Li, Yue; Schnelle, John; Spector, William D; Glance, Laurent G; Mukamel, Dana B
2010-02-01
To assess the impact of facility case mix on cross-sectional variations and short-term stability of the "Nursing Home Compare" incontinence quality measure (QM) and to determine whether multivariate risk adjustment can minimize such impacts. Retrospective analyses of the 2005 national minimum data set (MDS) that included approximately 600,000 long-term care residents in over 10,000 facilities in each quarterly sample. Mixed logistic regression was used to construct the risk-adjusted QM (nonshrinkage estimator). Facility-level ordinary least-squares models and adjusted R(2) were used to estimate the impact of case mix on cross-sectional and short-term longitudinal variations of currently published and risk-adjusted QMs. At least 50 percent of the cross-sectional variation and 25 percent of the short-term longitudinal variation of the published QM are explained by facility case mix. In contrast, the cross-sectional and short-term longitudinal variations of the risk-adjusted QM are much less susceptible to case-mix variations (adjusted R(2)<0.10), even for facilities with more extreme or more unstable outcome. Current "Nursing Home Compare" incontinence QM reflects considerable case-mix variations across facilities and over time, and therefore it may be biased. This issue can be largely addressed by multivariate risk adjustment using risk factors available in the MDS.
PIA and REWIND: Two New Methodologies for Cross Section Adjustment
DOE Office of Scientific and Technical Information (OSTI.GOV)
Palmiotti, G.; Salvatores, M.
2017-02-01
This paper presents two new cross section adjustment methodologies intended for coping with the problem of compensations. The first one PIA, Progressive Incremental Adjustment, gives priority to the utilization of experiments of elemental type (those sensitive to a specific cross section), following a definite hierarchy on which type of experiment to use. Once the adjustment is performed, both the new adjusted data and the new covariance matrix are kept. The second methodology is called REWIND (Ranking Experiments by Weighting for Improved Nuclear Data). This new proposed approach tries to establish a methodology for ranking experiments by looking at the potentialmore » gain they can produce in an adjustment. Practical applications for different adjustments illustrate the results of the two methodologies against the current one and show the potential improvement for reducing uncertainties in target reactors.« less
Length bias correction in one-day cross-sectional assessments - The nutritionDay study.
Frantal, Sophie; Pernicka, Elisabeth; Hiesmayr, Michael; Schindler, Karin; Bauer, Peter
2016-04-01
A major problem occurring in cross-sectional studies is sampling bias. Length of hospital stay (LOS) differs strongly between patients and causes a length bias as patients with longer LOS are more likely to be included and are therefore overrepresented in this type of study. To adjust for the length bias higher weights are allocated to patients with shorter LOS. We determined the effect of length-bias adjustment in two independent populations. Length-bias correction is applied to the data of the nutritionDay project, a one-day multinational cross-sectional audit capturing data on disease and nutrition of patients admitted to hospital wards with right-censoring after 30 days follow-up. We applied the weighting method for estimating the distribution function of patient baseline variables based on the method of non-parametric maximum likelihood. Results are validated using data from all patients admitted to the General Hospital of Vienna between 2005 and 2009, where the distribution of LOS can be assumed to be known. Additionally, a simplified calculation scheme for estimating the adjusted distribution function of LOS is demonstrated on a small patient example. The crude median (lower quartile; upper quartile) LOS in the cross-sectional sample was 14 (8; 24) and decreased to 7 (4; 12) when adjusted. Hence, adjustment for length bias in cross-sectional studies is essential to get appropriate estimates. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Osawa, Atsushi; Miwa, Kenta; Wagatsuma, Kei; Takiguchi, Tomohiro; Tamura, Shintaro; Akimoto, Kenta
2012-01-01
The image quality in (18)FDG PET/CT often degrades as the body size increases. The purpose of this study was to evaluate the relationship between image quality and the body size using original phantoms of variable cross-sectional areas in PET/CT. We produced five water phantoms with different cross-sectional areas. The long axis of phantom was 925 mm, and the cross-sectional area was from 324 to 1189 cm(2). These phantoms with the sphere (diameter 10 mm) were filled with (18)F-FDG solution. The radioactivity concentration of background in the phantom was 1.37, 2.73, 4.09 and 5.46 kBq/mL. The scanning duration was 30 min in list mode acquisition for each measurement. Background variability (N(10 mm)), noise equivalent count rates (NECR(phantom)), hot sphere contrast (Q(H,10 mm)) as physical evaluation and visual score of sphere detection were measured, respectively. The relationship between image quality and the various cross-sectional areas was also analyzed under the above-mentioned conditions. As cross-sectional area increased, NECR(phantom) progressively decreased. Furthermore, as cross-sectional area increased, N(10 mm) increased and Q(H,10 mm) decreased. Image quality became degraded as body weight increased because noise and contrast contributed to image quality. The visual score of sphere detection deteriorated in high background radioactivity concentration because a false positive detection in cross-sectional area of the phantom increased. However, additional increases in scanning periods could improve the visual score. We assessed tendencies in the relationship between image quality and body size in PET/CT. Our results showed that time adjustment was more effective than dose adjustment for stable image quality of heavier patients in terms of the large cross-sectional area.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Schmittroth, F.
1978-01-01
Applications of a new data-adjustment code are given. The method is based on a maximum-likelihood extension of generalized least-squares methods that allow complete covariance descriptions for the input data and the final adjusted data evaluations. The maximum-likelihood approach is used with a generalized log-normal distribution that provides a way to treat problems with large uncertainties and that circumvents the problem of negative values that can occur for physically positive quantities. The computer code, FERRET, is written to enable the user to apply it to a large variety of problems by modifying only the input subroutine. The following applications are discussed:more » A 75-group a priori damage function is adjusted by as much as a factor of two by use of 14 integral measurements in different reactor spectra. Reactor spectra and dosimeter cross sections are simultaneously adjusted on the basis of both integral measurements and experimental proton-recoil spectra. The simultaneous use of measured reaction rates, measured worths, microscopic measurements, and theoretical models are used to evaluate dosimeter and fission-product cross sections. Applications in the data reduction of neutron cross section measurements and in the evaluation of reactor after-heat are also considered. 6 figures.« less
Seeing mountains in mole hills: geographical-slant perception
NASA Technical Reports Server (NTRS)
Proffitt, D. R.; Creem, S. H.; Zosh, W. D.; Kaiser, M. K. (Principal Investigator)
2001-01-01
When observers face directly toward the incline of a hill, their awareness of the slant of the hill is greatly overestimated, but motoric estimates are much more accurate. The present study examined whether similar results would be found when observers were allowed to view the side of a hill. Observers viewed the cross-sections of hills in real (Experiment 1) and virtual (Experiment 2) environments and estimated the inclines with verbal estimates, by adjusting the cross-section of a disk, and by adjusting a board with their unseen hand to match the inclines. We found that the results for cross-section viewing replicated those found when observers directly face the incline. Even though the angles of hills are directly evident when viewed from the side, slant perceptions are still grossly overestimated.
NASA Astrophysics Data System (ADS)
Hue, B. M.; Isataev, T.; Erdemchimeg, B.; Artukh, A. G.; Aznabaev, D.; Davaa, S.; Klygin, S. A.; Kononenko, G. A.; Khuukhenkhuu, G.; Kuterbekov, K.; Lukyanov, S. M.; Mikhailova, T. I.; Maslov, V. A.; Mendibaev, K.; Sereda, Yu M.; Penionzhkevich, Yu E.; Vorontsov, A. N.
2017-12-01
Preliminary results of measurements of the total reaction cross sections σR and neutron removal cross section σ-xn for weakly bound 6He, 8Li, 9Be and 10Be nuclei at energy range (20-35) A MeV with 28Si target is presented. The secondary beams of light nuclei were produced by bombardment of the 22Ne (35 A MeV) primary beam on Be target and separated by COMBAS fragment-separator. In dispersive focal plane a horizontal slit defined the momentum acceptance as 1% and a wedge degrader of 200 μm Al was installed. The Bρ of the second section of the fragment-separator was adjusted for measurements in energy range (20-35) A MeV. Two-neutron removal cross sections for 6He and 10Be and one -neutron removal cross sections 8Li and 9Be were measured.
Physical activity after myocardial infarction: is it related to mental health?
Rius-Ottenheim, Nathaly; Geleijnse, Johanna M; Kromhout, Daan; van der Mast, Roos C; Zitman, Frans G; Giltay, Erik J
2013-06-01
Physical inactivity and poor mental wellbeing are associated with poorer prognoses in patients with cardiovascular disease. We aimed to analyse the cross-sectional and prospective associations between physical activity and mental wellbeing in patients with a history of myocardial infarction. Longitudinal, observational study. We investigated 600 older subjects with a history of myocardial infarction (age range 60-80 years) who participated in the Alpha Omega Trial (AOT). They were tested twice at baseline and at 40 months follow-up for physical activity - with the Physical Activity Scale for the Elderly (PASE); depressive symptoms - with the Geriatric Depression Scale (GDS-15); and dispositional optimism - with the Life Orientation Test (LOT-R). Linear (multilevel) and logistic regression analyses were used to examine cross-sectional and longitudinal associations. Physical activity was cross-sectionally associated with depressive symptoms (adjusted beta = -0.143; p = 0.001), but not with dispositional optimism (adjusted beta = 0.074; p = 0.07). We found a synchrony of change between physical activity and depressive symptoms (adjusted beta = -0.155; p < 0.001), but not with dispositional optimism (adjusted beta = 0.049; p = 0.24). Baseline physical activity did not predict depressive symptoms at 40 months follow-up. Concordant inverse associations were observed for (changes) in physical activity and depressive symptoms. Physical activity did not predict depressive symptoms or low optimism.
Hsia, Renee Y; Akosa Antwi, Yaa; Weber, Ellerie
2014-01-15
To examine the between-hospital variation of charges and discounted prices for uncomplicated vaginal and caesarean section deliveries, and to determine the institutional and market-level characteristics that influence adjusted charges. Using data from the California Office of Statewide Health Planning and Development (OSHPD), we conducted a cross-sectional study of all privately insured patients admitted to California hospitals in 2011 for uncomplicated vaginal delivery (diagnosis-related group (DRG) 775) or uncomplicated caesarean section (DRG 766). Hospital charges and discounted prices adjusted for each patient's clinical and demographic characteristics. We analysed 76 766 vaginal deliveries and 32 660 caesarean sections in California in 2011. After adjusting for patient demographic and clinical characteristics, we found that the average California woman could be charged as little as US$3296 or as much as US$37 227 for a vaginal delivery, and US$8312-US$70 908 for a caesarean section depending on which hospital she was admitted to. The discounted prices were, on an average, 37% of the charges. We found that hospitals in markets with middling competition had significantly lower adjusted charges for vaginal deliveries, while hospitals with higher wage indices and casemixes, as well as for-profit hospitals, had higher adjusted charges. Hospitals in markets with higher uninsurance rates charged significantly less for caesarean sections, while for-profit hospitals and hospitals with higher wage indices charged more. However, the institutional and market-level factors included in our models explained only 35-36% of the between-hospital variation in charges. These results indicate that charges and discounted prices for two common, relatively homogeneous diagnosis groups-uncomplicated vaginal delivery and caesarean section-vary widely between hospitals and are not well explained by observable patient or hospital characteristics.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Lipton, Robert, E-mail: lipton@math.lsu.edu; Polizzi, Anthony, E-mail: polizzi@math.lsu.edu
We employ metamaterial beam-wave interaction structures for tuning the gain and bandwidth of short traveling wave tubes. The interaction structures are made from metal rings of uniform cross section, which are periodically deployed along the length of the traveling wave tube. The aspect ratio of the ring cross sections is adjusted to control both gain and bandwidth. The frequency of operation is controlled by the filling fraction of the ring cross section with respect to the size of the period cell.
Martinson, H.A.; Finneran, S.D.; Topinka, L.J.
1984-01-01
The May 18, 1980, eruption of Mount St. Helens generated a lateral blast, lahars and tephra deposits that altered tributary channels in the Lewis River drainage basin. In order to assess potential flood hazards, study channel adjustments, and construct a sediment budget for the perturbed drainages on the east and southeast flanks of the volcano, channel cross sections were monumented and surveyed on Pine Creek, Muddy River, and Smith Creek during September and October of 1980. Additional cross sections were monumented and surveyed on Swift Creek, Bean Creek, and Clearwater Creek during the summer of 1981. The network of 88 channel cross sections has been resurveyed annually. Selected cross sections have been surveyed more frequently, following periods of higher flow. The repetitive cross-section surveys provide measurements of bank erosion or accretion and of channel erosion or aggradation. The report presents channel cross-section profiles constructed from the survey data collected during water years 1980-82. (USGS)
Cross-Sectional HIV Incidence Estimation in HIV Prevention Research
Brookmeyer, Ron; Laeyendecker, Oliver; Donnell, Deborah; Eshleman, Susan H.
2013-01-01
Accurate methods for estimating HIV incidence from cross-sectional samples would have great utility in prevention research. This report describes recent improvements in cross-sectional methods that significantly improve their accuracy. These improvements are based on the use of multiple biomarkers to identify recent HIV infections. These multi-assay algorithms (MAAs) use assays in a hierarchical approach for testing that minimizes the effort and cost of incidence estimation. These MAAs do not require mathematical adjustments for accurate estimation of the incidence rates in study populations in the year prior to sample collection. MAAs provide a practical, accurate, and cost-effective approach for cross-sectional HIV incidence estimation that can be used for HIV prevention research and global epidemic monitoring. PMID:23764641
Terrio, Paul J.; Nazimek, John E.
1997-01-01
The upstream reaches of the Kankakee River in Indiana have been channelized, straightened, and ditched to facilitate agriculture; the downstream reaches of the river in Illinois have not been so altered. Concerns about the adjustments of this low-gradient river in response to these disturbances have led to studies of sedimentation along the Kankakee River in Illinois. The U.S. Geological Survey (USGS) began a study in 1992 to determine sedimentation characteristics of the Kankakee River in Illinois. As part of this study, changes in channel cross-section geometry and channel volume were determined by comparing measurements of cross-section geometry over time in two reaches of the Kankakee River. The study documents some of the adjustments of the Kankakee River to land-use changes and channelization in the upstream drainage area. The timing, magnitude, and process of adjustment are of interest in developing a better understanding of how alluvial stream systems in agricultural areas respond to disturbances in the drainage area. The data used for the study included cross-section measurements made by two State of Illinois agencies from 1959 to 1980 and measurements made by the USGS in 1994. The analyses indicated a net aggradation of about 133,600 cubic yards (yd3) of sediment in the Momence Wetlands reach, a naturally meandering reach of the river, from 1980 to 1994. Aggradation occurred at 25 cross sections in this reach, and scour occurred at 10 cross sections. All but one of the cross sections in the upstream third of the reach indicated aggradation, whereas aggradation and scour were found in the middle and downstream thirds of the reach. The magnitude of change was greatest in the middle third of the reach and was least in the downstream third of the reach. A net aggradation of approximately 298,600 yd3 of sediment was indicated for the Six-Mile Pool, a pooled reach of the river upstream from a dam, from 1978 to 1994. Approximately 182,900 yd3 of sediment accumulated from 1980 to 1994, and approximately 115,700 yd3 of sediment accumulated from 1978 to 1980. Most of the aggradation occurred in the middle third of the Six-Mile Pool reach.
Correction of sampling bias in a cross-sectional study of post-surgical complications.
Fluss, Ronen; Mandel, Micha; Freedman, Laurence S; Weiss, Inbal Salz; Zohar, Anat Ekka; Haklai, Ziona; Gordon, Ethel-Sherry; Simchen, Elisheva
2013-06-30
Cross-sectional designs are often used to monitor the proportion of infections and other post-surgical complications acquired in hospitals. However, conventional methods for estimating incidence proportions when applied to cross-sectional data may provide estimators that are highly biased, as cross-sectional designs tend to include a high proportion of patients with prolonged hospitalization. One common solution is to use sampling weights in the analysis, which adjust for the sampling bias inherent in a cross-sectional design. The current paper describes in detail a method to build weights for a national survey of post-surgical complications conducted in Israel. We use the weights to estimate the probability of surgical site infections following colon resection, and validate the results of the weighted analysis by comparing them with those obtained from a parallel study with a historically prospective design. Copyright © 2012 John Wiley & Sons, Ltd.
NASA Astrophysics Data System (ADS)
Ferguson, Sean P.; Rennie, Colin D.
2017-05-01
A growing body of research has focused on evaluating the adjustment characteristics of semi-alluvial channels containing proximate bedrock, mixed, and alluvial sections. Active orogens have been the focus of most empirical field-based studies with comparatively less focus on semi-alluvial bedrock channels located in other regions. In this study, we present an inventory of channel geometry data collected from semi-alluvial bedrock channels in Ontario and Québec, Canada, which are not subject to tectonic uplift. Data were sourced from a variety of physiographic settings, permitting evaluation of the influence of alluvial cover, lithology, and gradient on cross-sectional channel form. Our results show no substantial difference in channel width or scaling behaviour amongst bedrock, mixed, and alluvial channels included in our study, except for sedimentary bedrock channels virtually bare of alluvial cover that represent a uniquely wide, distinct subgroup. Channel gradient does not appear to exhibit any observable control on channel width amongst our study rivers, suggesting that sedimentary bedrock channels form a distinct subgroup because of lithology. Comparatively, the widths of our bedrock channels formed in igneous/metamorphic bedrock are comparable to the widths of mixed channels and alluvial channels for a given discharge and drainage area. Our findings also suggest that cross-sectional adjustment of sedimentary bedrock channels is achieved through lateral erosion of the channel banks and downward erosion of the channel bed, whereas cross-sectional adjustment of igneous/metamorphic bedrock is primarily achieved through downward erosion of the bed with limited lateral erosion of the banks.
Use and Impact of Covariance Data in the Japanese Latest Adjusted Library ADJ2010 Based on JENDL-4.0
DOE Office of Scientific and Technical Information (OSTI.GOV)
Yokoyama, K., E-mail: yokoyama.kenji09@jaea.go.jp; Ishikawa, M.
2015-01-15
The current status of covariance applications to fast reactor analysis and design in Japan is summarized. In Japan, the covariance data are mainly used for three purposes: (1) to quantify the uncertainty of nuclear core parameters, (2) to identify important nuclides, reactions and energy ranges which are dominant to the uncertainty of core parameters, and (3) to improve the accuracy of core design values by adopting the integral data such as the critical experiments and the power reactor operation data. For the last purpose, the cross section adjustment based on the Bayesian theorem is used. After the release of JENDL-4.0,more » a development project of the new adjusted group-constant set ADJ2010 was started in 2010 and completed in 2013. In the present paper, the final results of ADJ2010 are briefly summarized. In addition, the adjustment results of ADJ2010 are discussed from the viewpoint of use and impact of nuclear data covariances, focusing on {sup 239}Pu capture cross section alterations. For this purpose three kind of indices, called “degree of mobility,” “adjustment motive force,” and “adjustment potential,” are proposed.« less
Differential cross sections in a thick brane world scenario
NASA Astrophysics Data System (ADS)
Pedraza, Omar; Arceo, R.; López, L. A.; Cerón, V. E.
2018-04-01
The elastic differential cross section is calculated at low energies for the elements He and Ne using an effective 4D electromagnetic potential coming from the contribution of the massive Kaluza-Klein modes of the 5D vector field in a thick brane scenario. The length scale is adjusted in the potential to compare with known experimental data and to set bounds for the parameter of the model.
ERIC Educational Resources Information Center
Darling, Nancy
2005-01-01
This study extends previous understanding of the association between adolescent extracurricular activity participation and adjustment by asking whether participation in school-based extracurricular activities is associated with lower substance use and depression, higher grades and academic aspirations, and more positive attitude toward school. In…
Alonso Roca, Rafael; Figueroa Guerrero, Carmen Arlene; Mainar de Paz, Victoria; Arribas García, M Paz; Sánchez Perruca, Luis; Rodríguez Barrientos, Ricardo; Casado López, Mariano; Pedraza Flechas, Ana M
2015-09-07
To determine quality control of patients with oral anticoagulant treatment recruited in Primary Care (PC) using the Rosendaal method to estimate time in therapeutic range (TTR) and comparing it with fraction of international normalized ratio (INR) in range and cross-sectional analysis (last INR registred). A retrospective observational study based on electronic medical record in routine clinical practice. PC centers (262) in Madrid. We included all patients with acenocumarol treatment, with an INR therapeutic range established between 2 and 3. We excluded patients with valvular pathology and disrupted clinical follow up in PC (<3 INR determinations in the studied period, a period of>90 days or ≥ 3 periods of>60 days between 2 determinations). The final population was 49,312 patients. The variables considered were all INR values and their respective dates. TTR was calculated by the 3 methods above mentioned. We considered "therapeutic range" INR between 2-3 and "adjusted range" INR between 1.8-3.2. Optimal control for each patient was considered TTR>60%. By using Rosendaal method, TTR was 66.8% (81.7% adjusted), with a percentage of total INR in range was 58.8% (66.5% adjusted), and, with the cross-sectional analysis, it was 70.5% (76.8% adjusted). Mean TTR was 65% (standard deviation 20.3), and the percentage of patients with TTR>60% was 63.3% (88.1% adjusted). The quality control of patients with oral anticoagulants in PC in Madrid is acceptable, similar or higher to other studies and pivotal trials of new anticoagulants. Compared to the Rosendaal method, total fraction of INR underestimates quality control, and cross-sectional analysis slightly overestimates it. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.
Provan, Sella A; Angel, Kristin; Ødegård, Sigrid; Mowinckel, Petter; Atar, Dan; Kvien, Tore K
2008-01-01
Introduction Disease activity in patients with rheumatoid arthritis (RA) is associated with increased cardiovascular morbidity and mortality, of which N-terminal pro-brain natriuretic peptide (NT-proBNP) is a predictor. Our objective was to examine the cross-sectional and longitudinal associations between markers of inflammation, measures of RA disease activity, medication used in the treatment of RA, and NT-proBNP levels (dependent variable). Methods Two hundred thirty-eight patients with RA of less than 4 years in duration were followed longitudinally with three comprehensive assessments of clinical and radiographic data over a 10-year period. Serum samples were frozen and later batch-analyzed for NT-proBNP levels and other biomarkers. Bivariate, multivariate, and repeated analyses were performed. Results C-reactive protein (CRP) levels at baseline were cross-sectionally associated with NT-proBNP levels after adjustment for age and gender (r2 adjusted = 0.23; P < 0.05). At the 10-year follow-up, risk factors for cardiovascular disease were recorded. Duration of RA and CRP levels were independently associated with NT-proBNP in the final model that was adjusted for gender, age, and creatinine levels (r2 adjusted = 0.38; P < 0.001). In the longitudinal analyses, which adjusted for age, gender, and time of follow-up, we found that repeated measures of CRP predicted NT-proBNP levels (P < 0.001). Conclusion CRP levels are linearly associated with levels of NT-proBNP in cross-sectional and longitudinal analyses of patients with RA. The independent associations of NT-proBNP levels and markers of disease activity with clinical cardiovascular endpoints need to be further investigated. PMID:18573197
Hsia, Renee Y; Akosa Antwi, Yaa; Weber, Ellerie
2014-01-01
Objective To examine the between-hospital variation of charges and discounted prices for uncomplicated vaginal and caesarean section deliveries, and to determine the institutional and market-level characteristics that influence adjusted charges. Design, setting and participants Using data from the California Office of Statewide Health Planning and Development (OSHPD), we conducted a cross-sectional study of all privately insured patients admitted to California hospitals in 2011 for uncomplicated vaginal delivery (diagnosis-related group (DRG) 775) or uncomplicated caesarean section (DRG 766). Outcome measures Hospital charges and discounted prices adjusted for each patient's clinical and demographic characteristics. Results We analysed 76 766 vaginal deliveries and 32 660 caesarean sections in California in 2011. After adjusting for patient demographic and clinical characteristics, we found that the average California woman could be charged as little as US$3296 or as much as US$37 227 for a vaginal delivery, and US$8312–US$70 908 for a caesarean section depending on which hospital she was admitted to. The discounted prices were, on an average, 37% of the charges. We found that hospitals in markets with middling competition had significantly lower adjusted charges for vaginal deliveries, while hospitals with higher wage indices and casemixes, as well as for-profit hospitals, had higher adjusted charges. Hospitals in markets with higher uninsurance rates charged significantly less for caesarean sections, while for-profit hospitals and hospitals with higher wage indices charged more. However, the institutional and market-level factors included in our models explained only 35–36% of the between-hospital variation in charges. Conclusions These results indicate that charges and discounted prices for two common, relatively homogeneous diagnosis groups—uncomplicated vaginal delivery and caesarean section—vary widely between hospitals and are not well explained by observable patient or hospital characteristics. PMID:24435892
Factors influencing adjustment to a colostomy in Chinese patients: a cross-sectional study.
Hu, Ailing; Pan, Yunfeng; Zhang, Meifen; Zhang, June; Zheng, Meichun; Huang, Manrong; Ye, Xinmei; Wu, Xianrong
2014-01-01
We evaluated persons living with a colostomy in order to characterize and describe relationships among adjustment, self-care ability, and social support. One hundred twenty-nine colostomy patients from 5 hospitals in Guangzhou, capital city of the Guangdong province, were recruited by convenience sampling. Cross-sectional data were collected from a survey that included demographic and pertinent clinical data related to their ostomy. The survey also incorporated Chinese language versions of the Ostomy Adjustment Scale, Exercise of Self-Care Agency Scale, and Perceived Social Support Scale. These scales were used to measure the levels and degrees of adjustment, self-care ability, and social support of colostomy patients. Respondents completed the survey during outpatient clinics visit after creation of a colostomy. Scores from the Ostomy Adjustment Scale revealed that 96.9% of colostomy patients reported low to moderate adjustment (128.6 ± 19.38) to their stoma. Self-care ability and social support of patients were positively correlated with the adjustment level (R = 0.33, R = 0.21). Several factors, including being a housewife, paying medical expense by oneself, inability to manage the ostomy without assistance, and not participating in an ostomy support group, were associated with a lower level of adjustment (P < .05). Worries about odor and antipathy toward the ostomy significantly contributed to lower levels of adjustment to the stoma (P < .01). Overall adjustment to a colostomy was moderate. Self-care ability and social support associated with having a colostomy positively influenced adjustment. Adjustment was also influenced by occupation, health insurance provider, and ability to care for the stoma without requiring assistance.
The relation between pathological worrying and fatigue in a working population.
Andrea, H; Beurskens, A J H M; Kant, Ij; Davey, G C L; Field, A P; van Schayck, C P
2004-10-01
This study aimed to explore cross-sectional and longitudinal associations between pathological worry and fatigue in a working population. In employees with very low or very high fatigue levels, psychometrics of the Penn State Worry Questionnaire (PSWQ; measuring pathological worry) and the Checklist Individual Strength (CIS; measuring fatigue) were examined and their cross-sectional and longitudinal associations were explored. Pathological worry and fatigue can be measured as different constructs. However, pathological worry and fatigue were also associated on a cross-sectional level. Pathological worry predicted fatigue level 10 months later, but this association disappeared after adjustment for the cross-sectional association between pathological worry and fatigue. Although they can be measured as different constructs, pathological worry and fatigue seem to be associated. When studying longitudinal relations between pathological worry and fatigue, their cross-sectional association should be taken into account. Pathological worry might not be a risk factor for fatigue per se, but might act more like a mediating factor.
ERIC Educational Resources Information Center
Wong, Jessica Y.; Earl, Joanne K.
2009-01-01
This cross-sectional study examines three predictors of retirement adjustment: individual (demographic and health), psychosocial (work centrality), and organizational (conditions of workforce exit). It also examines the effect of work centrality on post-retirement activity levels. Survey data was collected from 394 retirees (aged 45-93 years).…
ERIC Educational Resources Information Center
Jackson, Kelly F.; Yoo, Hyung Chol; Guevarra, Rudy, Jr.; Harrington, Blair A.
2012-01-01
This study examined relations between perceived racial discrimination, multiracial identity integration (i.e., racial distance and racial conflict), and psychological adjustment (i.e., distress symptoms, positive affect, and negative affect) of 263 multiracial adults, using an online cross-sectional survey design. As hypothesized, higher levels of…
DOE Office of Scientific and Technical Information (OSTI.GOV)
Palmiotti, Giuseppe; Salvatores, Massimo; Hursin, Mathieu
2016-11-01
A critical examination of the role of uncertainty assessment, target accuracies, role of integral experiment for validation and, consequently, of data adjustments methods is underway since several years at OECD-NEA, the objective being to provide criteria and practical approaches to use effectively the results of sensitivity analyses and cross section adjustments for feedback to evaluators and experimentalists in order to improve without ambiguities the knowledge of neutron cross sections, uncertainties, and correlations to be used in a wide range of applications and to meet new requirements and constraints for innovative reactor and fuel cycle system design. An approach will bemore » described that expands as much as possible the use in the adjustment procedure of selected integral experiments that provide information on “elementary” phenomena, on separated individual physics effects related to specific isotopes or on specific energy ranges. An application to a large experimental data base has been performed and the results are discussed in the perspective of new evaluation projects like the CIELO initiative.« less
NASA Astrophysics Data System (ADS)
Palmiotti, Giuseppe; Salvatores, Massimo; Hursin, Mathieu; Kodeli, Ivo; Gabrielli, Fabrizio; Hummel, Andrew
2017-09-01
A critical examination of the role of uncertainty assessment, target accuracies, role of integral experiment for validation and, consequently, of data adjustments methods is underway since several years at OECD-NEA, the objective being to provide criteria and practical approaches to use effectively the results of sensitivity analyses and cross section adjustments for feedback to evaluators and experimentalists in order to improve without ambiguities the knowledge of neutron cross sections, uncertainties, and correlations to be used in a wide range of applications and to meet new requirements and constraints for innovative reactor and fuel cycle system design. An approach will be described that expands as much as possible the use in the adjustment procedure of selected integral experiments that provide information on "elementary" phenomena, on separated individual physics effects related to specific isotopes or on specific energy ranges. An application to a large experimental data base has been performed and the results are discussed in the perspective of new evaluation projects like the CIELO initiative.
Baseline adjustments for binary data in repeated cross-sectional cluster randomized trials.
Nixon, R M; Thompson, S G
2003-09-15
Analysis of covariance models, which adjust for a baseline covariate, are often used to compare treatment groups in a controlled trial in which individuals are randomized. Such analysis adjusts for any baseline imbalance and usually increases the precision of the treatment effect estimate. We assess the value of such adjustments in the context of a cluster randomized trial with repeated cross-sectional design and a binary outcome. In such a design, a new sample of individuals is taken from the clusters at each measurement occasion, so that baseline adjustment has to be at the cluster level. Logistic regression models are used to analyse the data, with cluster level random effects to allow for different outcome probabilities in each cluster. We compare the estimated treatment effect and its precision in models that incorporate a covariate measuring the cluster level probabilities at baseline and those that do not. In two data sets, taken from a cluster randomized trial in the treatment of menorrhagia, the value of baseline adjustment is only evident when the number of subjects per cluster is large. We assess the generalizability of these findings by undertaking a simulation study, and find that increased precision of the treatment effect requires both large cluster sizes and substantial heterogeneity between clusters at baseline, but baseline imbalance arising by chance in a randomized study can always be effectively adjusted for. Copyright 2003 John Wiley & Sons, Ltd.
A Stochastic Approach For Extending The Dimensionality Of Observed Datasets
NASA Technical Reports Server (NTRS)
Varnai, Tamas
2002-01-01
This paper addresses the problem that in many cases, observations cannot provide complete fields of the measured quantities, because they yield data only along a single cross-section through the examined fields. The paper describes a new Fourier-adjustment technique that allows existing fractal models to build realistic surroundings to the measured cross-sections. This new approach allows more representative calculations of cloud radiative processes and may be used in other areas as well.
ERIC Educational Resources Information Center
Wimberly, Sarah R.; Carver, Charles S.; Laurenceau, Jean-Philippe; Harris, Suzanne D.; Antoni, Michael H.
2005-01-01
Two studies examined breast cancer patients' perceptions of their partners' reactions to their diagnosis and treatment as influences on 3 aspects of patients' well-being: psychosexual adjustment, emotional distress, and marital satisfaction. Study 1, cross-sectional, indicated that partner initiation of sex, frequency of sex, a positive 1st sexual…
Children's sleep and adjustment over time: the role of socioeconomic context.
El-Sheikh, Mona; Kelly, Ryan J; Buckhalt, Joseph A; Benjamin Hinnant, J
2010-01-01
Relations were examined between children's sleep and their externalizing and internalizing symptoms. Longitudinal relations were examined when children were in 3rd (T1) and 5th (T2) grades, and cross-sectional relations were assessed at T2. Participants included 176 children at T1 (M = 8.68 years) and 141 children at T2 (M = 10.70 years). Sleep was examined via subjective reports and actigraphy. Children reported on anxiety, self-esteem, and depression symptoms, and parents reported on children's externalizing and internalizing symptoms. Cross-sectionally and longitudinally, sleep problems were associated with worse adjustment outcomes; African American children or those from lower socioeconomic status homes were at particular risk. Findings highlight the importance of adequate sleep for children's optimal development, especially in the context of ecological risk.
Peng, Wenbo; Sibbritt, David W; Hickman, Louise; Adams, Jon
2015-10-01
To examine the association between self-prescribed complementary and alternative medicine use and menopause-related symptoms, stratified by menopausal status. Data were obtained from a cross-sectional survey of a nationally representative sample of 10,011 menopausal women from the Australian Longitudinal Study on Women's Health, conducted in 2010. Multivariable logistic regression models were applied to identify if the use of selected self-prescribed complementary and alternative medicine was significantly associated with a range of menopause-related symptoms. Vitamins/minerals were more likely to be used by natural menopausal women experiencing anxiety (adjusted OR=1.20) and/or stiff/painful joints (adjusted OR=1.16). Yoga/meditation was more likely to be used by women with hysterectomy (adjusted OR=1.76) or natural menopausal women (adjusted OR=1.38) experiencing anxiety. Herbal medicines were more likely to be used by natural menopausal women experiencing anxiety (adjusted OR=1.22), tiredness (adjusted OR=1.20), and/or stiff/painful joints (adjusted OR=1.17), and by women with oophorectomy experiencing tiredness (adjusted OR=1.45). Aromatherapy oils were more likely to be used by natural menopausal women experiencing night sweats (adjusted OR=1.25) and by women with hysterectomy experiencing anxiety (adjusted OR=2.02). Chinese medicines were more likely to be used by women with oophorectomy experiencing stiff/painful joints (adjusted OR=4.06) and/or palpitations (adjusted OR=3.06). Our study will help improve the patient-provider communication regarding complementary and alternative medicine use for menopause, and we conclude that menopausal status should be taken into account by providers for menopause care. The women's experience and motivations of such use warrant further research. Copyright © 2015 Elsevier Ltd. All rights reserved.
Size and Shape of the Distant Magnetotail
NASA Technical Reports Server (NTRS)
Sibeck, D.G.; Lin, R.-Q.
2014-01-01
We employ a global magnetohydrodynamic model to study the effects of the interplanetary magnetic field (IMF) strength and direction upon the cross-section of the magnetotail at lunar distances. The anisotropic pressure of draped magnetosheath magnetic field lines and the inclusion of a reconnection-generated standing slow mode wave fan bounded by a rotational discontinuity within the definition of the magnetotail result in cross-sections elongated in the direction parallel to the component of the IMF in the plane perpendicular to the Sun-Earth line. Tilted cross-tail plasma sheets separate the northern and southern lobes within these cross-sections. Greater fast mode speeds perpendicular than parallel to the draped magnetos heath magnetic field lines result in greater distances to the bow shock in the direction perpendicular than parallel to the component of the IMF in the plane transverse to the Sun-Earth line. The magnetotail cross-section responds rapidly to reconnected magnetic field lines requires no more than the magnetosheath convection time to appear at any distance downstream, and further adjustments of the cross-section in response to the anisotropic pressures of the draped magnetic field lines require no more than 10-20 minutes. Consequently for typical ecliptic IMF orientations and strengths, the magnetotail cross-section is oblate while the bow shock is prolate.
Paterson, Euan N; Neville, Charlotte E; Silvestri, Giuliana; Montgomery, Shannon; Moore, Evelyn; Silvestri, Vittorio; Cardwell, Christopher R; MacGillivray, Tom J; Maxwell, Alexander P; Woodside, Jayne V; McKay, Gareth J
2018-04-27
Associations between dietary patterns and chronic kidney disease are not well established, especially in European populations. We conducted a cross-sectional study of 1033 older Irish women (age range 56-100 years) with a restricted lifestyle. Dietary intake was assessed using a food frequency questionnaire. Renal function was determined by estimated glomerular filtration rate. Two dietary patterns were identified within the study population using factor analysis. A significant negative association was found between unhealthy dietary pattern adherence and renal function in both unadjusted and adjusted models controlling for potential confounding variables (p for trend <0.001), with a mean difference in estimated glomerular filtration rate of -6 ml/min/1.73 m 2 between those in the highest fifth of adherence to the unhealthy dietary pattern compared to the lowest, in the fully adjusted model. Chronic kidney disease risk was significantly greater for the highest fifth, compared to the lowest fifth of unhealthy dietary pattern adherence in adjusted models (adjusted odds ratio = 2.62, p < 0.001). Adherence to the healthy dietary pattern was not associated with renal function or chronic kidney disease in adjusted models. In this cohort, an unhealthy dietary pattern was associated with lower renal function and greater prevalence of chronic kidney disease.
NASA Astrophysics Data System (ADS)
El Ghazi, Haddou; John Peter, A.
2017-04-01
Hydrogenic-like donor-impurity related self and induced polarizations, bending energy and photo-ionization cross section in spherical core/shell zinc blende (In,Ga)N/GaN are computed. Based on the variational approach and within effective-mass and one parabolic approximations, the calculations are made under finite potential barrier taking into account of the discontinuity of the effective-mass and the constant dielectric. The photo-ionization cross section is studied according to the photon incident energy considering the effects of hydrostatic pressure, applied electric field, structure's radius, impurity's position and indium composition in the core. It is obtained that the influences mentioned above lead to either blue shifts or redshifts of the resonant peak of the photo-ionization cross section spectrum. The unusual behavior related to the structure radius is discussed which is as a consequence of the finite potential confinement. We have shown that the photo-ionization cross section can be controlled with adjusting the internal and external factors. These properties can be useful for producing some device applications such as quantum dot infrared photodetectors.
Martinson, H.A.; Hammond, H.E.; Mast, W.W.; Mango, P.D.
1986-01-01
The May 18, 1980, eruption of Mount St. Helens generated a lateral blast, lahars, and tephra deposits that altered stream channels in the Lewis River drainage basin. In order to assess potential flood hazards, monitor channel adjustments, and construct a sediment budget for disturbed drainages on the east and southeast flanks of the volcano, channel cross sections were monumented and surveyed on Pine Creek, Muddy River, and Smith Creek during September and October of 1980. Additional cross sections were monumented and surveyed on Swift Creek, Bean Creek , and Clearwater Creek during 1981. This network of channel cross sections has been resurveyed annually. Selected cross sections have been surveyed more frequently, following periods of higher flow. Longitudinal stream profiles of the low-water thalweg and (or) water surfaces were surveyed periodically for selected short reaches of channel. Corresponding map views for these reaches were constructed using the survey data and aerial photographs. This report presents plots of channel cross-section profiles, longitudinal stream profiles, and channel maps constructed from survey data collected during water years 1983-84. (USGS)
NASA Technical Reports Server (NTRS)
Evans, JuliAnn (Inventor); Gundo, Daniel P. (Inventor); Harper, Jennifer S. (Inventor); Mulenburg, Gerald M. (Inventor); Skundberg, Thomas L. (Inventor)
1996-01-01
An animal feeder for use in a metabolic cage is introduced. The feeder includes a confined passageway and an adjustable notched gate proceeding a food cup. The gate is adjusted so that the entry area to the food cup approximates the cross sectional head area of the animal. Food ejected from the food cup by a caged animal is dropped through a grate into a spill tray.
Grace Kho, Woei Feng; Cheah, Whye Lian; Hazmi, Helmy
2018-03-01
Hypertension is a health issue affecting adolescents. Accumulating evidence affirms that elevated blood pressure begins in childhood and tracks into adulthood. This cross-sectional study was conducted to determine the prevalence of elevated blood pressure and its predictors among secondary school students in Sarawak, Malaysia. A total of 2,461 secondary school students aged 12-17 years from 19 schools in Sarawak participated in the study. Questionnaire was used to obtain socio-demographic data, parental history of hypertension, and self-reported physical activity. Anthropometric and blood pressure measurements were taken. Data was entered and analysed using SPSS version 23.0. The prevalence of adolescents with elevated blood pressure, overweight, central obesity, and overfat were 30.1%, 24.3%, 13.5%, and 6.7%, respectively. Multivariate logistic regression demonstrated the predictors significantly associated with elevated blood pressure among respondents: overweight (adjusted odds ratio=3.144), being male (adjusted odds ratio=3.073), being Chinese (adjusted odds ratio=2.321) or Iban (adjusted odds ratio=1.578), central obesity (adjusted odds ratio=2.145), being overfat (adjusted odds ratio=1.885), and being an older adolescent (adjusted odds ratio=1.109). Parental history of hypertension, locality, and physical activity showed no significant associations. The obesity epidemic must be tackled at community and school levels by health education and regulation of school canteen foods. Copyright© by the National Institute of Public Health, Prague 2018.
ERIC Educational Resources Information Center
Schaefer, Earl S.
This paper reports the development of a Classroom Behavior Inventory and a series of studies which have developed and refined methods for collecting teacher ratings of children's social, emotional and task-oriented behavior from preschool through high school. Findings suggest that the Classroom Behavior Inventory is a relatively economical,…
Holtschlag, David J.; Koschik, John A.
2003-01-01
Acoustic Doppler current profilers (ADCP) were used to survey flow velocities in Detroit River from July 8-19, 2002, as part of a study to assess the susceptibility of public water intakes to contaminants on the St. Clair-Detroit River Waterway. More than 3.5 million point velocities were measured at 130 cross sections. Cross sections were generally spaced about 1,800 ft apart along the river from the head of Detroit River at the outlet of Lake St. Clair to the mouth of Detroit River on Lake Erie. Two transects were surveyed at each cross section, one in each direction across the river. Along each transect, velocity profiles were generally obtained 0.8-2.2 ft apart. At each velocity profile, average water velocity data were obtained at 1.64 ft intervals of depth. The raw position and velocity data from the ADCP field survey were adjusted for local magnetic anomalies using global positioning system (GPS) measurements at the end points of the transects. The adjusted velocity and ancillary data can be retrieved though the internet and extracted to column-oriented data files.
NASA Astrophysics Data System (ADS)
Latif, A. A.; Mohamad, H.; Abu Bakar, M. H.; Muhammad, F. D.; Mahdi, M. A.
