context Volumetric studies have reported relatively decreased cortical thickness and gray matter volumes in adults with Attention-Deficit/Hyperactivity Disorder (ADHD) whose childhood status was retrospectively recalled. We present the first prospective study combining cortical thickness and voxel-based morphometry (VBM) in adults diagnosed with ADHD in childhood. Objective In adults who had Combined Type ADHD in childhood, to 1) test whether they exhibit cortical thinning and decreased gray matter in regions hypothesized related to ADHD, and 2) test whether anatomic differences are associated with current ADHD diagnosis, including persistence versus remission. Design Cross-sectional analysis embedded in a 33-year prospective follow-up at mean age 41. Setting Research outpatient center. Participants ADHD probands were from a cohort of 207 6–12 year old Caucasian boys; male comparison subjects (n=178) had been free of ADHD in childhood. We obtained MRI scans in 59 probands and 80 comparisons (28% and 45% of original samples, respectively). Main Outcome Measure Whole-brain VBM and vertex-wise cortical thickness analyses. Results Cortex was significantly thinner in ADHD probands than comparisons in the dorsal attentional network and limbic areas (FDR<0.05, corrected). Additionally, gray matter was significantly decreased in probands in right caudate, right thalamus and bilateral cerebellar hemispheres. Probands with persistent ADHD (n=17) did not differ significantly from remitters (n=26) at FDR<0.05. At uncorrected p<0.05, remitters had thicker cortex relative to those with persistent ADHD in medial occipital cortex, insula, parahippocampus, and prefrontal regions. Conclusions We observed anatomic gray matter reductions in adults with childhood ADHD, regardless of current diagnosis. The most affected regions underpin top-down control of attention and regulation of emotion and motivation. Exploratory analyses suggest that diagnostic remission may result from

Changes in Waist Circumference among German Adults over Time – Compiling Results of Seven Prospective Cohort Studies

PubMed Central

Haftenberger, Marjolein; Mensink, Gert B.M.; Vogt, Susanne; Thorand, Barbara; Peters, Annette; Herzog, Beatrice; Hartwig, Saskia; Greiser, Karin Halina; Ittermann, Till; Schipf, Sabine; Völzke, Henry; Merz, Benedikt; Nöthlings, Ute; Koch, Manja; Neamat-Allah, Jasmine; Katzke, Verena; Kaaks, Rudolf; Boeing, Heiner; Bachlechner, Ursula; Scheidt-Nave, Christa; Schienkiewitz, Anja

2016-01-01

Aim This study aims to quantify longitudinal changes in waist circumference (WC) among adults aged 45–64 years in Germany. Methods Data of 15,444 men and 17,207 women from one nationwide and six regional prospective German cohort studies were analyzed. The sex-specific mean change in WC per year of follow-up was assessed for each study separately. Findings from the cohort-by-cohort analysis were combined by applying meta-analytic methods. Progression to central obesity (WC ≥ 102 cm in men and ≥ 88 cm in women) within a standardized period of 10 years was described for each study. Results The estimated mean change in WC per year of follow-up for all cohorts combined was 0.53 (95s% confidence interval 0.29–0.76) cm/year for men and 0.63 (0.48–0.77) cm/year for women, but varied between the included studies. Within 10 years, about 20s% of individuals with low WC (<94 cm in men; <80 cm in women) and about 50s% of individuals with intermediate WC (94–102 cm in men; 80–88 cm in women) progressed to central obesity. Conclusion The increase in mean WC with aging along with a profound increase of central adiposity is obviously and may have several adverse health effects. Obesity prevention programs should also focus on abdominal obesity. PMID:27701174

An instrument measuring prospective mathematics teacher self-regulated learning: validity and reliability

NASA Astrophysics Data System (ADS)

Nugroho, A. A.; Juniati, D.; Siswono, T. Y. E.

2018-03-01

Self Regulated Learning (SRL) is an individual's ability to achieve academic goals by controlling behavior, motivate yourself and use cognitive in learning, so it is important for a teacher especially teachers of mathematics related to the ability of management, design, implementation of learning and evaluation of learning outcomes. The purpose of the research is to develop an instrument to describe the SRL of a prospective mathematics teacher. Data were collected by (1) the study of the theory of SRL produced the indicator SRL used to design the questionnaire SRL; (2) analysis of the questionnaire SRL obtained from several References; and (3) development stage of the SRL questionnaire through validity test of content and empirical validation. The study involved 2 content experts in mathematics, 1 linguist, and 92 prospective mathematics teachers. The results of the research on content validity test based on Indonesian expert and 2 content experts indicate that the content can assess the indicator of the SRL and feasible to be used, in the test of legibility of two prospective mathematics teacher concluded that the instrument has a language that can be understood by the prospective teacher of mathematics and on empirical validation involving 92 prospective mathematics teacher generate data that of 65 statements there are 3 invalid statements. Reliability calculation shows high category that values 0,93. The conclusion is the SRL instrument developed for the prospective mathematics teacher.

Natural Mentoring Processes Deter Externalizing Problems Among Rural African American Emerging Adults: A Prospective Analysis

PubMed Central

Kogan, Steven M.; Brody, Gene H.; Chen, Yi-fu

2011-01-01

A 3-wave model linking natural mentoring relationships to externalizing behavior was tested with 345 rural African American emerging adults in their final year of high school. Structural equation models were executed linking multi-informant reports of mentor-emerging adult relationship quality with youths’ externalizing behavior 18 months later. Consistent with our primary hypotheses, emerging adults whose relationships with their natural mentors were characterized by instrumental and emotional support and affectively positive interactions reported lower levels of anger, rule-breaking behavior, and aggression. These effects emerged independent of the influences of family support and youth gender. Two intrapersonal processes, a future orientation and self-regulation, emerged as mediators of the influence of natural mentoring relationships. The influence of natural mentors was most pronounced for emerging adults experiencing high levels of life stress. PMID:21293917

Nonrhabdomyosarcoma soft tissue sarcoma (NRSTS) in pediatric and young adult patients: Results from a prospective study using limited-margin radiotherapy.