2016-02-01
We have proposed and demonstrated a carbon nanotube-based mode-locked erbium-doped fiber laser with switchable wavelength in the C-band wavelength region by varying the net gain cross section of erbium. The carbon nanotube is coated on a tapered fiber to form the saturable absorber for the purpose of mode-locking by exploiting the concept of evanescent field interaction on the tapered fiber with the carbon nanotube in a ring cavity configuration. The propagation loss is adjusted by inducing macrobend losses of the optical fiber in the cavity through a fiber spooling technique. Since the spooling radius can be gradually adjusted to achieve continuous tuning of attenuation, this passive tuning approach can be an alternative to optical tunable attenuator, with freedom of external device integration into the laser cavity. Based on this alteration, the net gain cross section of the laser system can be tailored to three different lasing wavelength ranges; 1533, 1560 nm and both (1533 and 1560 nm) with the minimum pulse duration of 734 fs. The proposed design is simple and stable with high beam quality and good reliability for multiple applications.
Health care funding levels and patient outcomes: a national study.
Byrne, Margaret M; Pietz, Kenneth; Woodard, Lechauncy; Petersen, Laura A
2007-04-01
Health care funding levels differ significantly across geographic regions, but there is little correlation between regional funding levels and outcomes of elderly Medicare beneficiaries. Our goal was to determine whether this relationship holds true in a non-Medicare population cared for in a large integrated health care system with a capitated budget allocation system. We explored the association between health care funding and risk-adjusted mortality in the 22 Veterans Affairs (VA) geographic Networks over a six-year time period. Allocations to Networks were adjusted for illness burden using Diagnostic Cost Groups. To test the association between funding and risk-adjusted three-year mortality, we ran logistic regressions with single-year patient cohorts, as well as hierarchical regressions on a six year longitudinal data set, clustering on VA Network. A 1000 dollar increase in funding per unit of patient illness burden was associated with a 2-8% reduction in three-year mortality in cross sectional regressions. However, in longitudinal hierarchical regressions clustering on Network, the significant effect of funding level was eliminated. When longitudinal data are used, the significant cross sectional effect of funding levels on mortality disappear. Thus, the factors driving differences in mortality are Network effects, although part of the Network effect may be due to past levels of funding. Our results provide a caution for cross sectional examinations of the association between regional health care funding levels and health outcomes. Copyright (c) 2006 John Wiley & Sons, Ltd.
NASA Technical Reports Server (NTRS)
Webster, C. R. (Inventor)
1986-01-01
A method and apparatus for an optogalvanic spectroscopy system are disclosed. Orthogonal geometry exists between the axis of a laser probe beam and the axis of a discharge created by a pair of spaced apart and longituduinally aligned high voltage electrodes. The electrodes are movable to permit adjustment of the location of a point in the discharge which is to irradiated by a laser beam crossing the discharge region. The cell dimensions are selected so that the cross section of the discharge region is substantly comparable in size to the cross section of the laser beam passing orthogonally through the discharge region.
Path length differencing and energy conservation of the S[sub N] Boltzmann/Spencer-Lewis equation
DOE Office of Scientific and Technical Information (OSTI.GOV)
Filippone, W.L.; Monahan, S.P.
It is shown that the S[sub N] Boltzmann/Spencer-Lewis equations conserve energy locally if and only if they satisfy particle balance and diamond differencing is used in path length. In contrast, the spatial differencing schemes have no bearing on the energy balance. Energy is conserved globally if it is conserved locally and the multigroup cross sections are energy conserving. Although the coupled electron-photon cross sections generated by CEPXS conserve particles and charge, they do not precisely conserve energy. It is demonstrated that these cross sections can be adjusted such that particles, charge, and energy are conserved. Finally, since a conventional negativemore » flux fixup destroys energy balance when applied to path legend, a modified fixup scheme that does not is presented.« less
Dewey, Jack D.; Roybal, F.E.; Funderburg, D.E.
1979-01-01
Cross-section channel profiles, sediment transport and hydrologic data have been observed and computed for a series of pre-dam and post-dam investigations from 1970 to 1975 at 37 cross sections established along a 59-mile study reach from Cochiti Dam to Isleta Diversion Dam, New Mexico. Cochiti Dam began impounding water in November 1973. Because the dam will trap virtually all of the sediment load originating upstream and water discharge will be controlled, it is expected that equilibrium values of channel width, depth, slope and sediment-transport capability in the existing main stem of the Rio Grande will change. Changes in cross sections with time and space and changes in size distribution of sediments are documented. (Woodard-USGS).
NASA Astrophysics Data System (ADS)
Hu, Liyuan; Song, Yushou; Hou, Yingwei; Liu, Huilan; Li, Hui
2018-07-01
A semi-microscopic analytical expression of the nucleus-nucleus total reaction cross section (σR) was proposed based on the strong absorption model. It is suitable for stable nuclei at intermediate energies. The matter density distributions of nuclei and the nucleon-nucleon total cross section were both considered. Particularly, the Fermi motion effect of the nucleons in a nucleus was also taken into account. The parametrization of σR was applied to the colliding systems including 12C. The experimental data at energies from 30 to 1000 MeV/nucleon were well reproduced, according to which an approach of deriving σR without adjustable parameters was developed. The necessity of considering the Fermi motion effect in the parametrization was discussed.
Hajdarbegovic, E; Blom, H; Verkouteren, J A C; Hofman, A; Hollestein, L M; Nijsten, T
2016-07-01
Epidermal barrier impairment and an altered immune system in atopic dermatitis (AD) may predispose to ultraviolet-induced DNA damage. To study the association between AD and actinic keratosis (AK) in a population-based cross-sectional study. AD was defined by modified criteria of the U.K. working party's diagnostic criteria. AKs were diagnosed by physicians during a full-body skin examination, and keratinocyte cancers were identified via linkage to the national pathology database. The results were analysed in adjusted multivariable and multinomial models. A lower proportion of subjects with AD had AKs than those without AD: 16% vs. 24%, P = 0·002; unadjusted odds ratio (OR) 0·60, 95% confidence interval (CI) 0·42-0·83; adjusted OR 0·74, 95% CI 0·51-1·05; fully adjusted OR 0·69, 95% CI 0·47-1·07. In a multinomial model patients with AD were less likely to have ≥ 10 AKs (adjusted OR 0·28, 95% CI 0·09-0·90). No effect of AD on basal cell carcinoma or squamous cell carcinoma was found: adjusted OR 0·71, 95% CI 0·41-1·24 and adjusted OR 1·54, 95% CI 0·66-3·62, respectively. AD in community-dwelling patients is not associated with AK. © 2016 British Association of Dermatologists.
Abelev, B; Adam, J; Adamová, D; Adare, A M; Aggarwal, M M; Aglieri Rinella, G; Agocs, A G; Agostinelli, A; Aguilar Salazar, S; Ahammed, Z; Ahmad Masoodi, A; Ahmad, N; Ahn, S A; Ahn, S U; Akindinov, A; Aleksandrov, D; Alessandro, B; Alfaro Molina, R; Alici, A; Alkin, A; Almaráz Aviña, E; Alme, J; Alt, T; Altini, V; Altinpinar, S; Altsybeev, I; Andrei, C; Andronic, A; Anguelov, V; Anielski, J; Anson, C; Antičić, T; Antinori, F; Antonioli, P; Aphecetche, L; Appelshäuser, H; Arbor, N; Arcelli, S; Arend, A; Armesto, N; Arnaldi, R; Aronsson, T; Arsene, I C; Arslandok, M; Asryan, A; Augustinus, A; Averbeck, R; Awes, T C; Äystö, J; Azmi, M D; Bach, M; Badalà, A; Baek, Y W; Bailhache, R; Bala, R; Baldini Ferroli, R; Baldisseri, A; Baldit, A; Baltasar Dos Santos Pedrosa, F; Bán, J; Baral, R C; Barbera, R; Barile, F; Barnaföldi, G G; Barnby, L S; Barret, V; Bartke, J; Basile, M; Bastid, N; Basu, S; Bathen, B; Batigne, G; Batyunya, B; Baumann, C; Bearden, I G; Beck, H; Behera, N K; Belikov, I; Bellini, F; Bellwied, R; Belmont-Moreno, E; Bencedi, G; Beole, S; Berceanu, I; Bercuci, A; Berdnikov, Y; Berenyi, D; Bergognon, A A E; Berzano, D; Betev, L; Bhasin, A; Bhati, A K; Bhom, J; Bianchi, N; Bianchi, L; Bianchin, C; Bielčík, J; Bielčíková, J; Bilandzic, A; Bjelogrlic, S; Blanco, F; Blanco, F; Blau, D; Blume, C; Boccioli, M; Bock, N; Böttger, S; Bogdanov, A; Bøggild, H; Bogolyubsky, M; Boldizsár, L; Bombara, M; Book, J; Borel, H; Borissov, A; Bose, S; Bossú, F; Botje, M; Botta, E; Boyer, B; Braidot, E; Braun-Munzinger, P; Bregant, M; Breitner, T; Browning, T A; Broz, M; Brun, R; Bruna, E; Bruno, G E; Budnikov, D; Buesching, H; Bufalino, S; Busch, O; Buthelezi, Z; Caballero Orduna, D; Caffarri, D; Cai, X; Caines, H; Calvo Villar, E; Camerini, P; Canoa Roman, V; Cara Romeo, G; Carena, F; Carena, W; Carlin Filho, N; Carminati, F; Casanova Díaz, A; Castillo Castellanos, J; Castillo Hernandez, J F; Casula, E A R; Catanescu, V; Cavicchioli, C; Ceballos Sanchez, C; Cepila, J; Cerello, P; Chang, B; Chapeland, S; Charvet, J L; Chattopadhyay, S; Chattopadhyay, S; Chawla, I; Cherney, M; Cheshkov, C; Cheynis, B; Chibante Barroso, V; Chinellato, D D; Chochula, P; Chojnacki, M; Choudhury, S; Christakoglou, P; Christensen, C H; Christiansen, P; Chujo, T; Chung, S U; Cicalo, C; Cifarelli, L; Cindolo, F; Cleymans, J; Coccetti, F; Colamaria, F; Colella, D; Conesa Balbastre, G; Conesa Del Valle, Z; Constantin, P; Contin, G; Contreras, J G; Cormier, T M; Corrales Morales, Y; Cortese, P; Cortés Maldonado, I; Cosentino, M R; Costa, F; Cotallo, M E; Crescio, E; Crochet, P; Cruz Alaniz, E; Cuautle, E; Cunqueiro, L; Dainese, A; Dalsgaard, H H; Danu, A; Das, D; Das, K; Das, I; Dash, S; Dash, A; De, S; de Barros, G O V; De Caro, A; de Cataldo, G; de Cuveland, J; De Falco, A; De Gruttola, D; Delagrange, H; Deloff, A; Demanov, V; De Marco, N; Dénes, E; De Pasquale, S; Deppman, A; D Erasmo, G; de Rooij, R; Diaz Corchero, M A; Di Bari, D; Dietel, T; Di Giglio, C; Di Liberto, S; Di Mauro, A; Di Nezza, P; Divià, R; Djuvsland, Ø; Dobrin, A; Dobrowolski, T; Domínguez, I; Dönigus, B; Dordic, O; Driga, O; Dubey, A K; Dubla, A; Ducroux, L; Dupieux, P; Dutta Majumdar, M R; Dutta Majumdar, A K; Elia, D; Emschermann, D; Engel, H; Erazmus, B; Erdal, H A; Espagnon, B; Estienne, M; Esumi, S; Evans, D; Eyyubova, G; Fabris, D; Faivre, J; Falchieri, D; Fantoni, A; Fasel, M; Fearick, R; Fedunov, A; Fehlker, D; Feldkamp, L; Felea, D; Fenton-Olsen, B; Feofilov, G; Fernández Téllez, A; Ferretti, A; Ferretti, R; Festanti, A; Figiel, J; Figueredo, M A S; Filchagin, S; Finogeev, D; Fionda, F M; Fiore, E M; Floris, M; Foertsch, S; Foka, P; Fokin, S; Fragiacomo, E; Francescon, A; Frankenfeld, U; Fuchs, U; Furget, C; Fusco Girard, M; Gaardhøje, J J; Gagliardi, M; Gago, A; Gallio, M; Gangadharan, D R; Ganoti, P; Garabatos, C; Garcia-Solis, E; Garishvili, I; Gerhard, J; Germain, M; Geuna, C; Gheata, M; Gheata, A; Ghidini, B; Ghosh, P; Gianotti, P; Girard, M R; Giubellino, P; Gladysz-Dziadus, E; Glässel, P; Gomez, R; Ferreiro, E G; González-Trueba, L H; González-Zamora, P; Gorbunov, S; Goswami, A; Gotovac, S; Grabski, V; Graczykowski, L K; Grajcarek, R; Grelli, A; Grigoras, C; Grigoras, A; Grigoriev, V; Grigoryan, S; Grigoryan, A; Grinyov, B; Grion, N; Gros, P; Grosse-Oetringhaus, J F; Grossiord, J-Y; Grosso, R; Guber, F; Guernane, R; Guerra Gutierrez, C; Guerzoni, B; Guilbaud, M; Gulbrandsen, K; Gunji, T; Gupta, A; Gupta, R; Gutbrod, H; Haaland, Ø; Hadjidakis, C; Haiduc, M; Hamagaki, H; Hamar, G; Han, B H; Hanratty, L D; Hansen, A; Harmanová-Tóthová, Z; Harris, J W; Hartig, M; Hasegan, D; Hatzifotiadou, D; Hayrapetyan, A; Heckel, S T; Heide, M; Helstrup, H; Herghelegiu, A; Herrera Corral, G; Herrmann, N; Hess, B A; Hetland, K F; Hicks, B; Hille, P T; Hippolyte, B; Horaguchi, T; Hori, Y; Hristov, P; Hřivnáčová, I; Huang, M; Humanic, T J; Hwang, D S; Ichou, R; Ilkaev, R; Ilkiv, I; Inaba, M; Incani, E; Innocenti, P G; Innocenti, G M; Ippolitov, M; Irfan, M; Ivan, C; Ivanov, A; Ivanov, M; Ivanov, V; Ivanytskyi, O; Jachołkowski, A; Jacobs, P M; Jang, H J; Janik, R; Janik, M A; Jayarathna, P H S Y; Jena, S; Jha, D M; Jimenez Bustamante, R T; Jirden, L; Jones, P G; Jung, H; Jusko, A; Kaidalov, A B; Kakoyan, V; Kalcher, S; Kaliňák, P; Kalliokoski, T; Kalweit, A; Kang, J H; Kaplin, V; Karasu Uysal, A; Karavichev, O; Karavicheva, T; Karpechev, E; Kazantsev, A; Kebschull, U; Keidel, R; Khan, P; Khan, S A; Khan, M M; Khanzadeev, A; Kharlov, Y; Kileng, B; Kim, S; Kim, B; Kim, T; Kim, D J; Kim, D W; Kim, J H; Kim, J S; Kim, M; Kim, M; Kirsch, S; Kisel, I; Kiselev, S; Kisiel, A; Klay, J L; Klein, J; Klein-Bösing, C; Kliemant, M; Kluge, A; Knichel, M L; Knospe, A G; Koch, K; Köhler, M K; Kollegger, T; Kolojvari, A; Kondratiev, V; Kondratyeva, N; Konevskikh, A; Korneev, A; Kour, R; Kowalski, M; Kox, S; Koyithatta Meethaleveedu, G; Kral, J; Králik, I; Kramer, F; Kraus, I; Krawutschke, T; Krelina, M; Kretz, M; Krivda, M; Krizek, F; Krus, M; Kryshen, E; Krzewicki, M; Kucheriaev, Y; Kugathasan, T; Kuhn, C; Kuijer, P G; Kulakov, I; Kumar, J; Kurashvili, P; Kurepin, A B; Kurepin, A; Kuryakin, A; Kushpil, V; Kushpil, S; Kvaerno, H; Kweon, M J; Kwon, Y; Ladrón de Guevara, P; Lakomov, I; Langoy, R; La Pointe, S L; Lara, C; Lardeux, A; La Rocca, P; Lea, R; Le Bornec, Y; Lechman, M; Lee, S C; Lee, G R; Lee, K S; Lefèvre, F; Lehnert, J; Lenhardt, M; Lenti, V; León, H; Leoncino, M; León Monzón, I; León Vargas, H; Lévai, P; Lien, J; Lietava, R; Lindal, S; Lindenstruth, V; Lippmann, C; Lisa, M A; Liu, L; Loggins, V R; Loginov, V; Lohn, S; Lohner, D; Loizides, C; Loo, K K; Lopez, X; López Torres, E; Løvhøiden, G; Lu, X-G; Luettig, P; Lunardon, M; Luo, J; Luparello, G; Luquin, L; Luzzi, C; Ma, K; Ma, R; Madagodahettige-Don, D M; Maevskaya, A; Mager, M; Mahapatra, D P; Maire, A; Malaev, M; Maldonado Cervantes, I; Malinina, L; Mal'Kevich, M V D; Malzacher, P; Mamonov, A; Mangotra, L; Manko, V; Manso, F; Manzari, V; Mao, Y; Marchisone, M; Mareš, J; Margagliotti, G V; Margotti, A; Marín, A; Marin Tobon, C A; Markert, C; Marquard, M; Martashvili, I; Martinengo, P; Martínez, M I; Martínez Davalos, A; Martínez García, G; Martynov, Y; Mas, A; Masciocchi, S; Masera, M; Masoni, A; Massacrier, L; Mastroserio, A; Matthews, Z L; Matyja, A; Mayer, C; Mazer, J; Mazzoni, M A; Meddi, F; Menchaca-Rocha, A; Mercado Pérez, J; Meres, M; Miake, Y; Milano, L; Milosevic, J; Mischke, A; Mishra, A N; Miśkowiec, D; Mitu, C; Mlynarz, J; Mohanty, B; Molnar, L; Montaño Zetina, L; Monteno, M; Montes, E; Moon, T; Morando, M; Moreira De Godoy, D A; Moretto, S; Morsch, A; Muccifora, V; Mudnic, E; Muhuri, S; Mukherjee, M; Müller, H; Munhoz, M G; Musa, L; Musso, A; Nandi, B K; Nania, R; Nappi, E; Nattrass, C; Naumov, N P; Navin, S; Nayak, T K; Nazarenko, S; Nazarov, G; Nedosekin, A; Nicassio, M; Niculescu, M; Nielsen, B S; Niida, T; Nikolaev, S; Nikolic, V; Nikulin, S; Nikulin, V; Nilsen, B S; Nilsson, M S; Noferini, F; Nomokonov, P; Nooren, G; Novitzky, N; Nyanin, A; Nyatha, A; Nygaard, C; Nystrand, J; Ochirov, A; Oeschler, H; Oh, S; Oh, S K; Oleniacz, J; Oppedisano, C; Ortiz Velasquez, A; Ortona, G; Oskarsson, A; Ostrowski, P; Otwinowski, J; Oyama, K; Ozawa, K; Pachmayer, Y; Pachr, M; Padilla, F; Pagano, P; Paić, G; Painke, F; Pajares, C; Pal, S K; Palaha, A; Palmeri, A; Papikyan, V; Pappalardo, G S; Park, W J; Passfeld, A; Pastirčák, B; Patalakha, D I; Paticchio, V; Pavlinov, A; Pawlak, T; Peitzmann, T; Pereira Da Costa, H; Pereira De Oliveira Filho, E; Peresunko, D; Pérez Lara, C E; Perez Lezama, E; Perini, D; Perrino, D; Peryt, W; Pesci, A; Peskov, V; Pestov, Y; Petráček, V; Petran, M; Petris, M; Petrov, P; Petrovici, M; Petta, C; Piano, S; Piccotti, A; Pikna, M; Pillot, P; Pinazza, O; Pinsky, L; Pitz, N; Piyarathna, D B; Planinic, M; Płoskoń, M; Pluta, J; Pocheptsov, T; Pochybova, S; Podesta-Lerma, P L M; Poghosyan, M G; Polák, K; Polichtchouk, B; Pop, A; Porteboeuf-Houssais, S; Pospíšil, V; Potukuchi, B; Prasad, S K; Preghenella, R; Prino, F; Pruneau, C A; Pshenichnov, I; Puchagin, S; Puddu, G; Pulvirenti, A; Punin, V; Putiš, M; Putschke, J; Quercigh, E; Qvigstad, H; Rachevski, A; Rademakers, A; Räihä, T S; Rak, J; Rakotozafindrabe, A; Ramello, L; Ramírez Reyes, A; Raniwala, S; Raniwala, R; Räsänen, S S; Rascanu, B T; Rathee, D; Read, K F; Real, J S; Redlich, K; Reichelt, P; Reicher, M; Renfordt, R; Reolon, A R; Reshetin, A; Rettig, F; Revol, J-P; Reygers, K; Riccati, L; Ricci, R A; Richert, T; Richter, M; Riedler, P; Riegler, W; Riggi, F; Rodrigues Fernandes Rabacal, B; Rodríguez Cahuantzi, M; Rodriguez Manso, A; Røed, K; Rohr, D; Röhrich, D; Romita, R; Ronchetti, F; Rosnet, P; Rossegger, S; Rossi, A; Roy, P; Roy, C; Rubio Montero, A J; Rui, R; Russo, R; Ryabinkin, E; Rybicki, A; Sadovsky, S; Šafařík, K; Sahoo, R; Sahu, P K; Saini, J; Sakaguchi, H; Sakai, S; Sakata, D; Salgado, C A; Salzwedel, J; Sambyal, S; Samsonov, V; Sanchez Castro, X; Šándor, L; Sandoval, A; Sano, M; Sano, S; Santo, R; Santoro, R; Sarkamo, J; Scapparone, E; Scarlassara, F; Scharenberg, R P; Schiaua, C; Schicker, R; Schmidt, C; Schmidt, H R; Schreiner, S; Schuchmann, S; Schukraft, J; Schutz, Y; Schwarz, K; Schweda, K; Scioli, G; Scomparin, E; Scott, R; Segato, G; Selyuzhenkov, I; Senyukov, S; Seo, J; Serci, S; Serradilla, E; Sevcenco, A; Shabetai, A; Shabratova, G; Shahoyan, R; Sharma, N; Sharma, S; Rohni, S; Shigaki, K; Shimomura, M; Shtejer, K; Sibiriak, Y; Siciliano, M; Sicking, E; Siddhanta, S; Siemiarczuk, T; Silvermyr, D; Silvestre, C; Simatovic, G; Simonetti, G; Singaraju, R; Singh, R; Singha, S; Singhal, V; Sinha, B C; Sinha, T; Sitar, B; Sitta, M; Skaali, T B; Skjerdal, K; Smakal, R; Smirnov, N; Snellings, R J M; Søgaard, C; Soltz, R; Son, H; Song, M; Song, J; Soos, C; Soramel, F; Sputowska, I; Spyropoulou-Stassinaki, M; Srivastava, B K; Stachel, J; Stan, I; Stan, I; Stefanek, G; Steinpreis, M; Stenlund, E; Steyn, G; Stiller, J H; Stocco, D; Stolpovskiy, M; Strabykin, K; Strmen, P; Suaide, A A P; Subieta Vásquez, M A; Sugitate, T; Suire, C; Sukhorukov, M; Sultanov, R; Šumbera, M; Susa, T; Symons, T J M; Szanto de Toledo, A; Szarka, I; Szczepankiewicz, A; Szostak, A; Szymański, M; Takahashi, J; Tapia Takaki, J D; Tauro, A; Tejeda Muñoz, G; Telesca, A; Terrevoli, C; Thäder, J; Thomas, D; Tieulent, R; Timmins, A R; Tlusty, D; Toia, A; Torii, H; Toscano, L; Trubnikov, V; Truesdale, D; Trzaska, W H; Tsuji, T; Tumkin, A; Turrisi, R; Tveter, T S; Ulery, J; Ullaland, K; Ulrich, J; Uras, A; Urbán, J; Urciuoli, G M; Usai, G L; Vajzer, M; Vala, M; Valencia Palomo, L; Vallero, S; Vande Vyvre, P; van Leeuwen, M; Vannucci, L; Vargas, A; Varma, R; Vasileiou, M; Vasiliev, A; Vechernin, V; Veldhoen, M; Venaruzzo, M; Vercellin, E; Vergara, S; Vernet, R; Verweij, M; Vickovic, L; Viesti, G; Vikhlyantsev, O; Vilakazi, Z; Villalobos Baillie, O; Vinogradov, Y; Vinogradov, A; Vinogradov, L; Virgili, T; Viyogi, Y P; Vodopyanov, A; Voloshin, S; Voloshin, K; Volpe, G; von Haller, B; Vranic, D; Øvrebekk, G; Vrláková, J; Vulpescu, B; Vyushin, A; Wagner, V; Wagner, B; Wan, R; Wang, M; Wang, D; Wang, Y; Wang, Y; Watanabe, K; Weber, M; Wessels, J P; Westerhoff, U; Wiechula, J; Wikne, J; Wilde, M; Wilk, A; Wilk, G; Williams, M C S; Windelband, B; Xaplanteris Karampatsos, L; Yaldo, C G; Yamaguchi, Y; Yang, H; Yang, S; Yasnopolskiy, S; Yi, J; Yin, Z; Yoo, I-K; Yoon, J; Yu, W; Yuan, X; Yushmanov, I; Zaccolo, V; Zach, C; Zampolli, C; Zaporozhets, S; Zarochentsev, A; Závada, P; Zaviyalov, N; Zbroszczyk, H; Zelnicek, P; Zgura, I S; Zhalov, M; Zhang, X; Zhang, H; Zhou, D; Zhou, Y; Zhou, F; Zhu, J; Zhu, J; Zhu, X; Zichichi, A; Zimmermann, A; Zinovjev, G; Zoccarato, Y; Zynovyev, M; Zyzak, M
Measurements of cross sections of inelastic and diffractive processes in proton-proton collisions at LHC energies were carried out with the ALICE detector. The fractions of diffractive processes in inelastic collisions were determined from a study of gaps in charged particle pseudorapidity distributions: for single diffraction (diffractive mass M X <200 GeV/ c 2 ) [Formula: see text], and [Formula: see text], respectively at centre-of-mass energies [Formula: see text]; for double diffraction (for a pseudorapidity gap Δ η >3) σ DD / σ INEL =0.11±0.03,0.12±0.05, and [Formula: see text], respectively at [Formula: see text]. To measure the inelastic cross section, beam properties were determined with van der Meer scans, and, using a simulation of diffraction adjusted to data, the following values were obtained: [Formula: see text] mb at [Formula: see text] and [Formula: see text] at [Formula: see text]. The single- and double-diffractive cross sections were calculated combining relative rates of diffraction with inelastic cross sections. The results are compared to previous measurements at proton-antiproton and proton-proton colliders at lower energies, to measurements by other experiments at the LHC, and to theoretical models.
Asai, Yumi; Imamura, Kotaro; Kawakami, Norito
2017-06-01
This study aimed to investigate associations of job stressors with panic attack (PA) and panic disorder (PD) among Japanese workers. A cross-sectional online questionnaire survey was conducted of 2060 workers. Job strain, effort/reward imbalance, and workplace social support were measured by the job content questionnaire and effort/reward imbalance questionnaire. These variables were classified into tertiles. PA/PD were measured by self-report based on the mini international neuropsychiatric interview (MINI). Multiple logistic regression was conducted, adjusting for demographic, lifestyle, and health-related covariates. Data from 1965 participants were analyzed. Adjusted odds ratio (OR) of PA/PD was significantly greater for the group with high effort/reward imbalance compared with the group with low effort/reward imbalance (ORs, 2.64 and 2.94, respectively, both P < 0.05). This study found effort/reward imbalance was associated with having PA/PD among Japanese workers.
Nsiah-Boateng, Eric; Asenso-Boadi, Francis; Dsane-Selby, Lydia; Andoh-Adjei, Francis-Xavier; Otoo, Nathaniel; Akweongo, Patricia; Aikins, Moses
2017-02-06
A robust medical claims review system is crucial for addressing fraud and abuse and ensuring financial viability of health insurance organisations. This paper assesses claims adjustment rate of the paper- and electronic-based claims reviews of the National Health Insurance Scheme (NHIS) in Ghana. The study was a cross-sectional comparative assessment of paper- and electronic-based claims reviews of the NHIS. Medical claims of subscribers for the year, 2014 were requested from the claims directorate and analysed. Proportions of claims adjusted by the paper- and electronic-based claims reviews were determined for each type of healthcare facility. Bivariate analyses were also conducted to test for differences in claims adjustments between healthcare facility types, and between the two claims reviews. The electronic-based review made overall adjustment of 17.0% from GHS10.09 million (USD2.64 m) claims cost whilst the paper-based review adjusted 4.9% from a total of GHS57.50 million (USD15.09 m) claims cost received, and the difference was significant (p < 0.001). However, there were no significant differences in claims cost adjustment rate between healthcare facility types by the electronic-based (p = 0.0656) and by the paper-based reviews (p = 0.6484). The electronic-based review adjusted significantly higher claims cost than the paper-based claims review. Scaling up the electronic-based review to cover claims from all accredited care providers could reduce spurious claims cost to the scheme and ensure long term financial sustainability.
Metzger, Zvi; Teperovich, Ehud; Zary, Raviv; Cohen, Raphaela; Hof, Rafael
2010-04-01
To introduce a new concept, the self-adjusting file (SAF), and discuss its unique features compared with current rotary nickel-titanium file systems. The SAF file is hollow and designed as a thin cylindrical nickel-titanium lattice that adapts to the cross-section of the root canal. A single file is used throughout the procedure. It is inserted into a path initially prepared by a # 20 K-file and operated with a transline- (in-and-out) vibration. The resulting circumferential pressure allows the file's abrasive surface to gradually remove a thin uniform hard-tissue layer from the entire root canal surface, resulting in a canal with a similar cross-section but of larger dimensions. This holds also for canals with an oval or flat cross-section, which will be enlarged to a flat or oval cross-section of larger dimensions. The straightening of curved canals is also reduced because of the high pliability of the file and the absence of a rigid metal core. Thus, the original shape of the root canal is respected both longitudinally and in cross-section. The hollow SAF file is operated with a constant flow of irrigant that enters the full length of the canal and that is activated by the vibration and is replaced continuously throughout the procedure. This results in effective cleaning even at the cul de sac apical part of the canal. The SAF has high mechanical endurance; file separation does not occur; and mechanical failure, if it occurs, is limited to small tears in the latticework. The SAF represents a new step forward in endodontic file development that may overcome many of the shortcomings of current rotary nickel-titanium file systems. Copyright (c) 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Sartori, E.; Roussin, R.W.
This paper presents a brief review of computer codes concerned with checking, plotting, processing and using of covariances of neutron cross-section data. It concentrates on those available from the computer code information centers of the United States and the OECD/Nuclear Energy Agency. Emphasis will be placed also on codes using covariances for specific applications such as uncertainty analysis, data adjustment and data consistency analysis. Recent evaluations contain neutron cross section covariance information for all isotopes of major importance for technological applications of nuclear energy. It is therefore important that the available software tools needed for taking advantage of this informationmore » are widely known as hey permit the determination of better safety margins and allow the optimization of more economic, I designs of nuclear energy systems.« less
Consistency between cross-sectional and longitudinal SNP: blood lipid associations.
Costanza, Michael C; Beer-Borst, Sigrid; James, Richard W; Gaspoz, Jean-Michel; Morabia, Alfredo
2012-02-01
Various studies have linked different genetic single nucleotide polymorphisms (SNPs) to different blood lipids (BL), but whether these "connections" were identified using cross-sectional or longitudinal (i.e., changes over time) designs has received little attention. Cross-sectional and longitudinal assessments of BL [total, high-, low-density lipoprotein cholesterol (TC, HDL, LDL), triglycerides (TG)] and non-genetic factors (body mass index, smoking, alcohol intake) were measured for 2,002 Geneva, Switzerland, adults during 1999-2008 (two measurements, median 6 years apart), and 20 SNPs in 13 BL metabolism-related genes. Fixed and mixed effects repeated measures linear regression models, respectively, were employed to identify cross-sectional and longitudinal SNP:BL associations among the 1,516 (76%) study participants who reported not being treated for hypercholesterolemia at either measurement time. One-third more (12 vs. 9) longitudinal than cross-sectional associations were found [Bonferroni-adjusted two-tailed p < 0.00125 (=0.05/2)/20) for each of the four ensembles of 20 SNP:individual BL associations tested under the two study designs]. There was moderate consistency between the cross-sectional and longitudinal findings, with eight SNP:BL associations consistently identified across both study designs: [APOE.2 and APOE.4 (rs7412 and rs429358)]:TC; HL/LIPC (rs2070895):HDL; [APOB (rs1367117), APOE.2 and APOE.4 (rs7412 and rs429358)]:LDL; [APOA5 (rs2072560) and APOC III (rs5128)]:TG. The results suggest that cross-sectional studies, which include most genome-wide association studies (GWAS), can assess the large majority of SNP:BL associations. In the present analysis, which was much less powered than a GWAS, the cross-sectional study was around 2/3 (67%) as efficient as the longitudinal study.
Holtschlag, David J.; Koschik, John A.
2003-01-01
Acoustic Doppler current profilers (ADCP) were used to measure flow velocities in St. Clair River during a survey in May and June of 2002, as part of a study to assess the susceptibility of public water intakes to contaminants on the St. Clair-Detroit River Waterway. The survey provides 2.7 million point velocity measurements at 104 cross sections. Sections are spaced about 1,630 ft apart along the river from Port Huron to Algonac, Michigan, a distance of 28.6 miles. Two transects were obtained at each cross section, one in each direction across the river. Along each transect, velocity profiles were obtained 2-4 ft apart. At each velocity profile, average water velocity data were obtained at 1.64 ft intervals of depth. The raw position and velocity data from the ADCP field survey were adjusted for local magnetic anomalies using global positioning system (GPS) measurements at the end points of the transects. The adjusted velocity and ancillary data can be retrieved through the internet and extracted to column-oriented data files.
Nansel, Tonja R.; Craig, Wendy; Overpeck, Mary D.; Saluja, Gitanjali; Ruan, W. June
2008-01-01
Objective To determine whether the relationship between bullying and psychosocial adjustment is consistent across countries by standard measures and methods. Design Cross-sectional self-report surveys were obtained from nationally representative samples of students in 25 countries. Involvement in bullying, as bully, victim, or both bully and victim, was assessed. Setting Surveys were conducted at public and private schools throughout the participating countries. Participants Participants included all consenting students in sampled classrooms, for a total of 113200 students at average ages of 11.5, 13.5, and 15.5 years. Main Outcome Measures Psychosocial adjustment dimensions assessed included health problems, emotional adjustment, school adjustment, relationships with classmates, alcohol use, and weapon carrying. Results Involvement in bullying varied dramatically across countries, ranging from 9% to 54% of youth. However, across all countries, involvement in bullying was associated with poorer psychosocial adjustment (P<.05). In all or nearly all countries, bullies, victims, and bully-victims reported greater health problems and poorer emotional and social adjustment. Victims and bully-victims consistently reported poorer relationships with classmates, whereas bullies and bully-victims reported greater alcohol use and weapon carrying. Conclusions The association of bullying with poorer psychosocial adjustment is remarkably similar across countries. Bullying is a critical issue for the health of youth internationally. PMID:15289243
Kokaze, Akatsuki; Ishikawa, Mamoru; Matsunaga, Naomi; Karita, Kanae; Yoshida, Masao; Ohtsu, Tadahiro; Ochiai, Hirotaka; Shirasawa, Takako; Nanri, Hinako; Saga, Nobuyuki; Ohtsu, Iichiro; Hoshino, Hiromi; Takashima, Yutaka
2014-12-20
Mitochondrial DNA 5178 cytosine/adenine (Mt5178 C/A) polymorphism reportedly modulates the effects of coffee consumption on the risk of hypertension, dyslipidemia and abnormal glucose tolerance. The objective of this analysis was to investigate whether Mt5178 C/A polymorphism modifies the effects of coffee consumption on erythrocytic parameters in male Japanese health check-up examinees. A total of 436 men (mean age ± standard deviation, 54.1 ± 7.8 years) were selected from among individuals visiting the hospital for regular medical check-ups. After Mt5178 C/A genotyping, an exploratory cross-sectional analysis assessing the joint effects of Mt5178 C/A polymorphism and coffee consumption on red blood cell counts, hematocrit and hemoglobin was conducted. For Mt5178C genotypic men, after adjustment for age, body mass index, alcohol consumption, habitual smoking and green tea consumption, coffee consumption significantly decreased red blood cell counts (P for trend = 0.022) and hemoglobin (P for trend = 0.035). The risk of anemia, defined as hemoglobin of <14 g/dL, after the aforementioned adjustment, appeared to depend on coffee consumption (P for trend = 0.078), and the adjusted odds ratio for anemia was significantly higher in men who consumed ≥4 cups of coffee per day than in those who consumed <1 cup per day (odds ratio = 3.771, 95% confidence interval: 1.088 to 13.06, P = 0.036). For Mt5178A genotypic men, coffee consumption possibly reduced the risk of anemia (P for trend = 0.049). However, after the aforementioned adjustment, the statistical significance disappeared (P for trend = 0.137). This exploratory cross-sectional analysis suggests that Mt5178 C/A polymorphism modulates the effects of coffee consumption on erythrocytic parameters and the risk of anemia in male Japanese health check-up examinees.
Shafiq, Yasir; Khowaja, Asif Raza; Yousafzai, Mohammad Tahir; Ali, Syed Asad; Zaidi, Anita; Saleem, Ali Faisal
2017-09-01
A higher incidence of neonatal tetanus implies failure of the vaccination program in Pakistan. The objective of this study was to assess knowledge, attitudes and practices related to tetanus toxoid (TT) vaccine in women of childbearing age. We performed a cross-sectional survey in peri-urban Karachi, Pakistan, among women of childbearing age, stratified into three mutually exclusive groups as: married pregnant; married non-pregnant; and unmarried. Descriptive and inferential analyses were performed to estimate vaccine coverage and knowledge attributes. A total of 450 women participated, of which the largest proportion were married and non-pregnant (n = 185/450, 41%). Over 50% of women (n = 258/450) had not received TT vaccine. Most unmarried women (n = 139, 97%) were unvaccinated. Non-vaccination predictors included: women aged <25 years without any formal education (adjusted odds ratio [OR], 2.1; 95% confidence interval [CI], 1.0-4.4), lack of knowledge about free vaccination (adjusted OR, 4.0; 95% CI, 1.64-10.20), poor knowledge of tetanus disease/vaccination (adjusted OR, 4.6; 95%, 2.2-9.6), living with extended family (adjusted OR, 2.0; 95% CI, 1.04-3.96); family non-supporting vaccination (adjusted OR, 5.7; 95% CI, 2.3-13.9); and husband/other family member deciding upon issues related to women's health (adjusted OR, 2.9; 95% CI, 1.3-6.6). Low coverage of TT vaccine is largely influenced by poor knowledge, family structure and family decision-making in the local communities of Pakistan.
Innes, Kim E; Sambamoorthi, Usha
2017-05-19
Previous studies have documented memory impairment in several chronic pain syndromes. However, the potential link between memory loss and osteoarthritis (OA), the second most common cause of chronic pain, remains little explored. In this cross-sectional study, we examine the association of perceived memory loss to OA and assess the potential mediating influence of sleep and mood disturbance in a large Appalachian population. Cross-sectional. US Ohio Valley. A total of 21,982 Appalachian adults age 40 years or older drawn from the C8 Health Project (N = 19,004 adults without and 2,478 adults with OA). All participants completed a comprehensive health survey between 2005 and 2006. Medical history, including physician diagnosis of OA, lifestyle factors, short- and long-term memory loss, sleep quality, and mood were assessed via self-report. After adjustment for demographic, lifestyle, health-related, and other factors, participants with OA were almost three times as likely to report frequent memory loss (adjusted odds ratios [ORs] for short- and long-term memory loss, respectively = 2.7, 95% confidence interval [CI] = 2.2-3.3, and 2.6, 95% CI = 2.0-3.3). The magnitude of these associations increased significantly with rising frequency of reported joint pain (adjusted OR for OA with frequent joint pain vs no OA = 3.3, 95% CI = 2.6-4.1, P trend < 0.00001). Including measures of mood and sleep impairment attenuated but did not eliminate these associations (ORs for any memory loss = 2.0, 95% CI = 1.6-2.4, and 2.1, 95% CI = 1.7-2.8, adjusted for sleep and mood impairment, respectively; OR = 1.8, 95% CI = 1.4-2.2, adjusted for both factors). In this large cross-sectional study, OA and related joint pain were strongly associated with perceived memory loss; these associations may be partially mediated by sleep and mood disturbance. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
Boltzmann Calculations of Electron Transport in CF4 and CF_4/Ar
NASA Astrophysics Data System (ADS)
Wang, Yicheng; van Brunt, R. J.
1996-10-01
A new set of electron collisional cross sections(L. G. Christophorou, J. K. Olthoff, and M. V. V. S. Rao, J. Phys. Chem. Ref. Data, submitted (May 1996)) for CF4 has been proposed, based primarily upon available experimental measurements. In this paper we present the results of calculations of the drift velocity, ionization coefficient, and attachment coefficient for electrons in CF4 based upon the new cross section set, using a two-term Boltzmann calculation. Comparison of results with experimental determinations of the transport parameters, such as drift velocity, are presented, along with comparison of results obtained using two previously pubished(M. Hyashi, in Swarm Studies and Elastic Electron-Molecule Collisions) (1987); and Y. Nakamura in Gaseous Electronics and Their Applications (1991) electron impact cross section sets for CF_4. Additions and adjustments to the cross section sets required for the model to achieve consitency with transport data are discussed. - Research sponsored in part by the U.S. Air Force Wright Laboratory under contract F33615-96-C-2600 with the University of Tennessee. Also, Department of Physics, The University of Tennessee, Knoxville, TN.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Lukyanov, V. K., E-mail: lukyanov@theor.jinr.ru; Zemlyanaya, E. V.; Lukyanov, K. V.