PubMed

Tinkle, Christopher L; Fernandez-Pineda, Israel; Sykes, April; Lu, Zhaohua; Hua, Chia-Ho; Neel, Michael D; Bahrami, Armita; Shulkin, Barry L; Kaste, Sue C; Pappo, Alberto; Spunt, Sheri L; Krasin, Matthew J

2017-11-15

Indications for and delivery of adjuvant therapies for pediatric nonrhabdomyosarcoma soft tissue sarcoma (NRSTS) have been derived largely from adult studies; therefore, significant concern remains regarding radiation exposure to normal tissue. The authors report long-term treatment outcomes and toxicities for pediatric and young adult patients with high-grade NRSTS who were treated on a prospective trial using limited-margin radiotherapy. Sixty-two patients (ages 3-22 years) with predominantly high-grade NRSTS requiring radiation were treated on a phase 2 institutional study of conformal external-beam radiotherapy and/or brachytherapy using a 1.5-cm to 2-cm anatomically constrained margin. The estimated cumulative incidence of local failure, Gray's method estimated cumulative incidence of local failure, Kaplan-Meier method estimated survival, competing-risk regression model determined predictors of disease outcome, and toxicity was reported according to CTCAE v2.0. At a median follow-up of 5.1 years (range, 0.2-10.9 years), 9 patients had experienced local failure. The 5-year overall cumulative incidence of local failure was 14.8% (95% confidence interval [CI], 7.2%-25%), and all but 1 local failure occurred outside the highest-dose irradiation volume. The 5-year Kaplan-Meier estimates for event-free and overall survival were 49.3% (95% CI, 36.3%-61.1%) and 67.9% (95% CI, 54.2%-78.3%), respectively. Multivariable analysis indicated that younger age was the only independent predictor of local recurrence (P = .004). The 5-year cumulative incidence of grade 3 or 4 late toxicity was 15% (95% CI, 7.2%-25.3%). The delivery of limited-margin radiotherapy using conformal external-beam radiotherapy or brachytherapy provides a high rate of local tumor control without an increase in marginal failures and with acceptable treatment-related morbidity. Cancer 2017;123:4419-29. © 2017 American Cancer Society. © 2017 American Cancer Society.

Do commonly used frailty models predict mortality, loss of autonomy and mental decline in older adults in northwestern Russia? A prospective cohort study.

PubMed

Turusheva, Anna; Frolova, Elena; Korystina, Elena; Zelenukha, Dmitry; Tadjibaev, Pulodjon; Gurina, Natalia; Turkeshi, Eralda; Degryse, Jean-Marie

2016-05-09

Frailty prevalence differs across countries depending on the models used to assess it that are based on various conceptual and operational definitions. This study aims to assess the clinical validity of three frailty models among community-dwelling older adults in north-western Russia where there is a higher incidence of cardiovascular disease and lower life expectancy than in European countries. The Crystal study is a population-based prospective cohort study in Kolpino, St. Petersburg, Russia. A random sample of the population living in the district was stratified into two age groups: 65-75 (n = 305) and 75+ (n = 306) and had a baseline comprehensive health assessment followed by a second one after 33.4 +/-3 months. The total observation time was 47 +/-14.6 months. Frailty was assessed according to the models of Fried, Puts and Steverink-Slaets. Its association with mortality at 5 years follow-up as well as dependency, mental and physical decline at around 2.5 years follow up was explored by multivariable and time-to-event analyses. Mortality was predicted independently from age, sex and comorbidities only by the frail status of the Fried model in those over 75 years old [HR (95 % CI) = 2.50 (1.20-5.20)]. Mental decline was independently predicted only by pre-frail [OR (95 % CI) = 0.24 (0.10-0.55)] and frail [OR (95 % CI) = 0.196 (0.06-0.67)] status of Fried model in those 65-75 years old. The prediction of dependency and physical decline by pre-frail and frail status of any the three frailty models was not statistically significant in this cohort of older adults. None of the three frailty models was valid at predicting 5 years mortality and disability, mental and physical decline at 2.5 years in a cohort of older adults in north-west Russia. Frailty by the Fried model had only limited value for mortality in those 75 years old and mental decline in those 65-75 years old. Further research is needed to identify valid frailty markers for older adults in this

Early Adult Outcomes of Adolescents Who Deliberately Poisoned Themselves

ERIC Educational Resources Information Center

Harrington, Richard; Pickles, Andrew; Aglan, Azza; Harrington, Val; Burroughs, Heather; Kerfoot, Michael

2006-01-01

Objective: To describe the early adult psychopathological and social outcomes of adolescents who deliberately poisoned themselves. Method: Prospective cohort study with a 6-year follow-up of 132 of 158 (84%) adolescents who, between ages 11 and 16 years, had taken part in a randomized trial of a brief family intervention after deliberate…

Prospective Elementary Teachers' Analysis of Children's Science Talk in an Undergraduate Physics Course

ERIC Educational Resources Information Center

Harlow, Danielle B.; Swanson, Lauren H.; Otero, Valerie K.

2014-01-01

We investigated how prospective teachers used physics content knowledge when analyzing the talk of elementary children during special activities in an undergraduate physics content course designed for prospective teachers. We found that prospective teachers used content knowledge to reflect on their own learning and to identify students'…

Long-term outcome after arterial ischemic stroke in children and young adults.

PubMed

Goeggel Simonetti, Barbara; Cavelti, Ariane; Arnold, Marcel; Bigi, Sandra; Regényi, Mária; Mattle, Heinrich P; Gralla, Jan; Fluss, Joel; Weber, Peter; Hackenberg, Annette; Steinlin, Maja; Fischer, Urs

2015-05-12

To compare long-term outcome of children and young adults with arterial ischemic stroke (AIS) from 2 large registries. Prospective cohort study comparing functional and psychosocial long-term outcome (≥2 years after AIS) in patients who had AIS during childhood (1 month-16 years) or young adulthood (16.1-45 years) between January 2000 and December 2008, who consented to follow-up. Data of children were collected prospectively in the Swiss Neuropediatric Stroke Registry, young adults in the Bernese stroke database. Follow-up information was available in 95/116 children and 154/187 young adults. Median follow-up of survivors was 6.9 years (interquartile range 4.7-9.4) and did not differ between the groups (p = 0.122). Long-term functional outcome was similar (p = 0.896): 53 (56%) children and 84 (55%) young adults had a favorable outcome (modified Rankin Scale 0-1). Mortality in children was 14% (13/95) and in young adults 7% (11/154) (p = 0.121) and recurrence rate did not differ (p = 0.759). Overall psychosocial impairment and quality of life did not differ, except for more behavioral problems among children (13% vs 5%, p = 0.040) and more frequent reports of an impact of AIS on everyday life among adults (27% vs 64%, p < 0.001). In a multivariate regression analysis, low Pediatric NIH Stroke Scale/NIH Stroke Scale score was the most important predictor of favorable outcome (p < 0.001). There were no major differences in long-term outcome after AIS in children and young adults for mortality, disability, quality of life, psychological, or social variables. © 2015 American Academy of Neurology.

Statin Use and Hospital Length of Stay Among Adults Hospitalized With Community-acquired Pneumonia.