The folding-model optical potential is generalized in such a way as to apply it to calculating the cross sections for inelastic scattering of π{sup ±}-mesons on {sup 28}Si, {sup 40}Ca, {sup 58}Ni, and {sup 208}Pb nuclei at the energies of 162, 180, 226, and 291 MeV leading to the excitation of the 2{sup +} and 3{sup −} collective states. In doing this, use is made of known nucleon-density distributions in nuclei and the pion–nucleon scattering amplitude whose parameters were obtained previously by fitting the elastic scattering cross sections for the same nuclei. Thus, the values of quadrupole (β{sub 2}) andmore » octupole (β{sub 3}) deformations of nuclei appear here as the only adjustable parameters. The scattering cross section is calculated by solving the relativistic wave equation, whereby effects of relativization and distortion in the entrance and exit scattering channels are taken exactly into account. The cross sections calculated in this way for inelastic scattering are in good agreement with respective experimental data. The importance of the inclusion of in-medium effects in choosing parameters of the pion–nucleon amplitude is emphasized.« less
Psychosocial Working Conditions and Cognitive Complaints among Swedish Employees
Stenfors, Cecilia U. D.; Magnusson Hanson, Linda; Oxenstierna, Gabriel; Theorell, Töres; Nilsson, Lars-Göran
2013-01-01
Background Cognitive complaints involving problems with concentration, memory, decision-making and thinking are relatively common in the work force. The sensitivity of both subjective and objective cognitive functioning to common psychiatric conditions, stress levels and to cognitive load makes it plausible that psychosocial working conditions play a role in cognitive complaints. Thus, this study aimed to test the associations between psychosocial work factors and cognitive complaints in nationally representative samples of the Swedish work force. Cross-sectional (n = 9751) and prospective (n = 3644; two time points two years apart) sequential multiple regression analyses were run, adjusting for general confounders, depressive- and sleeping problems. Additional prospective analyses were run adjusting for baseline cognitive complaints. Cross-sectional results High quantitative demands, information and communication technology (ICT) demands, underqualification and conflicts were positively associated with cognitive complaints, while social support, good resources at work and overqualification were negatively associated with cognitive complaints in all models. Skill discretion and decision authority were weakly associated with cognitive complaints. Conflicts were more strongly associated with cognitive complaints in women than in men, after adjustment for general confounders. Prospective results Quantitative job demands, ICT demands and underqualification were positively associated with future cognitive complaints in all models, including when adjusted for baseline cognitive complaints. Decision authority was weakly positively associated with future cognitive complaints, only after adjustment for depressive- and sleeping problems respectively. Social support was negatively associated with future cognitive complaints after adjustment for general confounders and baseline cognitive complaints. Skill discretion and resources were negatively associated with future cognitive complaints after adjustment for general confounders. The associations between quantitative demands and future cognitive complaints were stronger in women. Discussion/Conclusions The findings indicate that psychosocial working conditions should be taken into account when considering cognitive complaints among employees. PMID:23560101
Berry, Patricia A; Teichtahl, Andrew J; Galevska-Dimitrovska, Ana; Hanna, Fahad S; Wluka, Anita E; Wang, Yuanyuan; Urquhart, Donna M; English, Dallas R; Giles, Graham G; Cicuttini, Flavia M
2008-01-01
Introduction Although vastus medialis and lateralis are important determinants of patellofemoral joint function, their relationship with patellofemoral joint structure is unknown. The aim of this study was to examine potential determinants of vastus medialis and lateralis cross-sectional areas and the relationship between the cross-sectional area and patella cartilage and bone volumes. Methods Two hundred ninety-seven healthy adult subjects had magnetic resonance imaging of their dominant knee. Vastus medialis and lateralis cross-sectional areas were measured 37.5 mm superior to the quadriceps tendon insertion at the proximal pole of the patella. Patella cartilage and bone volumes were measured from these images. Demographic data and participation in vigorous physical activity were assessed by questionnaire. Results The determinants of increased vastus medialis and lateralis cross-sectional areas were older age (P ≤ 0.002), male gender (P < 0.001), and greater body mass index (P ≤ 0.07). Participation in vigorous physical activity was positively associated with vastus medialis cross-sectional area (regression coefficient [beta] 90.0; 95% confidence interval [CI] 38.2, 141.7) (P < 0.001) but not with vastus lateralis cross-sectional area (beta 10.1; 95% CI -18.1, 38.3) (P = 0.48). The cross-sectional area of vastus medialis only was positively associated with patella cartilage volume (beta 0.6; 95% CI 0.23, 0.94) (P = 0.001) and bone volume (beta 3.0; 95% CI 1.40, 4.68) (P < 0.001) after adjustment for potential confounders. Conclusions Our results in a pain-free community-based population suggest that increased cross-sectional area of vastus medialis, which is associated with vigorous physical activity, and increased patella cartilage and bone volumes may benefit patellofemoral joint health and reduce the long-term risk of patellofemoral pathology. PMID:19077298
Sacroiliac joint dysfunction in patients with herniated lumbar disc: a cross-sectional study.
Madani, Seyed Pezhman; Dadian, Mohammad; Firouznia, Keykavous; Alalawi, Salah
2013-01-01
To determine the relative frequency of sacroiliac joint dysfunction in a sample of patients with image proven lumbar disc herniation. A single group cross-sectional study was conducted in a three year period from 2007 in an outpatient clinic at a university hospital. Overall, 202 patients aged more than or equal to 18 years with image proven herniated lumbar disc and with physical findings suggestive of lumbosacral root irritation were included. Overall, 146 (72.3%) participants had sacroiliac joint dysfunction. The dysfunction was significantly more prevalent in females (p< 0.001, adjusted OR=2.46, 95% CI=1.00 to 6.03), patients with recurrent pain (p< 0.005, adjusted OR=2.33 with 95% CI=1.10 to 4.89) and patients with positive straight leg raising provocative test (p< 0.0001, adjusted OR=5.07, 95% CI=2.37 to 10.85). There was no significant relationship between the prevalence of SIJD, and working hours, duration of low back pain, or body mass index. Sacroiliac joint dysfunction is a significant pathogenic factor with high possibility of occurrence in low back pain. Thus, regardless of intervertebral disc pathology, sacroiliac joint dysfunction must be considered in clinical decision making.
Automatic Monitoring of Tunnel Deformation Based on High Density Point Clouds Data
NASA Astrophysics Data System (ADS)
Du, L.; Zhong, R.; Sun, H.; Wu, Q.
2017-09-01
An automated method for tunnel deformation monitoring using high density point clouds data is presented. Firstly, the 3D point clouds data are converted to two-dimensional surface by projection on the XOY plane, the projection point set of central axis on XOY plane named Uxoy is calculated by combining the Alpha Shape algorithm with RANSAC (Random Sampling Consistency) algorithm, and then the projection point set of central axis on YOZ plane named Uyoz is obtained by highest and lowest points which are extracted by intersecting straight lines that through each point of Uxoy and perpendicular to the two -dimensional surface with the tunnel point clouds, Uxoy and Uyoz together form the 3D center axis finally. Secondly, the buffer of each cross section is calculated by K-Nearest neighbor algorithm, and the initial cross-sectional point set is quickly constructed by projection method. Finally, the cross sections are denoised and the section lines are fitted using the method of iterative ellipse fitting. In order to improve the accuracy of the cross section, a fine adjustment method is proposed to rotate the initial sectional plane around the intercept point in the horizontal and vertical direction within the buffer. The proposed method is used in Shanghai subway tunnel, and the deformation of each section in the direction of 0 to 360 degrees is calculated. The result shows that the cross sections becomes flat circles from regular circles due to the great pressure at the top of the tunnel
Ghasem-Zadeh, Ali; Burghardt, Andrew; Wang, Xiao-Fang; Iuliano, Sandra; Bonaretti, Serena; Bui, Minh; Zebaze, Roger; Seeman, Ego
2017-08-01
Individuals differ in forearm length. As microstructure differs along the radius, we hypothesized that errors may occur when sexual and racial dimorphisms are quantified at a fixed distance from the radio-carpal joint. Microstructure was quantified ex vivo in 18 cadaveric radii using high resolution peripheral quantitative computed tomography and in vivo in 158 Asian and Caucasian women and men at a fixed region of interest (ROI), a corrected ROI positioned at 4.5-6% of forearm length and using the fixed ROI adjusted for cross sectional area (CSA), forearm length or height. Secular effects of age were assessed by comparing 38 younger and 33 older women. Ex vivo, similar amounts of bone mass fashioned adjacent cross sections. Larger distal cross sections had thinner porous cortices of lower matrix mineral density (MMD), a larger medullary CSA and higher trabecular density. Smaller proximal cross-sections had thicker less porous cortices of higher MMD, a small medullary canal with little trabecular bone. Taller persons had more distally positioned fixed ROIs which moved proximally when corrected. Shorter persons had more proximally positioned fixed ROIs which moved distally when corrected, so dimorphisms lessened. In the corrected ROIs, in Caucasians, women had 0.6 SD higher porosity and 0.6 SD lower trabecular density than men (p<0.01). In Asians, women had 0.25 SD higher porosity (NS) and 0.5 SD lower trabecular density than men (p<0.05). In women, Asians had 0.8 SD lower porosity and 0.3 SD higher trabecular density than Caucasians (p<0.01). In men, Asians and Caucasians had similar porosity and trabecular density. Results were similar using an adjusted fixed ROI. Adjusting for secular effects of age on forearm length resulted in the age-related increment in porosity increasing from 2.08 SD to 2.48 SD (p<0.05). Assessment of sex, race and age related differences in microstructure requires measurement of anatomically equivalent regions. Copyright © 2017 Elsevier Inc. All rights reserved.
Eltoft, Agnethe; Arntzen, Kjell Arne; Hansen, John-Bjarne; Wilsgaard, Tom; Mathiesen, Ellisiv B; Johnsen, Stein Harald
2017-08-01
CRP predicts cardiovascular disease (CVD) in large epidemiologic studies. The aim of the present study was to elucidate the role of CRP in atherosclerosis formation and progression in a prospective population-based study. 6503 middle-aged subjects from The Tromsø study had serum CRP, carotid ultrasound and complete covariate data collected at baseline in 1994. Of these, 4730 and 2917 attended follow-up surveys with repeated assessments in 2001 and 2007, respectively. The cross-sectional associations between CRP and subclinical carotid atherosclerosis, and the longitudinal associations between baseline CRP and novel plaque formation and plaque progression were assessed in generalized estimating equations and linear mixed models stratified by sex. At baseline, traditional risk factors and plaque prevalence increased by CRP risk categories (<1 mg/L, 1-3 mg/L, and >3 mg/L) in both sexes. In cross-sectional analyses, multivariable-adjusted CRP was associated with plaque prevalence and total plaque area (TPA) in men and women. Age-adjusted baseline CRP >3 mg/L compared to CRP <1 mg/L predicted novel plaque formation (OR 1.44, CI 1.08-1.92) and TPA progression (β = 0.0.029 (CI, 0.003-0.056)) in men, but not in women. In neither men nor women was baseline CRP a predictor of TPA-progression or novel plaque formation when adjusted for traditional risk factors. CRP was associated with plaque presence and TPA in cross-sectional analyses, but was not an independent predictor of novel plaque formation or plaque progression. Our findings suggest that CRP may link to CVD by other mechanisms than promoting formation and progression of atherosclerotic plaques. Copyright © 2017 Elsevier B.V. All rights reserved.
Kische, Hanna; Ewert, Ralf; Fietze, Ingo; Gross, Stefan; Wallaschofski, Henri; Völzke, Henry; Dörr, Marcus; Nauck, Matthias; Obst, Anne; Stubbe, Beate; Penzel, Thomas; Haring, Robin
2016-11-01
Associations between sex hormones and sleep habits originate mainly from small and selected patient-based samples. We examined data from a population-based sample with various sleep characteristics and the major part of sex hormones measured by mass spectrometry. We used data from 204 men and 213 women of the cross-sectional Study of Health in Pomerania-TREND. Associations of total T (TT) and free T, androstenedione (ASD), estrone, estradiol (E2), dehydroepiandrosterone-sulphate, SHBG, and E2 to TT ratio with sleep measures (including total sleep time, sleep efficiency, wake after sleep onset, apnea-hypopnea index [AHI], Insomnia Severity Index, Epworth Sleepiness Scale, and Pittsburgh Sleep Quality Index) were assessed by sex-specific multivariable regression models. In men, age-adjusted associations of TT (odds ratio 0.62; 95% confidence interval (CI) 0.46-0.83), free T, and SHBG with AHI were rendered nonsignificant after multivariable adjustment. In multivariable analyses, ASD was associated with Epworth Sleepiness Scale (β-coefficient per SD increase in ASD: -0.71; 95% CI: -1.18 to -0.25). In women, multivariable analyses showed positive associations of dehydroepiandrosterone-sulphate with wake after sleep onset (β-coefficient: .16; 95% CI 0.03-0.28) and of E2 and E2 to TT ratio with Epworth Sleepiness Scale. Additionally, free T and SHBG were associated with AHI in multivariable models among premenopausal women. The present cross-sectional, population-based study observed sex-specific associations of androgens, E2, and SHBG with sleep apnea and daytime sleepiness. However, multivariable-adjusted analyses confirmed the impact of body composition and health-related lifestyle on the association between sex hormones and sleep.
Evaluation of proton cross-sections for radiation sources in the proton accelerator
NASA Astrophysics Data System (ADS)
Cho, Young-Sik; Lee, Cheol-Woo; Lee, Young-Ouk
2007-08-01
Proton Engineering Frontier Project (PEFP) is currently building a proton accelerator in Korea which consists of a proton linear accelerator with 100 MeV of energy, 20 mA of current and various particle beam facilities. The final goal of this project consists of the production of 1 GeV proton beams, which will be used for various medical and industrial applications as well as for research in basic and applied sciences. Carbon and copper in the proton accelerator for PEPP, through activation, become radionuclides such as 7Be and 64Cu. Copper is a major element of the accelerator components and the carbon is planned to be used as a target material of the beam dump. A recent survey showed that the currently available cross-sections create a large difference from the experimental data in the production of some residual nuclides by the proton-induced reactions for carbon and copper. To more accurately estimate the production of radioactive nuclides in the accelerator, proton cross-sections for carbon and copper are evaluated. The TALYS code was used for the evaluation of the cross-sections for the proton-induced reactions. To obtain the cross-sections which best fits the experimental data, optical model parameters for the neutron, proton and other complex particles such as the deuteron and alpha were successively adjusted. The evaluated cross-sections in this study are compared with the measurements and other evaluations .
Danziger, John; Biggs, Mary L.; Niemi, Matt; Ix, Joachim H.; Kizer, Jorge R.; Djoussé, Luc; de Boer, Ian H.; Siscovick, David S.; Kestenbaum, Bryan; Mukamal, Kenneth J.
2014-01-01
Background Despite extensive study, the role of vitamin D in insulin resistance and secretion remains unclear. Objective To examine the cross-sectional and longitudinal relationships between 25-hydroxyvitamin D (25(OH)D) concentrations and indices of insulin resistance and secretion in older adults. Methods and Results Among 2134 participants of the Cardiovascular Health Study who were free from cardiovascular disease, we measured serum 25(OH)D concentrations in samples collected in 1992–1993. We examined insulin resistance and secretion using Homeostasis Model Assessment (HOMA) estimates cross-sectionally and among 1469 participants who had repeated HOMA measures four years later (1996–1997). In cross-sectional analysis, each 10 ng/mL increment in 25(OH)D concentration was associated with a 0.09 lower adjusted HOMA-IR [95%CI (−0.17, −0.02), p=0.01]. However, baseline 25(OH)D concentrations were not associated with change in HOMA-IR over 4 years of follow up (p=0.48). 25(OH)D concentrations were not associated with insulin secretion, as determined by HOMA-β, in either cross-sectional or longitudinal analysis. Conclusions Circulating 25(OH)D concentrations are associated with lower insulin resistance in cross-sectional but not longitudinal analyses. Whether this reflects residual confounding in cross-sectional analyses or the short-term nature of the relationship between vitamin D and insulin sensitivity will require trials with repeated measures of these factors. PMID:23987236
Nakajima, Shun; Komada, Yoko; Sasai-Sakuma, Taeko; Okajima, Isa; Harada, Yutaka; Watanabe, Kazue; Inoue, Yuichi
2017-05-01
Sleep reactivity assessed using the Ford Insomnia Response to Stress Test (FIRST) is associated with depression. This study clarified stress reactivity and insomnia effects on depressive symptoms. A cross-sectional questionnaire survey was administered to 2645 participating government employees (35.4% female, mean age 42.8 years) during health checks conducted at Tottori prefecture, Japan, in June 2012. Questionnaire items included: demographic information; the FIRST; the Pittsburgh Sleep Quality Index (PSQI); and a 12-item version of the Center for Epidemiological Studies Depression scale (CES-D). The study defined CES-D scores of ≥12 points as positive for depression, PSQI scores of ≥5.5 points as positive for insomnia symptoms, and FIRST scores of ≥19 points as indicating higher sleep reactivity. Multivariate logistic regression analysis revealed insomnia (adjusted OR = 3.40), higher sleep reactivity (adjusted OR = 1.78), presence of disease currently being treated (adjusted OR = 1.84), and being female (adjusted OR = 1.53) as independently associated with depression. Participants with insomnia and a high FIRST score showed higher CES-D scores than those with insomnia alone and those with high FIRST without insomnia (all p < 0.01). Sleep reactivity might be associated with depression, independent of insomnia. Elevated sleep reactivity and insomnia symptoms are thought to aggravate depressive symptoms. Copyright © 2017 Elsevier B.V. All rights reserved.
Fujita, Sumiko; Kawakami, Norito; Ando, Emiko; Inoue, Akiomi; Tsuno, Kanami; Kurioka, Sumiko; Kawachi, Ichiro
2016-03-01
The aim of the study was to examine the cross-sectional multilevel association between unit-level workplace social capital and individual-level work engagement among employees in health care settings. The data were collected from employees of a Japanese health care corporation using a questionnaire. The analyses were limited to 440 respondents from 35 units comprising five or more respondents per unit. Unit-level workplace social capital was calculated as an average score of the Workplace Social Capital Scale for each unit. Multilevel regression analysis with a random intercept model was conducted. After adjusting for demographic variables, unit-level workplace social capital was significantly and positively associated with respondents' work engagement (P < 0.001). The association remained significant after additionally adjusting for individual-level perceptions of workplace social capital (P < 0.001). Workplace social capital might exert a positive contextual effect on work engagement of employees in health care settings.
Universal empirical fit to L-shell X-ray production cross sections in ionization by protons
NASA Astrophysics Data System (ADS)
Lapicki, G.; Miranda, J.
2018-01-01
A compilation published in 2014, with a recent 2017 update, contains 5730 experimental total L-shell X-ray production cross sections (XRPCS). The database covers an energy range from 10 keV to 1 GeV, and targets from 18Ar to 95Am. With only two adjustable parameters, universal fit to these data normalized to XRPCS calculated at proton velocity v1 equal to the electron velocity in the L-shell v2L, is obtained in terms of a single ratio of v1/v2L. This fit reproduces 97% of the compiled XRPCS to within a factor of 2.
Effects of Increased Loading on In Vivo Tendon Properties: A Systematic Review
WIESINGER, HANS-PETER; KÖSTERS, ALEXANDER; MÜLLER, ERICH; SEYNNES, OLIVIER R.
2015-01-01
ABSTRACT Introduction In vivo measurements have been used in the past two decades to investigate the effects of increased loading on tendon properties, yet the current understanding of tendon macroscopic changes to training is rather fragmented, limited to reports of tendon stiffening, supported by changes in material properties and/or tendon hypertrophy. The main aim of this review was to analyze the existing literature to gain further insights into tendon adaptations by extracting patterns of dose-response and time-course. Methods PubMed/Medline, SPORTDiscus, and Google Scholar databases were searched for studies examining the effect of training on material, mechanical, and morphological properties via longitudinal or cross-sectional designs. Results Thirty-five of 6440 peer-reviewed articles met the inclusion criteria. The key findings were i) the confirmation of a nearly systematic adaptation of tendon tissue to training, ii) the important variability in the observed changes in tendon properties between and within studies, and iii) the absence of a consistent incremental pattern regarding the dose-response or the time-course relation of tendon adaptation within the first months of training. However, long-term (years) training was associated with a larger tendon cross-sectional area, without any evidence of differences in material properties. Our analysis also highlighted several gaps in the existing literature, which may be addressed in future research. Conclusions In line with some cross-species observations about tendon design, tendon cross-sectional area allegedly constitutes the ultimate adjusting parameter to increased loading. We propose here a theoretical model placing tendon hypertrophy and adjustments in material properties as parts of the same adaptive continuum. PMID:25563908
Xirasagar, Sudha; Lin, Herng-Ching
2004-12-01
To test the hypotheses that: (1) average adjusted costs per discharge are higher in high-competition relative to low-competition markets, and (2) increased competition is associated with cost convergence between public and for-profit (FP) hospitals for case payment diagnoses, but not for cost-plus reimbursed diagnoses. Taiwan's National Health Insurance database; 325,851 inpatient claims for cesarean section, vaginal delivery, prostatectomy, and thyroidectomy (all case payment), and bronchial asthma and cholelithiasis (both cost-based payment). Retrospective population-based, cross-sectional study. Diagnosis-wise regression analyses were done to explore associations between cost per discharge and hospital ownership under high and low competition, adjusted for clinical severity and institutional characteristics. Adjusted costs per discharge are higher for all diagnoses in high-competition markets. For case payment diagnoses, the magnitudes of adjusted cost differences between public and FP hospitals are lower under high competition relative to low competition. This is not so for the cost-based diagnoses. We find that the empirical evidence supports both our hypotheses.
2017-10-01
baseline were available for 228 PD subjects. In a logistic regression model adjusted for age and sex , Ch4 density was associated with lower risk of...events, there were no significant differences in age or sex (p>0.05). PD subjects with 2 or more psychotic events had significantly lower baseline Ch4...Aim 1 and 2 include use of linear regression models to adjust for age, sex , and other significant covariates. Aim 3 is a cross-sectional controlled
Somanath, Renuka Pulikallu; Mishra, Ram Manohar; Saggurti, Niranjan; Parimi, Prabhakar
2013-01-01
This paper examines the association between female sex workers' (FSWs) noncommercial partnerships with risk of HIV in Andhra Pradesh, India. Data were drawn from a cross-sectional behavioral and biological survey conducted in 2009 among 3225 FSWs from Andhra Pradesh. Participants were asked about their sexual partnerships, condom use, and vulnerability factors and tested for HIV and sexually transmitted infections. The key independent variables considered were presence of a noncommercial sexual partner (no, yes) and the nature of such partnerships (regular, nonregular). FSWs who reported husband as noncommercial partner were considered to have a regular partner, while the rest were defined as having nonregular partners. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated to measure the associations between variables of interest. Almost three-fourths (74.8%) of FSWs reported having noncommercial partners (regular: 55.6%; nonregular: 19.3%). FSWs in nonregular partnerships were more likely to be HIV positive (13.1% versus 10.9%, adjusted OR: 1.4, 95% CI: 1.1–1.8), have syphilis (10.3% versus 4.2%, adjusted OR: 2.3, 95% CI: 1.6–3.3), use condoms inconsistently with occasional clients (21.0% versus 16.5%, adjusted OR: 1.5, 95% CI: 1.2–1.9), and report forced sex (25.1% versus 14.1%, adjusted OR: 1.9, 95% CI: 1.5–2.4) as compared to those in regular partnerships. HIV prevention programs need to emphasize safe sex behaviors, particularly among FSWs who have nonregular partners. PMID:23533729
Parental smoking, exposure to secondhand smoke at home, and smoking initiation among young children.
Wang, Man Ping; Ho, Sai Yin; Lam, Tai Hing
2011-09-01
To investigate the associations of parental smoking and secondhand smoke (SHS) exposure at home with smoking initiation among young children in Hong Kong. A prospective school-based survey of Hong Kong primary 2-4 students was conducted at baseline in 2006 and followed up in 2008. Self-administered anonymous questionnaires were used to collect information about smoking, SHS exposure at home, parental smoking, and sociodemographic characteristics. Cross-sectional and prospective associations of SHS exposure at home and parental smoking with student smoking were analyzed using logistic regression adjusting for potential confounders. Cross-sectional association between parental smoking and ever smoking was significant with adjustment of sociodemographic characteristics but became insignificant after adjusting for home SHS exposure. Home SHS exposure mediated the association between parental smoking and students smoking (p = .03). Prospectively, parental smoking was not associated with smoking initiation after adjusting for home SHS exposure. Each day increase in home SHS exposure significantly predicted 16% excess risk of smoking initiation after adjusting for parental smoking. The prospective effect of parental smoking on smoking initiation was significantly mediated by baseline home SHS exposure (p < .01). Higher exposure to SHS at home predicted smoking initiation of young Chinese children in Hong Kong independent of parental smoking status. On the other hand, the effect of parental smoking on smoking initiation was mediated through SHS exposure at home. To prevent children from smoking as well as the harm of SHS exposure, parents and other family members should quit smoking or at least reduce smoking at home.
Personal Fables, Narcissism, and Adolescent Adjustment
ERIC Educational Resources Information Center
Aalsma, Matthew C.; Lapsley, Daniel K.; Flannery, Daniel J.
2006-01-01
The relationship among three personal fables ("omnipotence," "invulnerability," "personal uniqueness"), narcissism, and mental health variables was assessed in a large, cross-sectional sample of adolescents drawn from Grades 6 (n = 94), 8 (n = 223), 10 (n = 142), and 12 (n = 102). Participants responded to the New Personal Fable Scale, the…
Psychosocial Correlates of Dating Violence Victimization among Latino Youth
ERIC Educational Resources Information Center
Howard, Donna E.; Beck, Kenneth; Kerr, Melissa Hallmark; Shattuck, Teresa
2005-01-01
To examine the association between physical dating violence victimization and risk and protective factors, an anonymous, cross-sectional, self-reported survey was administered to Latino youth (n = 446) residing in suburban Washington, DC. Multivariate logistic regression models were constructed, and adjusted OR and 95% CI were examined.…
Evaluating the "cushion effect" among children in frontal motor vehicle crashes.
Harbaugh, Calista M; Zhang, Peng; Henderson, Brianna; Derstine, Brian A; Holcombe, Sven A; Wang, Stewart C; Kohoyda-Inglis, Carla; Ehrlich, Peter F
2018-05-01
The "Cushion Effect," the phenomenon in which obesity protects against abdominal injury in adults in motor vehicle accidents, has not been evaluated among pediatric patients. This work evaluates the association between subcutaneous fat cross-sectional area, quantified using analytic morphomic techniques and abdominal injury. This retrospective study includes 119 patients aged 1 to 18years involved in frontal impact motor vehicle accidents (2003-2015) with computed tomography scans. Subcutaneous fat cross-sectional area was measured and converted to age- and gender-adjusted percentiles from population-based normative data. Multivariable analysis determined the risk of the primary outcome, Maximum Abbreviated Injury Scale (MAIS) 2+ abdominal injury, after adjusting for age, weight, seatbelt status, and impact rating. MAIS 2+ abdominal injuries occurred in 20 (16.8%) of the patients. Subcutaneous fat area percentile was not significantly associated with MAIS 2+ abdominal injury on multivariable logistic regression (adjusted Odds Ratio, 0.86; 95% CI, 0.72-1.03; p=0.10). The "cushion effect" was not apparent among pediatric frontal motor vehicle crash victims in this study. Future work is needed to investigate other analytic morphomic measures. By understanding how body composition relates to injury patterns, there is a unique opportunity to improve vehicle safety design. Prognosis Study, Level III. Copyright © 2018. Published by Elsevier Inc.
Vigorous physical activity, mental health, perceived stress, and socializing among college students.
Vankim, Nicole A; Nelson, Toben F
2013-01-01
To examine cross-sectional associations between vigorous physical activity, mental health, perceived stress, and socializing among 4-year college students. A national cross-sectional sample of 4-year colleges in the United States. Ninety-four 4-year colleges in the United States. A total of 14,804 undergraduate students. Self-report vigorous physical activity, perceived stress (measured using the Cohen Perceived Stress Scale), mental health (measured using the SF-36), and socializing (assessed using self-report number of friends and hours spent socializing). Logistic regression models accounting for clustering within schools were estimated to examine the association between vigorous physical activity, mental health, perceived stress, and socializing. Adjusted models included high school vigorous physical activity and sociodemographic characteristics. Students who met vigorous physical activity recommendations were less likely to report poor mental health (adjusted odds ratio [OR]: .79; 95% confidence interval [CI]: .69, .90) and perceived stress (adjusted OR: .75; 95% CI: .67, .83) than students who did not meet recommendations. In addition, socializing partially mediated the relationship between vigorous physical activity, mental health, and perceived stress; however, race and sex did not moderate the relationship. Interventions aiming to improve mental well-being of college students should also consider promoting physical activity. At least some of the positive benefits of physical activity may arise from social interactions.
da Câmara, Saionara M A; Zunzunegui, Maria Victoria; Pirkle, Catherine; Moreira, Mayle A; Maciel, Álvaro C C
2015-01-01
To examine associations between menopausal status and physical performance in middle-aged women from the Northeast region of Brazil. Cross-sectional study of women between 40 to 65 years old living in Parnamirim. Women were recruited by advertisements in primary care neighborhood centers across the city. Physical performance was assessed by grip strength, gait speed and chair stands. Menopausal status was determined using the Stages of Reproductive Aging Workshop classification and women were classified in: premenopausal, perimenopausal or postmenopausal. Multiple linear regression analyses were performed to model the effect of menopausal status on each physical performance measure, adjusting for covariates (age, family income, education, body mass index, parity and age at first birth). The premenopausal women were significantly stronger and performed better in chair stands than perimenopausal and postmenopausal women. Gait speed did not vary significantly by menopausal status. In multivariate analyses, menopausal status remained statistically significant only for grip strength. In fully adjusted analyses, premenopausal women had grip strength mean of 2.226 Kgf (95% CI: 0.361 - 4.091) higher than the postmenopausal group. This study provides further evidence for the associations between menopause and physical performance in middle-aged women, since grip strength is weaker in peri and postmenopausal women compared to premenopausal, even adjusted for age and other covariates.
Laska, Melissa N.; Murray, David M.; Lytle, Leslie A.; Harnack, Lisa J.
2012-01-01
Previous studies have yielded inconsistent results in documenting the association between key dietary factors and adolescent weight change over time. The purpose of this study was to examine the extent to which changes in adolescent sugar-sweetened beverage, diet soda, breakfast and fast food consumption were associated with changes in BMI and percent body fat (PBF), both cross-sectionally and longitudinally. Our sample included 693 Minnesota adolescents followed over two years. Adjusting for physical activity, puberty, race, socio-economic status, age, and total energy intake, cross-sectional findings indicated that for both males and females, diet soda consumption was significantly and positively associated with BMI and PBF, and breakfast intake was significantly and negatively associated with BMI and PBF among girls. In longitudinal analyses, however, there were no significant associations after adjusting for the number of tests performed. This study adds to previous research through its methodological strengths, including adjustment for physical activity and energy intake assessed using state-of-the-art methods (i.e., accelerometers and 24-hour dietary recalls), as well as its evaluation of both BMI and PBF. Additional research is needed to better understand the complex constellation of factors that contribute to adolescent weight gain over time. PMID:21701567
NASA Astrophysics Data System (ADS)
Zhou, Meirong; Xia, Junqiang; Lu, Jinyou; Deng, Shanshan; Lin, Fenfen
2017-05-01
In the past 50 years, the Shishou reach in the middle Yangtze River underwent significant channel evolution owing to the implementation of an artificial cutoff, the construction of bank revetment works and the operation of the Three Gorges Project (TGP). Based on the measured hydrological data and topographic data, the processes of channel evolution in this reach were investigated mainly from the adjustments in planform and cross-sectional geometries. The variation in planform geometry obtained in this study indicates that (i) the artificial cutoff at Zhongzhouzi caused the river regime to adjust drastically, with the mean rate of thalweg migration at reach scale of 42.0 m/a over the period 1966-1975; (ii) then the effect of this artificial cutoff reduced gradually, with the mean migration rate decreasing to < 30 m/a in 1975-1993, while it increased to > 40 m/a owing to the occurrence of high water levels in 1993-1998; and (iii) the average annual rate of thalweg migration decreased to 29.3 m/a because of the impacts of various bank protection engineering and the TGP operation during the period 2002-2015. However, remarkable thalweg migration processes still occurred in local regions after the TGP operation, which resulted in significant bankline migration in local reaches of Beimenkou, Shijiatai, and Tiaoxiankou. In addition, the adjustments of bankfull channel geometry were investigated at section and reach scales after the TGP operation. Calculated results show that lateral channel migration in this reach was restricted by various river regulation works and that channel evolution was mainly characterized by an increase in bankfull depth and cross-sectional area. Empirical relationships were developed between the reach-scale bankfull dimensions (depth and area), the bankfull widths at specified sections, and the previous 5-year average fluvial erosion intensity during flood seasons, with high correlation degrees between them being obtained.
Arora, Garima; Mackay, Daniel F; Conway, David I; Pell, Jill P
2016-06-16
Oral health impacts on general health and quality of life, and oral diseases are the most common non-communicable diseases worldwide. Non-White ethnic groups account for an increasing proportion of the UK population. This study explores whether there are ethnic differences in oral health and whether these are explained by differences in sociodemographic or lifestyle factors, or use of dental services. We used the Adult Dental Health Survey 2009 to conduct a cross-sectional study of the adult general population in England, Wales and Northern Ireland. Ethnic groups were compared in terms of oral health, lifestyle and use of dental services. Logistic regression analyses were used to determine whether ethnic differences in fillings, extractions and missing teeth persisted after adjustment for potential sociodemographic confounders and whether they were explained by lifestyle or dental service mediators. The study comprised 10,435 (94.6 %) White, 272 (2.5 %) Indian, 165 (1.5 %) Pakistani/Bangladeshi and 187 (1.7 %) Black participants. After adjusting for confounders, South Asian participants were significantly less likely, than White, to have fillings (Indian adjusted OR 0.25, 95 % CI 0.17-0.37; Pakistani/Bangladeshi adjusted OR 0.43, 95 % CI 0.26-0.69), dental extractions (Indian adjusted OR 0.33, 95 % CI 0.23-0.47; Pakistani/Bangladeshi adjusted OR 0.41, 95 % CI 0.26-0.63), and <20 teeth (Indian adjusted OR 0.31, 95 % CI 0.16-0.59; Pakistani/Bangladeshi adjusted OR 0.22, 95 % CI 0.08-0.57). They attended the dentist less frequently and were more likely to add sugar to hot drinks, but were significantly less likely to consume sweets and cakes. Adjustment for these attenuated the differences but they remained significant. Black participants had reduced risk of all outcomes but after adjustment for lifestyle the difference in fillings was attenuated, and extractions and tooth loss became non-significant. Contrary to most health inequalities, oral health was better among non-White groups, in spite of lower use of dental services. The differences could be partially explained by reported differences in dietary sugar.
Staiger, Douglas O; Sharp, Sandra M; Gottlieb, Daniel J; Bevan, Gwyn; McPherson, Klim; Welch, H Gilbert
2013-01-01
Objective To determine the bias associated with frequency of visits by physicians in adjusting for illness, using diagnoses recorded in administrative databases. Setting Claims data from the US Medicare program for services provided in 2007 among 306 US hospital referral regions. Design Cross sectional analysis. Participants 20% sample of fee for service Medicare beneficiaries residing in the United States in 2007 (n=5 153 877). Main outcome measures The effect of illness adjustment on regional mortality and spending rates using standard and visit corrected illness methods for adjustment. The standard method adjusts using comorbidity measures based on diagnoses listed in administrative databases; the modified method corrects these measures for the frequency of visits by physicians. Three conventions for measuring comorbidity are used: the Charlson comorbidity index, Iezzoni chronic conditions, and hierarchical condition categories risk scores. Results The visit corrected Charlson comorbidity index explained more of the variation in age, sex, and race mortality across the 306 hospital referral regions than did the standard index (R2=0.21 v 0.11, P<0.001) and, compared with sex and race adjusted mortality, reduced regional variation, whereas adjustment using the standard Charlson comorbidity index increased it. Although visit corrected and age, sex, and race adjusted mortality rates were similar in hospital referral regions with the highest and lowest fifths of visits, adjustment using the standard index resulted in a rate that was 18% lower in the highest fifth (46.4 v 56.3 deaths per 1000, P<0.001). Age, sex, and race adjusted spending as well as visit corrected spending was more than 30% greater in the highest fifth of visits than in the lowest fifth, but only 12% greater after adjustment using the standard index. Similar results were obtained using the Iezzoni and the hierarchical condition categories conventions for measuring comorbidity. Conclusion The rates of visits by physicians introduce substantial bias when regional mortality and spending rates are adjusted for illness using comorbidity measures based on the observed number of diagnoses recorded in Medicare’s administrative database. Adjusting without correction for regional variation in visit rates tends to make regions with high rates of visits seem to have lower mortality and lower costs, and vice versa. Visit corrected comorbidity measures better explain variation in age, sex, and race mortality than observed measures, and reduce observational intensity bias. PMID:23430282
Su, Shaobing; Li, Xiaoming; Lin, Danhua; Zhu, Maoling
2017-01-01
Existing research has found that parental migration may negatively impact the psychological adjustment of left-behind children. However, limited longitudinal research has examined if and how future orientation (individual protective factor) and social support (contextual protective factor) are associated with the indicators of psychological adjustment (i.e., life satisfaction, school satisfaction, happiness, and loneliness) of left-behind children. In the current longitudinal study, we examined the differences in psychological adjustment between left-behind children and non-left behind children (comparison children) in rural areas, and explored the protective roles of future orientation and social support on the immediate (cross-sectional effects) and subsequent (lagged effects) status of psychological adjustment for both groups of children, respectively. The sample included 897 rural children ( M age = 14.09, SD = 1.40) who participated in two waves of surveys across six months. Among the participants, 227 were left-behind children with two parents migrating, 176 were with one parent migrating, and 485 were comparison children. Results showed that, (1) left-behind children reported lower levels of life satisfaction, school satisfaction, and happiness, as well as a higher level of loneliness in both waves; (2) After controlling for several demographics and characteristics of parental migration among left-behind children, future orientation significantly predicted life satisfaction, school satisfaction, and happiness in both cross-sectional and longitudinal regression models, as well as loneliness in the longitudinal regression analysis. Social support predicted immediate life satisfaction, school satisfaction, and happiness, as well as subsequent school satisfaction. Similar to left-behind children, comparison children who reported higher scores in future orientation, especially future expectation, were likely to have higher scores in most indicators of psychological adjustment measured at the same time and subsequently. However, social support seemed not exhibit as important in the immediate status of psychological adjustment of comparison children as that of left-behind children. Findings, implications, and limitations of the present study were discussed.
Experiments in a three-dimensional adaptive-wall wind tunnel
NASA Technical Reports Server (NTRS)
Schairer, E. T.
1983-01-01
Three dimensional adaptive-wall experiments were performed in the Ames Research Center (ARC) 25- by 13-cm indraft wind tunnel. A semispan wing model was mounted to one sidewall of a test section with solid sidewalls, and slotted top and bottom walls. The test section had separate top and bottom plenums which were divided into streamwise and cross-stream compartments. An iterative procedure was demonstrated for measuring wall interference and for adjusting the plenum compartment pressures to eliminate such interference. The experiments were conducted at a freestream Mach number of 0.60 and model angles of attack between 0 and 6 deg. Although in all the experiments wall interference was reduced after the plenum pressures were adjusted, interference could not be completely eliminated.
Leonardo's Rule, Self-Similarity, and Wind-Induced Stresses in Trees
NASA Astrophysics Data System (ADS)
Eloy, Christophe
2011-12-01
Examining botanical trees, Leonardo da Vinci noted that the total cross section of branches is conserved across branching nodes. In this Letter, it is proposed that this rule is a consequence of the tree skeleton having a self-similar structure and the branch diameters being adjusted to resist wind-induced loads.
Corpus Callosum Morphometrics in Young Children with Autism Spectrum Disorder
ERIC Educational Resources Information Center
Boger-Megiddo, Inbal; Shaw, Dennis W. W.; Friedman, Seth D.; Sparks, Bobbi F.; Artru, Alan A.; Giedd, Jay N.; Dawson, Geraldine; Dager, Stephen R.
2006-01-01
This study assessed digital corpus callosum cross sectional areas in 3-4 year olds with autism spectrum disorder (ASD) compared to typically developing (TD) and developmentally delayed (DD) children. Though not different in absolute size compared to TD, ASD callosums were disproportionately small adjusted for increased ASD cerebral volume. ASD…
Developmental Conditions of Adaptive Self-Stabilization in Adolescence: An Exploratory Study
ERIC Educational Resources Information Center
Greve, Werner; Thomsen, Tamara
2013-01-01
In a cross-sectional study with 541 German students (mean age: 12.61 yrs) and (for a subsample of N = 350) one of their parents, developmental conditions for a particular resource of self-regulation ("Flexibility of Goal Adjustment"; Brandtstadter & Renner, 1990) are investigated. Theoretical ¨ arguments and empirical results from…
Hayashi, Kei; Kawachi, Ichiro; Ohira, Tetsuya; Kondo, Katsunori; Shirai, Kokoro; Kondo, Naoki
2016-10-05
We sought to evaluate the associations between frequency of daily laughter with heart disease and stroke among community-dwelling older Japanese women and men. We analyzed cross-sectional data in 20 934 individuals (10 206 men and 10 728 women) aged 65 years or older, who participated in the Japan Gerontological Evaluation Study in 2013. In the mail-in survey, participants provided information on daily frequency of laughter, as well as body mass index, demographic and lifestyle factors, and diagnoses of cardiovascular disease, hyperlipidemia, hypertension, and depression. Even after adjustment for hyperlipidemia, hypertension, depression, body mass index, and other risk factors, the prevalence of heart diseases among those who never or almost never laughed was 1.21 (95% CI, -1.03-1.41) times higher than those who reported laughing every day. The adjusted prevalence ratio for stroke was 1.60 (95% CI, 1.24-2.06). Daily frequency of laughter is associated with lower prevalence of cardiovascular diseases. The association could not be explained by confounding factors, such as depressive symptoms.
Hayashi, Kei; Kawachi, Ichiro; Ohira, Tetsuya; Kondo, Katsunori; Shirai, Kokoro; Kondo, Naoki
2016-01-01
Background We sought to evaluate the associations between frequency of daily laughter with heart disease and stroke among community-dwelling older Japanese women and men. Methods We analyzed cross-sectional data in 20 934 individuals (10 206 men and 10 728 women) aged 65 years or older, who participated in the Japan Gerontological Evaluation Study in 2013. In the mail-in survey, participants provided information on daily frequency of laughter, as well as body mass index, demographic and lifestyle factors, and diagnoses of cardiovascular disease, hyperlipidemia, hypertension, and depression. Results Even after adjustment for hyperlipidemia, hypertension, depression, body mass index, and other risk factors, the prevalence of heart diseases among those who never or almost never laughed was 1.21 (95% CI, −1.03–1.41) times higher than those who reported laughing every day. The adjusted prevalence ratio for stroke was 1.60 (95% CI, 1.24–2.06). Conclusions Daily frequency of laughter is associated with lower prevalence of cardiovascular diseases. The association could not be explained by confounding factors, such as depressive symptoms. PMID:26972732
Association between maternal health literacy and child vaccination in India: a cross-sectional study
Johri, Mira; Subramanian, S V; Sylvestre, Marie-Pierre; Dudeja, Sakshi; Chandra, Dinesh; Koné, Georges K; Sharma, Jitendar K; Pahwa, Smriti
2015-01-01
Background Education of mothers may improve child health. We investigated whether maternal health literacy, a rapidly modifiable factor related to mother's education, was associated with children's receipt of vaccines in two underserved Indian communities. Methods Cross-sectional surveys in an urban and a rural site. We assessed health literacy using Indian child health promotion materials. The outcome was receipt of three doses of diphtheria-tetanus-pertussis (DTP3) vaccine. We used multivariate logistic regression to investigate the relationship between maternal health literacy and vaccination status independently in each site. For both sites, adjusted models considered maternal age, maternal and paternal education, child sex, birth order, household religion and wealth quintile. Rural analyses used multilevel models adjusted for service delivery characteristics. Urban analyses represented cluster characteristics through fixed effects. Results The rural analysis included 1170 women from 60 villages. The urban analysis included 670 women from nine slum clusters. In each site, crude and adjusted models revealed a positive association between maternal health literacy and DTP3. In the rural site, the adjusted OR was 1.57 (95% CI 1.11 to 2.21, p=0.010) for those with medium health literacy, and OR=1.30 (95% CI 0.89 to 1.91, p=0.172) for those with high health literacy. In the urban site, the adjusted OR was 1.10 (95% CI 0.65 to 1.88, p=0.705) for those with medium health literacy, and OR=2.06 (95% CI 1.06 to 3.99, p=0.032) for those with high health literacy. Conclusions In these study settings, maternal health literacy is independently associated with child vaccination. Initiatives targeting health literacy could improve vaccination coverage. PMID:25827469
Flohr, Carsten; Tuyen, Luc Nguyen; Lewis, Sarah; Quinnell, Rupert; Minh, Truong Tan; Liem, Ho Thanh; Campbell, Jim; Pritchard, David; Hien, Tran Tinh; Farrar, Jeremy; Williams, Hywel; Britton, John
2006-12-01
Geohelminth infection and poor hygiene may be protective against allergic sensitization. To determine whether current helminth infection is associated with a reduced prevalence of allergen skin test sensitization in a Southeast Asian population of children with a high prevalence of hookworm infection. A total of 1742 Vietnamese schoolchildren were invited to take part in a cross-sectional survey. Allergen skin sensitization to house dust mites (Dermatophagoides pteronyssinus and Dermatophagoides farinae) and American cockroach (Periplaneta americana) were measured and stool samples for qualitative and quantitative geohelminth estimation collected. A total of 1601 children age 6 to 18 participated. Sensitization to dust mites was present in 14.4% and to cockroach in 27.6% of children. In a mutually adjusted model, the risk of sensitization to dust mites was reduced in those with higher hookworm burden (adjusted odds ratio [OR] for 350+ vs no eggs per gram, 0.61; 95% CI, 0.39-0.96) and with Ascaris infection (adjusted OR, 0.28; 0.10-0.78), and increased in those using flush toilets (adjusted OR for flush toilet vs none/bush/pit, 2.51; 1.00-6.28). In contrast, sensitization to cockroach was not independently related to geohelminth infection but was increased in those regularly drinking piped or well water rather than from a stream (adjusted OR, 1.33; 1.02-1.75). Geohelminth infection, sanitation, and water supply influence the risk of allergic sensitization in Vietnamese children. This is consistent with a protective effect against allergy by geohelminth or other gastrointestinal infection. If the inverse relationship between geohelminth infection, poor sanitation, and allergic sensitization proves to be causal, drugs derived from parasite products may help to alleviate clinical allergic disease.