PubMed

Havers, Fiona; Bramley, Anna M; Finelli, Lyn; Reed, Carrie; Self, Wesley H; Trabue, Christopher; Fakhran, Sherene; Balk, Robert; Courtney, D Mark; Girard, Timothy D; Anderson, Evan J; Grijalva, Carlos G; Edwards, Kathryn M; Wunderink, Richard G; Jain, Seema

2016-06-15

Prior retrospective studies suggest that statins may benefit patients with community-acquired pneumonia (CAP) due to antiinflammatory and immunomodulatory effects. However, prospective studies of the impact of statins on CAP outcomes are needed. We determined whether statin use was associated with improved outcomes in adults hospitalized with CAP. Adults aged ≥18 years hospitalized with CAP were prospectively enrolled at 3 hospitals in Chicago, Illinois, and 2 hospitals in Nashville, Tennessee, from January 2010-June 2012. Adults receiving statins before and throughout hospitalization (statin users) were compared with those who did not receive statins (nonusers). Proportional subdistribution hazards models were used to examine the association between statin use and hospital length of stay (LOS). In-hospital mortality was a secondary outcome. We also compared groups matched on propensity score. Of 2016 adults enrolled, 483 (24%) were statin users; 1533 (76%) were nonusers. Statin users were significantly older, had more comorbidities, had more years of education, and were more likely to have health insurance than nonusers. Multivariable regression demonstrated that statin users and nonusers had similar LOS (adjusted hazard ratio [HR], 0.99; 95% confidence interval [CI], .88-1.12), as did those in the propensity-matched groups (HR, 1.03; 95% CI, .88-1.21). No significant associations were found between statin use and LOS or in-hospital mortality, even when stratified by pneumonia severity. In a large prospective study of adults hospitalized with CAP, we found no evidence to suggest that statin use before and during hospitalization improved LOS or in-hospital mortality. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Effectiveness of one-year pharmacological treatment of adult attention-deficit/hyperactivity disorder (ADHD): an open-label prospective study of time in treatment, dose, side-effects and comorbidity.

PubMed

Fredriksen, Mats; Dahl, Alv A; Martinsen, Egil W; Klungsøyr, Ole; Haavik, Jan; Peleikis, Dawn E

2014-12-01

How to generalize from randomized placebo controlled trials of ADHD drug treatment in adults to 'real-world' clinical practice is intriguing. This open-labeled prospective observational study examined the effectiveness of long-term stimulant and non-stimulant medication in adult ADHD including dose, side-effects and comorbidity in a clinical setting. A specialized ADHD outpatient clinic gave previously non-medicated adults (n=250) with ADHD methylphenidate as first-line drug according to current guidelines. Patients who were non-tolerant or experiencing low efficacy were switched to amphetamine or atomoxetine. Primary outcomes were changes of ADHD-symptoms evaluated with the Adult ADHD Self-Report Scale (ASRS) and overall severity by the Global Assessment of Functioning (GAF). Secondary outcomes were measures of mental distress, and response on the Clinical-Global-Impressions-Improvement Scale. Data at baseline and follow-ups were compared in longitudinal mixed model analyses for time on-medication, dosage, comorbidity, and side-effects. As results, 232 patients (93%) completed examination at the 12 month endpoint, and 163 (70%) remained on medication. Compared with the patients who discontinued medication, those still on medication had greater percentage reduction in ASRS-scores (median 39%, versus 13%, P<0.001) and greater improvement of GAF (median 20% versus 4%, P<0.001) and secondary outcomes. Continued medication and higher cumulated doses showed significant associations to sustained improvement. Conversely, psychiatric comorbidity and side-effects were related to lower effectiveness and more frequent termination of medication. Taken together, one-year treatment with stimulants or atomoxetine was associated with a clinically significant reduction in ADHD symptoms and mental distress, and improvement of measured function. No serious adverse events were observed. Copyright © 2014 Elsevier B.V. and ECNP. All rights reserved.

Greenness and job-related chronic stress in young adults: a prospective cohort study in Germany

PubMed Central

Herrera, Ronald; Markevych, Iana; Berger, Ursula; Gerlich, Jessica; Nowak, Dennis; Schlotz, Wolff; Vogelberg, Christian; von Mutius, Erika; Weinmayr, Gudrun; Windstetter, Doris; Weigl, Matthias; Heinrich, Joachim; Radon, Katja

2018-01-01

Objectives We aimed to prospectively study the association between normalised difference vegetation index (NDVI) as a measure of greenness around homes and occupational stress. Setting A population-based cohort in Munich and Dresden cities was followed from age 16–18 years to age 20–23 years (n=1632). Participants At baseline, all participants attended high-school while at follow-up some had started working and others studying at university. At baseline and in each follow-up, we assigned NDVI based on participants’ residential geocoded addresses and categorised it by quartiles. Outcome measures School-related, university-related or job-related self-reported chronic stress was assessed at the two follow-ups by the Trier Scale for Assessment of Chronic Stress using work discontent and work overload as outcomes. We modelled the association employing ordinal generalised estimating equations model accounting for changes in sociodemographics, non-job-related stress, job history and environmental covariates. Stratified analysis by each city was performed. Results NVDI at baseline was higher for participants from Dresden (median=0.36; IQR 0.31–0.41) than Munich (0.31; 0.26–0.34). At follow-up, it decreased only for participants in Dresden (0.34; 0.30–0.40). Higher greenness (quartile 4 vs quartile 1) was associated with less work discontent (OR 0.89; 95% CI 0.80 to 0.99) and less work overload (OR 0.87; 95% CI 0.78 to 0.96). In stratified analyses, results were more consistent for Munich than for Dresden. Conclusions Our results suggest that residential green spaces, using the vegetation index as a proxy for exposure, are inversely associated with two types of job-related chronic stress in German young adults transitioning from school to university or working life. PMID:29866734

Aerodigestive Foreign Bodies in Adult Ethiopian Patients: A Prospective Study at Tikur Anbessa Hospital, Ethiopia

PubMed Central

Bekele, Abebe

2014-01-01

Introduction. Foreign bodies (FBs) in the aerodigestive tract are important causes of morbidity and mortality and pose diagnostic and therapeutic challenges. The best method of removal of an esophageal and tracheobronchial FB is endoscopic guided extraction. Objective. To present our experience of the removal of aerodigestive FBs in adult Ethiopian patients using rigid endoscopes. Methods. A hospital-based prospective study, at Tikur Anbessa Referral and Teaching Hospital, from January 2011 to December 2012 (over two years). Results. A total of 32 patients (18 males and 14 females) with a mean age of 28.0 ± 12.74 years were treated for FB ingestion and aspiration at Tikur Anbessa Hospital. The FBs were impacted at the esophagus in 18 (56.2%) patients, at the pharynx in 7 (21.8%), and at the air way in 7 (21.8%) patients. Pieces of bones were the commonest objects found in the esophagus (17/18 of the cases) and the pharynx (4/7), while fractured tracheostomy tubes and needles were frequently seen in the air way (3/7 cases each). The foreign bodies were visible in plain radiographs of 26 (81.2%) patients. Successful extraction of FBs was achieved by using Mc gill forceps in 11 cases, rigid esophagoscopes in 9 patients, and bronchoscopes in 4 cases. Four cases required open surgery to remove the foreign bodies. Two complications (one pneumothorax and one esophageal perforation) occurred. All patients were discharged cured. Discussion and Recommendations. Aerodigestive FBs are not so rare in the hospital and timely diagnosis and removal of accidentally ingested and aspirated foreign body should be performed so as to avoid the potentially lethal complications associated. Rigid esophagoscopy requires general anesthesia and is associated with its own complications, but our experience and outcome of its use are encouraging. PMID:24834074

Cannabis use and adult ADHD symptoms.