Johansen, Ingrid Hjulstad; Baste, Valborg; Rosta, Judith; Aasland, Olaf G; Morken, Tone
2017-01-01
Objectives The aim of this study was to investigate whether reported prevalence of experienced threats, real acts of violence and debilitating fear of violence among Norwegian doctors have increased over the last two decades. Design Repeated cross-sectional survey. Setting All healthcare levels and medical specialties in Norway. Participants Representative samples of Norwegian doctors in 1993 (n=2628) and 2014 (n=1158). Main outcome measures Relative risk (RR) of self-reported prevalence of work-time experiences of threats and real acts of violence, and of being physically or psychologically unfit during the last 12 months due to fear of violence, in 2014 compared with 1993, adjusted by age, gender and medical specialty. Results There were no differences in self-reported threats (adjusted RR=1.01, 95% CI 0.95 to 1.08) or real acts (adjusted RR=0.90, 95% CI 0.80 to 1.03) of violence when comparing 2014 with 1993. The proportion of doctors who had felt unfit due to fear of violence decreased from 1993 to 2014 (adjusted RR=0.53, 95% CI 0.39 to 0.73). Although still above average, the proportion of doctors in psychiatry who reported real acts of violence decreased substantially from 1993 to 2014 (adjusted RR=0.75, 95% CI 0.60 to 0.95). Conclusions A substantial proportion of doctors experience threats and real acts of violence during their work-time career, but there was no evidence that workplace violence has increased over the last two decades. Still, the issue needs to be addressed as part of the doctors’ education and within work settings. PMID:28801441
Shahzad, Khurram; Akhtar, Saeed; Mahmud, Sadia
2006-01-01
Background This study aimed to estimate the prevalence and to identify some risk factors of adult asthma in male leather tannery workers in Karachi, Pakistan. Methods A cross sectional study was conducted from August 2003 to March 2004 on leather tannery workers of Karachi, Pakistan. Data were collected from 641 workers engaged in 95 different tanneries in Korangi industrial area selected as sample of convenience. Face to face interviews were performed using a structured pre-tested questionnaire by trained data collectors. Results Prevalence of adult asthma was 10.8% (69/641) in this study population. The prevalence of perceived work-related asthma was 5.3% (34/641). Multivariable logistic regression model showed that after taking into account the age effect, the leather tannery worker were more likely to be asthmatic, if they were illiterate (adjusted OR = 2.13, 95% CI: 1.17–3.88), of Pathan ethnicity (adjusted OR = 2.69; 95% CI: 1.35–5.36), ever-smoked (adjusted OR = 2.22, 95% CI: 1.16–4.26), reportedly never used gloves during different tanning tasks (OR = 3.28; 95% CI : 1.72–6.26). Also, the final model showed a significant interaction between perceived allergy and duration of work. Those who perceived to have allergy were more likely to have asthma if their duration of work was 8 years (adjusted OR = 2.26; 95% CI: 1.19 – 4.29) and this relationship was even stronger if duration was 13 years (adjusted OR = 3.67; 95% CI: 1.98–6.79). Conclusion Prevalence of asthma in leather tannery workers appears to be high and is associated with educational status, ethnicity, smoking, glove use, perceived to have allergy and duration of work. PMID:17144930
Shahzad, Khurram; Akhtar, Saeed; Mahmud, Sadia
2006-12-05
This study aimed to estimate the prevalence and to identify some risk factors of adult asthma in male leather tannery workers in Karachi, Pakistan. A cross sectional study was conducted from August 2003 to March 2004 on leather tannery workers of Karachi, Pakistan. Data were collected from 641 workers engaged in 95 different tanneries in Korangi industrial area selected as sample of convenience. Face to face interviews were performed using a structured pre-tested questionnaire by trained data collectors. Prevalence of adult asthma was 10.8% (69/641) in this study population. The prevalence of perceived work-related asthma was 5.3% (34/641). Multivariable logistic regression model showed that after taking into account the age effect, the leather tannery worker were more likely to be asthmatic, if they were illiterate (adjusted OR = 2.13, 95% CI: 1.17-3.88), of Pathan ethnicity (adjusted OR = 2.69; 95% CI: 1.35-5.36), ever-smoked (adjusted OR = 2.22, 95% CI: 1.16-4.26), reportedly never used gloves during different tanning tasks (OR = 3.28; 95% CI : 1.72-6.26). Also, the final model showed a significant interaction between perceived allergy and duration of work. Those who perceived to have allergy were more likely to have asthma if their duration of work was 8 years (adjusted OR = 2.26; 95% CI: 1.19 - 4.29) and this relationship was even stronger if duration was 13 years (adjusted OR = 3.67; 95% CI: 1.98-6.79). Prevalence of asthma in leather tannery workers appears to be high and is associated with educational status, ethnicity, smoking, glove use, perceived to have allergy and duration of work.
Newtonraj, Ariarathinam; Murugan, Natesan; Singh, Zile; Chauhan, Ramesh Chand; Velavan, Anandan; Mani, Manikandan
2017-05-01
Physical inactivity is the fourth leading cause of death worldwide. Increase in physical activity decreases the incidence of cardiovascular diseases, Type 2 diabetes, stroke, and improves psychological wellbeing. To study the level of physical inactivity among the adult population in an urban area of Puducherry in India and its associated risk factors. This cross-sectional study was conducted among 569 adult participants from an urban area of Pondicherry. The level of physical inactivity was measured by using WHO standard Global Physical Activity Questionnaire (GPAQ). Overall prevalence of physical inactivity in our study was 49.7% (CI: 45.6-53.8). Among the physically active people, contribution of physical activity by work was 77.4%, leisure time activities were 11.6% and transport time was 11%. Both men and women were equally inactive {Physically inactive among women was 50% (CI:44.1-55.9)} and {Physically inactive among men was 49.5% (CI:43.8-55.2)}. Prevalence of physical inactivity was increasing with increasing age. Non tobacco users were two times more active than tobacco users {Adjusted Odds Ratio: 2.183 (1.175- 4.057)}. Employed were more active as compared to retired {Adjusted Odds Ratio: 0.412 (0.171-0.991)}, students {Adjusted Odds Ratio: 0.456 (0.196-1.060)}, house wives {Adjusted Odds Ratio: 0.757 (0.509-1.127)} and unemployed {Adjusted Odds Ratio: 0.538 (0.271-1.068)}. Non alcoholics were only 0.34 times as active as alcoholics. Level of physical activity was found to be insufficient among adult urban population of Puducherry. Working adult population found to be active, that too due to their work pattern. There is a need to promote leisure time and travelling time physical activity.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Wright, R.Q.; Renier, J.P.; Bucholz, J.A.
1995-08-01
The original ANSL-V cross-section libraries (ORNL-6618) were developed over a period of several years for the physics analysis of the ANS reactor, with little thought toward including the materials commonly needed for shielding applications. Materials commonly used for shielding applications include calcium barium, sulfur, phosphorous, and bismuth. These materials, as well as {sup 6}Li, {sup 7}Li, and the naturally occurring isotopes of hafnium, have been added to the ANSL-V libraries. The gamma-ray production and gamma-ray interaction cross sections were completely regenerated for the ANSL-V 99n/44g library which did not exist previously. The MALOCS module was used to collapse the 99n/44gmore » coupled library to the 39n/44g broad- group library. COMET was used to renormalize the two-dimensional (2- D) neutron matrix sums to agree with the one-dimensional (1-D) averaged values. The FRESH module was used to adjust the thermal scattering matrices on the 99n/44g and 39n/44g ANSL-V libraries. PERFUME was used to correct the original XLACS Legendre polynomial fits to produce acceptable distributions. The final ANSL-V 99n/44g and 39n/44g cross-section libraries were both checked by running RADE. The AIM module was used to convert the master cross-section libraries from binary coded decimal to binary format (or vice versa).« less
Evaporation residue cross-section measurements for 48Ti-induced reactions
NASA Astrophysics Data System (ADS)
Sharma, Priya; Behera, B. R.; Mahajan, Ruchi; Thakur, Meenu; Kaur, Gurpreet; Kapoor, Kushal; Rani, Kavita; Madhavan, N.; Nath, S.; Gehlot, J.; Dubey, R.; Mazumdar, I.; Patel, S. M.; Dhibar, M.; Hosamani, M. M.; Khushboo, Kumar, Neeraj; Shamlath, A.; Mohanto, G.; Pal, Santanu
2017-09-01
Background: A significant research effort is currently aimed at understanding the synthesis of heavy elements. For this purpose, heavy ion induced fusion reactions are used and various experimental observations have indicated the influence of shell and deformation effects in the compound nucleus (CN) formation. There is a need to understand these two effects. Purpose: To investigate the effect of proton shell closure and deformation through the comparison of evaporation residue (ER) cross sections for the systems involving heavy compound nuclei around the ZCN=82 region. Methods: A systematic study of ER cross-section measurements was carried out for the 48Ti+Nd,150142 , 144Sm systems in the energy range of 140 -205 MeV . The measurement has been performed using the gas-filled mode of the hybrid recoil mass analyzer present at the Inter University Accelerator Centre (IUAC), New Delhi. Theoretical calculations based on a statistical model were carried out incorporating an adjustable barrier scaling factor to fit the experimental ER cross section. Coupled-channel calculations were also performed using the ccfull code to obtain the spin distribution of the CN, which was used as an input in the calculations. Results: Experimental ER cross sections for 48Ti+Nd,150142 were found to be considerably smaller than the statistical model predictions whereas experimental and statistical model predictions for 48Ti+144Sm were of comparable magnitudes. Conclusion: Though comparison of experimental ER cross sections with statistical model predictions indicate considerable non-compound-nuclear processes for 48Ti+Nd,150142 reactions, no such evidence is found for the 48Ti+144Sm system. Further investigations are required to understand the difference in fusion probabilities of 48Ti+142Nd and 48Ti+144Sm systems.
An evaluation of fruit and vegetable consumption and cigarette smoking among youth.
Haibach, Jeffrey P; Homish, Gregory G; Collins, R Lorraine; Ambrosone, Christine B; Giovino, Gary A
2015-06-01
Research across the past 4 decades has supported a cross-sectional association between adult cigarette smoking and lower fruit and vegetable consumption (FVC), and emerging research suggests higher FVC may predict cessation. Among youth, findings are limited to a few cross-sectional studies with somewhat mixed results. Here we evaluated the FVC-smoking association among youth both cross-sectionally and longitudinally. We analyzed data from a subsample of the National Longitudinal Survey of Youth 1979: Child and Young Adult. The subsample included adolescents aged 14-18 years at baseline in the year 2004. Multivariable cross-sectional analyses assessed whether baseline FVC was associated with smoking frequency among ever-smokers (n = 578). Longitudinally, the study assessed whether baseline FVC predicted smoking progression among baseline never-smokers who tried a cigarette by 4-year follow-up (n = 388). Multivariable regression models adjusted for age, gender, race/ethnicity, parental education, and health behavior orientation. Cross-sectionally, youth who consumed fruit ≥2 times per day were 53% less likely (RR = 0.47; p < .05) than those who typically did not consume fruit to be in a higher smoking frequency category. Longitudinally, the fruit consumption and smoking association was not significant (RR = 0.61; p = .282). There were no significant associations observed between vegetable consumption and smoking. Fruit consumption, but not vegetable consumption, was inversely associated with smoking frequency cross-sectionally but not longitudinally. Further research is needed to provide information on the consistency of the FVC-smoking relationship among youth and may help to elucidate possible explanatory mechanisms. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
2011-01-01
Background Empirical evidence suggests that an association between the built environment and physical activity exists. This evidence is mostly derived from cross-sectional studies that do not account for other causal explanations such as neighborhood self-selection. Experimental and quasi-experimental designs can be used to isolate the effect of the built environment on physical activity, but in their absence, statistical techniques that adjust for neighborhood self-selection can be used with cross-sectional data. Previous reviews examining the built environment-physical activity relationship have not differentiated among findings based on study design. To deal with self-selection, we synthesized evidence regarding the relationship between objective measures of the built environment and physical activity by including in our review: 1) cross-sectional studies that adjust for neighborhood self-selection and 2) quasi-experiments. Method In September 2010, we searched for English-language studies on built environments and physical activity from all available years in health, leisure, transportation, social sciences, and geographical databases. Twenty cross-sectional and 13 quasi-experimental studies published between 1996 and 2010 were included in the review. Results Most associations between the built environment and physical activity were in the expected direction or null. Land use mix, connectivity and population density and overall neighborhood design were however, important determinants of physical activity. The built environment was more likely to be associated with transportation walking compared with other types of physical activity including recreational walking. Three studies found an attenuation in associations between built environment characteristics and physical activity after accounting for neighborhood self-selection. Conclusion More quasi-experiments that examine a broader range of environmental attributes in relation to context-specific physical activity and that measure changes in the built environment, neighborhood preferences and their effect on physical activity are needed. PMID:22077952
Acute pulmonary function change associated with work on large dairies in California.
Eastman, Chelsea; Schenker, Marc B; Mitchell, Diane C; Tancredi, Daniel J; Bennett, Deborah H; Mitloehner, Frank M
2013-01-01
To study whether dairy workers in California have lower baseline and greater cross-shift decrements in lung function than control employees. A cross-sectional study of 210 dairy and 47 control workers who completed questionnaires and spirometry before and after the work shift. Dairy work was associated with mean baseline differences of -0.132 L (P = 0.07) and -0.131 L (P = 0.13) in forced expiratory volume in 1 second and forced vital capacity, respectively, compared with control employees, adjusting for age, height, smoking status, and days back at work since last day off. Dairy work was associated with a mean cross-shift difference of -65.2 mL (P = 0.02) and -103.1 mL (P < 0.01) in forced expiratory volume in 1 second and forced vital capacity, respectively, adjusting for smoking status and work-shift time. Dairy work in California was associated with mild acute airway obstruction. The unclear long-term effect of dairy work in California merits further investigation.
Cross-Cultural Adjustment of Chinese Students in Japan: School Adjustment and Educational Support
ERIC Educational Resources Information Center
Li, Yuan Xiang; Sano, Hideki; Ahn, Ruth
2013-01-01
This study investigates Chinese immigrant students' cross-cultural and school adjustment issues in Japanese schools. Using a quantitative method, a survey which collected students' demographic information, cross-cultural adjustment, and school adjustment questions was administered to 143 Chinese junior high and high school students in Tokyo and…
Xirasagar, Sudha; Lin, Herng-Ching
2004-01-01
Objective To test the hypotheses that: (1) average adjusted costs per discharge are higher in high-competition relative to low-competition markets, and (2) increased competition is associated with cost convergence between public and for-profit (FP) hospitals for case payment diagnoses, but not for cost-plus reimbursed diagnoses. Data Sources Taiwan's National Health Insurance database; 325,851 inpatient claims for cesarean section, vaginal delivery, prostatectomy, and thyroidectomy (all case payment), and bronchial asthma and cholelithiasis (both cost-based payment). Study Design Retrospective population-based, cross-sectional study. Data Analysis Diagnosis-wise regression analyses were done to explore associations between cost per discharge and hospital ownership under high and low competition, adjusted for clinical severity and institutional characteristics. Principal Findings Adjusted costs per discharge are higher for all diagnoses in high-competition markets. For case payment diagnoses, the magnitudes of adjusted cost differences between public and FP hospitals are lower under high competition relative to low competition. This is not so for the cost-based diagnoses. Conclusions We find that the empirical evidence supports both our hypotheses. PMID:15544646
Roswall, Nina; Christensen, Jeppe Schultz; Bidstrup, Pernille Envold; Raaschou-Nielsen, Ole; Jensen, Steen Solvang; Tjønneland, Anne; Sørensen, Mette
2018-05-01
Traffic noise stresses and disturbs sleep. It has been associated with various diseases, and has recently also been associated with lifestyle. Hence, the association between traffic noise and disease could partly operate via a pathway of lifestyle habits, including smoking and alcohol intake. We investigated associations between modelled residential traffic noise and smoking habits and alcohol consumption. In a cohort of 57,053 participants, we performed cross-sectional analyses using data from a baseline questionnaire (1993-97), and longitudinal analyses of change between baseline and follow-up (2000-02). Smoking status (never, former, current) and intensity (tobacco, g/day) and alcohol consumption (g/day) was self-reported at baseline and follow-up. Address history from 1987-2002 for all participants were found in national registries, and road traffic and railway noise was modelled 1 and 5 years before enrolment, and from baseline to follow-up. Analyses were performed using logistic and linear regression, and adjusted for demographics, socioeconomic variables, leisure-time sports, and noise from the opposite source (road/railway). Road traffic noise exposure 5 years before baseline was positively associated with alcohol consumption (adjusted difference per 10 dB: 1.38 g/day, 95% confidence interval (CI): 1.10-1.65), smoking intensity (adjusted difference per 10 dB: 0.40 g/day, 95% CI: 0.19-0.61), and odds for being a current vs. never/former smoker at baseline (odds ratio (OR): 1.14; 95% CI: 1.10-1.17). In longitudinal analyses, we found no association between road traffic noise and change in smoking and alcohol habits. Railway noise was not associated with smoking habits and alcohol consumption, neither in cross-sectional nor in longitudinal analyses. The study suggests that long-term exposure to residential road traffic is associated with smoking habits and alcohol consumption, albeit only in cross-sectional, but not in longitudinal analyses. Copyright © 2017 Elsevier Ltd. All rights reserved.
Islam, Mohammad Rafiqul; Khan, Ismail; Attia, John; Hassan, Sheikh Mohammad Nazmul; McEvoy, Mark; D'Este, Catherine; Azim, Syed; Akhter, Ayesha; Akter, Shahnaz; Shahidullah, Sheikh Mohammad; Milton, Abul Hasnat
2012-12-07
Chronic arsenic exposure and its association with hypertension in adults are inconclusive and this cross-sectional study investigated the association. The study was conducted between January and July 2009 among 1,004 participants from 1,682 eligible women and men aged ≥30 years living in rural Bangladesh who had continuously consumed arsenic-contaminated drinking water for at least 6 months. Hypertension was defined as systolic blood pressure ≥140 mmHg (systolic hypertension) and diastolic blood pressure ≥90 mmHg (diastolic hypertension). Pulse pressure was calculated by deducting diastolic from systolic pressure and considered to be increased when the difference was ≥55 mmHg. The prevalence of hypertension was 6.6% (95% CI: 5.1-8.3%). After adjustment for other factors, no excess risk of hypertension was observed for arsenic exposure >50 μg/L or to that of arsenic exposure as quartiles or as duration. Arsenic concentration as quartiles and >50 μg/L did show a strong relationship with increased pulse pressure (adjusted OR: 3.54, 95% CI: 1.46-8.57), as did arsenic exposure for ≥10 years (adjusted OR: 5.25, 95% CI: 1.41-19.51). Arsenic as quartiles showed a dose response relationship with increased pulse pressure. Our study suggests an association between higher drinking water arsenic or duration and pulse pressure, but not hypertension.
Vigorous Physical Activity, Mental Health, Perceived Stress, and Socializing Among College Students
VanKim, Nicole A.; Nelson, Toben F.
2013-01-01
Purpose To examine cross-sectional associations between vigorous physical activity, mental health, perceived stress, and socializing among 4-year college students. Design A national cross-sectional sample of 4-year colleges in the United States. Setting Ninety-four 4-year colleges in the United States. Subjects A total of 14,804 undergraduate students. Measures Self-report vigorous physical activity, perceived stress (measured using the Cohen Perceived Stress Scale), mental health (measured using the SF-36), and socializing (assessed using self-report number of friends and hours spent socializing). Analysis Logistic regression models accounting for clustering within schools were estimated to examine the association between vigorous physical activity, mental health, perceived stress, and socializing. Adjusted models included high school vigorous physical activity and sociodemographic characteristics. Results Students who met vigorous physical activity recommendations were less likely to report poor mental health (adjusted odds ratio [OR]: .79; 95% confidence interval [CI]: .69, .90) and perceived stress (adjusted OR: .75; 95% CI: .67, .83) than students who did not meet recommendations. In addition, socializing partially mediated the relationship between vigorous physical activity, mental health, and perceived stress; however, race and sex did not moderate the relationship. Conclusion Interventions aiming to improve mental well-being of college students should also consider promoting physical activity. At least some of the positive benefits of physical activity may arise from social interactions. PMID:23470187
Islam, Mohammad Rafiqul; Khan, Ismail; Attia, John; Hassan, Sheikh Mohammad Nazmul; McEvoy, Mark; D’Este, Catherine; Azim, Syed; Akhter, Ayesha; Akter, Shahnaz; Shahidullah, Sheikh Mohammad; Milton, Abul Hasnat
2012-01-01
Chronic arsenic exposure and its association with hypertension in adults are inconclusive and this cross-sectional study investigated the association. The study was conducted between January and July 2009 among 1,004 participants from 1,682 eligible women and men aged ≥30 years living in rural Bangladesh who had continuously consumed arsenic-contaminated drinking water for at least 6 months. Hypertension was defined as systolic blood pressure ≥140 mmHg (systolic hypertension) and diastolic blood pressure ≥90 mmHg (diastolic hypertension). Pulse pressure was calculated by deducting diastolic from systolic pressure and considered to be increased when the difference was ≥55 mmHg. The prevalence of hypertension was 6.6% (95% CI: 5.1–8.3%). After adjustment for other factors, no excess risk of hypertension was observed for arsenic exposure >50μg/L or to that of arsenic exposure as quartiles or as duration. Arsenic concentration as quartiles and >50 μg/L did show a strong relationship with increased pulse pressure (adjusted OR: 3.54, 95% CI: 1.46–8.57), as did arsenic exposure for ≥10 years (adjusted OR: 5.25, 95% CI: 1.41–19.51). Arsenic as quartiles showed a dose response relationship with increased pulse pressure. Our study suggests an association between higher drinking water arsenic or duration and pulse pressure, but not hypertension. PMID:23222207
Lu, Ciyong; Wu, Jie; Deng, Xueqing; Hong, Lingyao; Gao, Xue; He, Yuan
2012-01-01
Background School bullying is an emerging problem in China. The present study aimed to measure the prevalence of bullying behaviors among Chinese adolescents and to examine the association of bullying and being bullied with family factors, school factors and indicators of psychosocial adjustment. Methods A cross-sectional study was conducted. A total of 8,342 middle school students were surveyed in four cities in the Guangdong Province. Self-reports on bullying involvement and information regarding family factors, school factors and psychosocial adjustment were collected. Descriptive statistics and multi-level logistic regression analysis were used to evaluate the prevalence of school bullying and explore potentially influential factors. Results Of the total sample, 20.83% (1,738) reported being involved in bullying behaviors. Of the respondents, 18.99% were victims of bullying, 8.60% were bullies and 6.74% both bullied themselves and bullied others. Factors that were determined to be correlated with bullying behaviors included grade, parental caring, consideration of suicide, running away from home, time spent online per day and being in a physical fight. Conclusion Bullying was determined to be prevalent among Chinese adolescents. Given the concurrent psychosocial adjustment, family and school factors associated with bullying, as well as the potential long-term negative outcomes for these youth, this issue merits serious attention, both for future research and preventive intervention. PMID:22815693
Lee, Min-Su; Shin, Joon-Shik; Lee, Jinho; Lee, Yoon Jae; Kim, Me-riong; Park, Ki Byung; Shin, Dongjin; Cho, Jae-Heung; Ha, In-Hyuk
2015-12-01
Sleep duration holds considerable importance as an indicator of mental/physical health. The objective of this study was to investigate the association between sleep duration, mental health, and chronic disease prevalence in Koreans. Of 31,596 subjects eligible for the Korean National Health and Nutrition Examination Survey V (2010-2012), 17,638 participants who answered items on sleep duration (aged ≥ 19 yrs) were analyzed in a cross-sectional study. Association between sleep duration, mental health, and chronic disease prevalence was assessed using logistic regression, and adjusted for various socioeconomic and lifestyle characteristics. Short or long sleep duration showed correlations with mental health, and items of significance showed gender-specific patterns. Women displayed significant associations with stress and depressive symptoms, and men with stress, thoughts of suicide, and psychiatric counseling. While stress was related with short sleep duration in both genders, depressive symptoms showed a relationship with long duration in men, and short duration in women. Prevalence of any chronic disease was associated with ≤ 6 h sleep when adjusted for factors including mental health, and among chronic diseases, cancer and osteoarthritis showed associations with short sleep duration, while diabetes and dyslipidemia were associated with normal sleep duration. Mental health problems were associated with sleep duration with gender-specific patterns. Associations with osteoarthritis, cancer, diabetes, dyslipidemia and abnormal sleep duration persisted after adjustment for mental health.
Feng, Wei; Cui, Xiuqing; Liu, Bing; Liu, Chuanyao; Xiao, Yang; Lu, Wei; Guo, Huan; He, Meian; Zhang, Xiaomin; Yuan, Jing; Chen, Weihong; Wu, Tangchun
2015-01-01
Elevated heavy metals and fasting plasma glucose (FPG) levels were both associated with increased risk of cardiovascular diseases. However, studies on the associations of heavy metals and essential elements with altered FPG and diabetes risk were limited or conflicting. The objective of this study was to evaluate the potential associations of heavy metals and essential trace elements with FPG and diabetes risk among general Chinese population. We conducted a cross-sectional study to investigate the associations of urinary concentrations of 23 metals with FPG, impaired fasting glucose (IFG) and diabetes among 2242 community-based Chinese adults in Wuhan. We used the false discovery rate (FDR) method to correct for multiple hypothesis tests. After adjusting for potential confounders, urinary aluminum, titanium, cobalt, nickel, copper, zinc, selenium, rubidium, strontium, molybdenum, cadmium, antimony, barium, tungsten and lead were associated with altered FPG, IFG or diabetes risk (all P< 0.05); arsenic was only dose-dependently related to diabetes (P< 0.05). After additional adjustment for multiple testing, titanium, copper, zinc, selenium, rubidium, tungsten and lead were still significantly associated with one or more outcomes (all FDR-adjusted P< 0.05). Our results suggest that multiple metals in urine are associated with FPG, IFG or diabetes risk. Because the cross-sectional design precludes inferences about causality, further prospective studies are warranted to validate our findings.
Lee, Bokim; Jung, Hye-Sun
2012-01-01
The researchers conducted a cross-sectional survey to determine the relationship between handling heavy items during pregnancy and spontaneous abortion among working women in South Korea. One thousand working women were selected from a database of those eligible for maternity benefits under the National Employment Insurance Plan. Study results showed that handling heavy items during pregnancy was associated with an increased risk of spontaneous abortion after adjusting for general characteristics of the participants and their work environment. A collective effort is needed on the parts of employers, employees, occupational health nurses, and the government to protect working women from lifting heavy items while pregnant. Copyright 2012, SLACK Incorporated.
Miller, Kirk A.; Mason, John P.
2000-01-01
The water-surface profile and flood boundaries for the computed 100-year flood were determined for a part of the lower Salt River in Lincoln County, Wyoming. Channel cross-section data were provided by Lincoln County. Cross-section data for bridges and other structures were collected and compiled by the U.S. Geological Survey. Roughness coefficients ranged from 0.034 to 0.100. The 100-year flood was computed using standard methods, ranged from 5,170 to 4,120 cubic feet per second through the study reach, and was adjusted proportional to contributing drainage area. Water-surface elevations were determined by the standard step-backwater method. Flood boundaries were plotted on digital basemaps.
ERIC Educational Resources Information Center
Li, Xiaoming; Barnett, Douglas; Fang, Xiaoyi; Lin, Xiuyun; Zhao, Guoxiang; Zhao, Junfeng; Hong, Yan; Zhang, Liying; Naar-King, Sylvie; Stanton, Bonita
2009-01-01
Cross-sectional data were gathered from 1,625 children (M age = 12.85, SD = 2.21) which included 755 AIDS orphans, 466 vulnerable children, and 404 comparison children. Participants completed self-report measures of exposure to traumatic events, and psychosocial adjustment including behavior problems, depression, self-esteem, and future…
ERIC Educational Resources Information Center
Lloyd, Tracey; Hastings, R. P.
2008-01-01
Background: Existing research studies suggest that parenting a child with intellectual disabilities (ID) can be a stressful experience. However, there are few data addressing the question of how or why parents might experience considerable distress. In the present study, psychological variables (acceptance, mindfulness, avoidant coping) are…
School as a Determinant for Health Outcomes--A Structural Equation Model Analysis
ERIC Educational Resources Information Center
Ravens-Sieberer, Ulrike; Freeman, John; Kokonyei, Gyongyi; Thomas, Christiane A.; Erhart, Michael
2009-01-01
Purpose: The purpose of this paper is to investigate whether students' perceptions of their school environment and their adjustment to school are associated with health outcomes across gender and age groups. Design/methodology/approach: Data from the cross-sectional international Health Behavior in School-aged Children Survey of the year 2002…
Grade-Level Declines in Perceived Academic Support from Peers: A Moderated Mediation Analysis
ERIC Educational Resources Information Center
Altermatt, Ellen Rydell
2017-01-01
Prior research demonstrates that perceived academic support from peers positively predicts school adjustment. In this cross-sectional study, we provide evidence that perceived academic support from peers declines from 3rd to 8th grade and that this decline is partially mediated by grade-level declines in perceptions that academic success…
USDA-ARS?s Scientific Manuscript database
Classical, one-dimensional, mobile bed, sediment-transport models simulate vertical channel adjustment, raising or lowering cross-section node elevations to simulate erosion or deposition. This approach does not account for bank erosion processes including toe scour and mass failure. In many systems...
Hooper, Claudie; De Souto Barreto, Philipe; Payoux, Pierre; Salabert, Anne Sophie; Guyonnet, Sophie; Andrieu, Sandrine; Vellas, Bruno
2017-08-01
Omega-3 (n-3) and 6 (n-6) polyunsaturated fatty acids (PUFAs) have been associated with reduced cognitive decline in observational studies. Hence, we examined the cross-sectional associations between cortical β-amyloid (Aβ) and erythrocyte membrane PUFAs in 61 non-demented elderly individuals reporting subjective memory complaints from the Multidomain Alzheimer Preventive Trial placebo arm. Cortical-to-cerebellar standard uptake value ratios were obtained using [ 18 F] florbetapir positron emission tomography. Fatty acids were measured in erythrocyte membranes by gas chromatography. Associations were explored using adjusted multiple linear regression models and were considered significant at p ≤ 0.005 after correction for multiple testing (10 comparisons). We found no significant associations between cortical Aβ and erythrocyte membrane PUFAs. The associations closest to significance after adjustment were those between Aβ and erythrocyte membrane arachidonic acid (without apolipoprotein E status adjustment: B-coefficient, 0.03; CI, 0.01, 0.05; p = 0.02. Including Apolipoprotein E adjustment: B-coefficient, 0.03; CI, 0.00, 0.06; p = 0.04) and Aβ and erythrocyte membrane linoleic acid (without apolipoprotein E status adjustment: B-coefficient, -0.02; CI, -0.04, 0.00; p = 0.02. Including Apolipoprotein E adjustment: B-coefficient, -0.02; CI, -0.04, 0.00; p = 0.09). Furthermore, the association between Aβ and erythrocyte membrane arachidonic acid seemed to be specific to Apolipoprotein E ε4 non-carriers (B-coefficient 0.03, CI: 0.00, 0.06, p = 0.03, n = 36). In contrast, no association was found between Aβ and erythrocyte membrane linoleic acid in Apolipoprotein E ε4 stratified analysis. Investigating the relationships between Aβ and PUFAs longitudinally would provide further evidence as to whether fatty acids, particularly arachidonic acid and linoleic acid, might modulate cognition through Aβ-dependent mechanisms. © 2017 International Society for Neurochemistry.
Rajapakse, C. S.; Diamond, M.; Honig, S.; Recht, M. P.; Weiss, D. S.; Regatte, R. R.
2013-01-01
Summary Micro-finite element analysis applied to high-resolution (0.234-mm length scale) MRI reveals greater whole and cancellous bone stiffness, but not greater cortical bone stiffness, in the distal femur of female dancers compared to controls. Greater whole bone stiffness appears to be mediated by cancellous, rather than cortical bone adaptation. Introduction The purpose of this study was to compare bone mechanical competence (stiffness) in the distal femur of female dancers compared to healthy, relatively inactive female controls. Methods This study had institutional review board approval. We recruited nine female modern dancers (25.7± 5.8 years, 1.63±0.06 m, 57.1±4.6 kg) and ten relatively inactive, healthy female controls matched for age, height, and weight (32.1±4.8 years, 1.6±0.04 m, 55.8±5.9 kg). We scanned the distal femur using a 7-T MRI scanner and a three-dimensional fast low-angle shot sequence (TR/TE= 31 ms/5.1 ms, 0.234 mm×0.234 mm×1 mm, 80 slices). We applied micro-finite element analysis to 10-mm-thick volumes of interest at the distal femoral diaphysis, metaphysis, and epiphysis to compute stiffness and cross-sectional area of whole, cortical, and cancellous bone, as well as cortical thickness. We applied two-tailed t-tests and ANCOVA to compare groups. Results Dancers demonstrated greater whole and cancellous bone stiffness and cross-sectional area at all locations (p< 0.05). Cortical bone stiffness, cross-sectional area, and thickness did not differ between groups (>0.08). At all locations, the percent of intact whole bone stiffness for cortical bone alone was lower in dancers (p<0.05). Adjustment for cancellous bone cross-sectional area eliminated significant differences in whole bone stiffness between groups (p>0.07), but adjustment for cortical bone cross-sectional area did not (p<0.03). Conclusions Modern dancers have greater whole and cancellous bone stiffness in the distal femur compared to controls. Elevated whole bone stiffness in dancers may be mediated via cancellous, rather than cortical bone adaptation. PMID:22893356
Wilson, Katherine T; Bohnert, Ashley E; Ambrose, Alex; Davis, Destiny Y; Jones, Dina M; Magee, Matthew J
2014-01-13
The association between student characteristics and depression among students attending women's colleges (single-sex institutions of higher education that exclude or limit males from admission) is poorly understood. Our objective was to estimate the prevalence of depression and determine behavioral and social characteristics associated with depression among students attending a women's college. We administered a cross-sectional Internet-based survey between April and May 2012 to students (n = 277) enrolled at a private women's college in the southeastern US. Center for Epidemiologic Studies Depression (CES-D) and Depression Anxiety Stress Scale 21 (DASS-21) instruments measured self-reported depression. Bivariate and multivariable logistic regression methods were used to estimate adjusted associations. Prevalence of depression measured by CES-D and DASS-21 instruments was 26.3% (95% confidence interval [CI] 20.8-32.3%) and 26.0% (95% CI 20.4-32.3%), respectively. After adjusting for confounders, absence of strong social support (prevalence odds ratio [OR] = 4.3, 95% CI 1.4-13.7), history of mental health disorder (OR = 4.8 95% CI 1.9-12.4), and poor sleep hygiene (OR = 2.8, 95% CI 1.3-5.8) were associated with depression. This cross-sectional survey identified absence of strong social support, history of mental health disorder, and poor sleep hygiene as potential predictors of depression among students attending a women's college. Further investigation of these factors may inform depression interventions for students attending women's colleges and other undergraduate student populations.
Rugulies, Reiner; Martin, Marie H T; Garde, Anne Helene; Persson, Roger; Albertsen, Karen
2012-03-01
Exposure to deadlines at work is increasing in several countries and may affect health. We aimed to investigate cross-sectional and longitudinal associations between frequency of difficult deadlines at work and sleep quality. Study participants were knowledge workers, drawn from a representative sample of Danish employees who responded to a baseline questionnaire in 2006 (n = 363) and a follow-up questionnaire in 2007 (n = 302). Frequency of difficult deadlines was measured by self-report and categorized into low, intermediate, and high. Sleep quality was measured with a Total Sleep Quality Score and two indexes (Awakening Index and Disturbed Sleep Index) derived from the Karolinska Sleep Questionnaire. Analyses on the association between frequency of deadlines and sleep quality scores were conducted with multiple linear regression models, adjusted for potential confounders. In addition, we used multiple logistic regression models to analyze whether frequency of deadlines at baseline predicted caseness of sleep problems at follow-up among participants free of sleep problems at baseline. Frequent deadlines were cross-sectionally and longitudinally associated with poorer sleep quality on all three sleep quality measures. Associations in the longitudinal analyses were greatly attenuated when we adjusted for baseline sleep quality. The logistic regression analyses showed that frequent deadlines at baseline were associated with elevated odds ratios for caseness of sleep problems at follow-up, however, confidence intervals were wide in these analyses. Frequent deadlines at work were associated with poorer sleep quality among Danish knowledge workers. We recommend investigating the relation between deadlines and health endpoints in large-scale epidemiologic studies. Copyright © 2011 Wiley Periodicals, Inc.
Guo, Yanjun; Ma, Jixuan; Lu, Wei; He, Jintong; Zhang, Runbo; Yuan, Jing; Chen, Weihong
2016-01-01
Exhaled carbon monoxide (eCO) and fractional exhaled nitric oxide (FeNO) could reflect underlying inflammatory and oxidative stresses, which play important roles in pathogenetic pathways of metabolic syndrome (MetS). However, epidemiologic evidence was limited. We conducted a study in Wuhan-Zhuhai (WHZH) cohort of 3649 community participants to investigate the association between eCO, FeNO and MetS in both cross-sectional and prospective ways. The results showed that higher eCO and FeNO were associated cross-sectionally with a higher prevalence of MetS. The multivariable-adjusted odds ratios for MetS at baseline were 1.22 (95% confidence interval [CI]: 1.11 to 1.35) associated with per log eCO and 1.14 (95% CI: 1.00 to 1.30) associated with per log FeNO. During a follow-up of 3 years, 358/2181 new developed MetS cases were identified. Compared with lowest quartile of eCO and FeNO, the multivariable-adjusted risk ratios (95% CI) for MetS were 1.48 (1.06 to 2.06) related to the highest quartile of eCO. These findings remained consistent across sex but not smoking status, eCO was only associated with MetS in non-smokers when stratified by smoking status. In conclusion, our study demonstrated that eCO and FeNO were independently and positively associated with the prevalence of MetS cross-sectionally, while only eCO was positively related with the incidence of MetS prospectively. PMID:27076211
Associations of muscle force, power, cross-sectional muscle area and bone geometry in older UK men.
Zengin, Ayse; Pye, Stephen R; Cook, Michael J; Adams, Judith E; Rawer, Rainer; Wu, Frederick C W; O'Neill, Terence W; Ward, Kate A
2017-08-01
Ageing is associated with sarcopenia, osteoporosis, and increased fall risk, all of which contribute to increased fracture risk. Mechanically, bone strength adapts in response to forces created by muscle contractions. Adaptations can be through changes in bone size, geometry, and bending strength. Muscle mass is often used as a surrogate for muscle force; however, force can be increased without changes in muscle mass. Increased fall risk with ageing has been associated with a decline in muscle power-which is a measure of mobility. The aims of this study were as follows: (i) to investigate the relationship between muscle parameters in the upper and lower limbs with age in UK men and the influence of ethnicity on these relationships; (ii) to examine the relationships between jump force/grip strength/cross-sectional muscle area (CSMA) with bone outcomes at the radius and tibia. White European, Black Afro-Caribbean, and South Asian men aged 40-79 years were recruited from Manchester, UK. Cortical bone mineral content, cross-sectional area, cortical area, cross-sectional moment of inertia, and CSMA were measured at the diaphysis of the radius and tibia using peripheral quantitative computed tomography. Lower limb jump force and power were measured from a single two-legged jump performed on a ground-reaction force platform. Grip strength was measured using a dynamometer. Associations between muscle and bone outcomes was determined using linear regression with adjustments for age, height, weight, and ethnicity. Three hundred and one men were recruited. Jump force was negatively associated with age; for every 10 year increase in age, there was a 4% reduction in jump force (P < 0.0001). There was a significant age-ethnicity interaction for jump power (P = 0.039); after adjustments, this was attenuated (P = 0.088). For every 10 year increase in age, grip strength decreased by 11%. Jump force was positively associated with tibial bone outcomes: a 1 standard deviation greater jump force was associated with significantly higher cortical bone mineral content 3.1%, cross-sectional area 4.2%, cortical area 3.4%, and cross-sectional moment of inertia 6.8% (all P < 0.001). Cross-sectional muscle area of the lower leg was not associated with tibial bone outcomes. Both grip strength and CSMA of the arm were positively associated, to a similar extent, with radius diaphyseal bone outcomes. Jump force and power are negatively associated with age in UK men. In the lower limb, the measurement of jump force is more strongly related to bone outcomes than CSMA. It is important to consider jump force and power when understanding the aetiology of bone loss and mobility in ageing men. © 2017 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders.
Predictors of adjustment and growth in women with recurrent ovarian cancer.