PubMed

Fergusson, David M; Boden, Joseph M

2008-05-01

The present study examined the associations between cannabis use in adolescence and young adulthood and self-reported adult attention deficit/hyperactivity disorder (ADHD) symptoms in adulthood. A 25-year prospective longitudinal study of the health, development, and adjustment of a birth cohort of 1265 New Zealand children. Measures included assessments of adolescent and young adult cannabis use and ADHD symptoms at age 25, measures of childhood socioeconomic disadvantage, family adversity, childhood and early adolescent behavioural adjustment and cognitive ability, and adolescent and young adult other drug use. Cannabis use by age 25 was significantly (p<.0001) associated with increasing self-reported adult ADHD symptoms at age 25. Adjustment of the association for potentially confounding factors from childhood and early adolescence reduced the magnitude of the association, but it remained statistically significant (p<.0001). However, control for the mediating effects of other drug use in adolescence and early adulthood reduced the association between cannabis use and adult ADHD symptoms to statistical non-significance (p>.20). The current study suggested that the association between cannabis use and adult ADHD symptoms was mediated by other substance use that was associated with cannabis use. The results suggest that cannabis use leads to other drug use, which in turn leads to increased ADHD symptoms. However, it should be noted that the potential influence of such factors as genetic predispositions may still be unaccounted for.

Assessment Tools for Adult Education.

ERIC Educational Resources Information Center

Shefrin, Carol; Shafer, Dehra; Forlizzi, Lori

The Assessment Tools for Adult Education project was designed to provide training and support to staff of the Pennsylvania Bureau of Adult Basic and Literacy Education (ABLE) funded programs to help them use assessment tools and procedures to document the learning gains of the adult students they serve. The following candidate assessment…

Participatory Design of Learning Media: Designing Educational Computer Games with and for Teenagers

ERIC Educational Resources Information Center

Danielsson, Karin; Wiberg, Charlotte

2006-01-01

This paper reports on how prospective users may be involved in the design of entertaining educational computer games. The paper illustrates an approach, which combines traditional Participatory Design methods in an applicable way for this type of design. Results illuminate the users' important contribution during game development, especially when…

An inherited genetic variant in CEP72 promoter predisposes to vincristine-induced peripheral neuropathy in adults with acute lymphoblastic leukemia

PubMed Central

Stock, Wendy; Diouf, Barthelemy; Crews, Kristine R.; Pei, Deqing; Cheng, Cheng; Laumann, Kristina; Mandrekar, Sumithra J.; Luger, Selina; Advani, Anjali; Stone, Richard M.; Larson, Richard A.; Evans, William E.

2016-01-01

Peripheral neuropathy is a major toxicity of vincristine, yet no strategies exist for identifying at-risk adult patients. We used a case-control design of 48 adults receiving protocol therapy for acute lymphoblastic leukemia (ALL) who developed vincristine-induced neuropathy (NCI Grade 2-4) during treatment, and 48 matched controls who did not develop grade 2-4 neuropathy. Peripheral neuropathy was prospectively graded by NCI criteria. CEP72 promoter genotype (rs924607) was determined using PCR based SNP genotyping. Frequency of the CEP72 T/T genotype was higher in cases (31% vs 10%, p=0.0221) and the incidence of vincristine-induced neuropathy (grades 2-4) was significantly higher in patients homozygous for the CEP72 T/T genotype. 75% of the 20 patients homozygous for the CEP72 T allele developed grade 2-4 neuropathy, compared to 44% of patients with CEP72 CC or CT genotype (p=0.0221). The CEP72 polymorphism can identify adults at increased risk of vincristine-induced peripheral neuropathy. PMID:27618250

Prospective observational studies to assess comparative effectiveness: the ISPOR good research practices task force report.

PubMed

Berger, Marc L; Dreyer, Nancy; Anderson, Fred; Towse, Adrian; Sedrakyan, Art; Normand, Sharon-Lise

2012-01-01

In both the United States and Europe there has been an increased interest in using comparative effectiveness research of interventions to inform health policy decisions. Prospective observational studies will undoubtedly be conducted with increased frequency to assess the comparative effectiveness of different treatments, including as a tool for "coverage with evidence development," "risk-sharing contracting," or key element in a "learning health-care system." The principle alternatives for comparative effectiveness research include retrospective observational studies, prospective observational studies, randomized clinical trials, and naturalistic ("pragmatic") randomized clinical trials. This report details the recommendations of a Good Research Practice Task Force on Prospective Observational Studies for comparative effectiveness research. Key issues discussed include how to decide when to do a prospective observational study in light of its advantages and disadvantages with respect to alternatives, and the report summarizes the challenges and approaches to the appropriate design, analysis, and execution of prospective observational studies to make them most valuable and relevant to health-care decision makers. The task force emphasizes the need for precision and clarity in specifying the key policy questions to be addressed and that studies should be designed with a goal of drawing causal inferences whenever possible. If a study is being performed to support a policy decision, then it should be designed as hypothesis testing-this requires drafting a protocol as if subjects were to be randomized and that investigators clearly state the purpose or main hypotheses, define the treatment groups and outcomes, identify all measured and unmeasured confounders, and specify the primary analyses and required sample size. Separate from analytic and statistical approaches, study design choices may strengthen the ability to address potential biases and confounding in

Questions Industrial Prospects Most Often Ask about A Rural Community. Circular CRD-20.

ERIC Educational Resources Information Center

Lee, V. Wilson

Designed to help industrial development teams be prepared to promptly and accurately answer any questions industrial prospects might have, this publication provides a listing of 441 questions which industrial prospects might ask. The questions are grouped into 16 categories: community government (27), local services (18), population (18),…

Prospective Special Education Teachers' Metaphorical Perceptions on the Concept of Special Education Teacher

ERIC Educational Resources Information Center

Deniz, Levent

2016-01-01

The aim of this research is to define the perceptions of prospective special education teachers regarding special education teacher through metaphors. Phenomenology design was used in this research. The study group comprised 116 third year prospective special education teachers studying at Marmara University, Ataturk Faculty of Education, Special…

Adults Need D.E. Too.

ERIC Educational Resources Information Center

Moorman, Jerry Wayne

This handbook for the distributive education coordinator was designed to provide information on adult distributive education (D.E.) and to outline the necessary steps in establishing and conducting an adult program. It begins with an introduction which lists the intrinsic values of adult D.E. and the advantages that these programs offer to the…

Functional Impairment in Adult Sleepwalkers: A Case-Control Study

PubMed Central

Lopez, Regis; Jaussent, Isabelle; Scholz, Sabine; Bayard, Sophie; Montplaisir, Jacques; Dauvilliers, Yves

2013-01-01

Study Objectives: To investigate the restorative quality of sleep and daytime functioning in sleepwalking adult patients in comparison with controls. Design: Prospective case-control study. Setting: Data were collected at the Sleep Disorders Center, Hôpital-Gui-de Chauliac, Montpellier, France between June 2007 and January 2011. Participants: There were 140 adult sleepwalkers (100 (median age 30 y, 55% male) in whom primary SW was diagnosed) who underwent 1 night of video polysomnography. All patients participated in a standardized clinical interview and completed a battery of questionnaires to assess clinical characteristics of parasomnia, daytime sleepiness, fatigue, insomnia, depressive and anxiety symptoms, and health-related quality of life. Results were compared with those of 100 sex- and age-matched normal controls. Interventions: N/A. Measurements and Results: Of the sleepwalkers, 22.3% presented with daily episodes and 43.5% presented with weekly episodes. Median age at sleepwalking onset was 9 y. Familial history of sleepwalking was reported in 56.6% of sleepwalkers and violent sleep related behaviors in 57.9%, including injuries requiring medical care for at least one episode in 17%. Significant associations were found between sleepwalking and daytime sleepiness, fatigue, insomnia, depressive and anxiety symptoms, and altered quality of life. Early-onset sleepwalkers had higher frequency of violent behaviors and injuries. Sleepwalkers with violent behaviors had higher frequency of sleep terrors and triggering factors, with greater alteration in health-related quality of life. Conclusion: Adult sleepwalking is a potentially serious condition that may induce violent behaviors, self-injury or injury to bed partners, sleep disruption, excessive daytime sleepiness, fatigue, and psychological distress, all of which affect health-related quality of life. Citation: Lopez R; Jaussent I; Scholz S; Bayard S; Montplaisir J; Dauvilliers Y. Functional impairment in

Safety of discontinuing cotrimoxazole prophylaxis among HIV infected adults on anti-retroviral therapy in Uganda (COSTOP trial): Design.

PubMed

Anywaine, Zacchaeus; Abaasa, Andrew; Levin, Jonathan; Kasirye, Ronnie; Kamali, Anatoli; Grosskurth, Heiner; Munderi, Paula; Nunn, Andrew

2015-07-01

Cotrimoxazole (CTX) prophylaxis is recommended by the World Health Organisation for HIV infected persons. However, once HIV infected patients have commenced ART in resource limited settings, the benefits of continued CTX prophylaxis are not known. The few studies that investigated the safety of discontinuing CTX prophylaxis in these settings had limitations due to their design. COSTOP is a randomised double blind placebo controlled non-inferiority trial among HIV infected Ugandan adults stabilised on anti-retroviral treatment (ART). Participants with CD4 count of 250 or more cells/mm(3) are randomised to two arms: the intervention arm in which CTX is discontinued and the control arm in which CTX prophylaxis is continued. The study aims to assess whether the intervention regimen is not inferior, with respect to the incidence of pre-defined CTX-preventable events, to the control regimen and superior with respect to the incidence of haematological adverse events. Studies that have previously evaluated the safety of discontinuing CTX prophylaxis among HIV infected adults in resource limited settings have provided moderate to low quality evidence owing in part to methodological limitations. COSTOP is designed and conducted with sufficient rigour to answer this question. The results of the trial will assist in guiding policy recommendations. This paper describes the design and methodological considerations important for the conduct of CTX cessation studies. Copyright © 2015. Published by Elsevier Inc.

Sinking or Swimming: Findings from a Survey of State Adult Education Tuition and Financing Policies

ERIC Educational Resources Information Center

Foster, Marcie

2012-01-01

At no time in recent history has the importance of adult education been greater and the funding more threatened. Despite the fact that as many as 93 million adults in the U.S. may need basic skills services to improve their economic prospects, funding for these services is stagnating at the federal level and being slashed in statehouses and state…

Maintaining Healthy Behavior: A Prospective Study of Psychological Well-Being and Physical Activity

PubMed Central

Kim, Eric S.; Kubzansky, Laura D.; Soo, Jackie; Boehm, Julia K.

2016-01-01

Background Although higher psychological well-being has been linked with a range of positive biological processes and health outcomes, the prospective association between psychological well-being and physical activity among older adults has been understudied. Purpose We tested whether higher baseline psychological well-being predicted higher levels of physical activity over time. Methods Prospective data were from the English Longitudinal Study of Ageing, a nationally representative sample of English adults over the age of 50. Our sample included 9,986 adults who were assessed up to six times across an average of 11 years. Results After adjusting for sociodemographic factors, each standard deviation increase in baseline psychological well-being was associated with higher median physical activity in linear regression models that examined physical activity across all six waves (β=0.20; 95% confidence interval [CI]: 0.18–0.21) and in linear mixed effect models that examined repeated measures of physical activity over the entire follow-up period (β=0.20; 95% CI: 0.19–0.21). Further, higher baseline psychological well-being was associated with a slower rate of decline in physical activity among people who were active at baseline (hazard ratio [HR]=0.79, 95% CI: 0.76–0.82) and increasing physical activity among people who were inactive at baseline (HR=1.28, 95% CI: 1.22–1.35). Findings were maintained after adjusting for baseline health status and depression. Conclusions Psychological well-being was independently associated with attaining and maintaining higher physical activity levels over 11 years, suggesting that it may be a valuable target for interventions aimed at helping older adults acquire more physical activity. PMID:27822613

Retaining the Learning Disabled Adult. A Handbook for Adult Basic Education Instructors.

ERIC Educational Resources Information Center

Hawkins, Diane, Comp.

This handbook is designed to address teachers' most common concerns about learning disabilities (LDs) and teaching adults with LDs. Section 1 defines LDs by describing traits that adults with LDs share. Section 2 focuses on identification of students with LDs. LD characteristics are divided into eight categories: academics, speech/language, motor…

Comparative Long-Term Effectiveness of a Monotherapy with Five Antiepileptic Drugs for Focal Epilepsy in Adult Patients: A Prospective Cohort Study

PubMed Central

Zhu, Pan; He, Ru-Qian; Bao, Yi-Xin; Zheng, Rong-Yuan; Xu, Hui-Qin

2015-01-01

Objective To evaluate and compare long-term effectiveness of five antiepileptic drugs (AEDs) for monotherapy of adult patients with focal epilepsy in routine clinical practice. Methods Adult patients with focal epilepsy, who were prescribed with carbamazepine (CBZ), valproate (VPA), lamotrigine (LTG), topiramate (TPM), or oxcarbazepine (OXC) as monotherapy, during the period from January 2004 to June 2012 registered in Wenzhou Epilepsy Follow Up Registry Database (WEFURD), were included in the study. Prospective long-term follow-up was conducted until June 2013. The endpoints were time to treatment failure, time to seizure remission, and time to first seizure. Results This study included 654 patients: CBZ (n=125), VPA (n=151), LTG (n=135), TPM (n=76), and OXC (n=167). The retention rates of CBZ, VPA, LTG, TPM, and OXC at the third year were 36.1%, 32.4%, 57.6%, 37.9%, and 41.8%, respectively. For time to treatment failure, LTG was significantly better than CBZ and VPA (LTG vs. CBZ, hazard ratio, [HR] 0.80 [95% confidence interval: 0.67-0.96], LTG vs. VPA, 0.53 [0.37-0.74]); TPM was worse than LTG (TPM vs. LTG, 1.77 [1.15-2.74]), and OXC was better than VPA (0.86 [0.78-0.96]). After initial target doses, the seizure remission rates of CBZ, VPA, LTG, TPM, and OXC were 63.0%, 77.0%, 83.6%, 67.9%, and 75.3%, respectively. LTG was significantly better than CBZ (1.44 [1.15-1.82]) and OXC (LTG vs. OXC, 0.76 [0.63-0.93]); OXC was less effective than LTG in preventing the first seizure (1.20 [1.02-1.40]). Conclusion LTG was the best, OXC was better than VPA only, while VPA was the worst. The others were equivalent for comparisons between five AEDs regarding the long-term treatment outcomes of monotherapy for adult patients with focal epilepsy in a clinical practice. For selecting AEDs for these patients among the first-line drugs, LTG is an appropriate first choice; others are reservation in the first-line but VPA is not. PMID:26147937

Management of refractory status epilepticus in adults

PubMed Central

Rossetti, Andrea O.; Lowenstein, Daniel H.