Ponto, Julie Ann; Ellington, Lee; Mellon, Suzanne; Beck, Susan L
2010-05-01
To analyze predictors of adjustment and growth in women who had experienced recurrent ovarian cancer using components of the Resiliency Model of Family Stress, Adjustment, and Adaptation as a conceptual framework. Cross-sectional. Participants were recruited from national cancer advocacy groups. 60 married or partnered women with recurrent ovarian cancer. Participants completed an online or paper survey. Independent variables included demographic and illness variables and meaning of illness. Outcome variables were psychological adjustment and post-traumatic growth. A model of five predictor variables (younger age, fewer years in the relationship, poorer performance status, greater symptom distress, and more negative meaning) accounted for 64% of the variance in adjustment but did not predict post-traumatic growth. This study supports the use of a model of adjustment that includes demographic, illness, and appraisal variables for women with recurrent ovarian cancer. Symptom distress and poorer performance status were the most significant predictors of adjustment. Younger age and fewer years in the relationship also predicted poorer adjustment. Nurses have the knowledge and skills to influence the predictors of adjustment to recurrent ovarian cancer, particularly symptom distress and poor performance status. Nurses who recognize the predictors of poorer adjustment can anticipate problems and intervene to improve adjustment for women.
Hashimoto, Tomomi; Takase, Hiroyuki; Okado, Tateo; Sugiura, Tomonori; Yamashita, Sumiyo; Kimura, Genjiro; Ohte, Nobuyuki; Dohi, Yasuaki
2016-08-01
The close association between dietary salt and hypertension is well established. However, previous studies generally assessed salt intake without adjustment for body weight. Herein, we investigated the significance of body weight-adjusted salt intake in the general population. The present cross-sectional study included 7629 participants from our yearly physical checkup program, and their salt intake was assessed using a spot urine test to estimate 24-hour urinary salt excretion. Total salt intake increased with increasing body weight. Body weight-adjusted salt intake was greater in participants with hypertension than in those without hypertension. Systolic blood pressure, estimated glomerular filtration rate, and urinary albumin were independently correlated with body weight-adjusted salt intake after adjustment for possible cardiovascular risk factors. Excessive body weight-adjusted salt intake could be related to an increase in blood pressure and hypertensive organ damage. Adjustment for body weight might therefore provide clinically important information when assessing individual salt intake. Copyright © 2016 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.
Least-Squares Neutron Spectral Adjustment with STAYSL PNNL
NASA Astrophysics Data System (ADS)
Greenwood, L. R.; Johnson, C. D.
2016-02-01
The STAYSL PNNL computer code, a descendant of the STAY'SL code [1], performs neutron spectral adjustment of a starting neutron spectrum, applying a least squares method to determine adjustments based on saturated activation rates, neutron cross sections from evaluated nuclear data libraries, and all associated covariances. STAYSL PNNL is provided as part of a comprehensive suite of programs [2], where additional tools in the suite are used for assembling a set of nuclear data libraries and determining all required corrections to the measured data to determine saturated activation rates. Neutron cross section and covariance data are taken from the International Reactor Dosimetry File (IRDF-2002) [3], which was sponsored by the International Atomic Energy Agency (IAEA), though work is planned to update to data from the IAEA's International Reactor Dosimetry and Fusion File (IRDFF) [4]. The nuclear data and associated covariances are extracted from IRDF-2002 using the third-party NJOY99 computer code [5]. The NJpp translation code converts the extracted data into a library data array format suitable for use as input to STAYSL PNNL. The software suite also includes three utilities to calculate corrections to measured activation rates. Neutron self-shielding corrections are calculated as a function of neutron energy with the SHIELD code and are applied to the group cross sections prior to spectral adjustment, thus making the corrections independent of the neutron spectrum. The SigPhi Calculator is a Microsoft Excel spreadsheet used for calculating saturated activation rates from raw gamma activities by applying corrections for gamma self-absorption, neutron burn-up, and the irradiation history. Gamma self-absorption and neutron burn-up corrections are calculated (iteratively in the case of the burn-up) within the SigPhi Calculator spreadsheet. The irradiation history corrections are calculated using the BCF computer code and are inserted into the SigPhi Calculator workbook for use in correcting the measured activities. Output from the SigPhi Calculator is automatically produced, and consists of a portion of the STAYSL PNNL input file data that is required to run the spectral adjustment calculations. Within STAYSL PNNL, the least-squares process is performed in one step, without iteration, and provides rapid results on PC platforms. STAYSL PNNL creates multiple output files with tabulated results, data suitable for plotting, and data formatted for use in subsequent radiation damage calculations using the SPECTER computer code (which is not included in the STAYSL PNNL suite). All components of the software suite have undergone extensive testing and validation prior to release and test cases are provided with the package.
Beyond the Cross-Sectional: Neighborhood Poverty Histories and Preterm Birth
Margerison-Zilko, Claire; Jun, Jina; Marchi, Kristen; Fingar, Kathryn; Braveman, Paula
2015-01-01
Objectives. We examined associations between longitudinal neighborhood poverty trajectories and preterm birth (PTB). Methods. Using data from the Neighborhood Change Database (1970–2000) and the American Community Survey (2005–2009), we categorized longitudinal trajectories of poverty for California neighborhoods (i.e., census tracts). Birth data included 23 291 singleton California births from the Maternal and Infant Health Assessment (2003–2009). We estimated associations (adjusted for individual-level covariates) between PTB and longitudinal poverty trajectories and compared these to associations using traditional, cross-sectional measures of poverty. Results. Compared to neighborhoods with long-term low poverty, those with long-term high poverty and those that experienced increasing poverty early in the study period had 41% and 37% increased odds of PTB (95% confidence interval [CI] = 1.18, 1.69 and 1.09, 1.72, respectively). High (compared with low) cross-sectional neighborhood poverty was not associated with PTB (odds ratio = 1.08; 95% CI = 0.91, 1.28). Conclusions. Neighborhood poverty histories may contribute to an understanding of perinatal health and should be considered in future research. PMID:25880941
A Comprehensive X-Ray Absorption Model for Atomic Oxygen
NASA Technical Reports Server (NTRS)
Gorczyca, T. W.; Bautista, M. A.; Hasoglu, M. F.; Garcia, J.; Gatuzz, E.; Kaastra, J. S.; Kallman, T. R.; Manson, S. T.; Mendoza, C.; Raassen, A. J. J.;
2013-01-01
An analytical formula is developed to accurately represent the photoabsorption cross section of atomic Oxygen for all energies of interest in X-ray spectral modeling. In the vicinity of the K edge, a Rydberg series expression is used to fit R-matrix results, including important orbital relaxation effects, that accurately predict the absorption oscillator strengths below threshold and merge consistently and continuously to the above-threshold cross section. Further, minor adjustments are made to the threshold energies in order to reliably align the atomic Rydberg resonances after consideration of both experimental and observed line positions. At energies far below or above the K-edge region, the formulation is based on both outer- and inner-shell direct photoionization, including significant shake-up and shake-off processes that result in photoionization-excitation and double-photoionization contributions to the total cross section. The ultimate purpose for developing a definitive model for oxygen absorption is to resolve standing discrepancies between the astronomically observed and laboratory-measured line positions, and between the inferred atomic and molecular oxygen abundances in the interstellar medium from XSTAR and SPEX spectral models.
Olson, Daniel; Lamb, Molly M; Lopez, Maria R; Paniagua-Avila, Maria A; Zacarias, Alma; Samayoa-Reyes, Gabriela; Cordon-Rosales, Celia; Asturias, Edwin J
2017-09-01
We examined burden and factors associated with norovirus (NoV) acute gastroenteritis (AGE) among children in rural Guatemala. Children age 6 weeks to 17 years were enrolled into three AGE surveillance groups, using two-stage cluster sampling: a prospective participatory syndromic surveillance (PSS) cohort and two cross-sectional rapid active sampling (RAS) surveys, conducted from April 2015 to February 2016. Epidemiologic and NoV testing data were used to identify factors associated with NoV infection, AGE, and NoV+ AGE. The three cross-sectional surveys (PSS enrollment visit, RAS Survey 1, and RAS Survey 2) enrolled 1,239 children, who reported 134 (11%) AGE cases, with 20% of AGE and 11% of non-AGE samples positive for NoV. Adjusted analyses identified several modifiable factors associated with AGE and NoV infection. The cross-sectional RAS surveys were practical and cost-effective in identifying population-level risk factors for AGE and NoV, supporting their use as a tool to direct limited public health resources toward high-risk populations.
Beyond the cross-sectional: neighborhood poverty histories and preterm birth.
Margerison-Zilko, Claire; Cubbin, Catherine; Jun, Jina; Marchi, Kristen; Fingar, Kathryn; Braveman, Paula
2015-06-01
We examined associations between longitudinal neighborhood poverty trajectories and preterm birth (PTB). Using data from the Neighborhood Change Database (1970-2000) and the American Community Survey (2005-2009), we categorized longitudinal trajectories of poverty for California neighborhoods (i.e., census tracts). Birth data included 23 291 singleton California births from the Maternal and Infant Health Assessment (2003-2009). We estimated associations (adjusted for individual-level covariates) between PTB and longitudinal poverty trajectories and compared these to associations using traditional, cross-sectional measures of poverty. Compared to neighborhoods with long-term low poverty, those with long-term high poverty and those that experienced increasing poverty early in the study period had 41% and 37% increased odds of PTB (95% confidence interval [CI] = 1.18, 1.69 and 1.09, 1.72, respectively). High (compared with low) cross-sectional neighborhood poverty was not associated with PTB (odds ratio = 1.08; 95% CI = 0.91, 1.28). Neighborhood poverty histories may contribute to an understanding of perinatal health and should be considered in future research.
Heitmuller, Franklin T.; Greene, Lauren E.
2009-01-01
The U.S. Geological Survey, in cooperation with the Texas Water Development Board, evaluated historical channel adjustment and estimated selected hydraulic values at U.S. Geological Survey streamflow-gaging stations in the lower Sabine River Basin in Texas and Louisiana and lower Brazos River Basin in Texas to support geomorphic assessments of the Texas Instream Flow Program. Channel attributes including cross-section geometry, slope, and planform change were evaluated to learn how each river's morphology changed over the years in response to natural and anthropogenic disturbances. Historical and contemporary cross-sectional channel geometries at several gaging stations on each river were compared, planform changes were assessed, and hydraulic values were estimated including mean flow velocity, bed shear stress, Froude numbers, and hydraulic depth. The primary sources of historical channel morphology information were U.S. Geological Survey hard-copy discharge-measurement field notes. Additional analyses were done using computations of selected flow hydraulics, comparisons of historical and contemporary aerial photographs, comparisons of historical and contemporary ground photographs, evaluations of how frequently stage-discharge rating curves were updated, reviews of stage-discharge relations for field measurements, and considerations of bridge and reservoir construction activities. Based on historical cross sections at three gaging stations downstream from Toledo Bend Reservoir, the lower Sabine River is relatively stable, but is subject to substantial temporary scour-and-fill processes during floods. Exceptions to this characterization of relative stability include an episode of channel aggradation at the Sabine River near Bon Wier, Texas, during the 1930s, and about 2 to 3 feet of channel incision at the Sabine River near Burkeville, Texas, since the late 1950s. The Brazos River, at gaging stations downstream from Waco, Texas, has adjusted to a combination of hydrologic, sedimentary, and anthropogenic controls. Since the 1960s, numerous point bars have vertically accreted and vegetation has encroached along the channel margins, which probably promotes channel-bed incision to compensate for a reduction in cross-sectional area. Channel incision was detected at all gaging stations along the Brazos River, and the depth of incision is greatest in the lowermost gaging stations, exemplified by about 5 feet of channel-bed incision between 1993 and 2004 at Richmond, Texas. One notable exception to this pattern of incision was a period of aggradation at U.S. Geological Survey gaging station 08096500 Brazos River at Waco, Texas, during the late 1920s and 1930s, probably associated with upstream dam construction. Lateral channel migration rates along the Brazos River determined from aerial photographs are greatest between Waco and Hempstead, Texas, with numerous bends moving an average of more than 10 feet per year. Migration rates at selected bends downstream from Hempstead were measured as less than 10 feet per year, on average. Two tributaries of the Brazos River, the Little and Navasota Rivers, also were investigated for historical channel adjustment. The Little River near Cameron, Texas (08106500) has incised its channel bed about 12 feet since 1949, and the lower Navasota River shows complex adjustment to bridge construction activities and a channel avulsion.
Woestenberg, Petra J; King, Audrey J; van der Sande, Marianne A B; Donken, Robine; Leussink, Suzan; van der Klis, Fiona R M; Hoebe, Christian J P A; Bogaards, Johannes A; van Benthem, Birgit H B
2017-04-01
Data from a vaccine trial and from post-vaccine surveillance in the United Kingdom have suggested that the bivalent HPV-16/18 vaccine offers cross-protection against HPV-6/11 and protection against anogenital warts (AGW). We studied the effect of the bivalent vaccine on genital HPV-6/11 positivity and AGW in the Netherlands. We included all vaccine-eligible women from the PASSYON study, a biennial cross-sectional study among 16- to 24-year-old sexually transmitted infection (STI) clinic attendants. Vaginal self-swabs were analyzed for type specific HPV and AGW were diagnosed at the STI-clinic. Prevalence of HPV-6 and/or HPV-11 and AGW were compared between self-reported vaccinated and unvaccinated women by log-binomial regression analysis, adjusted for demographics and risk behavior. Of the 1198 women included, 56% reported to be vaccinated at least once. Relative to unvaccinated women, the adjusted prevalence ratio (PR) for HPV-6/11 was 1.03 (95% confidence interval [CI] 0.74-1.43) for women vaccinated at least once. The crude PR for AGW was 0.67 (95% CI 0.22-2.07) for women vaccinated at least once. Adjustment did not change these results. We observed no cross-protective effect of the bivalent vaccine on genital HPV-6/11 positivity and a non-significant partially protective effect on AGW. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
Cross-sectional relationships of exercise and age to adiposity in60,617 male runners
DOE Office of Scientific and Technical Information (OSTI.GOV)
Williams, Paul T.; Pate, Russell R.
2004-06-01
The objective of this report is to assess in men whether exercise affects the estimated age-related increase in adiposity, and contrariwise, whether age affects the estimated exercise-related decrease in adiposity. Cross-sectional analyses of 64,911 male runners who provided data on their body mass index (97.6 percent), waist (91.1 percent), hip (47.1 percent), and chest circumferences (77.9 percent). Between 18 to 55 years old, the decline in BMI with weekly distance run (slope+-SE) was significantly greater in men 25-55 years old (slope+-:-0.036+-0.001 kg/m2 per km/wk) than in younger men (-0.020+-0.002 kg/m 2 per km/wk). Declines in waist circumference with running distancemore » were also significantly greater in older than younger men (P<10-9 for trend),i.e., the slopes decreased progressively from -0.035+-0.004 cm per km/wk in 18-25 year old men to -0.097+-0.003 cm per km/wk in 50-55 year old men. Increases in BMI with age were greater for men who ran under 16km/wk than for longer distance runners. Waist circumference increased with age at all running levels, but the increase appeared to diminish by running further (0.259+-0.015 cm per year if running<8 km/wk and 0.154+-0.003 cm per year for>16 km/wk). In men over 50 years old, BMI declined -0.038+-0.001 kg/m2 per km/wk run when adjusted for age and declined -0.054+-0.003 kg/m2 (increased 0.021+-0.007 cm) per year of age when adjusted for running distance. Their waist circumference declined-0.096+-0.002 cm per km/wk run when adjusted for age and increased 0.021+-0.007 cm per year of age when adjusted for running distance. These cross-sectional data suggest that age and vigorous exercise interact with each other in affecting mens adiposity, and support the proposition that vigorous physical activity must increase with age to prevent middle-age weight gain. We estimate that a man who ran 16 km/wk at age 25 would need to increase their weekly running distance by 65.7 km/wk by age 50 in order to maintain his same waist circumference.« less
ERIC Educational Resources Information Center
Qing, Siyu
2014-01-01
The National Science Foundation (NSF) Survey of Doctorate Recipients (SDR) collects information on a sample of individuals in the United States with PhD degrees. A significant portion of the sampled individuals appear in multiple survey years and can be linked across time. Survey weights in each year are created and adjusted for oversampling and…
Association between breast-feeding and severity of acute viral respiratory tract infection.
Vereen, Shanda; Gebretsadik, Tebeb; Hartert, Tina V; Minton, Patricia; Woodward, Kimberly; Liu, Zhouwen; Carroll, Kecia N
2014-09-01
In a cross-sectional analysis of 629 mother-infants dyads, breast-feeding (ever vs. never) was associated with decreased relative odds of a lower versus upper respiratory tract infection (adjusted odds ratio: 0.64; 95% confidence interval: 0.42-0.99). There was not a significant association between breast-feeding and bronchiolitis severity score or length of hospital stay.
Uceda, Mónica; Ziegler, Otto; Lindo, Felipe; Herrera-Pérez, Eder
2013-01-01
Background. Asthma and allergic rhinitis are highly prevalent conditions that cause major illness worldwide. This study aimed to assess the association between allergic rhinitis and asthma control in Peruvian school children. Methods. A cross-sectional study was conducted among 256 children with asthma recruited in 5 schools from Lima and Callao cities. The outcome was asthma control assessed by the asthma control test. A score test for trend of odds was used to evaluate the association between allergic rhinitis severity and the prevalence of inadequate asthma control. A generalized linear regression model was used to estimate the adjusted prevalence ratios of inadequate asthma control. Results. Allergic rhinitis was present in 66.4% of the population with asthma. The trend analysis showed a positive association between allergic rhinitis and the probability of inadequate asthma control (P < 0.001). It was associated with an increased prevalence of inadequate asthma control, with adjusted prevalence ratios of 1.53 (95% confidence interval: 1.19−1.98). Conclusion. This study indicates that allergic rhinitis is associated with an inadequate level of asthma control, giving support to the recommendation of evaluating rhinitis to improve asthma control in children. PMID:23984414
Yen, I H; Ragland, D R; Greiner, B A; Fisher, J M
1999-01-01
There is evidence of an association between occupational stress and alcohol consumption. This study investigates the association between workplace racial discrimination and alcohol consumption in a sample of urban transit operators. During 1993-1995, after undergoing a medical exam, 1,542 transit operators completed an interview. Depending on the outcome, we used logistic or linear regression models to examine the cross-sectional relationship between discrimination experience and alcohol consumption. Operators who reported discrimination in at least one situation, out of a possible four, were more likely to have had negative life consequences as a result of drinking (adjusted OR = 1.97; 95% CI, 1.20-3.83) and were more likely to be classified as having an alcohol disorder (OR = 1.56 [0.96-2.54]), compared to those who reported no instances of workplace discrimination. Results adjusted simultaneously for age, sex, race/ethnicity, education, income, marital status, and seniority. There was no association between workplace discrimination and heavy drinking or drinks per month. Cross-sectional data from a sample of urban transit operators indicates an association between workplace racial discrimination and some measures of alcohol consumption.
Huang, Tao; Gejl, Anne Kær; Tarp, Jakob; Andersen, Lars Bo; Peijs, Lone; Bugge, Anna
2017-03-15
The purpose of this study was to examine the associations between objectively measured physical activity and serum brain-derived neurotrophic factor (BDNF) in adolescents. Cross-sectional analyses were performed using data from 415 adolescents who participated in the 2015 follow-up of the Childhood Health Activity and Motor Performance School Study Denmark (the CHAMPS-study DK). Physical activity was objectively measured by accelerometry monitors. Serum BDNF levels were analyzed using the Enzyme-linked immunosorbent assay (ELISA). Anthropometrics and pubertal status were measured using standardized procedures. With adjustment for age, pubertal status and body mass index, mean physical activity (counts per minute) was negatively associated with serum BDNF in boys (P=0.013). Similarly, moderate-to-vigorous physical activity (MVPA) was negatively associated with serum BDNF in boys (P=0.035). In girls, mean physical activity and MVPA were not associated with serum BDNF. Without adjustment for wear time, sedentary time was not associated with serum BDNF in either sex. These findings indicate that higher physical activity is associated with lower serum BDNF in boys, but not in girls. Copyright © 2016 Elsevier Inc. All rights reserved.
Cross-cultural adjustment to the United States: the role of contextualized extraversion change
Liu, Mengqiao; Huang, Jason L.
2015-01-01
Personality traits can predict how well-sojourners and expatriates adjust to new cultures, but the adjustment process remains largely unexamined. Based on recent findings that reveal personality traits predict as well as respond to life events and experiences, this research focuses on within-person change in contextualized extraversion and its predictive validity for cross-cultural adjustment in international students who newly arrived in US colleges. We proposed that the initial level as well as the rate of change in school extraversion (i.e., contextualized extraversion that reflects behavioral tendency in school settings) will predict cross-cultural adjustment, withdrawal cognitions, and school satisfaction. Latent growth modeling of three-wave longitudinal surveys of 215 new international students (54% female, Mage = 24 years) revealed that the initial level of school extraversion significantly predicted cross-cultural adjustment, (lower) withdrawal cognitions, and satisfaction, while the rate of change (increase) in school extraversion predicted cross-cultural adjustment and (lower) withdrawal cognitions. We further modeled global extraversion and cross-cultural motivation as antecedents and explored within-person change in school extraversion as a proximal factor that affects adjustment outcomes. The findings highlight the malleability of contextualized personality, and more importantly, the importance of understanding within-person change in contextualized personality in a cross-cultural adjustment context. The study points to more research that explicate the process of personality change in other contexts. PMID:26579033
Cross-cultural adjustment to the United States: the role of contextualized extraversion change.
Liu, Mengqiao; Huang, Jason L
2015-01-01
Personality traits can predict how well-sojourners and expatriates adjust to new cultures, but the adjustment process remains largely unexamined. Based on recent findings that reveal personality traits predict as well as respond to life events and experiences, this research focuses on within-person change in contextualized extraversion and its predictive validity for cross-cultural adjustment in international students who newly arrived in US colleges. We proposed that the initial level as well as the rate of change in school extraversion (i.e., contextualized extraversion that reflects behavioral tendency in school settings) will predict cross-cultural adjustment, withdrawal cognitions, and school satisfaction. Latent growth modeling of three-wave longitudinal surveys of 215 new international students (54% female, M age = 24 years) revealed that the initial level of school extraversion significantly predicted cross-cultural adjustment, (lower) withdrawal cognitions, and satisfaction, while the rate of change (increase) in school extraversion predicted cross-cultural adjustment and (lower) withdrawal cognitions. We further modeled global extraversion and cross-cultural motivation as antecedents and explored within-person change in school extraversion as a proximal factor that affects adjustment outcomes. The findings highlight the malleability of contextualized personality, and more importantly, the importance of understanding within-person change in contextualized personality in a cross-cultural adjustment context. The study points to more research that explicate the process of personality change in other contexts.
Ngwa, Julius S; Cabral, Howard J; Cheng, Debbie M; Pencina, Michael J; Gagnon, David R; LaValley, Michael P; Cupples, L Adrienne
2016-11-03
Typical survival studies follow individuals to an event and measure explanatory variables for that event, sometimes repeatedly over the course of follow up. The Cox regression model has been used widely in the analyses of time to diagnosis or death from disease. The associations between the survival outcome and time dependent measures may be biased unless they are modeled appropriately. In this paper we explore the Time Dependent Cox Regression Model (TDCM), which quantifies the effect of repeated measures of covariates in the analysis of time to event data. This model is commonly used in biomedical research but sometimes does not explicitly adjust for the times at which time dependent explanatory variables are measured. This approach can yield different estimates of association compared to a model that adjusts for these times. In order to address the question of how different these estimates are from a statistical perspective, we compare the TDCM to Pooled Logistic Regression (PLR) and Cross Sectional Pooling (CSP), considering models that adjust and do not adjust for time in PLR and CSP. In a series of simulations we found that time adjusted CSP provided identical results to the TDCM while the PLR showed larger parameter estimates compared to the time adjusted CSP and the TDCM in scenarios with high event rates. We also observed upwardly biased estimates in the unadjusted CSP and unadjusted PLR methods. The time adjusted PLR had a positive bias in the time dependent Age effect with reduced bias when the event rate is low. The PLR methods showed a negative bias in the Sex effect, a subject level covariate, when compared to the other methods. The Cox models yielded reliable estimates for the Sex effect in all scenarios considered. We conclude that survival analyses that explicitly account in the statistical model for the times at which time dependent covariates are measured provide more reliable estimates compared to unadjusted analyses. We present results from the Framingham Heart Study in which lipid measurements and myocardial infarction data events were collected over a period of 26 years.
Absolute or relative? A comparative analysis of the relationship between poverty and mortality.
Fritzell, Johan; Rehnberg, Johan; Bacchus Hertzman, Jennie; Blomgren, Jenni
2015-01-01
We aimed to examine the cross-national and cross-temporal association between poverty and mortality, in particular differentiating the impact of absolute and relative poverty. We employed pooled cross-sectional time series analysis. Our measure of relative poverty was based upon the standard 60% of median income. The measure of absolute, or fixed, poverty was based upon the US poverty threshold. Our analyses were conducted on data for 30 countries between 1978 and 2010, a total of 149 data points. We separately studied infant, child, and adult mortality. Our findings highlight the importance of relative poverty for mortality. Especially for infant and child mortality, we found that our estimates of fixed poverty is close to zero either in the crude models, or when adjusting for gross domestic product. Conversely, the relative poverty estimates increased when adjusting for confounders. Our results seemed robust to a number of sensitivity tests. If we agree that risk of death is important, the public policy implication of our findings is that relative poverty, which has close associations to overall inequality, should be a major concern also among rich countries.
Relationship adjustment, depression, and anxiety during pregnancy and the postpartum period.
Whisman, Mark A; Davila, Joanne; Goodman, Sherryl H
2011-06-01
The associations between relationship adjustment and symptoms of depression and anxiety were evaluated in a sample of pregnant married or cohabiting women (N = 113) who were at risk for perinatal depression because of a prior history of major depression. Women completed self-report measures of relationship adjustment, depressive symptoms, and anxiety symptoms monthly during pregnancy and for the first six months following the birth of their child. Multilevel modeling was used to examine concurrent and time-lagged within-subjects effects for relationship adjustment and depressive and anxiety symptoms. Results revealed that (a) relationship adjustment was associated with both depressive symptoms and anxiety symptoms in concurrent analyses; (b) relationship adjustment was predictive of subsequent anxiety symptoms but not subsequent depressive symptoms in lagged analyses; and (c) depressive symptoms were predictive of subsequent relationship adjustment in lagged analyses with symptoms of depression and anxiety examined simultaneously. These results support the continued investigation into the cross-sectional and longitudinal associations between relationship functioning and depressive and anxiety symptoms in women during pregnancy and the postpartum period. 2011 APA, all rights reserved
Anish, TS; Vijayakumar, K; Leela, Itty Amma KR
2011-01-01
Background: The world is experiencing a pandemic of chikungunya which has swept across Indian Ocean and the Indian subcontinent. Kerala the southernmost state of India was affected by the chikungunya epidemic twice, first in 2006 and then in 2007. Kerala has got geography and climate which are highly favorable for the breeding of Aedes albopictus, the suspected vector. Aim: The aim of the study was to highlight the various domestic and environmental factors of the families affected by chikungunya in 2007 in Thiruvananthapuram district (rural) of Kerala. Settings and design:This is a cross-sectional survey conducted in Thiruvananthapuram (rural) district during November 2007. Settings and design: This is a cross-sectional survey conducted in Thiruvananthapuram (rural) district during November 2007 Materials and Methods: Samples were selected from field area under three Primary Health Centers.These areas represent the three terrains of the district namely the highland, midland, and lowland. The sample size was estimated to be 134 houses from each study area.The field area of health workers was selected as clusters and six subcenters from each primary health center were randomly selected (lot method). Results and Conclusions: The proportion of population affected by chikungunya fever is 39.9% (38.9-40.9%). The investigators observed water holding containers in the peri-domestic area of 95.6% of the houses. According to regression (binary logistic) analysis, the area of residence [adjusted odds ratio (OR) = 8.01 (6.06-14.60)], residing in a non-remote area [adjusted OR=0.25 (0.16-0.38)], perceived mosquito menace [adjusted OR=3.07 (2.31-4.64)], and containers/tires outside the house [adjusted OR=5.61 (2.74-27.58)] were the independent predictors of the occurrence of chikungunya in households. PMID:21572606
Grimes, Tamasine C; Duggan, Catherine A; Delaney, Tim P; Graham, Ian M; Conlon, Kevin C; Deasy, Evelyn; Jago-Byrne, Marie-Claire; O' Brien, Paul
2011-01-01
AIMS Movement into or out of hospital is a vulnerable period for medication safety. Reconciling the medication a patient is using before admission with the medication prescribed on discharge, and documenting any changes (medication reconciliation) is recommended to improve safety. The aims of the study were to investigate the factors contributing to medication reconciliation on discharge, and identify the prevalence of non-reconciliation. METHODS The study was a cross-sectional, observational survey using consecutive discharges from purposively selected services in two acute public hospitals in Ireland. Medication reconciliation, potential for harm and unplanned re-admission were investigated. RESULTS Medication non-reconciliation was identified in 50% of 1245 inpatient episodes, involving 16% of 9569 medications. The majority of non-reconciled episodes had potential to result in moderate (63%) or severe (2%) harm. Handwritten rather than computerized discharges (adjusted odds ratio (adjusted OR) 1.60, 95% CI 1.11, 2.99), increasing number of medications (adjusted OR 1.26, 95% CI 1.21, 1.31) or chronic illness (adjusted OR 2.08, 95% CI 1.33, 3.24) were associated with non-reconciliation. Omission of endocrine, central nervous system and nutrition and blood drugs was more likely on discharge, whilst omission on admission and throughout inpatient care, without documentation, was more likely for obstetric, gynaecology and urinary tract (OGU) or respiratory drugs. Documentation in the discharge communication that medication was intentionally stopped during inpatient care was less likely for cardiovascular, musculoskeletal and OGU drugs. Errors involving the dose were most likely for respiratory drugs. CONCLUSIONS The findings inform strategies to facilitate medication reconciliation on discharge from acute hospital care. PMID:21284705
Sontrop, Jessica M; Dixon, Stephanie N; Garg, Amit X; Buendia-Jimenez, Inmaculada; Dohein, Oriane; Huang, Shih-Han S; Clark, William F
2013-01-01
Evidence from animal and human studies suggests a protective effect of higher water intake on kidney function and cardiovascular disease (CVD). Here the associations between water intake, chronic kidney disease (CKD) and CVD were examined in the general population. We conducted a cross-sectional analysis of the 2005-2006 National Health and Nutrition Examination Survey. Non-pregnant adults with an estimated glomerular filtration rate (eGFR) ≥30 ml/min/1.73 m(2) who were not taking diuretics were included. Total water intake from foods and beverages was categorized as low (<2.0 l/day), moderate (2.0-4.3 l/day) and high (>4.3 l/day). We examined associations between low total water intake and CKD (eGFR 30-60 ml/min/1.73 m(2)) and self-reported CVD. Of 3,427 adults (mean age 46 (range 20-84); mean eGFR 95 ml/min/1.73 m(2) (range 30-161)), 13% had CKD and 18% had CVD. CKD was higher among those with the lowest (<2.0 l/day) vs. highest total water intake (>4.3 l/day) (adjusted odds ratio (OR) 2.52; 95% confidence interval (CI) 0.91-6.96). When stratified by intake of (1) plain water and (2) other beverages, CKD was associated with low intake of plain water: adjusted OR 2.36 (95% CI 1.10-5.06), but not other beverages: adjusted OR 0.87 (95% CI 0.30-2.50). There was no association between low water intake and CVD (adjusted OR 0.76; 95% CI 0.37-1.59). Our results provide additional evidence suggesting a potentially protective effect of higher total water intake, particularly plain water, on the kidney. Copyright © 2013 S. Karger AG, Basel.
Ruhdorfer, Anja; Wirth, Wolfgang; Eckstein, Felix
2016-01-01
Objective To cross-sectionally determine the quantitative relationship of age-adjusted, sex-specific isometric knee extensor and flexor strength to patient-reported knee pain. Methods Difference of thigh muscle strength by age, and that of age-adjusted strength per unit increase on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) knee pain scale, was estimated from linear regression analysis of 4553 Osteoarthritis Initiative participants (58% women). Strata encompassing the minimal clinically important difference (MCID) in knee pain were compared to evaluate a potentially non-linear relationship between WOMAC pain levels and muscle strength. Results In Osteoarthritis Initiative participants without pain, the age-related difference in isometric knee extensor strength was −9.0%/−8.2% (women/men) per decade, and that of flexor strength was −11%/−6.9%. Differences in age-adjusted strength values for each unit of WOMAC pain (1/20) amounted to −1.9%/−1.6% for extensor and −2.5%/−1.7% for flexor strength. Differences in torque/weight for each unit of WOMAC pain ranged from −3.3 to − 2.1%. There was no indication of a non-linear relationship between pain and strength across the range of observed WOMAC values, and similar results were observed in women and men. Conclusion Each increase by 1/20 units in WOMAC pain was associated with a ~2% lower age-adjusted isometric extensor and flexor strength in either sex. As a reduction in muscle strength is known to prospectively increase symptoms in knee osteoarthritis and as pain appears to reduce thigh muscle strength, adequate therapy of pain and muscle strength is required in knee osteoarthritis patients to avoid a vicious circle of self-sustaining clinical deterioration. PMID:27836675
Sedentary lifestyle and emergence of hopelessness in middle-aged men.
Valtonen, Maarit; Laaksonen, David E; Laukkanen, Jari; Tolmunen, Tommi; Rauramaa, Rainer; Viinamäki, Heimo; Mursu, Jaakko; Savonen, Kai; Lakka, Timo A; Niskanen, Leo; Kauhanen, Jussi
2010-10-01
A sedentary lifestyle and psychosocial factors such as hopelessness and depression increase cardiovascular risk. Cross-sectional evidence suggests positive effects of physical exercise on psychological well being, but the time order of the relationship between physical activity and hopelessness has not been addressed. Population-based prospective cohort study with 630 middle-aged men participating in the 4-year follow-up and 509 men in the 11-year follow-up. We investigated the association of leisure-time physical activity (LTPA) with the development of hopelessness during the follow-up. LTPA and hopelessness were quantified with questionnaires. In cross-sectional analyses, LTPA was inversely associated with hopelessness, independently of depression. Among men who did not have feelings of hopelessness at baseline, those who reported engaging in at least 2.5 h/week of moderate-to-vigorous physical activity had a lower risk (odds ratio 0.65, 95% confidence interval: 0.39-1.09, P for the trend=0.047) to feel hopeless than sedentary men 4 years later after adjustment for age, smoking, alcohol consumption, cardiovascular disease and socioeconomic status. Furthermore, this relationship was not explained by body mass index or maximal oxygen uptake. Adjustment for depressive symptoms slightly weakened the association (odds ratio 0.66, 95% confidence interval: 0.39-1.11, P for the trend=0.060). After 11 years, men who reported being physically active at baseline were still less likely to feel hopeless, after adjusting for age. However, after further adjustment for other confounding factors the association was no longer significant. Moderate-to-vigorous physical activity seems to prevent development of hopelessness in middle-aged men. This protective effect may diminish over time.
Melzer, David; Osborne, Nicholas J; Henley, William E; Cipelli, Riccardo; Young, Anita; Money, Cathryn; McCormack, Paul; Luben, Robert; Khaw, Kay-Tee; Wareham, Nicholas J; Galloway, Tamara S
2012-03-27
The endocrine-disrupting chemical bisphenol A (BPA) is widely used in food and beverage packaging. Higher urinary BPA concentrations were cross-sectionally associated with heart disease in National Health and Nutrition Examination Survey (NHANES) 2003-2004 and NHANES 2005-2006, independent of traditional risk factors. We included 758 incident coronary artery disease (CAD) cases and 861 controls followed for 10.8 years from the European Prospective Investigation of Cancer-Norfolk UK. Respondents aged 40 to 74 years and free of CAD, stroke, or diabetes mellitus provided baseline spot urine samples. Urinary BPA concentrations (median value, 1.3 ng/mL) were low. Per-SD (4.56 ng/mL) increases in urinary BPA concentration were associated with incident CAD in age-, sex-, and urinary creatinine-adjusted models (n=1919; odds ratio=1.13; 95% confidence interval, 1.02-1.24; P=0.017). With CAD risk factor adjustment (including education, occupational social class, body mass index category, systolic blood pressure, lipid concentrations, and exercise), the estimate was similar but narrowly missed 2-sided significance (n=1744; odds ratio=1.11; 95% confidence interval, 1.00-1.23; P=0.058). Sensitivity analyses with the fully adjusted model, excluding those with early CAD (<3-year follow-up), body mass index >30, or abnormal renal function or with additional adjustment for vitamin C, C-reactive protein, or alcohol consumption, all produced similar estimates, and all showed associations at P≤0.05. Associations between higher BPA exposure (reflected in higher urinary concentrations) and incident CAD during >10 years of follow-up showed trends similar to previously reported cross-sectional findings in the more highly exposed NHANES respondents. Further work is needed to accurately estimate the prospective exposure-response curve and to establish the underlying mechanisms.
Wemakor, Anthony; Mensah, Kofi Akohene
2016-08-24
Stunting indicates failure to attain genetic potential for height and is a well-documented indicator for poor growth. Depression is common in women of reproductive age and women's mental health problems may affect the growth of young children. We examined the association between maternal depression and stunting in mother-child pairs attending Child Welfare Clinic (CWC) in Northern Ghana. An analytical cross-sectional study was performed involving mothers (15-45 years) and their children (0-59 months) who attended CWC at Bilpeila Health Centre, Tamale, Ghana. Socio-demographic data were collected using a semi-structured questionnaire, maternal depression was measured using Centre for Epidemiological Studies Depression Screening Scale, and anthropometry was conducted on children following standard procedures. The association between maternal depression and child stunting was examined in logistic regression adjusting for potential confounders. Prevalence rates of child stunting and maternal depression were estimated at 16.1 and 27.8 % respectively in Northern Ghana. Mothers with depression when compared with those without depression tended to be younger, be currently unmarried, belong to the poorest household wealth tertile, and were more likely to have low birth weight babies, so these characteristics were adjusted for. In an adjusted multivariate logistic regression model, children of depressed mothers were almost three times more likely to be stunted compared to children of non-depressed mothers (Adjusted OR = 2.48, 95 % CI 1.29-4.77, p = 0.0011). There is a high prevalence of depression among mothers in Northern Ghana which is associated with child stunting. Further studies are needed to identify the determinants of maternal depression and to examine its association with child stunting to inform nutrition programming.
Oellingrath, Inger M; Svendsen, Martin V; Hestetun, Ingebjørg
2014-11-01
To investigate the association between eating patterns and mental health problems in young Norwegian adolescents (12-13 years of age). Cross-sectional study. Dietary information was reported by parents using a retrospective FFQ. Eating patterns were identified using principal component analysis. The Strengths and Difficulties Questionnaire was used to measure mental health problems. The association between eating patterns and mental health problems was examined using multiple logistic regression analysis. Primary schools, Telemark County, Norway. Children (n 1095) aged 12-13 years and their parents. Children with high scores on a 'varied Norwegian' eating pattern were less likely to have indications of any psychiatric disorders (adjusted OR = 0·5; 95 % CI 0·3, 1·0) and hyperactivity-inattention disorders (adjusted OR = 0·4; 95 % CI 0·2, 0·8) than children with low scores on this pattern. Children with high scores on a 'junk/convenient' eating pattern were more likely to have indications of hyperactivity-inattention disorders (adjusted OR = 3·4; 95 % CI 1·3, 8·6) than children with low scores on this pattern. Children with high scores on a 'snacking' eating pattern were more likely to have indications of conduct/oppositional disorders (adjusted OR = 3·8; 95 % CI 1·2, 11·5) than those with low scores on this eating pattern. We identified a significant association between eating patterns and mental health problems in young adolescents, independently of physical activity, sedentary activity and background variables. A diverse diet rich in unrefined plant foods, fish and regular meals was associated with better mental health, while energy-dense, nutrient-poor diets and irregular meals were associated with poorer mental health.
Zachariah, Justin P; Hwang, Susan; Hamburg, Naomi M; Benjamin, Emelia J; Larson, Martin G; Levy, Daniel; Vita, Joseph A; Sullivan, Lisa M; Mitchell, Gary F; Vasan, Ramachandran S
2016-02-01
Adipokines may be potential mediators of the association between excess adiposity and vascular dysfunction. We assessed the cross-sectional associations of circulating adipokines with vascular stiffness in a community-based cohort of younger adults. We related circulating concentrations of leptin and leptin receptor, adiponectin, retinol-binding protein 4, and fatty acid-binding protein 4 to vascular stiffness measured by arterial tonometry in 3505 Framingham Third Generation cohort participants free of cardiovascular disease (mean age 40 years, 53% women). Separate regression models estimated the relations of each adipokine to mean arterial pressure and aortic stiffness, as carotid femoral pulse wave velocity, adjusting for age, sex, smoking, heart rate, height, antihypertensive treatment, total and high-density lipoprotein cholesterol, diabetes mellitus, alcohol consumption, estimated glomerular filtration rate, glucose, and C-reactive protein. Models evaluating aortic stiffness also were adjusted for mean arterial pressure. Mean arterial pressure was positively associated with blood retinol-binding protein 4, fatty acid-binding protein 4, and leptin concentrations (all P<0.001) and inversely with adiponectin (P=0.002). In fully adjusted models, mean arterial pressure was positively associated with retinol-binding protein 4 and leptin receptor levels (P<0.002 both). In fully adjusted models, aortic stiffness was positively associated with fatty acid-binding protein 4 concentrations (P=0.02), but inversely with leptin and leptin receptor levels (P≤0.03 both). In our large community-based sample, circulating concentrations of select adipokines were associated with vascular stiffness measures, consistent with the hypothesis that adipokines may influence vascular function and may contribute to the relation between obesity and hypertension. © 2015 American Heart Association, Inc.
Liu, Yen-Tze; Yang, Pei-Yu; Yang, Yu-Wen; Sun, Hung-Yu; Lin, I-Ching
2017-01-01
Metabolic syndrome is a worldwide disorder and also the major risk factor of several systemic diseases. Evidence identifying the association between metabolic syndrome and nephrolithiasis is lacking, especially in Taiwan. The aim of this study was to investigate the association between nephrolithiasis and metabolic syndrome and its components. This was a cross-sectional study conducted in the Health Examination Department of a medical center in Changhua, Taiwan, from January 2010 to December 2010. We reviewed the medical records of patients who had visited the Health Examination Center of Changhua Christian Hospital in 2010. A total of 3,886 individuals were enrolled. According to the exclusion criteria, those with an age <20 years and an abnormal renal function were excluded. A total of 3,793 subjects were included. All P -values are two tailed, and P <0.05 was defined as statistically significant. The results showed a correlation between nephrolithiasis and metabolic syndrome and its components. The multivariate-adjusted odds ratio (OR) (95% confidence interval [CI]) of metabolic syndrome for nephrolithiasis was 1.318 (1.083-1.604), with a P -value of 0.006. Larger waist circumference (multivariable-adjusted OR 1.338; 95% CI 1.098-1.631; P =0.004), higher blood pressure (multivariable-adjusted OR 1.333; 95% CI 1.106-1.607; P =0.003), and increased fasting glucose (multivariable-adjusted OR 1.276; 95% CI 1.054-1.546; P =0.01) were associated with nephrolithiasis. This is the first study in Taiwan to investigate the relationship between metabolic syndrome and nephrolithiasis. The mechanism is controversial, and several hypotheses are offered. Adequate lifestyle modification and proper treatment in metabolic syndrome management may both contribute to nephrolithiasis prevention.