2011-01-01

Summary Refractory status epilepticus (RSE) can be defined as status epilepticus that continues despite treatment with benzodiazepines and one antiepileptic drug. RSE should be treated promptly to prevent morbidity and mortality; however, scarce evidence is available to support the choice of specific treatments. Major independent outcome predictors are age (not modifiable) and etiology (that should be actively targeted). Recent recommendations for adults, relying upon limited evidence, suggest that RSE treatment aggressiveness should be tailored to the clinical situation: to minimize ICU-related complications, focal RSE without major consciousness impairment might initially be approached more conservatively; conversely, early induction of pharmacological coma is advisable in generalized-convulsive forms. At this stage, midazolam, propofol or barbiturates represent the most used alternatives. Several other treatments, such as additional anesthetics, other antiepileptic or immunomodulatory compounds, or non-pharmacological approaches (electroconvulsive treatment, hypothermia), have been used in protracted RSE. Treatment lasting weeks or months may sometimes result in a good outcome, as in selected cases after cerebral anoxia and encephalitis. Well-designed prospective studies of this condition are urgently needed. PMID:21939901

Physical Frailty Is Associated with Longitudinal Decline in Global Cognitive Function in Non-Demented Older Adults: A Prospective Study.

PubMed

Chen, S; Honda, T; Narazaki, K; Chen, T; Kishimoto, H; Haeuchi, Y; Kumagai, S

2018-01-01

To assess the relationship between physical frailty and subsequent decline in global cognitive function in the non-demented elderly. A prospective population-based study in a west Japanese suburban town, with two-year follow-up. Community-dwellers aged 65 and older without placement in long-term care, and not having a history of dementia, Parkinson's disease and depression at baseline, who participated in the cohort of the Sasaguri Genkimon Study and underwent follow-up assessments two years later (N = 1,045). Global cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Physical frailty was identified according to the following five components: weight loss, low grip strength, exhaustion, slow gait speed and low physical activities. Linear regression models were used to examine associations between baseline frailty status and the MoCA scores at follow-up. Logistic regression models were used to estimate the risk of cognitive decline (defined as at least two points decrease of MoCA score) according to baseline frailty status. Seven hundred and eight non-demented older adults were included in the final analyses (mean age: 72.6 ± 5.5 years, male 40.3%); 5.8% were frail, and 40.8% were prefrail at baseline. One hundred and fifty nine (22.5%) participants experienced cognitive decline over two years. After adjustment for baseline MoCA scores and all confounders, being frail at baseline was significantly associated with a decline of 1.48 points (95% confidence interval [CI], -2.37 to -0.59) in MoCA scores, as compared with non-frailty. Frail persons were over two times more likely to experience cognitive decline (adjusted odds ratio 2.28; 95% CI, 1.02 to 5.08), compared to non-frail persons. Physical frailty is associated with longitudinal decline in global cognitive function in the non-demented older adults over a period of two years. Physically frail older community-dwellers should be closely monitored for cognitive decline that can be

Design process and preliminary psychometric study of a video game to detect cognitive impairment in senior adults.

PubMed

Valladares-Rodriguez, Sonia; Perez-Rodriguez, Roberto; Facal, David; Fernandez-Iglesias, Manuel J; Anido-Rifon, Luis; Mouriño-Garcia, Marcos

2017-01-01

Assessment of episodic memory has been traditionally used to evaluate potential cognitive impairments in senior adults. Typically, episodic memory evaluation is based on personal interviews and pen-and-paper tests. This article presents the design, development and a preliminary validation of a novel digital game to assess episodic memory intended to overcome the limitations of traditional methods, such as the cost of its administration, its intrusive character, the lack of early detection capabilities, the lack of ecological validity, the learning effect and the existence of confounding factors. Our proposal is based on the gamification of the California Verbal Learning Test (CVLT) and it has been designed to comply with the psychometric characteristics of reliability and validity. Two qualitative focus groups and a first pilot experiment were carried out to validate the proposal. A more ecological, non-intrusive and better administrable tool to perform cognitive assessment was developed. Initial evidence from the focus groups and pilot experiment confirmed the developed game's usability and offered promising results insofar its psychometric validity is concerned. Moreover, the potential of this game for the cognitive classification of senior adults was confirmed, and administration time is dramatically reduced with respect to pen-and-paper tests. Additional research is needed to improve the resolution of the game for the identification of specific cognitive impairments, as well as to achieve a complete validation of the psychometric properties of the digital game. Initial evidence show that serious games can be used as an instrument to assess the cognitive status of senior adults, and even to predict the onset of mild cognitive impairments or Alzheimer's disease.

Design process and preliminary psychometric study of a video game to detect cognitive impairment in senior adults

PubMed Central

Perez-Rodriguez, Roberto; Facal, David; Fernandez-Iglesias, Manuel J.; Anido-Rifon, Luis; Mouriño-Garcia, Marcos

2017-01-01

Introduction Assessment of episodic memory has been traditionally used to evaluate potential cognitive impairments in senior adults. Typically, episodic memory evaluation is based on personal interviews and pen-and-paper tests. This article presents the design, development and a preliminary validation of a novel digital game to assess episodic memory intended to overcome the limitations of traditional methods, such as the cost of its administration, its intrusive character, the lack of early detection capabilities, the lack of ecological validity, the learning effect and the existence of confounding factors. Materials and Methods Our proposal is based on the gamification of the California Verbal Learning Test (CVLT) and it has been designed to comply with the psychometric characteristics of reliability and validity. Two qualitative focus groups and a first pilot experiment were carried out to validate the proposal. Results A more ecological, non-intrusive and better administrable tool to perform cognitive assessment was developed. Initial evidence from the focus groups and pilot experiment confirmed the developed game’s usability and offered promising results insofar its psychometric validity is concerned. Moreover, the potential of this game for the cognitive classification of senior adults was confirmed, and administration time is dramatically reduced with respect to pen-and-paper tests. Limitations Additional research is needed to improve the resolution of the game for the identification of specific cognitive impairments, as well as to achieve a complete validation of the psychometric properties of the digital game. Conclusion Initial evidence show that serious games can be used as an instrument to assess the cognitive status of senior adults, and even to predict the onset of mild cognitive impairments or Alzheimer’s disease. PMID:28674661

An 8 year follow-up of a specialist supported employment service for high-ability adults with autism or Asperger syndrome.