Job strain and resting heart rate: a cross-sectional study in a Swedish random working sample.
Eriksson, Peter; Schiöler, Linus; Söderberg, Mia; Rosengren, Annika; Torén, Kjell
2016-03-05
Numerous studies have reported an association between stressing work conditions and cardiovascular disease. However, more evidence is needed, and the etiological mechanisms are unknown. Elevated resting heart rate has emerged as a possible risk factor for cardiovascular disease, but little is known about the relation to work-related stress. This study therefore investigated the association between job strain, job control, and job demands and resting heart rate. We conducted a cross-sectional survey of randomly selected men and women in Västra Götalandsregionen, Sweden (West county of Sweden) (n = 1552). Information about job strain, job demands, job control, heart rate and covariates was collected during the period 2001-2004 as part of the INTERGENE/ADONIX research project. Six different linear regression models were used with adjustments for gender, age, BMI, smoking, education, and physical activity in the fully adjusted model. Job strain was operationalized as the log-transformed ratio of job demands over job control in the statistical analyses. No associations were seen between resting heart rate and job demands. Job strain was associated with elevated resting heart rate in the unadjusted model (linear regression coefficient 1.26, 95 % CI 0.14 to 2.38), but not in any of the extended models. Low job control was associated with elevated resting heart rate after adjustments for gender, age, BMI, and smoking (linear regression coefficient -0.18, 95 % CI -0.30 to -0.02). However, there were no significant associations in the fully adjusted model. Low job control and job strain, but not job demands, were associated with elevated resting heart rate. However, the observed associations were modest and may be explained by confounding effects.
Children and young adults with CF in the USA have better lung function compared with the UK.
Goss, Christopher H; MacNeill, Stephanie J; Quinton, Hebe B; Marshall, Bruce C; Elbert, Alexander; Knapp, Emily A; Petren, Kristofer; Gunn, Elaine; Osmond, Joanne; Bilton, Diana
2015-03-01
People with cystic fibrosis (CF) are managed differently in the USA and UK providing an opportunity to learn from differences in practice patterns. To compare cross-sectional demographics, practice patterns and clinical outcomes between US and UK CF patients. This was a cross-sectional study using 2010 data from patients in the US Cystic Fibrosis Foundation and the UK Cystic Fibrosis patient registries. The a priori outcome measures of interest were lung function and nutritional status. Descriptive statistics and two sample comparisons were performed. Stratification and multivariable linear regression were used to adjust for confounding. The study cohort included 13 777 children and 11 058 adults from the USA and 3968 children and 3965 adults from the UK. In children, mean body mass index centiles were similar. Lung function (FEV1 and FVC% predicted) was significantly higher in US patients ages 6-25 years of age. In a regression model adjusted for only age, FEV1% predicted was on average 3.31% of predicted (95% CI 2.65 to 3.96) higher in the USA compared with the UK. When adjusted for age, age at diagnosis, gender, pancreatic insufficiency and genotype, FEV1% predicted was on average 3.03% of predicted (95% CI 2.37 to 3.69) higher in the USA compared with the UK These differences persisted despite adjustment for possible confounders. Hypertonic saline and dornase alfa were much more commonly prescribed in US children. Children and young adults with CF have better lung function in the USA compared with the UK despite similar nutritional status. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Falvey, Cherie M.; Rosano, Caterina; Simonsick, Eleanor M.; Harris, Tamara; Strotmeyer, Elsa S.; Satterfield, Suzanne; Yaffe, Kristine
2013-01-01
OBJECTIVE To better understand the association between diabetes and cognitive impairment, we evaluated macro- and microstructural brain MRI measures for the total brain and regions of interest (ROIs) in a group of community-dwelling elders with and without diabetes. RESEARCH DESIGN AND METHODS MRI measures were obtained on 308 elders (mean age 83.3 years; n = 85 with diabetes) from the Health ABC Healthy Brain Substudy. We performed a series of linear regressions and used standardized β values to estimate the cross-sectional association between diabetes and macrostructural (gray matter volume [GMV] and white matter hyperintensities [WMHs]) and microstructural (mean diffusivity [MD] and fractional anisotropy [FA]) measures for the total brain and ROIs. Models were adjusted for age, race, and sex; GMV values for ROIs were also adjusted for total brain volume (TBV). RESULTS In multivariate-adjusted models, diabetes was associated with lower total GMV (P = 0.0006), GMV in the putamen (P = 0.02 for left and right), and TBV (P = 0.04) and greater cerebral atrophy (P = 0.02). There was no association with WMHs. On microstructural measures, diabetes was associated with reduced FA for total white matter (P = 0.006) and greater MD for the hippocampus (P = 0.006 left; P = 0.01 right), dorsolateral prefrontal cortex (P = 0.0007, left; P = 0.002, right), left posterior cingulate (P = 0.02), and right putamen (P = 0.02). Further adjustment for stroke, hypertension, and myocardial infarction produced similar results. CONCLUSIONS In this cross-sectional study, elders with diabetes compared with those without had greater brain atrophy and early signs of neurodegeneration. Further studies are needed to determine whether these structural changes associated with diabetes predict risk of cognitive decline. PMID:23160721
Poor Sleep Quality, Antepartum Depression and Suicidal Ideation among Pregnant Women
Gelaye, Bizu; Addae, Gifty; Neway, Beemnet; Larrabure-Torrealva, Gloria T.; Qiu, Chunfang; Stoner, Lee; Fernandez, Miguel Angel Luque; Sanchez, Sixto E.; Williams, Michelle A.
2016-01-01
Objective To evaluate the independent and combined associations of maternal self-reported poor sleep quality and antepartum depression with suicidal ideation during the third trimester Methods A cross-sectional study was conducted among 1,298 pregnant women (between 24 and 28 gestational weeks) attending prenatal clinics in Lima, Peru. Antepartum depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 (PHQ-9). The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to assess sleep quality. Multivariate logistical regression procedures were used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) after adjusting for putative confounders. Results Approximately, 17% of women were classified as having poor sleep quality (defined using the recommended criteria of PSQI global score of >5 vs. ≤5). Further, the prevalence of antepartum depression and suicidal ideation were 10.3% and 8.5%, respectively in this cohort. After adjusting for confounders including depression, poor sleep quality was associated with a 2.81-fold increased odds of suicidal ideation (OR=2.81; 95% CI 1.78–4.45). When assessed as a continuous variable, each 1-unit increase in the global PSQI score resulted in a 28% increase in odds for suicidal ideation, even after adjusting for depression (OR=1.28; 95% CI 1.15–1.41). The odds of suicidal ideation was particularly high among depressed women with poor sleep quality (OR=13.56 95% CI 7.53–24.41) as compared with women without either risk factor. Limitations This cross-sectional study utilized self-reported data. Causality cannot be inferred, and results may not be fully generalizable. Conclusion Poor sleep quality, even after adjusting for depression, is associated with antepartum suicidal ideation. Our findings support the need to explore sleep-focused interventions for pregnant women. PMID:27930912
Poor sleep quality, antepartum depression and suicidal ideation among pregnant women.
Gelaye, Bizu; Addae, Gifty; Neway, Beemnet; Larrabure-Torrealva, Gloria T; Qiu, Chunfang; Stoner, Lee; Luque Fernandez, Miguel Angel; Sanchez, Sixto E; Williams, Michelle A
2017-02-01
To evaluate the independent and combined associations of maternal self-reported poor sleep quality and antepartum depression with suicidal ideation during the third trimester METHODS: A cross-sectional study was conducted among 1298 pregnant women (between 24 and 28 gestational weeks) attending prenatal clinics in Lima, Peru. Antepartum depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 (PHQ-9). The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to assess sleep quality. Multivariate logistical regression procedures were used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) after adjusting for putative confounders. Approximately, 17% of women were classified as having poor sleep quality (defined using the recommended criteria of PSQI global score of >5 vs. ≤5). Further, the prevalence of antepartum depression and suicidal ideation were 10.3% and 8.5%, respectively in this cohort. After adjusting for confounders including depression, poor sleep quality was associated with a 2.81-fold increased odds of suicidal ideation (OR=2.81; 95% CI 1.78-4.45). When assessed as a continuous variable, each 1-unit increase in the global PSQI score resulted in a 28% increase in odds for suicidal ideation, even after adjusting for depression (OR=1.28; 95% CI 1.15-1.41). The odds of suicidal ideation was particularly high among depressed women with poor sleep quality (OR=13.56 95% CI 7.53-24.41) as compared with women without either risk factor. This cross-sectional study utilized self-reported data. Causality cannot be inferred, and results may not be fully generalizable. Poor sleep quality, even after adjusting for depression, is associated with antepartum suicidal ideation. Our findings support the need to explore sleep-focused interventions for pregnant women. Copyright © 2016 Elsevier B.V. All rights reserved.
Albuquerque, Sara; Narciso, Isabel; Pereira, Marco
2018-01-01
This study aimed to examine forms of dyadic coping (DC) as mediators of the association between parents' grief response and dyadic adjustment and to determine whether these indirect effects were moderated by the child's type of death, timing of death, and age. The study design was cross-sectional. The sample consisted of 197 bereaved parents. Participants completed the Prolonged Grief Disorder Scale, Revised Dyadic Adjustment Scale, and Dyadic Coping Inventory. Significant indirect effects of parents' grief response on dyadic adjustment were found through stress communication by oneself and by the partner, positive and negative DC by the partner, and joint DC. The timing of death moderated the association between grief response and dyadic adjustment and between joint DC and dyadic adjustment. Grief response was negatively associated with dyadic adjustment only when the death occurred after birth. Grief response was negatively associated with joint DC, which, in turn, was positively associated with dyadic adjustment, when the death occurred both before and after birth. However, the association was stronger in the latter. Specific forms of DC might be mechanisms through which grief response is associated with dyadic adjustment and should be promoted in clinical practice.
Goulart, Alessandra C; Santos, Itamar S; Lotufo, Paulo A; Benseñor, Isabela M
2015-10-01
The relationship between cardiovascular risk factors (CVRF) and migraine is controversial and might be different in both genders. These associations were evaluated in Brazilian middle-aged men and women from the Longitudinal Study of Adult Health (ELSA-Brasil). The cross-sectional relationship between our main outcome, which was migraine headache (definite, probable and overall), and CVRF was evaluated in the total sample and according to gender. We calculated frequencies and odds ratios (95% CI) for this relationship using binary and multinomial logistic regression analyses in crude, age-adjusted and multivariable models adjusted by potential confounders. Of 14,953 individuals who completed the data about headache and CVRF, the frequency of one-year migraine was of 29.5% (22.5% in women and 7.0% in men). In the multivariable-adjusted regression analyses, an inverse association between hypertension (OR, 0.53; 95% CI, 0.36-0.79), metabolic syndrome (OR, 0.65; 95% CI, 0.43-0.99) and definite migraine were confirmed for men, but not for women. In the opposite direction, a positive association between migraine headaches (definite, probable and overall) and dyslipidemia (overall migraine OR, 1.25; 95% CI, 1.13-1.38) was observed only for women, but not for men. A gender influence on the relationship between migraine and CVRF was verified in the ELSA-Brasil. © International Headache Society 2015.
Effects of euthanasia on the bereaved family and friends: a cross sectional study.
Swarte, Nikkie B; van der Lee, Marije L; van der Bom, Johanna G; van den Bout, Jan; Heintz, A Peter M
2003-07-26
To assess how euthanasia in terminally ill cancer patients affects the grief response of bereaved family and friends. Cross sectional study. Tertiary referral centre for oncology patients in Utrecht, the Netherlands. 189 bereaved family members and close friends of terminally ill cancer patients who died by euthanasia and 316 bereaved family members and close friends of comparable cancer patients who died a natural death between 1992 and 1999. Symptoms of traumatic grief assessed by the inventory of traumatic grief, current feelings of grief assessed by the Texas revised inventory of grief, and post-traumatic stress reactions assessed by the impact of event scale. The bereaved family and friends of cancer patients who died by euthanasia had less traumatic grief symptoms (adjusted difference -5.29 (95% confidence interval -8.44 to -2.15)), less current feeling of grief (adjusted difference 2.93 (0.85 to 5.01)); and less post-traumatic stress reactions (adjusted difference -2.79 (-5.33 to -0.25)) than the family and friends of patients who died of natural causes. These differences were independent of other risk factors. The bereaved family and friends of cancer patients who died by euthanasia coped better with respect to grief symptoms and post-traumatic stress reactions than the bereaved of comparable cancer patients who died a natural death. These results should not be interpreted as a plea for euthanasia, but as a plea for the same level of care and openness in all patients who are terminally ill.
Zhang, Hui-Shan; Mai, Yan-Bing; Li, Wei-Da; Xi, Wen-Tao; Wang, Jin-Ming; Lei, Yi-Xiong; Wang, Pei-Xi
The aims of this study were to explore the Pittsburgh Sleep Quality Index (PSQI) and health service utilization in Chinese general population, to investigate the association between PSQI and health service utilization and to identify the independent contributions of social demographic variables, health related factors and PSQI to health service utilization. In a cross-sectional community-based health survey using a multi-instrument questionnaire, 4067 subjects (≥15 years old) were studied. The Chinese version of the PSQI was used to assess sleep quality. Health service utilization was measured by recent two-week physician visit and annual hospitalization rates. Higher PSQI scores were associated with more frequent health service utilization. Higher scores in subjective sleep quality were associated with higher rate of recent two-week physician visit (adjusted OR = 1.24 per SD increase, P = 0.015). Higher scores in habitual sleep efficiency (adjusted OR = 1.24 per SD increase, P = 0.038) and sleep disturbances (adjusted OR = 2.09 per SD increase, P < 0.001) were associated with more frequent annual hospitalization. The independent influence of PSQI on the risk of recent two-week physician visit was 0.7%, and that of annual hospitalization 31.4%. Poorer sleep quality predicted more frequent health service utilization. The independent contribution of PSQI on health service utilization was smaller than social demographic variables. Copyright © 2016. Published by Elsevier B.V.
Woolcott, Orison O.; Castillo, Oscar A.; Gutierrez, Cesar; Elashoff, Robert M.; Stefanovski, Darko; Bergman, Richard N.
2014-01-01
Objective To determine whether geographical elevation is inversely associated with diabetes, while adjusting for multiple risk factors. Design and Methods This is a cross-sectional analysis of publicly available online data from the Behavioral Risk Factor Surveillance System, 2009. Final dataset included 285,196 US adult subjects. Odds ratios were obtained from multilevel mixed-effects logistic regression analysis. Results Among US adults (≥20 years old), the odds ratio for diabetes were 1.00 between 0−499 m of altitude (reference), 0.95 (95% confidence interval, 0.90 to 1.01) between 500−1,499 m, and 0.88 (0.81 to 0.96) between 1,500−3,500 m, adjusting for age, sex, body mass index, ethnicity, self-reported fruit and vegetable consumption, self-reported physical activity, current smoking status, level of education, income, health status, employment status, and county-level information on migration rate, urbanization, and latitude. The inverse association between altitude and diabetes in the US was found among men [0.84 (0.76 to 0.94)], but not women [1.09 (0.97 to 1.22)]. Conclusions Among US adults, living at high altitude (1,500−3,500 m) is associated with lower odds of having diabetes than living between 0−499 m, while adjusting for multiple risk factors. Our findings suggest that geographical elevation may be an important factor linked to diabetes. PMID:24890677
Tomey, Kristin; Greendale, Gail A; Kravitz, Howard M; Bromberger, Joyce T; Burns, John W; Dugan, Sheila A; de Leon, Carlos F Mendes
2015-01-01
Pain has been associated with cognitive problems in pain patients. This study evaluated the extent to which experiences of pain are associated with cognitive performance in a community sample of mid-life women, and the contribution of depressive symptoms to this association. A cross-sectional analysis was used with data from the Study of Women's Health Across the Nation (SWAN). Associations between aspects of pain and cognitive performance were evaluated using statistical models with and without depressive symptoms. The cognitive performance score was a composite of three cognitive tests, the Digit Span Backward Test, the Symbol Digit Modalities Test and the East Boston Memory Test. Greater pain experiences that interfered with daily work were independently associated with poorer cognitive performance, [β (SE) -0.074 (0.021); p value<0.01] and this association was partially explained by depressive symptoms [β (SE) -0.061 (0.022); p value<0.01 after adjusting for depressive symptoms]. Additionally, an independent association between a greater composite pain score and poorer cognitive performance was identified without adjusting for depressive symptoms, [β (SE) -0.002 (0.0009); p value<0.05] but was no longer significant after adjusting for depressive symptoms. Our results suggest that in mid-life women, greater pain is associated with poorer cognitive performance, and depressive symptoms play an important role in this association. Clinicians should be aware of these relationships when evaluating patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Basheer Ahamed, Shadir Bughari; Vanajassun, Purushothaman Pranav; Rajkumar, Kothandaraman; Mahalaxmi, Sekar
2018-04-01
Single cross-sectional nickel-titanium (NiTi) rotary instruments during continuous rotations are subjected to constant and variable stresses depending on the canal anatomy. This study was intended to create 2 new experimental, theoretic single-file designs with combinations of triple U (TU), triangle (TR), and convex triangle (CT) cross sections and to compare their bending stresses in simulated root canals with a single cross-sectional instrument using finite element analysis. A 3-dimensional model of the simulated root canal with 45° curvature and NiTi files with 5 cross-sectional designs were created using Pro/ENGINEER Wildfire 4.0 software (PTC Inc, Needham, MA) and ANSYS software (version 17; ANSYS, Inc, Canonsburg, PA) for finite element analysis. The NiTi files of 3 groups had single cross-sectional shapes of CT, TR, and TU designs, and 2 experimental groups had a CT, TR, and TU (CTU) design and a TU, TR, and CT (UTC) design. The file was rotated in simulated root canals to analyze the bending stress, and the von Mises stress value for every file was recorded in MPa. Statistical analysis was performed using the Kruskal-Wallis test and the Bonferroni-adjusted Mann-Whitney test for multiple pair-wise comparison with a P value <.05 (95 %). The maximum bending stress of the rotary file was observed in the apical third of the CT design, whereas comparatively less stress was recorded in the CTU design. The TU and TR designs showed a similar stress pattern at the curvature, whereas the UTC design showed greater stress in the apical and middle thirds of the file in curved canals. All the file designs showed a statistically significant difference. The CTU designed instruments showed the least bending stress on a 45° angulated simulated root canal when compared with all the other tested designs. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
Li, Xiaoming; Barnett, Douglas; Fang, Xiaoyi; Lin, Xiuyun; Zhao, Guoxiang; Zhao, Junfeng; Hong, Yan; Zhang, Liying; Naar-King, Sylvie; Stanton, Bonita
2009-09-01
Cross-sectional data were gathered from 1,625 children (M age = 12.85, SD = 2.21) which included 755 AIDS orphans, 466 vulnerable children, and 404 comparison children. Participants completed self-report measures of exposure to traumatic events, and psychosocial adjustment including behavior problems, depression, self-esteem, and future orientation. AIDS orphans and vulnerable children reported experiencing a higher total occurrence, density, duration, initial impact and lasting impact of traumatic events compared to comparison children. Scores reflecting adjustment were lower among orphans and vulnerable children than among comparison children. Both orphan status and traumatic events contributed unique variance in the expected direction to the prediction of psychosocial adjustment. The data in the current study suggested that children affected by HIV/AIDS in China are exposed to more trauma and suffer more adjustment problems than children who do not experience HIV/AIDS in their families.
Chaput, Jean-Philippe; Leblanc, Claude; Pérusse, Louis; Després, Jean-Pierre; Bouchard, Claude; Tremblay, Angelo
2009-10-01
The aim of this study was to determine the independent contribution of previously reported risk factors for adult overweight and obesity. A cross-sectional (n=537) and a longitudinal (n=283; 6-year follow-up period) analysis was performed for nine risk factors for overweight and obesity assessed in adult participants (aged 18-64 years) of the Quebec Family Study (QFS). The main outcome measure was overweight/obesity, defined as a BMI>or=25 kg/m2. Using logistic regression analysis adjusted for age, sex, and socioeconomic status, short sleep duration, high disinhibition eating behavior, low dietary calcium intake, high susceptibility to hunger behavior, nonparticipation in high-intensity physical exercise, high dietary restraint behavior, nonconsumption of multivitamin and dietary supplements, high dietary lipid intake, and high alcohol intake were all significantly associated with overweight and obesity in the cross-sectional sample. The analysis of covariance adjusted for age, socioeconomic status, and all other risk factors revealed that only individuals characterized by short sleep duration, high disinhibition eating behavior, and low dietary calcium intake had significantly higher BMI compared to the reference category in both sexes. Over the 6-year follow-up period, short-duration sleepers, low calcium consumers, and those with a high disinhibition and restraint eating behavior score were significantly more likely to gain weight and develop obesity. These results show that excess body weight or weight gain results from a number of obesogenic behaviors that have received considerable attention over the past decade. They also indicate that the four factors, which have the best predictive potential of variations in BMI, be it in a cross-sectional or a longitudinal analytical design, do not have a "caloric value" per se.
Nagayoshi, Mako; Lutsey, Pamela L.; Benkeser, David; Wassel, Christina L.; Folsom, Aaron R.; Shahar, Eyal; Iso, Hiroyasu; Allison, Matthew A.; Criqui, Michael H.; Redline, Susan
2016-01-01
Background and aims Numerous biological pathways linking sleep disturbances to atherosclerosis have been identified, such as insulin resistance, inflammation, hypertension, and endothelial dysfunction. Yet, the association of sleep apnea and sleep duration with peripheral artery disease (PAD) is not well characterized. Methods We evaluated the cross-sectional association between objectively measured sleep and prevalent PAD in 1,844 participants (mean age 68 years) who in 2010–2013 had in-home polysomnography, 7-day wrist actigraphy and ankle-brachial index (ABI) measurements. We also evaluated the relation between self-reported diagnosed sleep apnea and PAD incidence in 5,365 participants followed from 2000 to 2012. PAD was defined as ABI<0.90. Results In cross-sectional analyses, severe sleep apnea [apnea-hypopnea index (AHI) ≥30 vs. AHI <5] was associated with greater prevalent PAD only among black participants [multivariate adjusted prevalence ratio (95% CI): 2.29 (1.07–4.89); p-interaction = 0.05]. Short and long sleep duration was also associated with a 2-fold higher prevalence of PAD as compared with those who slept 7h/night, in the full sample. In longitudinal analyses, participants with self-reported diagnosed sleep apnea were at higher risk of incident PAD [multivariable adjusted hazard ratio (95% CI): 1.93 (1.05–3.53)], with no evidence of interaction by race/ethnicity. Conclusions These findings support a significant association between sleep apnea and prevalent and incident PAD, with evidence for stronger associations with objectively measured sleep apnea and cross sectional PAD in blacks. In addition, short and long sleep duration was associated with PAD. These results identify sleep disturbances as a potential risk factor for PAD. PMID:27423537
Fukunaka, Yasushi; Sawada, Susumu S; Nishiura, Chihiro; Noguchi, Jun; Tsukamoto, Koji; Otsuji, Yutaka; Marui, Eiji
2013-01-01
This study was a cross-sectional survey of Japanese workers regarding the relationship between touching the eyes or nose and susceptibility to URTI in workers. The survey respondents were 4,663 Japanese workers. Subjects were surveyed via a self-administered questionnaire regarding their susceptibility to URTI and how often they touched their eyes or nose. In addition, subjects were surveyed regarding their preventive behaviors and routine behaviors thought to be associated with URTIs. A multiple logistic regression model was used to assess the relationship between susceptibility to URTI and how often the eyes or nose are touched. Responses from 3,663 individuals who answered the self-administered questionnaire were analyzed. There were 1,590 individuals (42.9%) with a "frequent incidence of URTIs", defined as URTIs more than once a year. In terms of how often the eyes or nose are touched, the odds ratios (95% CI) for a frequent incidence of URTIs among the groups responding "sometimes" and "often" were 1.41 (1.21-1.63) and 1.96 (1.59-2.42) (trend test: p<0.001) compared with the groups responding "never" and "almost never". Multivariate-adjusted odds ratios adjusted for confounding factors, i.e., behaviors to prevent URTIs, routine behaviors associated with URTIs, age, sex and BMI, were 1.33 (1.14-1.54) and 1.69 (1.36-2.09) (trend test: p<0.001). The present cross-sectional study indicates that susceptibility to URTI and how often the eyes or nose are touched are significantly associated in Japanese workers, independent of preventive behaviors and routine behaviors associated with URTIs
Haring, Robin; Baumeister, Sebastian E; Völzke, Henry; Dörr, Marcus; Kocher, Thomas; Nauck, Matthias; Wallaschofski, Henri
2012-01-01
The suggested associations between sex hormone concentrations and inflammatory biomarkers in men originate from cross-sectional studies and small-scale clinical trials. But prior studies have not investigated longitudinal associations. Overall, 1344 men aged 20-79 years from the population-based cohort Study of Health in Pomerania were followed up for 5.0 (median) years. We used multivariable regression models to analyze cross-sectional and longitudinal associations of serum sex hormone concentrations (total testosterone [TT], sex hormone-binding globulin [SHBG], calculated free testosterone [free T], and dehydroepiandrosterone sulfate [DHEAS]) with biomarkers of inflammation (fibrinogen, high-sensitive C-reactive protein [hsCRP], and white blood cell count [WBC]) and oxidative stress (γ-glutamyl transferase [GGT]) using ordinary least square regression and generalized estimating equation models, respectively. Cross-sectional models revealed borderline associations of sex hormone concentrations with hsCRP, WBC, and GGT levels that were not retained after multivariable adjustment. Longitudinal multivariable analyses revealed an inverse association of baseline TT, free T, and DHEAS concentrations with change in fibrinogen levels (per SD decrement in TT, 0.25 [95% confidence interval, 0.04-0.45]; in free T, 0.30 [0.09-0.51]; and in DHEAS, 0.23 [0.11-0.36]). Furthermore, baseline DHEAS concentrations were inversely associated with change in WBC levels (per SD decrement, 0.53 [0.24-0.82]). Baseline TT, SHBG, free T, and DHEAS concentrations were also inversely associated with change in GGT after multivariable adjustment. The present study is the first to demonstrate prospective inverse associations between sex hormone concentrations and markers of inflammation and oxidative stress in men. Additional studies are warranted to elucidate potential mechanisms underlying the revealed associations.
Baudry, Julia; Lelong, Hélène; Adriouch, Solia; Julia, Chantal; Allès, Benjamin; Hercberg, Serge; Touvier, Mathilde; Lairon, Denis; Galan, Pilar; Kesse-Guyot, Emmanuelle
2017-08-02
Metabolic syndrome (MetS), a multicomponent condition, is a cardiovascular disease predictor. Although exposure to agricultural pesticides has been suggested as a potential contributor to the rising rates of obesity, type 2 diabetes, and other features of metabolic disorders, no studies have focused on the association between consumption of organic food (produced without synthetic pesticides) and MetS. We aimed to investigate the cross-sectional association between organic food consumption and MetS in French adults to determine whether it would be worth conducting further studies, particularly large prospective and randomised trials. A total of 8174 participants from the NutriNet-Santé study who attended a clinical visit and completed an organic food frequency questionnaire were included in this cross-sectional analysis. We evaluated the association between the proportion of organic food in the diet (overall and by food group) and MetS using Poisson regression models while adjusting for potential confounders. Higher organic food consumption was negatively associated with the prevalence of MetS: adjusted prevalence ratio was 0.69 (95% CI 0.61, 0.78) when comparing the third tertile of proportion of organic food in the diet with the first one (p value <0.0001). Higher consumption of organic plant-based foods was also related to a lower probability of having MetS. In addition, when stratifying by lifestyle factors (nutritional quality of the diet, smoking status, and physical activity), a significant negative association was detected in each subgroup (p values <0.05), except among smokers. Our results showed that a higher organic food consumption was associated with a lower probability of having MetS. Additional prospective studies and randomised trials are required to ascertain the relationship between organic food consumption and metabolic disorders.
Tolppanen, Anna-Maija; Sayers, Adrian; Fraser, William D; Lawlor, Debbie A
2012-12-01
Higher total serum 25-hydroxyvitamin D (25(OH)D) concentrations have been associated with better cognitive function mainly in cross-sectional studies in adults. It is unknown if the associations of different forms of 25(OH)D (25(OH)D(3) and 25(OH)D(2)) are similar. Prospective cohort study (n=3171) with serum 25(OH)D(3) and 25(OH)D(2) concentrations measured at mean age of 9.8 years and academic performance at age 13-14 years (total scores in English, mathematics and science) and 15-16 years (performance in General Certificates of Education examinations). Serum 25(OH)D(3) concentrations were not associated with any educational outcomes. Higher 25(OH)D(2) concentrations were associated with worse performance in English at age 13-14 years (adjusted SD change per doubling in 25(OH)D(2) (95% CI) -0.05 (-0.08 to -0.01)) and with worse academic performance at age 15-16 years (adjusted OR for obtaining ≥5 A*-C grades (95% CI) 0.91 (0.82 to 1.00)). The null findings with 25(OH)D(3) are in line with two previous cross-sectional studies in children. It is possible that the positive association of 25(OH)D with cognitive function seen in adults does not emerge until later in life or that the results from previous cross-sectional adult studies are due to reverse causality. The unexpected inverse association of 25(OH)D(2) with academic performance requires replication in further studies. Taken together, our findings do not support suggestions that children should have controlled exposure to sunlight, or vitamin D supplements, in order to increase academic performance.
2014-01-01
Background The association between student characteristics and depression among students attending women’s colleges (single-sex institutions of higher education that exclude or limit males from admission) is poorly understood. Our objective was to estimate the prevalence of depression and determine behavioral and social characteristics associated with depression among students attending a women’s college. Methods We administered a cross-sectional Internet-based survey between April and May 2012 to students (n = 277) enrolled at a private women’s college in the southeastern US. Center for Epidemiologic Studies Depression (CES-D) and Depression Anxiety Stress Scale 21 (DASS-21) instruments measured self-reported depression. Bivariate and multivariable logistic regression methods were used to estimate adjusted associations. Results Prevalence of depression measured by CES-D and DASS-21 instruments was 26.3% (95% confidence interval [CI] 20.8-32.3%) and 26.0% (95% CI 20.4-32.3%), respectively. After adjusting for confounders, absence of strong social support (prevalence odds ratio [OR] = 4.3, 95% CI 1.4-13.7), history of mental health disorder (OR = 4.8 95% CI 1.9-12.4), and poor sleep hygiene (OR = 2.8, 95% CI 1.3-5.8) were associated with depression. Conclusions This cross-sectional survey identified absence of strong social support, history of mental health disorder, and poor sleep hygiene as potential predictors of depression among students attending a women’s college. Further investigation of these factors may inform depression interventions for students attending women’s colleges and other undergraduate student populations. PMID:24410897
van den Boer, Janet H W; Kranendonk, Jentina; van de Wiel, Anne; Feskens, Edith J M; Geelen, Anouk; Mars, Monica
2017-09-08
Observational studies performed in Asian populations suggest that eating rate is related to BMI. This paper investigates the association between self-reported eating rate (SRER) and body mass index (BMI) in a Dutch population, after having validated SRER against actual eating rate. Two studies were performed; a validation and a cross-sectional study. In the validation study SRER (i.e., 'slow', 'average', or 'fast') was obtained from 57 participants (men/women = 16/41, age: mean ± SD = 22.6 ± 2.8 yrs., BMI: mean ± SD = 22.1 ± 2.8 kg/m 2 ) and in these participants actual eating rate was measured for three food products. Using analysis of variance the association between SRER and actual eating rate was studied. The association between SRER and BMI was investigated in cross-sectional data from the NQplus cohort (i.e., 1473 Dutch adults; men/women = 741/732, age: mean ± SD = 54.6 ± 11.7 yrs., BMI: mean ± SD = 25.9 ± 4.0 kg/m 2 ) using (multiple) linear regression analysis. In the validation study actual eating rate increased proportionally with SRER (for all three food products P < 0.01). In the cross-sectional study SRER was positively associated with BMI in both men and women (P = 0.03 and P < 0.001, respectively). Self-reported fast-eating women had a 1.13 kg/m 2 (95% CI 0.43, 1.84) higher BMI compared to average-speed-eating women, after adjusting for confounders. This was not the case in men; self-reported fast-eating men had a 0.29 kg/m 2 (95% CI -0.22, 0.80) higher BMI compared to average-speed-eating men, after adjusting for confounders. These studies show that self-reported eating rate reflects actual eating rate on a group-level, and that a high self-reported eating rate is associated with a higher BMI in this Dutch population.
Johri, Mira; Subramanian, S V; Sylvestre, Marie-Pierre; Dudeja, Sakshi; Chandra, Dinesh; Koné, Georges K; Sharma, Jitendar K; Pahwa, Smriti
2015-09-01
Education of mothers may improve child health. We investigated whether maternal health literacy, a rapidly modifiable factor related to mother's education, was associated with children's receipt of vaccines in two underserved Indian communities. Cross-sectional surveys in an urban and a rural site. We assessed health literacy using Indian child health promotion materials. The outcome was receipt of three doses of diphtheria-tetanus-pertussis (DTP3) vaccine. We used multivariate logistic regression to investigate the relationship between maternal health literacy and vaccination status independently in each site. For both sites, adjusted models considered maternal age, maternal and paternal education, child sex, birth order, household religion and wealth quintile. Rural analyses used multilevel models adjusted for service delivery characteristics. Urban analyses represented cluster characteristics through fixed effects. The rural analysis included 1170 women from 60 villages. The urban analysis included 670 women from nine slum clusters. In each site, crude and adjusted models revealed a positive association between maternal health literacy and DTP3. In the rural site, the adjusted OR was 1.57 (95% CI 1.11 to 2.21, p=0.010) for those with medium health literacy, and OR=1.30 (95% CI 0.89 to 1.91, p=0.172) for those with high health literacy. In the urban site, the adjusted OR was 1.10 (95% CI 0.65 to 1.88, p=0.705) for those with medium health literacy, and OR=2.06 (95% CI 1.06 to 3.99, p=0.032) for those with high health literacy. In these study settings, maternal health literacy is independently associated with child vaccination. Initiatives targeting health literacy could improve vaccination coverage. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Johansen, Ingrid Hjulstad; Baste, Valborg; Rosta, Judith; Aasland, Olaf G; Morken, Tone
2017-08-11
The aim of this study was to investigate whether reported prevalence of experienced threats, real acts of violence and debilitating fear of violence among Norwegian doctors have increased over the last two decades. Repeated cross-sectional survey. All healthcare levels and medical specialties in Norway. Representative samples of Norwegian doctors in 1993 (n=2628) and 2014 (n=1158). Relative risk (RR) of self-reported prevalence of work-time experiences of threats and real acts of violence, and of being physically or psychologically unfit during the last 12 months due to fear of violence, in 2014 compared with 1993, adjusted by age, gender and medical specialty. There were no differences in self-reported threats (adjusted RR=1.01, 95% CI 0.95 to 1.08) or real acts (adjusted RR=0.90, 95% CI 0.80 to 1.03) of violence when comparing 2014 with 1993. The proportion of doctors who had felt unfit due to fear of violence decreased from 1993 to 2014 (adjusted RR=0.53, 95% CI 0.39 to 0.73). Although still above average, the proportion of doctors in psychiatry who reported real acts of violence decreased substantially from 1993 to 2014 (adjusted RR=0.75, 95% CI 0.60 to 0.95). A substantial proportion of doctors experience threats and real acts of violence during their work-time career, but there was no evidence that workplace violence has increased over the last two decades. Still, the issue needs to be addressed as part of the doctors' education and within work settings. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Liang, Dong-Ke; Bai, Xiao-Juan; Wu, Bing; Han, Lu-Lu; Wang, Xiao-Nan; Yang, Jun; Chen, Xiang-Mei
2014-02-01
The significance of associations between bone mineral density (BMD) and atherosclerosis in the Asian population is less clear. The aim of this study was to explore the population-level associations between BMD and subclinical atherosclerosis. This was a community-based cross-sectional study conducted in Shenyang, China. A total of 385 Chinese women and men aged 37-87 years were studied. The BMD was measured at the total hip and lumbar spine using dual-energy x-ray absorptiometry. The ankle-brachial index (ABI), pulse wave velocity (PWV), and carotid intima-media thickness (CIMT) were measured to assess atherosclerosis. Multiple regression analysis was applied to study the associations. Multicolinearity was examined using the variance inflation factor, condition index, and variance proportions. Factor analysis and principal component regression were used to remove the problem of multicolinearity. The differences of ABI, PWV, and CIMT among the normal BMD, osteopenia, and osteoporosis groups were not found. Total hip BMD was correlated with ABI in women after adjustment for age (r = 0.156). Sex-specific regression models included adjustment for age, body mass index, cigarette smoking, alcohol consumption, menopausal status (women), systolic blood pressure, diastolic blood pressure, triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fasting blood glucose, serum uric acid, estimated glomerular filtration rate, high-sensitivity C-reactive protein, and fibrinogen. Total hip BMD was associated with ABI in women after adjustment for age (per SD decrease in ABI: -0.130 g/cm(2), P = .022), but the association was borderline significant after full adjustment (P = .045). Total hip BMD and lumbar spine BMD were not associated with ABI, PWV, and CIMT after full adjustment in participants without a fracture history. The risk of osteoporosis was not associated with ABI, PWV, and CIMT. Low BMD is not associated with subclinical atherosclerosis as assessed by ABI, PWV, and CIMT.
Feng, Qingmin; Liu, Shenglin; Yang, Lei; Xie, Mingxing
2016-01-01
Objective Studies from industrialized countries show that musculoskeletal disorders (MSD) occur commonly in sonographers. However, little is known about sonographers in China, where the awareness of ergonomics and MSD, workload, and available equipment/facilities may differ. We aimed to investigate the prevalence of MSD and associated risk factors in sonographers in central China. Methods A cross-sectional survey was conducted with 381 sonographers from 14 randomly selected tertiary hospitals in Hubei province, central China. Musculoskeletal symptoms (using the Nordic Questionnaire) and risk factors (mostly derived from the Health Benefit Trust survey instrument and the Dutch Musculoskeletal Questionnaire) were recorded. Multivariate logistic regression was used to quantify associations between risk factors and MSD. Results The 12-month period prevalence of MSD was 98.3%, being highest in the neck (93.5%) and shoulder (92.2%), followed by the lower back (83.2%), wrist/hand, upper back, and elbow. Factors contributing to neck pain were psychological fatigue, shoulder abduction and trunk bend-and-twist posture. Height-adjustable tables and chairs were protective factors. Shoulder pain was associated with female sex, health status, mental stress, shoulder abduction, and trunk bend-and-twist posture. Height-adjustable chairs and the awareness of adjusting the workstation before scanning were protective factors. Elbow pain was associated with health status and height-adjustable tables. Wrist/hand pain was associated with female sex, bending the wrist, and working with obese patients. Upper back pain was associated with shoulder abduction, height-adjustable chairs, and device location. Lower back pain was associated with the number of scans performed per day, awkward postures, bending the trunk, twisting or bending the neck forward, and using a footrest. Conclusions This study suggests a high prevalence of MSD in sonographers in central China. Hence, it is necessary to improve the awareness of MSD by training, and the ergonomics of their current work environment by addressing physical workload, and psychological and equipment/facility-related factors. PMID:27695095
Blauw, Lisanne L; Boon, Mariëtte R; Rosendaal, Frits R; de Mutsert, Renée; Gast, Karin B; van Dijk, Ko Willems; Rensen, Patrick C N; Dekkers, Olaf M
2015-11-01
Animal studies and human studies in small selected populations have shown a positive association between nicotine smoking and resting energy expenditure (REE), but data in large cohorts are lacking. We aimed to investigate the association between smoking behavior and REE in a large, population-based study. Population-based cross-sectional study. In this cross-sectional analysis of baseline measurements from the Netherlands Epidemiology of Obesity (NEO) study (n=6673), we included participants with REE measurement by indirect calorimetry who were not using lipid or glucose lowering drugs (n=1189). We used linear regression analysis to examine the association of smoking status (never, former, occasional, current smoker) and smoking quantity (pack years) with REE per kilogram (kg) fat free mass (FFM) and with REE adjusted for FFM. Models were adjusted for age, sex, ethnicity, educational level, physical activity, energy intake and body mass index (BMI). Mean (standard deviation, SD) age was 55.2 (5.9) years and BMI was 26.3 (4.4) kg/m(2). 60% of the participants were women. Mean (SD) REE/FFM (kcal/day/kg FFM) was for male never smokers 25.1 (2.0), male current smokers 26.4 (2.8), female never smokers 28.9 (2.5) and female current smokers 30.1 (3.7). After adjustment, only current smokers had a higher REE/FFM (mean difference 1.28, 95% CI 0.64, 1.92), and a higher REE adjusted for FFM (mean difference 60.3 kcal/day, 95% CI 29.1, 91.5), compared with never smokers. There was no association between pack years and REE/FFM (mean difference -0.01, 95% CI -0.06, 0.04) or REE adjusted for FFM (mean difference 0.2, 95% CI -2.4, 2.8) in current smokers. Current smoking is associated with a higher resting energy expenditure compared with never smoking in a large population-based cohort. Copyright © 2015 Elsevier Inc. All rights reserved.
Chew, Kew-Kim; Bremner, Alexandra; Stuckey, Bronwyn; Earle, Carolyn; Jamrozik, Konrad
2009-01-01
Cigarette smoking has been implicated in the pathophysiology of cardiovascular disease (CVD) and as a risk factor for erectile dysfunction (ED). However, various aspects of the associations between cigarette smoking, ED, and CVD need further elucidation. We explored the relationship between cigarette smoking, ED, and CVD using data from a population-based cross-sectional study of 1,580 participants. Postal questionnaires were sent to randomly selected age-stratified male population samples obtained from the Western Australia Electoral Roll. In addition to items covering sociodemographic and self-reported clinical information and smoking habits, the 5-item International Index of Erectile Function was used to assess erectile function. Compared with never smokers, the odds of ED, adjusted for age, square of age, and CVD, were significantly higher among current smokers (odds ratio [OR] = 1.40; 95% confidence interval [CI] 1.02, 1.92) and ever smokers (OR = 1.57; 95% CI 1.02, 2.42). Similarly, the adjusted odds of severe ED were significantly higher among former smokers. Albeit not statistically significant, the age-adjusted odds of ED among current smokers increased with the number of cigarettes smoked. Among former smokers, the age-adjusted odds of ED were significantly higher 6-10 years following cessation of smoking than < or = 5 or > 10 years. Compared with never smokers without CVD, the age-adjusted odds of ED among former smokers and ever smokers without CVD were about 1.6. Regardless of smoking, these odds were significantly higher among participants with CVD. Compared with never smokers, former smokers and ever smokers have significantly higher odds of ED. The relationship between smoking and ED is independent of that between smoking and CVD, and not because of confounding by CVD. Patterns of ED in former smokers suggest that there may be a latent interval between active smoking and symptomatic ED, involving a process initially triggered by smoking.
The relationship between loading history and proximal femoral diaphysis cross-sectional geometry.