PubMed

Howlin, Patricia; Alcock, Jennifer; Burkin, Catherine

2005-12-01

Few supported employment programmes have been specifically designed for people with autism, especially those who are more able. This study examines the outcome of a supported employment service (NAS Prospects) for adults with autism or Asperger syndrome (IQ 60+) over an 8 year period. Approximately 68 percent of clients found employment. Of the 192 jobs, the majority were permanent contracts and most involved administrative, technical or computing work. Assessment of current clients indicates that IQ, language skills and educational attainments are high. However, work has also been found for those of lower abilities. Individuals supported by Prospects show a rise in salaries, contribute more tax and claim fewer benefits. Satisfaction with the scheme is high among clients, employers and support workers. Although the programme continues to incur a financial deficit, this has decreased. Moreover, there are many non-financial benefits, which are difficult to quantify. The importance of specialist employment support of this kind is discussed.

The Contribution of Prospective Memory Performance to the Neuropsychological Assessment of Mild Cognitive Impairment.

PubMed

Lee, Stephen; Ong, Ben; Pike, Kerryn E; Mullaly, Elizabeth; Rand, Elizabeth; Storey, Elsdon; Ames, David; Saling, Michael; Clare, Linda; Kinsella, Glynda J

2016-01-01

Prospective memory difficulties are a feature of the amnestic form of mild cognitive impairment (aMCI). Although comprehensive test batteries of prospective memory are suitable for clinical practice, they are lengthy, which has detracted from their widespread clinical use. Our aim was to investigate the utility of a brief screening measure of prospective memory, which can be incorporated into a clinical neuropsychological assessment. Seventy-seven healthy older adults (HOA) and 77 participants with aMCI were administered a neuropsychological test battery, including a prospective memory screening measure (Envelope Task), a retrospective memory measure (CVLT-II), and a multi-item subjective memory questionnaire (Prospective and Retrospective Memory Questionnaire; PRMQ) and a single-item subjective memory scale. Compared with HOA participants, participants with aMCI performed poorly on the Envelope Task (η(2) = .38), which provided good discrimination of the aMCI and HOA groups (AUC = .83). In the aMCI group, there was a small but significant relationship between the Envelope Task and the single-item subjective rating of memory, with the Envelope Task accounting for 5-6% of the variance in subjective memory after accounting for emotional status. This relationship of prospective memory and subjective memory was not significant for the multi-item questionnaire (PRMQ); and, retrospective memory was not a significant predictor of self-rated memory, single-item, or multi-item. A brief screening measure of prospective memory, the Envelope Task, provides useful support to traditional memory measures in detecting aMCI.

A prospective cohort study of 122 adult patients presenting to an otolaryngologist's office with globus pharyngeus.

PubMed

Rasmussen, E R; Schnack, D T; Ravn, A T

2018-06-01

To investigate the epidemiology of globus pharyngeus in adult patients presenting to the otolaryngologist's office. Also, the predictors of persisting symptoms, prevalence of anxiety and the effect of clinical assessment were analysed. This was a prospective cohort study. Follow-up was carried out using a postal questionnaire. One otolaryngologists' office comprising three medical doctors. A total of 122 consecutive globus patients presenting to one otolaryngology office in a 1-year period. Globus incidence, gender and age distribution, predictors of persisting symptoms and the patient's health-related concerns. 3.8% of first-time visits were regarding globus. The mean age was 48 years [range 20-88 years], and a female predominance was found (ratio 1.49). Eighty-four per cent experienced anxiety, mainly due to fear of cancer. The most common pathological findings were reflux (15.6%) and post-infectious inflammation (10.6%). 21.4% of questionnaire responders reported full remission of their symptoms. Three predictors regarding symptom persistence were identified: male gender (OR 1.52), smoking (OR 3.4) and difficulties in breathing (OR 8.7). Patients with concomitant foreign body sensation were less likely to have persisting symptoms (OR 0.42). No cases of malignant disease were encountered. 94.7% was reassured by the office visit. The incidence of globus is 3.8% in the otolaryngologist's office. Female gender and concomitant foreign body sensation were predictive for presenting to the clinic even if symptom remission had occurred. Male gender, smoking and self-perceived breathing difficulties were predictive for persisting symptoms. Globus is an anxiety-causing symptom, but reassurance is provided by clinical examination by the otolaryngologist. © 2018 John Wiley & Sons Ltd.

Emerging Issues in Adult Female Acne

PubMed Central

Baldwin, Hillary E.; Cook-Bolden, Fran E.; Eichenfield, Lawrence F.; Friedlander, Sheila F.; Rodriguez, David A.

2017-01-01

Acne vulgaris (acne) is a common affliction in adolescence and is a growing problem in adult women. Despite an increasing awareness of acne in the adult female population, there is a lack of good prospective studies assessing the severity, distribution, and differential response to treatment in this group. The long-held dogma that acne in adult women develops on the lower one-third of the face has been recently challenged, and here the authors critically review data from available literature. Moreover, while adult female acne has traditionally been defined as disease in women over age 25, it is the authors’ experience that this group is subdivided into women ages 25 to 44 years, separate from perimenopausal patients, ages 45 years and up. While there is no data specifically comparing these two groups, the authors will review the existing data and provide practical recommendations based on our experience in treating these groups of patients. Finally, while there is a lack of data on this subject, it is the group’s opinion that adherence to medication regimens is likely higher in women than men, which influences therapeutic outcomes. PMID:28210380

Adult Basic Education Curriculum Guide for ABE Programs Serving Psychiatrically Ill Adult Students.

ERIC Educational Resources Information Center

Collier, Ezma V.

This curriculum guide is designed for use in adult basic education (ABE) programs serving psychiatrically ill adult students. Covered in the individual units are the following topics: personal hygiene and grooming, nutrition and health, money and money management, transportation and safety, government and law, values clarification, and…

Adult human neural stem cell therapeutics: Current developmental status and prospect.

PubMed

Nam, Hyun; Lee, Kee-Hang; Nam, Do-Hyun; Joo, Kyeung Min

2015-01-26

Over the past two decades, regenerative therapies using stem cell technologies have been developed for various neurological diseases. Although stem cell therapy is an attractive option to reverse neural tissue damage and to recover neurological deficits, it is still under development so as not to show significant treatment effects in clinical settings. In this review, we discuss the scientific and clinical basics of adult neural stem cells (aNSCs), and their current developmental status as cell therapeutics for neurological disease. Compared with other types of stem cells, aNSCs have clinical advantages, such as limited proliferation, inborn differentiation potential into functional neural cells, and no ethical issues. In spite of the merits of aNSCs, difficulties in the isolation from the normal brain, and in the in vitro expansion, have blocked preclinical and clinical study using aNSCs. However, several groups have recently developed novel techniques to isolate and expand aNSCs from normal adult brains, and showed successful applications of aNSCs to neurological diseases. With new technologies for aNSCs and their clinical strengths, previous hurdles in stem cell therapies for neurological diseases could be overcome, to realize clinically efficacious regenerative stem cell therapeutics.

Adult encephalitis surveillance: experiences from an Australian prospective sentinel site study.

PubMed

Eastwood, K; Paterson, B J; Levi, C; Givney, R; Loewenthal, M; DE Malmanche, T; Lai, K; Granerod, J; Durrheim, D N

2015-11-01

Few countries routinely collect comprehensive encephalitis data, yet understanding the epidemiology of this condition has value for clinical management, detecting novel and emerging pathogens, and guiding timely public health interventions. When this study was conducted there was no standardized diagnostic algorithm to aid identification of encephalitis or systematic surveillance for adult encephalitis. In July 2012 we tested three pragmatic surveillance options aimed at identifying possible adult encephalitis cases admitted to a major Australian hospital: hospital admissions searches, clinician notifications and laboratory test alerts (CSF herpes simplex virus requests). Eligible cases underwent structured laboratory investigation and a specialist panel arbitrated on the final diagnosis. One hundred and thirteen patients were initially recruited into the 10-month study; 20/113 (18%) met the study case definition, seven were diagnosed with infectious or immune-mediated encephalitis and the remainder were assigned alternative diagnoses. The laboratory alert identified 90% (102/113) of recruited cases including six of the seven cases of confirmed encephalitis suggesting that this may be a practical data source for case ascertainment. The application of a standardized diagnostic algorithm and specialist review by an expert clinical panel aided diagnosis of patients with encephalitis.

Better Indigenous Risk stratification for Cardiac Health study (BIRCH) protocol: rationale and design of a cross-sectional and prospective cohort study to identify novel cardiovascular risk indicators in Aboriginal Australian and Torres Strait Islander adults.

PubMed

Rémond, Marc G W; Stewart, Simon; Carrington, Melinda J; Marwick, Thomas H; Kingwell, Bronwyn A; Meikle, Peter; O'Brien, Darren; Marshall, Nathaniel S; Maguire, Graeme P

2017-08-23

Of the estimated 10-11 year life expectancy gap between Indigenous (Aboriginal and Torres Strait Islander people) and non-Indigenous Australians, approximately one quarter is attributable to cardiovascular disease (CVD). Risk prediction of CVD is imperfect, but particularly limited for Indigenous Australians. The BIRCH (Better Indigenous Risk stratification for Cardiac Health) project aims to identify and assess existing and novel markers of early disease and risk in Indigenous Australians to optimise health outcomes in this disadvantaged population. It further aims to determine whether these markers are relevant in non-Indigenous Australians. BIRCH is a cross-sectional and prospective cohort study of Indigenous and non-Indigenous Australian adults (≥ 18 years) living in remote, regional and urban locations. Participants will be assessed for CVD risk factors, left ventricular mass and strain via echocardiography, sleep disordered breathing and quality via home-based polysomnography or actigraphy respectively, and plasma lipidomic profiles via mass spectrometry. Outcome data will comprise CVD events and death over a period of five years. Results of BIRCH may increase understanding regarding the factors underlying the increased burden of CVD in Indigenous Australians in this setting. Further, it may identify novel markers of early disease and risk to inform the development of more accurate prediction equations. Better identification of at-risk individuals will promote more effective primary and secondary preventive initiatives to reduce Indigenous Australian health disadvantage.

The delay period as an opportunity to think about future intentions: Effects of delay length and delay task difficulty on young adult's prospective memory performance.

PubMed

Mahy, Caitlin E V; Schnitzspahn, Katharina; Hering, Alexandra; Pagobo, Jacqueline; Kliegel, Matthias

2018-05-01

The current study examined the impact of length and difficulty of the delay task on young adult's event-based prospective memory (PM). Participants engaged in either a short (2.5 min) or a long (15 min) delay that was filled with either a simple item categorization task or a difficult cognitive task. They also completed a questionnaire on whether they thought about the PM intention during the delay period and how often they thought about it. Results revealed that participants' PM was better after a difficult delay task compared to an easy delay task. Participants thought about the PM intention more often during the difficult delay task than during the easy delay task. PM performance was positively related to participants' reports of how many times they thought about their intentions. The important role of delay task difficulty in allowing or preventing individuals from refreshing their future intentions is discussed.

Implantable cardioverter-defibrillator lead failure in children and young adults: a matter of lead diameter or lead design?

PubMed

Janson, Christopher M; Patel, Akash R; Bonney, William J; Smoots, Karen; Shah, Maully J

2014-01-21

This study aimed to investigate the impact of lead diameter and design on implantable cardioverter-defibrillator (ICD) lead survival in children and young adults. Recent reports have called attention to high rates of lead failure in adults with small-diameter ICD leads, but data in the pediatric population is limited. We reviewed lead performance in consecutive subjects ≤30 years with transvenous right ventricular ICD leads implanted at our center between January 1995 and October 2011. Lead failure was defined as fracture, perforation, or sensing failure necessitating revision. A total of 120 ICD leads were implanted in 101 patients at a mean age of 15.5 ± 4.9 years. There were 47 small-diameter (≤8-F) and 73 standard-diameter (>8-F) leads. During a median follow-up of 28.7 months (interquartile range: 14.4 to 59.2 months), there were 25 lead failures (21% prevalence), with an incidence of 5.6%/year (95% confidence interval: 3.4 to 7.8). Sprint Fidelis (SF) (Medtronic, Inc., Minneapolis, Minnesota) leads had lower 3-year (69% vs. 92%, p < 0.01) and 5-year (44% vs. 86%, p < 0.01) survival probabilities than standard-diameter leads. In multivariate Cox regression, SF design conferred the greatest hazard ratio for lead failure (hazard ratio: 4.42, 95% confidence interval: 1.73 to 11.29, p < 0.01). Age and linear growth were not significantly associated with lead failure. In this single-center pediatric study that evaluated lead diameter, lead design, and patient factors, the SF design conferred the highest risk of lead failure, suggesting that design rather than diameter is the critical issue in ICD lead performance. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Predicting Remembering: Judgments of Prospective Memory After Traumatic Brain Injury.

PubMed

O'Brien, Katy H; Kennedy, Mary R T

2018-06-19

Adults with traumatic brain injuries (TBIs) often struggle with prospective memory (PM), the ability to remember to complete tasks in the future, such as taking medicines on a schedule. Metamemory judgments (or how well we think we will do at remembering) are linked to strategy use and are critical for managing demands of daily living. The current project used an Internet-based virtual reality tool to assess metamemory judgments of PM following TBI. Eighteen adults with moderate to severe TBI and 20 healthy controls (HCs) played Tying the String, a virtual reality game with PM items embedded across the course of a virtual work week. Participants studied PM items and made two judgments of learning about the likelihood of recognizing the CUE, that is, when the task should be done, and of recalling the TASK, that is, what needed to be done. Participants with TBI adjusted their metamemory expectations downward, but not enough to account for poorer recall performance. Absolute difference scores of metamemory accuracy showed that healthy adults were underconfident across PM components, whereas adults with TBI were markedly overconfident about their ability to recall TASKs. Adults with TBI appear to have a general knowledge that PM tasks will be difficult but are poor monitors of actual levels of success. Because metamemory monitoring is linked to strategy use, future work should examine using this link to direct PM intervention approaches.

International consensus on preliminary definitions of improvement in adult and juvenile myositis.