Niinimäki, Sirpa; Narra, Nathaniel; Härkönen, Laura; Abe, Shinya; Nikander, Riku; Hyttinen, Jari; Knüsel, Christopher; Sievänen, Harri
2017-07-08
We investigated the relationship between loading history and bone biomechanical properties used in physical activity reconstructions. These bone properties included bone bending and torsional strength (J), cortical area (CA), the direction of the major axis (theta angle), and element shape ratios determined from cross sections of standardized bone length. In addition, we explored the applicability of anatomically determined cross sections. Our material consisted of hip and proximal thigh magnetic resonance images of Finnish female athletes (N = 91) engaged in high-jump, triple-jump, endurance running, swimming, power-lifting, soccer and squash; along with a group of active non-athlete individuals (N = 20). We used regression analysis for size-adjustment, and the extracted residuals were then used to compare differences in the bone properties between groups. We found that triple-jumpers, soccer players, and squash players had the greatest values in CA and J, swimmers and non-athletes had the smallest, whereas high-jumpers, power-lifters, and endurance runners exhibited interim values. No between-the-group differences in element shape ratios or theta angles were found. We found that influences of activity were similar regardless of whether standardized length or anatomically determined cross sections were used. Extreme (triple-jump) and directionally inconsistent loading (soccer and squash) necessitate a more robust skeleton compared to directionally consistent loading (high-jump, power-lifting, and endurance running) or non-impact loading (swimming and non-athletes). However, not all of these relationships were statistically significant. Thus, information gained about physical activity using bone properties is informative but limited. Accounting for the limitations, the method is applicable on fragmented skeletal material as anatomically determined cross sections can be used. © 2017 Wiley Periodicals, Inc.
Kim, Young Saing; Kim, Eun Young; Kang, Shin Myung; Ahn, Hee Kyung; Kim, Hyung Sik
2017-09-01
Skeletal muscle depletion is an important prognostic factor in patients with chronic obstructive pulmonary disease (COPD); a recent study demonstrated significant correlations between pectoralis muscle area on an axial CT image and COPD-related traits. The purpose of this study was to evaluate the relation between pectoralis muscle areas on CT scans and total body skeletal muscle mass (SMM) in healthy subjects. For 434 subjects that underwent a low-dose chest CT and bioelectrical impedance analysis (BIA) during health screening from January to June of 2014, cross-sectional area of pectoralis muscles were measured in CT scans. Pearson's correlation and multiple linear regression analysis were used to assess the relationship between cross-sectional CT areas of pectoralis muscles and BIA-assessed SMMs. Mean age was 50 ± 10 years (78·8% were male). The mean cross-sectional area of pectoralis muscles was 24·1 cm 2 ± 6·8. A moderate correlation was observed between pectoralis muscle area and BIA-based SMM (r = 0·665, P<0.001). Multivariable analysis showed CT determined pectoralis muscle area was significantly associated with BIA-assessed SMM after adjusting for gender, weight, height and age (β = 0·14 ± 0·02, P<0·001). Cross-sectional area of the pectoralis muscles on single axial CT images shows moderate correlation with total body SMM determined by BIA in healthy subjects. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.
2012-01-01
Background Although data from longitudinal studies are sparse, effort-reward imbalance (ERI) seems to affect work ability. However, the potential pathway from restricted work ability to ERI must also be considered. Therefore, the aim of our study was to analyse cross-sectional and longitudinal associations between ERI and work ability and vice versa. Methods Data come from the Second German Sociomedical Panel of Employees. Logistic regression models were estimated to determine cross-sectional and longitudinal associations. The sample used to predict new cases of poor or moderate work ability was restricted to cases with good or excellent work ability at baseline. The sample used to predict new cases of ERI was restricted to persons without ERI at baseline. Results The cross-sectional analysis included 1501 full-time employed persons. The longitudinal analyses considered 600 participants with good or excellent baseline work ability and 666 participants without baseline ERI, respectively. After adjustment for socio-demographic variables, health-related behaviour and factors of the work environment, ERI was cross-sectionally associated with poor or moderate work ability (OR = 1.980; 95% CI: 1.428 to 2.747). Longitudinally, persons with ERI had 2.1 times higher odds of poor or moderate work ability after one year (OR = 2.093; 95% CI: 1.047 to 4.183). Conversely, persons with poor or moderate work ability had 2.6 times higher odds of an ERI after one year (OR = 2.573; 95% CI: 1.314 to 5.041). Conclusions Interventions that enable workers to cope with ERI or address indicators of ERI directly could promote the maintenance of work ability. Integration management programmes for persons with poor work ability should also consider their psychosocial demands. PMID:23067110
Francis, Patricia; Agoritsas, Thomas; Chopard, Pierre; Perneger, Thomas
2016-04-01
To determine the impact of adjusting for rating tendency (RT) on patient satisfaction scores in a large teaching hospital and to assess the impact of adjustment on the ranking of divisions. Cross-sectional survey. Large 2200-bed university teaching hospital. All adult patients hospitalized during a 1-month period in one of 20 medical divisions. None. Patient experience of care measured by the Picker Patient Experience questionnaire and RT scores. Problem scores were weakly but significantly associated with RT. Division ranking was slightly modified in RT adjusted models. Division ranking changed substantially in case-mix adjusted models. Adjusting patient self-reported problem scores for RT did impact ranking of divisions, although marginally. Further studies are needed to determine the impact of RT when comparing different institutions, particularly across inter-cultural settings, where the difference in RT may be more substantial. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.
Heitmuller, Franklin T.; Greene, Lauren E.; John D. Gordon, John D.
2010-01-01
The Sabine and Brazos are alluvial rivers; alluvial rivers are dynamic systems that adjust their geometry in response to changes in streamflow (discharge) and sediment load. In fluvial geomorphology, the term 'channel adjustment' refers to river channel changes in three geometric dimensions: (1) channel slope (profile); (2) the outline or shape, such as meandering or braided, projected on a horizontal plane (planform); and (3) cross-sectional form (shape). The primary objective of the study was to investigate how the channel morphology of these rivers has changed in response to reservoirs and other anthropogenic disturbances that have altered streamflow and sediment load. The results of this study are expected to aid ecological assessments in the lower Sabine River and lower Brazos River Basins for the Texas Instream Flow Program. Starting in the 1920s, several dams have been constructed on the Sabine and Brazos Rivers and their tributaries, and numerous bridges have been built and sometimes replaced multiple times, which have changed the natural flow regime and reduced or altered sediment loads downstream. Changes in channel geometry over time can reduce channel conveyance and thus streamflow, which can have adverse ecological effects. Channel attributes including cross-section form, channel slope, and planform change were evaluated to learn how each river's morphology changed over many years in response to natural and anthropogenic disturbances. Climate has large influence on the hydrologic regimes of the lower Sabine and lower Brazos River Basins. Equally important as climate in controlling the hydrologic regime of the two river systems are numerous reservoirs that regulate downstream flow releases. The hydrologic regimes of the two rivers and their tributaries reflect the combined influences of climate, flow regulation, and drainage area. Historical and contemporary cross-sectional channel geometries at 15 streamflow-gaging stations in the lower Sabine and lower Brazos River Basins were evaluated. An in-depth discussion of results from streamflow-gaging station 08028500 Sabine River near Bon Weir, Tex., is featured here as an example of the analyses that were done at each station.
Jokela, Markus; Nyberg, Solja T; Madsen, Ida E H; Lallukka, Tea; Ahola, Kirsi; Alfredsson, Lars; Batty, G David; Bjorner, Jakob B; Borritz, Marianne; Burr, Hermann; Casini, Annalisa; Clays, Els; De Bacquer, Dirk; Dragano, Nico; Erbel, Raimund; Ferrie, Jane E; Fransson, Eleonor I; Hamer, Mark; Heikkilä, Katriina; Jöckel, Karl-Heinz; Kittel, France; Knutsson, Anders; Koskenvuo, Markku; Ladwig, Karl-Heinz; Lunau, Thorsten; Nielsen, Martin L; Nordin, Maria; Oksanen, Tuula; Pejtersen, Jan H; Pentti, Jaana; Rugulies, Reiner; Salo, Paula; Schupp, Jürgen; Siegrist, Johannes; Singh-Manoux, Archana; Steptoe, Andrew; Suominen, Sakari B; Theorell, Töres; Vahtera, Jussi; Wagner, Gert G; Westerholm, Peter J M; Westerlund, Hugo; Kivimäki, Mika
2015-01-01
Objective To quantify the association between long working hours and alcohol use. Design Systematic review and meta-analysis of published studies and unpublished individual participant data. Data sources A systematic search of PubMed and Embase databases in April 2014 for published studies, supplemented with manual searches. Unpublished individual participant data were obtained from 27 additional studies. Review methods The search strategy was designed to retrieve cross sectional and prospective studies of the association between long working hours and alcohol use. Summary estimates were obtained with random effects meta-analysis. Sources of heterogeneity were examined with meta-regression. Results Cross sectional analysis was based on 61 studies representing 333 693 participants from 14 countries. Prospective analysis was based on 20 studies representing 100 602 participants from nine countries. The pooled maximum adjusted odds ratio for the association between long working hours and alcohol use was 1.11 (95% confidence interval 1.05 to 1.18) in the cross sectional analysis of published and unpublished data. Odds ratio of new onset risky alcohol use was 1.12 (1.04 to 1.20) in the analysis of prospective published and unpublished data. In the 18 studies with individual participant data it was possible to assess the European Union Working Time Directive, which recommends an upper limit of 48 hours a week. Odds ratios of new onset risky alcohol use for those working 49-54 hours and ≥55 hours a week were 1.13 (1.02 to 1.26; adjusted difference in incidence 0.8 percentage points) and 1.12 (1.01 to 1.25; adjusted difference in incidence 0.7 percentage points), respectively, compared with working standard 35-40 hours (incidence of new onset risky alcohol use 6.2%). There was no difference in these associations between men and women or by age or socioeconomic groups, geographical regions, sample type (population based v occupational cohort), prevalence of risky alcohol use in the cohort, or sample attrition rate. Conclusions Individuals whose working hours exceed standard recommendations are more likely to increase their alcohol use to levels that pose a health risk. PMID:25587065
Channel Width Change as a Potential Sediment Source, Minnesota River Basin
NASA Astrophysics Data System (ADS)
Lauer, J. W.; Echterling, C.; Lenhart, C. F.; Rausch, R.; Belmont, P.
2017-12-01
Turbidity and suspended sediment are important management considerations along the Minnesota River. The system has experience large and relatively consistent increases in both discharge and channel width over the past century. Here we consider the potential role of channel cross section enlargement as a sediment source. Reach-average channel width was digitized from aerial images dated between 1937 and 2015 along multiple sub-reaches of the Minnesota River and its major tributaries. Many of the sub-reaches include several actively migrating bends. The analysis shows relatively consistent increases in width over time, with average increase rates of 0.4 percent per year. Extrapolation to the river network using a regional relationship for cross-sectional area vs. drainage area indicates that large tributaries and main-stem reaches account for most of the bankfull cross-sectional volume in the basin. Larger tributaries and the main stem thus appear more important for widening related sediment production than small tributaries. On a basin-wide basis, widening could be responsible for a gross supply of more sediment than has been gaged at several main-stem sites, indicating that there may be important sinks for both sand and silt/clay size material distributed throughout the system. Sediment storage is probably largest along the lowest-slope reaches of the main stem. While channel width appears to have adjusted relatively quickly in response to discharge and other hydraulic modifications, net storage of sediment in floodplains probably occurs sufficiently slowly that depth adjustment will lag width adjustment significantly. Detailed analysis of the lower Minnesota River using a river segmenting approach allows for a more detailed assessment of reach-scale processes. Away from channel cutoffs, elongation of the channel at eroding bends is consistent with rates observed on other actively migrating rivers. However, the sinuosity increase has been more than compensated by several natural and engineered cutoffs. The sinuosity change away from cutoffs probably plays a relatively modest role in the reach's sediment budget. However, point bars and abandoned oxbow lakes are important zones of sediment storage that may be large enough to account for much of the widening-related production of sand in the reach.
Virtanen, Marianna; Jokela, Markus; Nyberg, Solja T; Madsen, Ida E H; Lallukka, Tea; Ahola, Kirsi; Alfredsson, Lars; Batty, G David; Bjorner, Jakob B; Borritz, Marianne; Burr, Hermann; Casini, Annalisa; Clays, Els; De Bacquer, Dirk; Dragano, Nico; Erbel, Raimund; Ferrie, Jane E; Fransson, Eleonor I; Hamer, Mark; Heikkilä, Katriina; Jöckel, Karl-Heinz; Kittel, France; Knutsson, Anders; Koskenvuo, Markku; Ladwig, Karl-Heinz; Lunau, Thorsten; Nielsen, Martin L; Nordin, Maria; Oksanen, Tuula; Pejtersen, Jan H; Pentti, Jaana; Rugulies, Reiner; Salo, Paula; Schupp, Jürgen; Siegrist, Johannes; Singh-Manoux, Archana; Steptoe, Andrew; Suominen, Sakari B; Theorell, Töres; Vahtera, Jussi; Wagner, Gert G; Westerholm, Peter J M; Westerlund, Hugo; Kivimäki, Mika
2015-01-13
To quantify the association between long working hours and alcohol use. Systematic review and meta-analysis of published studies and unpublished individual participant data. A systematic search of PubMed and Embase databases in April 2014 for published studies, supplemented with manual searches. Unpublished individual participant data were obtained from 27 additional studies. The search strategy was designed to retrieve cross sectional and prospective studies of the association between long working hours and alcohol use. Summary estimates were obtained with random effects meta-analysis. Sources of heterogeneity were examined with meta-regression. Cross sectional analysis was based on 61 studies representing 333,693 participants from 14 countries. Prospective analysis was based on 20 studies representing 100,602 participants from nine countries. The pooled maximum adjusted odds ratio for the association between long working hours and alcohol use was 1.11 (95% confidence interval 1.05 to 1.18) in the cross sectional analysis of published and unpublished data. Odds ratio of new onset risky alcohol use was 1.12 (1.04 to 1.20) in the analysis of prospective published and unpublished data. In the 18 studies with individual participant data it was possible to assess the European Union Working Time Directive, which recommends an upper limit of 48 hours a week. Odds ratios of new onset risky alcohol use for those working 49-54 hours and ≥ 55 hours a week were 1.13 (1.02 to 1.26; adjusted difference in incidence 0.8 percentage points) and 1.12 (1.01 to 1.25; adjusted difference in incidence 0.7 percentage points), respectively, compared with working standard 35-40 hours (incidence of new onset risky alcohol use 6.2%). There was no difference in these associations between men and women or by age or socioeconomic groups, geographical regions, sample type (population based v occupational cohort), prevalence of risky alcohol use in the cohort, or sample attrition rate. Individuals whose working hours exceed standard recommendations are more likely to increase their alcohol use to levels that pose a health risk. © Virtanen et al 2015.
Surgical tool alignment guidance by drawing two cross-sectional laser-beam planes.
Nakajima, Yoshikazu; Dohi, Takeyoshi; Sasama, Toshihiko; Momoi, Yasuyuki; Sugano, Nobuhiko; Tamura, Yuichi; Lim, Sung-hwan; Sakuma, Ichiro; Mitsuishi, Mamoru; Koyama, Tsuyoshi; Yonenobu, Kazuo; Ohashi, Satoru; Bessho, Masahiko; Ohnishi, Isao
2013-06-01
Conventional surgical navigation requires for surgeons to move their sight and conscious off the surgical field when checking surgical tool's positions shown on the display panel. Since that takes high risks of surgical exposure possibilities to the patient's body, we propose a novel method for guiding surgical tool position and orientation directly in the surgical field by a laser beam. In our navigation procedure, two cross-sectional planar laser beams are emitted from the two laser devices attached onto both sides of an optical localizer, and show surgical tool's entry position on the patient's body surface and its orientation on the side face of the surgical tool. In the experiments, our method gave the surgeons precise and accurate surgical tool adjusting and showed the feasibility to apply to both of open and percutaneous surgeries.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Soukhovitski, Efrem Sh.; Chiba, Satoshi; Lee, Jeong-Yeon
2005-05-24
A coupled-channels optical model with a coupling scheme based on nuclear wave functions of the soft-rotator model was applied to analyze experimental nucleon-nucleus interaction data for even-even nuclides with mass number A=24-122. We found that all the available data (total cross sections, angular distributions of elastically and inelastically scattered nucleons, and reaction cross sections) for these nuclides can be described to a good accuracy using an optical potential having smooth dependencies of potential values, radii, and diffuseness on the mass number. The individual properties of the target nuclides are accounted for by individuality of the nuclear Hamiltonian parameters, adjusted tomore » reproduce the low-lying collective level structure, Fermi energies, and deformation parameters.« less
The Causal Effects of Father Absence
McLanahan, Sara; Tach, Laura; Schneider, Daniel
2014-01-01
The literature on father absence is frequently criticized for its use of cross-sectional data and methods that fail to take account of possible omitted variable bias and reverse causality. We review studies that have responded to this critique by employing a variety of innovative research designs to identify the causal effect of father absence, including studies using lagged dependent variable models, growth curve models, individual fixed effects models, sibling fixed effects models, natural experiments, and propensity score matching models. Our assessment is that studies using more rigorous designs continue to find negative effects of father absence on offspring well-being, although the magnitude of these effects is smaller than what is found using traditional cross-sectional designs. The evidence is strongest and most consistent for outcomes such as high school graduation, children’s social-emotional adjustment, and adult mental health. PMID:24489431
Randall, Edin T; Bohnert, Amy M; Travers, Lea V
2015-06-01
This cross-sectional study examined relations between affluent adolescent adjustment and culturally salient factors within parent-child relationship and extracurricular domain. Bootstrapping techniques evaluated mediated effects among parental perfectionism, perceived parental pressure, intensity of organized activity (OA) involvement, and adolescent adjustment (i.e., depressive and anxiety symptoms, life satisfaction) within a sample of 10th graders and their parents (n = 88 parent-child pairs) from four high schools in affluent communities. Findings indicated that adolescents with more perfectionistic parents perceived more parental pressure and experienced poorer adjustment. Results also demonstrated that affluent adolescents who perceived more parental pressure were more intensely involved in OAs, but that higher OA intensity was linked to better adjustment. Findings highlight the importance of considering parental perfectionism when understanding adolescent behaviors and psychological outcomes, confirm the negative direct effects of parental pressure on adjustment, and corroborate prior research dispelling that highly intense OA involvement is linked to adolescent maladjustment. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.
Methodology and issues of integral experiments selection for nuclear data validation
NASA Astrophysics Data System (ADS)
Tatiana, Ivanova; Ivanov, Evgeny; Hill, Ian
2017-09-01
Nuclear data validation involves a large suite of Integral Experiments (IEs) for criticality, reactor physics and dosimetry applications. [1] Often benchmarks are taken from international Handbooks. [2, 3] Depending on the application, IEs have different degrees of usefulness in validation, and usually the use of a single benchmark is not advised; indeed, it may lead to erroneous interpretation and results. [1] This work aims at quantifying the importance of benchmarks used in application dependent cross section validation. The approach is based on well-known General Linear Least Squared Method (GLLSM) extended to establish biases and uncertainties for given cross sections (within a given energy interval). The statistical treatment results in a vector of weighting factors for the integral benchmarks. These factors characterize the value added by a benchmark for nuclear data validation for the given application. The methodology is illustrated by one example, selecting benchmarks for 239Pu cross section validation. The studies were performed in the framework of Subgroup 39 (Methods and approaches to provide feedback from nuclear and covariance data adjustment for improvement of nuclear data files) established at the Working Party on International Nuclear Data Evaluation Cooperation (WPEC) of the Nuclear Science Committee under the Nuclear Energy Agency (NEA/OECD).
Bleakley, Amy; Hennessy, Michael; Fishbein, Martin; Jordan, Amy
2010-01-01
Using a longitudinal web-based survey of adolescents 14-16 years of age, we estimate regression models where self-reported sexual behavior and content analytic-based exposure to sex in the media are related cross-sectionally and longitudinally. We find evidence for both cross-sectional non-recursive and prospective longitudinal relationships even after adjusting for both established predictors of sexual behavior (e.g., physical development, having a romantic partner, parental monitoring, peer and parental norms, respondent's age) and of exposure to sexual media content (e.g., time the respondent goes to bed, extracurricular activities, television in the bedroom, total time spent with television, music, videogames, and magazines). Sexually active adolescents are more likely to expose themselves to sex in the media and those exposed to sex in the media are more likely to progress in their sexual activity. These findings are consistent with others in the literature that demonstrate a causal effect of exposure to sexual content on sexual behavior but extend established results by also looking at the causal effect of sexual behavior on exposure both cross-sectionally and over time. PMID:20376301
Wang, Chao; Zhang, Qinglei; Shen, Shuiyun; Yan, Xiaohui; Zhu, Fengjuan; Cheng, Xiaojing; Zhang, Junliang
2017-03-02
The flow field configuration plays an important role on the performance of proton exchange membrane fuel cells (PEMFCs). For instance, channel/rib width and total channel cross-sectional area determine the under-rib convection and pressure drop respectively, both of which directly influence the water removal, in turn affecting the oxygen supply and cathodic oxygen reduction reaction. In this study, effects of under-rib convection and pressure drop on cell performance are investigated experimentally and numerically by adjusting the channel/rib width and channel cross-sectional area of flow fields. The results show that the performance differences with various flow field configurations mainly derive from the oxygen transport resistance which is determined by the water accumulation degree, and the cell performance would benefit from the narrower channels and smaller cross sections. It reveals that at low current densities when water starts to accumulate in GDL at under-rib regions, the under-rib convection plays a more important role in water removal than pressure drop does; in contrast, at high current densities when water starts to accumulate in channels, the pressure drop dominates the water removal to facilitate the oxygen transport to the catalyst layer.
NASA Astrophysics Data System (ADS)
Wang, Chao; Zhang, Qinglei; Shen, Shuiyun; Yan, Xiaohui; Zhu, Fengjuan; Cheng, Xiaojing; Zhang, Junliang
2017-03-01
The flow field configuration plays an important role on the performance of proton exchange membrane fuel cells (PEMFCs). For instance, channel/rib width and total channel cross-sectional area determine the under-rib convection and pressure drop respectively, both of which directly influence the water removal, in turn affecting the oxygen supply and cathodic oxygen reduction reaction. In this study, effects of under-rib convection and pressure drop on cell performance are investigated experimentally and numerically by adjusting the channel/rib width and channel cross-sectional area of flow fields. The results show that the performance differences with various flow field configurations mainly derive from the oxygen transport resistance which is determined by the water accumulation degree, and the cell performance would benefit from the narrower channels and smaller cross sections. It reveals that at low current densities when water starts to accumulate in GDL at under-rib regions, the under-rib convection plays a more important role in water removal than pressure drop does; in contrast, at high current densities when water starts to accumulate in channels, the pressure drop dominates the water removal to facilitate the oxygen transport to the catalyst layer.
2014-01-01
Background Improving the performance of community health workers (CHWs) is a global issue. The relationship between CHWs and their community may impact their performance. In Lao People’s Democratic Republic (Lao PDR), CHW are called village health volunteers (VHV). Lao PDR has a problem with VHV inactivity, especially in rural areas. This study focused on which aspects of social capital are related to VHV performance. Methods This research represents a cross-sectional study with a quantitative survey based primarily on interviews using a semi-structured questionnaire. Interviews were conducted with 149 VHVs living and working in the Sepon District. VHV performance evaluation was measured with scores on a 5-point scale, and the cutoff point for designating performance as good or poor was set at the median score. This evaluation of VHV performance was conducted as a self-evaluation by VHVs and by health center staff who were supervisors of the VHVs. Measurement of social capital was accomplished using the short version of the Adapted Social Capital Assessment Tool (SASCAT). For statistical analyses, logistic regression was used to calculate adjusted odds ratios (OR) and 95% confidence intervals (CI). Results The results of multiple logistic regression adjusted by moderator variables showed that citizenship activities in the structural social capital component of SASCAT were significantly related to performance in self-evaluation by VHVs (adjusted OR: 2.10, 95% CI: 1.19-3.71) and the evaluations by health center staff (adjusted OR: 1.67, 95% CI: 1.01-2.77). Support from groups (adjusted OR: 1.87, 95% CI: 1.27-2.76) and cognitive social capital (adjusted OR: 7.48, 95% CI: 2.14-26.10) were found to be significantly associated but only for VHV self-evaluation. Conclusions The results suggest that individuals who interact with important figures in the community and who cooperate with other villagers whenever problems arise, i.e., have social capital, exhibit good performance as VHVs. These findings suggest that increasing citizenship activities could increase the retention rate of CHWs and help improve their performance. Citizenship activities could also be used as a predictive indicator when selecting new CHWs. PMID:24620729
Rothman, Linda; Perry, Daniel; Buliung, Ron; Macarthur, Colin; To, Teresa; Macpherson, Alison; Larsen, Kristian; Howard, Andrew
2015-07-31
The presence of school crossing guards has been associated with more walking and more pedestrian-motor vehicle collisions (PMVCs) in area-level cross-sectional analyses. The objectives of the study were to (1) Determine the effect on PMVC rates of newly implemented crossing guards in Toronto, Canada (2) Determine where collisions were located in relation to crossing guards throughout the city, and whether they occurred during school travel times. School crossing guards with 50 m buffers were mapped along with police-reported child PMVCs from 2000-2011. (1) A quasi-experimental study identified all age collision counts near newly implemented guards before and after implementation, modeled using repeated measures Poisson regression adjusted for season and built environment variables. (2) A retrospective cohort study of all child PMVCS throughout the city to determine the proportions of child PMVCs which occurred during school travel times and at guard locations. There were 27,827 PMVCs, with 260 PMVCs at the locations of 58 newly implemented guards. Repeated measures adjusted Poisson regression found PMVCs rates remained unchanged at guard locations after implementation (IRR 1.02, 95 % CI 0.74, 1.39). There were 568 guards citywide with 1850 child PMVCs that occurred at guard locations. The majority of child PMVCs occurred outside school travel times (n = 1155, 62 %) and of those that occurred during school travel times, only 95 (13.7 %) were at a guard location. School crossing guards are a simple roadway modification to increase walking to school without apparent detrimental safety effects. Other more permanent interventions are necessary to address the frequency of child PMVCs occurring away from the location of crossing guards, and outside of school travel times.
Lassalle, Marion; Chastang, Jean-François; Niedhammer, Isabelle
2015-04-01
Prospective studies exploring the associations between a large range of occupational factors and psychotropic drug use among national samples of workers are seldom. This study investigates the cross-sectional and prospective associations between occupational factors, including a large set of psychosocial work factors, and psychotropic drug use in the national French working population. The study sample comprised 7542 workers for the cross-sectional analysis and 4213 workers followed up for a 4-year period for the prospective analysis. Psychotropic drug use was measured within the last 12 months and defined by the use of antidepressants, anxiolytics or hypnotics. Three groups of occupational factors were explored: classical and emergent psychosocial work factors, working time/hours and physical work exposures. Weighted Poisson regression analyses were performed to adjust for covariates. In the cross-sectional analysis, psychological demands, low social support and hiding emotions were associated with psychotropic drug use. Job insecurity for men and night work for women were associated with psychotropic drug use. In the prospective analysis, hiding emotions and physical exposure were predictive of psychotropic drug use. Dose-response associations were observed for the frequency/intensity of exposure and repeated exposure to occupational factors. This study underlines the role of psychosocial work factors, including emergent factors, in psychotropic drug use. Prevention policies oriented toward psychosocial work factors comprehensively may be useful to reduce this use. Copyright © 2015 Elsevier Ltd. All rights reserved.
Design, Analysis, and On-Sun Evaluation of Reflective Strips Under Controlled Buckling
NASA Technical Reports Server (NTRS)
Jaworske, Donald A.; Sechkar, Edward A.; Colozza, Anthony J.
2014-01-01
Solar concentrators are envisioned for use in a variety of space-based applications, including applications involving in situ resource utilization. Identifying solar concentrators that minimize mass and cost are of great interest, especially since launch cost is driven in part by the mass of the payload. Concentrators must also be able to survive the wide temperature excursions on the lunar surface. Identifying smart structures which compensate for changes in concentrator geometry brought about by temperature extremes are of interest. Some applications may benefit from the ability to change the concentrators focal pattern at will. This paper addresses a method of designing a single reflective strip to produce a desired focal pattern through the use of controlled buckling. Small variations in the cross section over the length of the reflective strip influence the distribution of light in the focal region. A finite element method of analysis is utilized here which calculates the curve produced for a given strip cross section and axial load. Varying axial force and strip cross section over the length of the reflective strip provide a means of optimizing ray convergence in the focal region. Careful selection of a tapered cross section yields a reflective strip that approximates a parabola. An array of reflective strips under controlled buckling produces a light weight concentrator and adjustments in the compression of individual strips provide a means of compensating for temperature excursions or changing the focal pattern at will.
Design, Analysis, and On-Sun Evaluation of Reflective Strips Under Controlled Buckling
NASA Technical Reports Server (NTRS)
Jaworske, D. A.; Sechkar, E. A.; Colozza, A. J.
2014-01-01
Solar concentrators are envisioned for use in a variety of space-based applications, including applications involving in situ resource utilization. Identifying solar concentrators that minimize mass and cost are of great interest, especially since launch cost is driven in part by the mass of the payload. Concentrators must also be able to survive the wide temperature excursions on the lunar surface. Identifying smart structures which compensate for changes in concentrator geometry brought about by temperature extremes are of interest. Some applications may benefit from the ability to change the concentrator's focal pattern at will. This paper addresses a method of designing a single reflective strip to produce a desired focal pattern through the use of controlled buckling. Small variations in the cross section over the length of the reflective strip influence the distribution of light in the focal region. A finite element method of analysis is utilized here which calculates the curve produced for a given strip cross section and axial load. Varying axial force and strip cross section over the length of the reflective strip provide a means of optimizing ray convergence in the focal region. Careful selection of a tapered cross section yields a reflective strip that approximates a parabola. An array of reflective strips under controlled buckling produces a light weight concentrator and adjustments in the compression of individual strips provide a means of compensating for temperature excursions or changing the focal pattern at will.
Predicting K0Λ photoproduction observables by using the multipole approach
NASA Astrophysics Data System (ADS)
Mart, T.; Rusli, A.
2017-12-01
We present an isobar model for kaon photoproduction on the proton γ p\\to K^+Λ that can nicely reproduce the available experimental data from threshold up to W=2.0 GeV. The background amplitude of the model is constructed from a covariant Feynman diagrammatic method, whereas the resonance one is formulated by using the multipole approach. All unknown parameters in both background and resonance amplitudes are extracted by adjusting the calculated observables to experimental data. With the help of SU(3) isospin symmetry and some information obtained from the Particle Data Group we estimate the cross section and polarization observables for the neutral kaon photoproduction on the neutron γ n\\to K^0Λ. The result indicates no sharp peak in the K^0Λ total cross section. The predicted differential cross section exhibits resonance structures only at cosθ=-1. To obtain sizable observables the present work recommends measurement of the K^0Λ cross section with W≳ 1.70 GeV, whereas for the recoiled Λ polarization measurement with W≈ 1.65-1.90 GeV would be advised, since the predictions of existing models show a large variance at this kinematics. The predicted electric and magnetic multipoles are found to be mostly different from those obtained in previous works. For W=1.75 and 1.95 GeV it is found that most of the single and double polarization observables demonstrate large asymmetries.
Scale Factor Study for 1:30 Local Scour Model
2016-08-01
railway crossing on the Santa Ana River near Corona , CA. Data from the scale factor study provide an adjustment for applying documented scour...upstream and downstream of the test section respectively. Discharge into the model came from three recirculation pumps with a total capacity of ERDC...upstream baffle blocks. The total discharge was measured by reading the differential from a manometer across a venturi meter and verified with a total
Controlling Sample Rotation in Acoustic Levitation
NASA Technical Reports Server (NTRS)
Barmatz, M. B.; Stoneburner, J. D.
1985-01-01
Rotation of acoustically levitated object stopped or controlled according to phase-shift monitoring and control concept. Principle applies to square-cross-section levitation chamber with two perpendicular acoustic drivers operating at same frequency. Phase difference between X and Y acoustic excitation measured at one corner by measuring variation of acoustic amplitude sensed by microphone. Phase of driver adjusted to value that produces no rotation or controlled rotation of levitated object.
Junne, Florian; Ziser, Katrin; Giel, Katrin Elisabeth; Schag, Kathrin; Skoda, Eva; Mack, Isabelle; Niess, Andreas; Zipfel, Stephan; Teufel, Martin
2017-01-01
Associations of specific types of stress with increased food intake and subsequent weight gain have been demonstrated in animal models as well as in experimental and epidemiological studies on humans. This study explores the research question of to what extent potentially obesity-related factors determine perceived stress in individuals with obesity. N = 547 individuals with obesity participated in a cross-sectional study assessing perceived stress as the outcome variable and potential determinants of stress related to obesity. Based on the available evidence, a five factorial model of 'obesity-related obesogenic stressors' was hypothesized, including the dimensions, 'drive for thinness', 'impulse regulation', 'ineffectiveness', 'social insecurity', and 'body dissatisfaction'. The model was tested using multiple linear regression analyses. The five factorial model of 'potentially obesity-related stressors' resulted in a total variance explanation of adjusted R² = 0.616 for males and adjusted R² = 0.595 for females for perceived stress. The relative variance contribution of the five included factors differed substantially for the two sexes. The findings of this cross-sectional study support the hypothesized, potentially obesity-related factors: 'drive for thinness', 'impulse regulation', 'ineffectiveness', 'social insecurity', and 'body dissatisfaction' as relevant determinants of perceived stress in individuals with obesity. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.
Gando, Yuko; Murakami, Haruka; Kawakami, Ryoko; Tanaka, Noriko; Sanada, Kiyoshi; Tabata, Izumi; Higuchi, Mitsuru; Miyachi, Motohiko
2014-02-01
It is unclear whether light physical activity is beneficially associated with insulin resistance, similar to moderate and/or vigorous physical activity. This cross-sectional study was performed to determine the relationship between the amount of light physical activity, as determined with a triaxial accelerometer, and insulin resistance. A total of 807 healthy men and women participated in this study. Physical activity was measured using a triaxial accelerometer worn for 28 days and summarized as light intensity (1.1-2.9 METs) or moderate to vigorous intensity (≥ 3.0 METs). Insulin resistance was evaluated by HOMA_R (FPG [mg/dL] × IRI [μU/mL]/405). The daily time spent in light physical activity was inversely associated with HOMA_R (r = -0.173, P < 0.05). After adjustment for confounders, the association between light physical activity and HOMA_R remained statistically significant (β = -0.119, P < .05). Light physical activity remained significantly associated with HOMA_R following further adjustment for moderate to vigorous intensity activity (β = -0.125, P < .05). Similar results were observed when light physical activity was modeled as quartiles, especially in elderly women. These cross-sectional data suggest that light-intensity physical activity is beneficially associated with insulin resistance in elderly Japanese women.
Dietary habits after myocardial infarction - results from a cross-sectional study.
Wallström, P; Mattisson, I; Tydén, P; Berglund, G; Janzon, L
2005-04-01
Comparing habitual nutrient intakes in persons with a history of acute myocardial infarction (AMI), and age-matched controls. Design. Cross-sectional study. Subjects. Men and women (525 cases and 1890 matched controls), aged 47-73 years, of the population-based Malmö Diet and Cancer cohort. Nutrient intakes were assessed by a validated modified diet history method. Body fatness was assessed by bioimpedance analysis. Case ascertainment was provided by national and regional registries. Men and women were analysed separately. Median time since AMI was 5.5 years in men and 3.8 years in women. Cases reported lower energy intakes (EIs) than controls, despite having similar basal metabolic rates. After adjustment for total EI, both male and female cases had lower fat intake and higher intake of several micronutrients, such as ascorbic acid, folate, and vitamin E, than controls, the difference being largest in men. Most of the cases reporting dietary change quoted 'disease' as their main reason for change. They had lower EI and lower energy-adjusted intake of fat than other cases. Survivors of AMI reported dietary habits more in line with current recommendations, particularly those who afterwards reported having changed their dietary habits. The possible bias introduced by social desirability is discussed.
Assessment of canes used by older adults in senior living communities.
Liu, Hao Howe; Eaves, Joshua; Wang, Wen; Womack, Jill; Bullock, Paige
2011-01-01
The purpose of this cross-sectional study is to provide basic but essential information about how older cane users obtain their canes and how they use these canes for their daily mobility, since there is still lack of information on these areas. Ninety-three older (≥65 years old) subjects who use canes for daily activities were recruited from four assisted living facilities and five retirement centers for this cross-sectional study. The assessment involved interviewing cane users with a questionnaire, examining their canes, and investigating how these canes were used by their owners during ambulation. The commonly used canes are (from most to least): adjustable single-tip, un-adjustable (wooden), small quad, and large quad. Five major problems from data analysis were identified: lack of medical consultation for device selection/use, incorrect cane height/maintenance, placement of cane in improper hand, inability to maintain the proper reciprocal gait pattern, and improper posture during ambulation. Only forward-leaning posture during ambulation might be associated with increased falls among the older cane users. Knowledge of these problems could assist health professionals to implement appropriate interventions in clinical settings and to provide community service to address all problems related to cane use. Published by Elsevier Ireland Ltd.
Tabuchi, Takahiro; Fukuhara, Hiroyuki; Iso, Hiroyasu
2012-09-01
Perceived discrimination has been shown to be associated with health. However, it is uncertain whether discrimination based on geographical place of residence (geographically-based discrimination), such as Buraku or Nishinari discrimination in Japan, is associated with health. We conducted a cross-sectional study (response rate = 52.3%) from February to March 2009 in a Buraku district of Nishinari ward in Osaka city, one of the most deprived areas in Japan. We implemented sex-stratified and education-stratified multivariate regression models to examine the association between geographically-based discrimination and two mental health outcomes (depressive symptoms and diagnosis of mental illness) with adjustment for age, socioeconomic status, social relationships and lifestyle factors. A total of 1994 persons aged 25-79 years (928 men and 1066 women) living in the district were analyzed. In the fully-adjusted model, perceived geographically-based discrimination was significantly associated with depressive symptoms and diagnosis of mental illness. It was more strongly associated among men or highly educated people than among women or among less educated people. The effect of geographically-based discrimination on mental health is independent of socioeconomic status, social relationship and lifestyle factors. Geographically-based discrimination may be one of the social determinants of mental health. Copyright © 2012. Published by Elsevier Ltd.
Vanegas, Emanuel; Calero, Erick; Plaza, Karin; Cano, Jose A.; Calderon, Juan Carlos; Valdano, Jorge; Gutierrez, Jorge Oswaldo; Guevara, Jose
2018-01-01
Purpose The purpose of this study is to assess the frequency of use of information and communication technologies and patterns of preference among Ecuadorian patients with diabetes. Methods We conducted an anonymous cross-sectional survey on type 2 diabetes mellitus. A chi-square test for association and adjusted regression analyses were performed. Results 248 patients were enrolled, with a mean sample age of 57.7 years. SMS was the most used ICT (66.0%). The Internet was used by 45.2% of patients to obtain information about diabetes. SMS and email were rated as the most useful ICTs for receiving information (64.5% and 28.1%, resp.) and asking physicians about diabetes (63.8% and 26.1%, resp.). Patients were also interested in receiving disease information (82.4%) and asking physicians about diabetes (84.7%) through WhatsApp. Adjusted logistic regressions revealed that individuals aged 55 years or younger, those with superior degree level, and those with long diabetes history preferred email for receiving information and asking physicians about diabetes compared to those above 55 years, those with low education level, and those with short diabetes history, respectively. Conclusion Understanding preferences of ICTs among patients with diabetes could facilitate application development targeted towards specific requirements from patients. PMID:29666639
Roberts, Calpurnyia B; Vines, Anissa I; Kaufman, Jay S; James, Sherman A
2008-03-01
Few studies have examined the impact of the frequency of discrimination on hypertension risk. The authors assessed the cross-sectional associations between frequency of perceived racial and nonracial discrimination and hypertension among 1,110 middle-aged African-American men (n = 393) and women (n = 717) participating in the 2001 follow-up of the Pitt County Study (Pitt County, North Carolina). Odds ratios were estimated using gender-specific unconditional weighted logistic regression with adjustment for relevant confounders and the frequency of discrimination. More than half of the men (57%) and women (55%) were hypertensive. The prevalences of perceived racial discrimination, nonracial discrimination, and no discrimination were 57%, 29%, and 13%, respectively, in men and 42%, 43%, and 15%, respectively, in women. Women recounting frequent nonracial discrimination versus those reporting no exposure to discrimination had the highest odds of hypertension (adjusted odds ratio = 2.34, 95% confidence interval: 1.09, 5.02). A nonsignificant inverse odds ratio was evident in men who perceived frequent exposure to racial or nonracial discrimination in comparison with no exposure. A similar association was observed for women reporting perceived racial discrimination. These results indicate that the type and frequency of discrimination perceived by African-American men and women may differentially affect their risk of hypertension.
2014-01-01
Background People with intellectual disability have significantly higher age-adjusted rates of mortality and morbidity (including obesity) than their non-disabled peers. They are also significantly less likely to be physically active. Methods Secondary analysis of de-identified cross-sectional data from the first two waves of Understanding Society, a new longitudinal study focusing on the life experiences of UK citizens. Interviews were undertaken with 50,994 individuals aged 16 and over in Wave 1 and 54,585 in Wave 2. Of these, 520 participants age 16–49 (1.8% of the unweighted age-restricted sample) were identified at either Wave 1 or Wave 2 as having self-reported intellectual impairments. Results British adults with self-reported intellectual impairments have higher rates of obesity, inactivity, tobacco and alcohol use and poorer nutrition than their non-disabled peers. Adjusting risk estimates for between group differences in age, gender and exposure to material hardship indicated that a significant proportion of their increased risk of obesity, tobacco use and poorer nutrition may be attributable to their poorer living conditions (rather than their self-reported intellectual impairments per se). Conclusions People with intellectual disabilities should begin to be regarded as a ‘vulnerable’ group in the context of public health policy and practice. PMID:24588837
Metabolic syndrome and mammographic density: The Study of Women’s Health Across the Nation (SWAN)
Conroy, Shannon M.; Butler, Lesley M.; Harvey, Danielle; Gold, Ellen B.; Sternfeld, Barbara; Greendale, Gail A.; Habel, Laurel A.
2013-01-01
The metabolic syndrome (MetS) is associated with an increase in breast cancer risk. In this study, we evaluated whether the MetS was associated with an increase in percent mammographic density (MD), a breast cancer risk factor. We used linear regression and mixed models to examine the cross-sectional and longitudinal associations of the MetS and components of the MetS to percent MD in 790 pre- and early perimenopausal women enrolled in the Study of Women’s Health Across the Nation (SWAN). In cross-sectional analyses adjusted for body mass index (BMI), modest inverse associations were observed between percent MD and the MetS (β = −2.5, SE = 1.9, p = 0.19), abdominal adiposity (β = −4.8, SE = 1.9, p = 0.01) and raised glucose (β = −3.7, SE = 2.4, p = 0.12). In longitudinal models adjusted for covariates including age and BMI, abdominal adiposity (β = 0.34, SE = 0.17, p = 0.05) was significantly positively associated with slower annual decline in percent MD with time. In conclusion, our results do not support the hypothesis that the MetS increases breast cancer risk via a mechanism reflected by an increase in percent MD. PMID:21105041
Ramlau-Hansen, Cecilia Høst; Moeller, Ulla Kristine; Bonde, Jens Peter; Olsen, Jørn; Thulstrup, Ane Marie
2011-03-01
To examine the association between low serum vitamin D concentration and estimates of male reproductive function. Cross-sectional study. University hospital. From a Danish pregnancy cohort established in 1984-1987, 347 sons were selected for a study conducted in 2005-2006. Semen parameters and reproductive hormones were related to vitamin D concentrations in 307 men. Semen characteristics and reproductive hormones. A high vitamin D level was unexpectedly associated with lower crude median total sperm count and percentage of normal morphology sperm and a high level of crude median sex hormone-binding globulin and FSH. After adjustment, the associations attenuated to nonsignificant associations, except for sex hormone-binding globulin. Additionally, adjusted free androgen index was lower at higher vitamin D levels, and men with high vitamin D had 11% (95% confidence interval, 1%-20%) lower free androgen index compared with men with low vitamin D. These results do not indicate that low vitamin D is a risk factor for poor semen quality in a population of young healthy men, but we may not have enough men with low vitamin D levels to detect an effect. New studies should include a larger proportion of vitamin D-deficient men. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Shiozawa, Nobuyoshi; Hayashimoto, Kanae; Suzuki, Etsuji; Kikuchi, Hiroshi; Takata, Shingo; Ashida, Kozo; Watanabe, Masutaka; Hosaki, Yasuhiro; Mitsunobu, Fumihiro
2010-08-09
Cigarette smoking and advanced age are well known as risk factors for chronic obstructive pulmonary disease (COPD), and nutritional abnormalities are important in patients with COPD. However, little is known about the nutritional status in non-COPD aging men with smoking history. We therefore investigated whether reduced lung function is associated with lower blood markers of nutritional status in those men. This association was examined in a cross-sectional study of 65 Japanese male current or former smokers aged 50 to 80 years: 48 without COPD (non-COPD group), divided into tertiles according to forced expiratory volume in one second as percent of forced vital capacity (FEV(1)/FVC), and 17 with COPD (COPD group). After adjustment for potential confounders, lower FEV(1)/FVC was significantly associated with lower red blood cell count (RBCc), hemoglobin, and total protein (TP); not with total energy intake. The difference in adjusted RBCc and TP among the non-COPD group tertiles was greater than that between the bottom tertile in the non-COPD group and the COPD group. In non-COPD aging men with smoking history, trends toward reduced nutritional status and anemia may independently emerge in blood components along with decreased lung function even before COPD onset.
Jackson, Kelly F; Yoo, Hyung Chol Brandon; Guevarra, Rudy; Harrington, Blair A
2012-04-01
This study examined relations between perceived racial discrimination, multiracial identity integration (i.e., racial distance and racial conflict), and psychological adjustment (i.e., distress symptoms, positive affect, and negative affect) of 263 multiracial adults, using an online cross-sectional survey design. As hypothesized, higher levels of perceived racial discrimination was related to lower levels of psychological adjustment (i.e., higher distress symptoms and negative affect). Also, higher levels of multiracial identity integration with low racial conflict was related to higher levels of psychological adjustment (i.e., lower distress symptoms and negative affect), whereas higher levels of multiracial identity integration with low racial distance was related to higher levels of psychological adjustment (i.e., lower negative affect). Finally, multiracial identity integration (i.e., lower racial conflict) moderated the relationship between perceived racial discrimination and psychological adjustment (i.e., negative affect) with results suggesting multiracial identity integration related to low racial conflict buffers the negative effects of perceived racial discrimination on psychological adjustment. Findings from this study are discussed in terms of future research on the psychological well-being of multiracial individuals and implications for clinical practice with multiracial adults.
Berger, Zoe E; Dalton, Louise J
2011-01-01
TO explore the factors that predict psychosocial adjustment in young people with a cleft and their parents. DESIGN, PARTICIPANTS, SETTING: The study used a cross-sectional postal questionnaire design involving young people aged between 11 and 16 and their parents from two cleft services. Data are presented for 91 adolescents and their mothers. Participants completed measures of psychological adjustment, coping, social experiences, satisfaction with appearance, stressful life events, cleft-related factors, and demographic information. Psychosocial adjustment in adolescents was predicted by their social experiences and maternal well-being. Satisfaction with appearance, perceived speech problems, and the use of avoidant coping strategies were also important factors relating to their adjustment. For mothers, adjustment was predicted by use of coping strategies such as self-blame, venting, and acceptance, in addition to perceived problems with their child's hearing and the number of stressful life events experienced. The findings are discussed in relation to the concepts of adjustment, coping, satisfaction with appearance, and maternal mental health. Directions for future research are outlined, and a number of opportunities and challenges for cleft services regarding the provision of timely interventions for this age group and their families are discussed.
Independent Life Skills among psychosocial care network users of Rio Grande do Sul, Brazil.
Rodrigues, Cândida Garcia Sinott Silveira; Jardim, Vanda Maria da Rosa; Kantorski, Luciane Prado; Coimbra, Valeria Cristina Christello; Treichel, Carlos Alberto Dos Santos; Francchini, Beatriz; Bretanha, Andreia Ferreira; Neutzling, Aline Dos Santos
2016-08-01
This is a cross-sectional study that aims to identify the prevalence of lower independent living skills and their associations in 390 users of psychiatric community-based services in the state Rio Grande do Sul, Brazil. For tracing the outcome it was used the "scale Independent Living Skills Survey", adopting a cut-off value lower than 2. The crude and adjusted analyses were conducted on binary logistic regressions and they considered a hierarchical model developed through a systematic literature review. In adjusted analysis the level of the same variables were adjusted to each other and to previous levels. The statistical significance remained as a < 0.05 p-value. The prevalence of smaller independent living skills was 33% and their associations were: younger age; no partner; lower education; resident at SRT; diagnosis of schizophrenia and younger diagnosis.
Bauer, Talya N; Bodner, Todd; Erdogan, Berrin; Truxillo, Donald M; Tucker, Jennifer S
2007-05-01
The authors tested a model of antecedents and outcomes of newcomer adjustment using 70 unique samples of newcomers with meta-analytic and path modeling techniques. Specifically, they proposed and tested a model in which adjustment (role clarity, self-efficacy, and social acceptance) mediated the effects of organizational socialization tactics and information seeking on socialization outcomes (job satisfaction, organizational commitment, job performance, intentions to remain, and turnover). The results generally supported this model. In addition, the authors examined the moderating effects of methodology on these relationships by coding for 3 methodological issues: data collection type (longitudinal vs. cross-sectional), sample characteristics (school-to-work vs. work-to-work transitions), and measurement of the antecedents (facet vs. composite measurement). Discussion focuses on the implications of the findings and suggestions for future research. 2007 APA, all rights reserved
2011-01-01
Background Social support is an important factor in the adaptation process of immigrants, helping for their integration in a new environment. The lack of social support may influence on well-being and health status. The aim of this study is to describe the social support of immigrant and native population and study the possible association between immigration and lack social support after adjusting for sociodemographic factors, income, stress and self-reported health status. Methods Cross-sectional population based study of immigrants and national patients without mental disorders of 15 urban primary health centers in the north-eastern area of Madrid. Participants provided information on social support, stress level, perceived health status and socio-economic characteristics. Descriptive and multiple logistic regression were conducted. Results The proportion of the global perception of social support among immigrants and natives was 79.2% and 94.2%, respectively. The lack of global social support adjusted prevalence ratio (PR) of immigrant was 2.72 (95% Confidence Interval = 1.81-4.09), showing a significant association with being male (PR = 2.26), having monthly income below 500 euros (PR = 3.81) and suffering stress (PR = 1.94). For the dimensions of lack of social support the higher association was being an immigrant and suffering stress. Conclusions We conclude that with regardless of the level of monthly income, stress level, self-reported health status, and gender, immigrant status is directly associated with lack social support. The variable most strongly associated with lack social support has been monthly income below 500 euros. PMID:21651759
Laska, Melissa N; Murray, David M; Lytle, Leslie A; Harnack, Lisa J
2012-01-01
Previous studies have yielded inconsistent results when documenting the association between key dietary factors and adolescent weight change over time. The purpose of this study was to examine the extent to which changes in adolescent sugar-sweetened beverage (SSB), diet soda, breakfast, and fast-food consumption were associated with changes in BMI and percent body fat (PBF). This study analyzed data from a sample of 693 Minnesota adolescents followed over 2 years. Random coefficient models were used to examine the relationship between dietary intake and BMI and PBF and to separate cross-sectional and longitudinal associations. Adjusting for total physical activity, total energy intake, puberty, race, socioeconomic status, and age, cross-sectional findings indicated that for both males and females, breakfast consumption was significantly and inversely associated with BMI and PBF, and diet soda intake was significantly and positively associated with BMI and PBF among females. In longitudinal analyses, however, there were fewer significant associations. Among males there was evidence of a significant longitudinal association between SSB consumption and PBF; after adjustment for energy intake, an increase of one serving of SSB per day was associated with an increase of 0.7 units of PBF among males. This study adds to previous research through its methodological strengths, including adjustment for physical activity and energy intake assessed using state-of-the-art methods (i.e., accelerometers and 24-h dietary recalls), as well as its evaluation of both BMI and PBF. Additional research is needed to better understand the complex constellation of factors that contribute to adolescent weight gain over time.
Wakasugi, Minako; James Kazama, Junichiro; Narita, Ichiei
2018-06-01
Objective Evidence suggests that the eating rate is positively associated with the body weight and blood pressure. Furthermore, people who are overweight or obese tend to have higher salt intakes than those of normal weight. To investigate whether or not the eating rate is also associated with the salt intake, a cross-sectional study was conducted using health examination survey data collected in 2014 from 7,941 residents of Sado City, Niigata, Japan. Methods The eating rates were evaluated using a questionnaire; 11.7% of participants rated themselves as slow eaters, 65.6% as normal eaters, and 22.7% as fast eaters. The salt intake was estimated from sodium and creatinine spot urine measurements using Tanaka's formula. Associations with eating rate were evaluated using multivariate linear regression analyses, with normal eaters as the reference (set at 0). Results Self-reported eating rates were positively associated with the salt intake after adjustment for age and sex [β coefficient (95% confidence interval) for slow -0.51 (-0.67, -0.35); fast 0.18 (0.05, 0.30) ]. Further adjustment for the body mass index showed that slower eaters had lower salt intakes than normal eaters, but there was no marked difference in the salt intake between normal and fast eaters. The association between slower eating and a lower salt intake persisted after further adjustment for comorbidities [slow -0.33 (-0.49, -0.18) ]. Conclusion Our results suggest that reducing eating rates may be an effective strategy for reducing dietary salt intake as well as preventing obesity.
Hilgard, Joseph; Engelhardt, Christopher R; Rouder, Jeffrey N
2017-07-01
Violent video games are theorized to be a significant cause of aggressive thoughts, feelings, and behaviors. Important evidence for this claim comes from a large meta-analysis by Anderson and colleagues (2010), who found effects of violent games in experimental, cross-sectional, and longitudinal research. In that meta-analysis, the authors argued that there is little publication or analytic bias in the literature, an argument supported by their use of the trim-and-fill procedure. In the present manuscript, we reexamine their meta-analysis using a wider array of techniques for detecting bias and adjusting effect sizes. Our conclusions differ from those of Anderson and colleagues in 3 salient ways. First, we detect substantial publication bias in experimental research on the effects of violent games on aggressive affect and aggressive behavior. Second, after adjustment for bias, the effects of violent games on aggressive behavior in experimental research are estimated as being very small, and estimates of effects on aggressive affect are much reduced. In contrast, the cross-sectional literature finds correlations that appear largely unbiased. Third, experiments meeting the original authors' criteria for methodological quality do not yield larger adjusted effects than other experiments, but instead yield larger indications of bias, indicating that perhaps they were selected for significance. We outline future directions for stronger experimental research. The results indicate the need for an open, transparent, and preregistered research process to test the existence of the basic phenomenon. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Effects of euthanasia on the bereaved family and friends: a cross sectional study
Swarte, Nikkie B; van der Lee, Marije L; van der Bom, Johanna G; van den Bout, Jan; Heintz, A Peter M
2003-01-01
Objective To assess how euthanasia in terminally ill cancer patients affects the grief response of bereaved family and friends. Design Cross sectional study. Setting Tertiary referral centre for oncology patients in Utrecht, the Netherlands. Participants 189 bereaved family members and close friends of terminally ill cancer patients who died by euthanasia and 316 bereaved family members and close friends of comparable cancer patients who died a natural death between 1992 and 1999. Main outcome measures Symptoms of traumatic grief assessed by the inventory of traumatic grief, current feelings of grief assessed by the Texas revised inventory of grief, and post-traumatic stress reactions assessed by the impact of event scale. Results The bereaved family and friends of cancer patients who died by euthanasia had less traumatic grief symptoms (adjusted difference -5.29 (95% confidence interval -8.44 to -2.15)), less current feeling of grief (adjusted difference 2.93 (0.85 to 5.01)); and less post-traumatic stress reactions (adjusted difference -2.79 (-5.33 to -0.25)) than the family and friends of patients who died of natural causes. These differences were independent of other risk factors. Conclusions The bereaved family and friends of cancer patients who died by euthanasia coped better with respect to grief symptoms and post-traumatic stress reactions than the bereaved of comparable cancer patients who died a natural death. These results should not be interpreted as a plea for euthanasia, but as a plea for the same level of care and openness in all patients who are terminally ill. PMID:12881258
Risk factors for eczema in infants born in Cuba: a population-based cross-sectional study.
Suárez-Medina, Ramón; Venero-Fernández, Silvia Josefina; de la Mora-Faife, Esperanza; García-García, Gladys; Del Valle-Infante, Ileana; Gómez-Marrero, Liem; Fabré-Ortiz, Dania; Fundora-Hernández, Hermes; Venn, Andrea; Britton, John; Fogarty, Andrew W
2014-03-25
There is a concern that allergic disease in childhood is higher than expected in Cuba. The aim of this study was to determine the risk factors for eczema of infants aged 12-15 months living in Havana. We used a cross-sectional epidemiological study design. Data on eczema symptoms and a wide range of lifestyle factors were collected by researcher administered questionnaires. Data were collected on 1956 children (96% response rate), of whom 672 (34%) were reported as having had eczema. Independent risk factors for eczema included young maternal age (adjusted odds ratio (OR) 0.98 per additional year of age; 95% confidence interval (CI) 0.97-0.99), child's weight (OR 1.13 per additional kg; 95% CI: 1.03-1.25), insect sting allergy (OR 2.11; 95% CI: 1.33-3.35), rodents in the home (OR 1.39; 95% CI: 1.10-1.76), attendance at childcare facilities (OR 1.34: 95% CI: 1.05-1.70) and self-reported mould in the home (OR 1.23; 95% CI: 1.07-1.41). Infant exposure to paracetamol was associated with an increased risk of eczema even after adjustment for wheeze (OR 1.22; 95% CI: 1.03-1.46). Despite a very different culture and environment, the consistency of these findings with those from more economically developed countries suggests potential causal associations. The association with paracetamol, even after adjustment for wheeze, suggests that intervention studies are required in young infants, to ascertain if this commonly used anti-pyretic medication increases allergic disease.
Firdu, Naod; Enquselassie, Fikre; Jerene, Degu
2017-01-01
For antiretroviral therapy (ART) to work effectively, adherence is very crucial. However, most studies done on ART adherence are either on children or on adults. There is limited information on the level of adherence among adolescents. Using a cross-sectional study design, we interviewed 273 HIV-infected adolescents receiving ART from three hospitals in Addis Ababa. We used a structured questionnaire to measure adherence levels using patient self-reports. Bivariate and multivariate methods were used for analysis. We interviewed 273 adolescents aged 13 to 19 years, and 144 (52.7%) of the participants were girls. Their mean age was 15.4 years (SD± 1.75). The self-reported adherence rate of the respondents was 79.1% (216/273). On bivariate analysis, variables like WHO clinical stage, being on Cotrimoxazole Prophylactic Therapy (CPT), marital and living status of the parent, whether parent was on ART or not and having special instructions for ART medications were associated with optimum adherence. However of those, only WHO stage IV (adjusted OR, 12.874 95% CI, 2.079-79.706), being on CPT (adjusted OR, 0.339 95% CI, 0.124-0.97) and adolescents with widowed parent (adjusted OR, 0.087 with 95% CI, 0.021-0.359) were found to be significantly associated with optimum ART adherence. The level of self-reported ART adherence among HIV-infected adolescents at the three hospitals was below the recommended threshold. Though earlier presentation of adolescents to care should be encouraged, more targeted adherence support should be planned for those who present at an early stage of their illness.
Carlsson, Axel C; Wändell, Per E; de Faire, Ulf; Hellénius, Mai-Lis
2008-12-01
To estimate the prevalence of hypertension, defined as systolic or diastolic blood pressure or both of at least 140/90 mmHg measured on one occasion or being treated for hypertension or both, in 60-year-old men and women in groups of immigrants compared to Swedish-born. A population-based, cross-sectional study in Stockholm County including 4228 participants (77% participation rate), of whom 19% were immigrants. Outcome measures were prevalence of hypertension in immigrants compared to Swedish-born men and women with adjustments for various metabolic, lifestyle and socio-economic characteristics. The prevalence of hypertension among Swedish-born individuals (n = 3327) was 61% in men and 44% in women, among Finnish-born individuals (n = 327) it was 77% in men and 62% in women and among non-European immigrants (n = 123) it was 51% in men and 36% in women. The mean blood pressure in Finnish-born men was 149/90 (hypertensive). After adjustments for metabolic, lifestyle and socio-economic characteristics, the odds ratio for hypertension in immigrants from Finland was 2.02 (1.56-2.61) and the odds ratio in immigrants from non-European countries was 0.52 (0.34-0.80) using Swedish-born participants as reference. About half of all 60-year-olds in Sweden had high blood pressure. The high prevalence of hypertension found in Finnish-born immigrants remained after adjustments for many factors and needs a genetic or environmental explanation. The high prevalence of hypertension in Sweden, especially in Finnish-born immigrants, calls for preventive actions.
Muscle strength and areal bone mineral density at the hip in women: a cross-sectional study.
Pasco, Julie A; Holloway, Kara L; Brennan-Olsen, Sharon L; Moloney, David J; Kotowicz, Mark A
2015-05-24
Muscle strengthening exercises are promoted for building and maintaining a healthy skeleton. We aimed to investigate the relationship between muscle strength and areal bone mineral density (BMD) at the hip in women aged 26-97 years. This cross-sectional study utilises data from 863 women assessed for the Geelong Osteoporosis Study. Measures of hip flexor and abductor strength were made using a hand-held dynamometer (Nicholas Manual Muscle Tester). The maximal measure from three trials on each leg was used for analyses. BMD was measured at the hip using dual energy x-ray absorptiometry (DXA; Lunar DPX-L). Total lean mass, body fat mass and appendicular lean mass were determined from whole body DXA scans. Linear regression techniques were used with muscle strength as the independent variable and BMD as the dependent variable. Models were adjusted for age and indices of body composition. Measures of age-adjusted hip flexor strength and hip abductor strength were positively associated with total hip BMD. For each standard deviation (SD) increase in hip flexor strength, the increase in mean total hip BMD (SD) was 10.4 % (p = 0.009). A similar pattern was observed for hip abductor strength, with an increase in mean total hip BMD of 22.8 % (p = 0.025). All associations between hip muscle strength and total hip BMD were independent of height, but were nullified after adjusting for appendicular lean mass or total lean mass. There was a positive association observed between muscle strength and BMD at the hip. However, this association was explained by measures of lean mass.
Sluik, D; van Lee, L; Geelen, A; Feskens, E J
2014-03-01
The habitual consumption of a specific type of alcoholic beverage may be related to the overall dietary pattern. The objective of this cross-sectional study was to investigate associations between alcoholic beverage preference and dietary intake in The Netherlands. A total of 2100 men and women from the Dutch National Food Consumption Survey 2007-2010 were studied. A general questionnaire assessed alcoholic beverage preference and two non-consecutive 24-h dietary recalls assessed overall diet. Mean nutrient and food group intakes, and adherence to the 2006 Dutch dietary guidelines across categories of alcoholic beverage preference were compared and adjusted for age, sex, body mass index (BMI), education, smoking, physical activity, energy intake and frequency and absolute alcohol consumption. Largest differences in dietary habits were detected between persons who preferred wine and those who preferred beer. Persons with a beer preference had a higher absolute intake of meat, soft drinks, margarine and snacks. In contrast, persons with a wine preference had a higher absolute consumption of healthy foods. However, after multiple adjustments, wine consumers still consumed less energy and more vegetables and fruit juices compared with beer consumers. Adherence to the Dutch dietary guidelines did not differ between preference categories after multiple adjustments. In this cross-sectional analysis in a representative sample of the Dutch population, a beer preference was associated with less healthy dietary behaviour, especially compared with wine preference. However, these differences were largely explained by other socio-demographic and lifestyle factors. These results suggest that alcoholic beverage preference may not be independently related to diet.
Aoyagi, Kiyoshi; Ross, Philip D; Nevitt, Michael C; Davis, James W; Wasnich, Richard D; Hayashi, Takuo; Takemoto, Tai-ichiro
2001-01-01
Background Japanese (both in Japan and Hawaii) have a lower incidence of falls and of hip fracture than North American and European Caucasians, but the reasons for these differences are not clear. Subjects and Methods A cross-sectional study. We compared neuromuscular risk factors for falls using performance-based measures (chair stand time, usual and rapid walking speed, and grip strength) among 163 Japanese women in Japan, 681 Japanese-American women in Hawaii and 9403 Caucasian women in the United States aged 65 years and over. Results After adjusting for age, the Caucasian women required about 40% more time to complete 5 chair stands than either group of Japanese. Walking speed was about 10% slower among Caucasians than native Japanese, whereas Japanese-American women in Hawaii walked about 11% faster than native Japanese. Grip strength was greatest in Japan, which may reflect the rural farming district that this sample was drawn from. Additional adjustment for height, weight or body mass index increased the adjusted means of chair stand time and grip strength among Japanese, but the differences remained significant. Conclusions Both native Japanese and Japanese-American women in Hawaii performed better than Caucasians on chair stand time and walking speed tests, and native Japanese had greater grip strength than Japanese in Hawaii and Caucasians. The biological implications of these differences in performance are uncertain, but may be useful in planning future comparisons between populations. PMID:11696243
Ndosi, Mwidimi; Alcacer-Pitarch, Begonya; Allanore, Yannick; Del Galdo, Francesco; Frerix, Marc; García-Díaz, Sílvia; Hesselstrand, Roger; Kendall, Christine; Matucci-Cerinic, Marco; Mueller-Ladner, Ulf; Sandqvist, Gunnel; Torrente-Segarra, Vicenç; Schmeiser, Tim; Sierakowska, Matylda; Sierakowska, Justyna; Sierakowski, Stanslaw; Redmond, Anthony
2018-02-20
The aim of this study was to adapt the Systemic Sclerosis Quality of Life Questionnaire (SScQoL) into six European cultures and validate it as a common measure of quality of life in systemic sclerosis (SSc). This was a seven-country (Germany, France, Italy, Poland, Spain, Sweden and UK) cross-sectional study. A forward-backward translation process was used to adapt the English SScQoL into target languages. SScQoL was completed by patients with SSc, then data were validated against the Rasch model. To correct local response dependency, items were grouped into the following subscales: function, emotion, sleep, social and pain and reanalysed for fit to the model, unidimensionality and cross-cultural equivalence. The adaptation of the SScQoL was seamless in all countries except Germany. Cross-cultural validation included 1080 patients with a mean age 58.0 years (SD 13.9) and 87% were women. Local dependency was evident in individual country data. Grouping items into testlets corrected the local dependency in most country specific data. Fit to the model, reliability and unidimensionality was achieved in six-country data after cross-cultural adjustment for Italy in the social subscale. The SScQoL was then calibrated into an interval level scale. The individual SScQoL items have translated well into five languages and overall, the scale maintained its construct validity, working well as a five-subscale questionnaire. Measures of quality of life in SSc can be directly compared across five countries (France, Poland Spain, Sweden and UK). Data from Italy are also comparable with the other five countries although require an adjustment. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Neuman, Melissa; Alcock, Glyn; Azad, Kishwar; Kuddus, Abdul; Osrin, David; More, Neena Shah; Nair, Nirmala; Tripathy, Prasanta; Sikorski, Catherine; Saville, Naomi; Sen, Aman; Colbourn, Tim; Houweling, Tanja A J; Seward, Nadine; Manandhar, Dharma S; Shrestha, Bhim P; Costello, Anthony; Prost, Audrey
2014-01-01
Objectives To describe the prevalence and determinants of births by caesarean section in private and public health facilities in underserved communities in South Asia. Design Cross-sectional study. Setting 81 community-based geographical clusters in four locations in Bangladesh, India and Nepal (three rural, one urban). Participants 45 327 births occurring in the study areas between 2005 and 2012. Outcome measures Proportion of caesarean section deliveries by location and type of facility; determinants of caesarean section delivery by location. Results Institutional delivery rates varied widely between settings, from 21% in rural India to 90% in urban India. The proportion of private and charitable facility births delivered by caesarean section was 73% in Bangladesh, 30% in rural Nepal, 18% in urban India and 5% in rural India. The odds of caesarean section were greater in private and charitable health facilities than in public facilities in three of four study locations, even when adjusted for pregnancy and delivery characteristics, maternal characteristics and year of delivery (Bangladesh: adjusted OR (AOR) 5.91, 95% CI 5.15 to 6.78; Nepal: AOR 2.37, 95% CI 1.62 to 3.44; urban India: AOR 1.22, 95% CI 1.09 to 1.38). We found that highly educated women were particularly likely to deliver by caesarean in private facilities in urban India (AOR 2.10; 95% CI 1.61 to 2.75) and also in rural Bangladesh (AOR 11.09, 95% CI 6.28 to 19.57). Conclusions Our results lend support to the hypothesis that increased caesarean section rates in these South Asian countries may be driven in part by the private sector. They also suggest that preferences for caesarean delivery may be higher among highly educated women, and that individual-level and provider-level factors interact in driving caesarean rates higher. Rates of caesarean section in the private sector, and their maternal and neonatal health outcomes, require close monitoring. PMID:25550293
Bastos, Francisco I; Bastos, Leonardo Soares; Coutinho, Carolina; Toledo, Lidiane; Mota, Jurema Corrêa; Velasco-de-Castro, Carlos Augusto; Sperandei, Sandro; Brignol, Sandra; Travassos, Tamiris Severino; Dos Santos, Camila Mattos; Malta, Monica Siqueira
2018-05-01
Different sampling strategies, analytic alternatives, and estimators have been proposed to better assess the characteristics of different hard-to-reach populations and their respective infection rates (as well as their sociodemographic characteristics, associated harms, and needs) in the context of studies based on respondent-driven sampling (RDS). Despite several methodological advances and hundreds of empirical studies implemented worldwide, some inchoate findings and methodological challenges remain. The in-depth assessment of the local structure of networks and the performance of the available estimators are particularly relevant when the target populations are sparse and highly stigmatized. In such populations, bottlenecks as well as other sources of biases (for instance, due to homophily and/or too sparse or fragmented groups of individuals) may be frequent, affecting the estimates.In the present study, data were derived from a cross-sectional, multicity RDS study, carried out in 12 Brazilian cities with transgender women (TGW). Overall, infection rates for HIV and syphilis were very high, with some variation between different cities. Notwithstanding, findings are of great concern, considering the fact that female TGW are not only very hard-to-reach but also face deeply-entrenched prejudice and have been out of the reach of most therapeutic and preventive programs and projects.We cross-compared findings adjusted using 2 estimators (the classic estimator usually known as estimator II, originally proposed by Volz and Heckathorn) and a brand new strategy to adjust data generated by RDS, partially based on Bayesian statistics, called for the sake of this paper, the RDS-B estimator. Adjusted prevalence was cross-compared with estimates generated by non-weighted analyses, using what has been called by us a naïve estimator or rough estimates.
Martín-Merino, Elisa; Calderón-Larrañaga, Amaia; Hawley, Samuel; Poblador-Plou, Beatriz; Llorente-García, Ana; Petersen, Irene; Prieto-Alhambra, Daniel
2018-01-01
Background Missing data are often an issue in electronic medical records (EMRs) research. However, there are many ways that people deal with missing data in drug safety studies. Aim To compare the risk estimates resulting from different strategies for the handling of missing data in the study of venous thromboembolism (VTE) risk associated with antiosteoporotic medications (AOM). Methods New users of AOM (alendronic acid, other bisphosphonates, strontium ranelate, selective estrogen receptor modulators, teriparatide, or denosumab) aged ≥50 years during 1998–2014 were identified in two Spanish (the Base de datos para la Investigación Farmacoepidemiológica en Atención Primaria [BIFAP] and EpiChron cohort) and one UK (Clinical Practice Research Datalink [CPRD]) EMR. Hazard ratios (HRs) according to AOM (with alendronic acid as reference) were calculated adjusting for VTE risk factors, body mass index (that was missing in 61% of patients included in the three databases), and smoking (that was missing in 23% of patients) in the year of AOM therapy initiation. HRs and standard errors obtained using cross-sectional multiple imputation (MI) (reference method) were compared to complete case (CC) analysis – using only patients with complete data – and longitudinal MI – adding to the cross-sectional MI model the body mass index/smoking values as recorded in the year before and after therapy initiation. Results Overall, 422/95,057 (0.4%), 19/12,688 (0.1%), and 2,051/161,202 (1.3%) VTE cases/participants were seen in BIFAP, EpiChron, and CPRD, respectively. HRs moved from 100.00% underestimation to 40.31% overestimation in CC compared with cross-sectional MI, while longitudinal MI methods provided similar risk estimates compared with cross-sectional MI. Precision for HR improved in cross-sectional MI versus CC by up to 160.28%, while longitudinal MI improved precision (compared with cross-sectional) only minimally (up to 0.80%). Conclusion CC may substantially affect relative risk estimation in EMR-based drug safety studies, since missing data are not often completely at random. Little improvement was seen in these data in terms of power with the inclusion of longitudinal MI compared with cross-sectional MI. The strategy for handling missing data in drug safety studies can have a large impact on both risk estimates and precision.
Martín-Merino, Elisa; Calderón-Larrañaga, Amaia; Hawley, Samuel; Poblador-Plou, Beatriz; Llorente-García, Ana; Petersen, Irene; Prieto-Alhambra, Daniel
2018-01-01
Missing data are often an issue in electronic medical records (EMRs) research. However, there are many ways that people deal with missing data in drug safety studies. To compare the risk estimates resulting from different strategies for the handling of missing data in the study of venous thromboembolism (VTE) risk associated with antiosteoporotic medications (AOM). New users of AOM (alendronic acid, other bisphosphonates, strontium ranelate, selective estrogen receptor modulators, teriparatide, or denosumab) aged ≥50 years during 1998-2014 were identified in two Spanish (the Base de datos para la Investigación Farmacoepidemiológica en Atención Primaria [BIFAP] and EpiChron cohort) and one UK (Clinical Practice Research Datalink [CPRD]) EMR. Hazard ratios (HRs) according to AOM (with alendronic acid as reference) were calculated adjusting for VTE risk factors, body mass index (that was missing in 61% of patients included in the three databases), and smoking (that was missing in 23% of patients) in the year of AOM therapy initiation. HRs and standard errors obtained using cross-sectional multiple imputation (MI) (reference method) were compared to complete case (CC) analysis - using only patients with complete data - and longitudinal MI - adding to the cross-sectional MI model the body mass index/smoking values as recorded in the year before and after therapy initiation. Overall, 422/95,057 (0.4%), 19/12,688 (0.1%), and 2,051/161,202 (1.3%) VTE cases/participants were seen in BIFAP, EpiChron, and CPRD, respectively. HRs moved from 100.00% underestimation to 40.31% overestimation in CC compared with cross-sectional MI, while longitudinal MI methods provided similar risk estimates compared with cross-sectional MI. Precision for HR improved in cross-sectional MI versus CC by up to 160.28%, while longitudinal MI improved precision (compared with cross-sectional) only minimally (up to 0.80%). CC may substantially affect relative risk estimation in EMR-based drug safety studies, since missing data are not often completely at random. Little improvement was seen in these data in terms of power with the inclusion of longitudinal MI compared with cross-sectional MI. The strategy for handling missing data in drug safety studies can have a large impact on both risk estimates and precision.
Caesarean birth rates in public and privately funded hospitals: a cross-sectional study.
Alonso, Bruna Dias; Silva, Flora Maria Barbosa da; Latorre, Maria do Rosário Dias de Oliveira; Diniz, Carmen Simone Grilo; Bick, Debra
2017-01-01
To examine maternal and obstetric factors influencing births by cesarean section according to health care funding. A cross-sectional study with data from Southeastern Brazil. Caesarean section births from February 2011 to July 2012 were included. Data were obtained from interviews with women whose care was publicly or privately funded, and from their obstetric and neonatal records. Univariate and multivariate analyses were conducted to generate crude and adjusted odds ratios (OR) with 95% confidence intervals (95%CI) for caesarean section births. The overall caesarean section rate was 53% among 9,828 women for whom data were available, with the highest rates among women whose maternity care was privately funded. Reasons for performing a c-section were infrequently documented in women's maternity records. The variables that increased the likelihood of c-section regardless of health care funding were the following: paid employment, previous c-section, primiparity, antenatal and labor complications. Older maternal age, university education, and higher socioeconomic status were only associated with c-section in the public system. Higher maternal socioeconomic status was associated with greater likelihood of a caesarean section birth in publicly funded settings, but not in the private sector, where funding source alone determined the mode of birth rather than maternal or obstetric characteristics. Maternal socioeconomic status and private healthcare funding continue to drive high rates of caesarean section births in Brazil, with women who have a higher socioeconomic status more likely to have a caesarean section birth in all birth settings.
A new version of JQMD for soft heavy-ion collisions
NASA Astrophysics Data System (ADS)
Mancusi, Davide; Niita, Koji; Sihver, Lembit
The JQMD model (JAERI Quantum Molecular Dynamics) has been successfully used for a long time now to describe many different aspects of nuclear reactions in a unified way. However, in soft, peripheral heavy-ion collisions, the JQMD model shows instabilities and spurious fluctuations that are responsible for an overestimation of few-nucleon-removal cross sections. The reasons of this shortcoming are, firstly, that the JQMD is not fully relativistically covariant, and secondly, that the fermionic nature of the nuclear ground state cannot be faithfully reproduced in a semi-classical framework. We present here R-JQMD, an improved and fully covariant version of JQMD that also features a new ground-state initialisation algorithm for nuclei. The new code is only marginally slower than JQMD and it produces physically sounder results. We also discuss whether R-JQMD can be adjusted to improve JQMD's agreement with measured heavy-ion fragmentation cross sections.
[Risk factors for cardiovascular disease in prison institution staff: a cross-sectional study].
Audi, Celene Aparecida Ferrari; Santiago, Silvia Maria; Andrade, Maria da Graça Garcia; Francisco, Priscila Maria Stolses Bergamo
2016-01-01
to analyze risk factors for cardiovascular disease in prison institution staff. this was a cross-sectional study with a sample of 127 staff of both sexes; prevalence ratios (PR) were estimated adjusted for age and education, as were the respective 95% confidence intervals (95%CI). higher proportions of waist circumference ratios were found above the recommended values (58.1%) and the accumulation of two risk factors for females (33.8%); among males there was higher prevalence of abnormal glucose levels (PR=10.73 - 95%CI 1.31;87.92) and blood pressure (PR=2.63 - 95%CI 1.31;6.50). the risk factors for cardiovascular disease found among staff in this study were waist circumference, glucose levels and blood pressure above the recommended values; these health risks can to be addressed through health promotion and disease prevention measures, as well as effective attention to those who are already sick.
Mullally, B J; Greiner, B A; Allwright, S; Paul, G; Perry, I J
2008-12-01
This study establishes baseline prevalence of smoking and cigarette consumption among Cork bar workers prior to the Republic of Ireland's (ROI) smokefree workplace legislation and compares gender- and age-specific smoking rates and estimates the adjusted odds of being a smoker for Cork bar workers relative to the general population. Cross-sectional random sample of bar workers in Cork city and cross-sectional random telephone survey of the general population were conducted prior to the smokefree legislation. Self reported smoking prevalence among Cork bar workers (n = 129) was 54% (58% using cotinine-validated measures), with particularly high rates in women (70%) and 18-28 years old (72%). Within the ROI (n = 1,240) sub-sample rates were substantially lower at 28%. Bar workers were twice as likely to be smokers as the general population sub-sample (OR = 2.15). Cork bar workers constitute an occupational group with an extremely high smoking prevalence.
Cetateanu, Andreea; Jones, Andy
2014-01-01
Using a large cross sectional English sample, we quantified the association between weight status in children aged 4–5 and 10–11 year, characteristics of the food environment, and area deprivation. We observed a positive association between the density of unhealthy food outlets in a neighbourhood and the prevalence of overweight and obesity in children. An association in the opposite direction was observed for other types of food outlets, although after adjustment this was only statistically significant for older children. The prevalence of fast food and other unhealthy food outlets explained only a small proportion of the observed associations between weight status and socioeconomic deprivation. Children׳s weight status may be influenced by their local environment, particularly older children, but associations between obesity and deprivation do not appear strongly due to local food environment characteristics. PMID:24561918
Cetateanu, Andreea; Jones, Andy
2014-05-01
Using a large cross sectional English sample, we quantified the association between weight status in children aged 4-5 and 10-11 year, characteristics of the food environment, and area deprivation. We observed a positive association between the density of unhealthy food outlets in a neighbourhood and the prevalence of overweight and obesity in children. An association in the opposite direction was observed for other types of food outlets, although after adjustment this was only statistically significant for older children. The prevalence of fast food and other unhealthy food outlets explained only a small proportion of the observed associations between weight status and socioeconomic deprivation. Children׳s weight status may be influenced by their local environment, particularly older children, but associations between obesity and deprivation do not appear strongly due to local food environment characteristics. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
Abdollahpour, Ibrahim; Nedjat, Saharnaz; Salimi, Yahya
2018-01-01
Now positive aspect of caregiving (PAC) is well-defined as caregiver gains, satisfaction, meaningful life, and enhanced family relationship. The adjusted association of PAC and caregiver burden is not well acknowledged. This study investigated the association of caregiver burden and PAC adjusting for potential confounders. This was a cross-sectional study that recruited 132 caregivers. A linear regression model with PAC was used to estimate the adjusted associations. The caregiver burden was negatively associated with PAC (mean difference in PAC per a 1-unit increase in caregiver burden = -0.12, 95% confidence interval: -0.18 to -0.056; P < .001). This association remained after adjustment for caregivers' age and marital status as well as patients' dependency level. The negative significant association of caregiver burden with PAC reinforces the need for interventional and/or educational programs aiming at decreasing the overall imposed burden. This can play an important role in improving caregivers' general health and quality of life.
Li, Chia-Chun; Rew, Lynn; Hwang, Shiow-Li
2012-01-01
We examined relationships among demographic and clinical characteristics, spiritual well-being, and psychosocial adjustment in Taiwanese patients with colorectal cancer and a colostomy. A descriptive, cross-sectional, exploratory study design was used to answer research questions. Participants were recruited from the outpatient ambulatory clinic in the gastrointestinal surgical department at the medical center of National Taiwan University. Forty-five Taiwanese patients aged 42 to 83 years who were diagnosed with colorectal cancer and underwent colostomy surgery participated in the study. Participants completed a personal data questionnaire designed for this study, along with 2 validated instruments, the Spiritual Well-Being Scale and the Psychosocial Adjustment to Illness Scale-Self Report. Forty-five persons participated in the study; 69% reported a moderate level of spiritual well-being. Participants reported strong adjustment to extended family relationships, but poor adjustment in sexual relationships. Spiritual well-being was significantly associated with psychosocial adjustment (r = -0.52, P < .01), and 4 predictors (income change after surgery, self-rated disease severity, time since surgery, and spiritual well-being) accounted for 53% of the variance in psychosocial adjustment. Spiritual well-being plays an important role for Taiwanese patients when faced with psychosocial adjustment related to life with colorectal cancer and a colostomy.
Children's questions about interparent conflict and violence: what's a mother to say?
McDonald, Renee; Jouriles, Ernest N; Rosenfield, David; Leahy, Matthew M
2012-02-01
This research examined the relation between mothers' responses to children's questions about interparent conflict and children's adjustment. Participants were 134 mothers and their children (70 boys, 64 girls), aged 7 to 10. In each family, an act of intimate-partner violence (IPV) had recently occurred. Mothers' responses to children's questions about interparent conflict were assessed via a semistructured interview coded to reflect the extent to which the mothers' responses addressed the content of the children's questions. Mothers and children reported on physical IPV. Mothers also reported on interparent conflict, parent-child aggression, and maternal warmth. Children's adjustment was assessed via mothers' and children's reports at two time points 6 months apart. The extent to which mothers' responses addressed the content of the children's questions about interparent conflict was negatively associated with children's adjustment problems, after accounting for the frequency of physical IPV, frequency of interparent conflict, parent-child aggression, and maternal warmth. These associations emerged cross-sectionally and prospectively. However, in those prospective analyses that accounted for children's baseline levels of adjustment, maternal responsiveness was not associated with later children's adjustment problems.
Kang, Huili; Chen, Yu-Ming; Han, Guiyuan; Huang, Hua; Chen, Wei-Qing; Wang, Xidan; Zhu, Ying-Ying; Xiao, Su-Mei
2016-01-23
This study aimed to elucidate the associations of age, BMI, and years of menstruation with proximal femur strength in Chinese postmenopausal women, which may improve the prediction of hip fracture risk. A cross-sectional study was conducted in 1322 Chinese postmenopausal women recruited from communities. DXA images were used to generate bone mineral density (BMD) and geometric parameters, including cross-sectional area (CSA), outer diameter (OD), cortical thickness (CT), section modulus (SM), buckling ratio (BR) at the narrow neck (NN), intertrochanter (IT), and femoral shaft (FS). Relationships of age, BMI, and years of menstruation with bone phenotypes were analyzed with the adjustment of height, age at menarche, total daily physical activity, education, smoking status, calcium tablet intake, etc. Age was associated with lower BMD, CSA, CT, SM, and higher BR (p < 0.05), which indicated a weaker bone strength at the proximal femur. BMI and years of menstruation had the positive relationships with proximal femur strength (p < 0.05). Further analyses showed that the ranges of absolute value of change slope per year, per BMI or per year of menstruation were 0.14%-1.34%, 0.20%-2.70%, and 0.16%-0.98%, respectively. These results supported that bone strength deteriorated with aging and enhanced with higher BMI and longer time of years of menstruation in Chinese postmenopausal women.
Kang, Huili; Chen, Yu-Ming; Han, Guiyuan; Huang, Hua; Chen, Wei-Qing; Wang, Xidan; Zhu, Ying-Ying; Xiao, Su-Mei
2016-01-01
This study aimed to elucidate the associations of age, BMI, and years of menstruation with proximal femur strength in Chinese postmenopausal women, which may improve the prediction of hip fracture risk. A cross-sectional study was conducted in 1322 Chinese postmenopausal women recruited from communities. DXA images were used to generate bone mineral density (BMD) and geometric parameters, including cross-sectional area (CSA), outer diameter (OD), cortical thickness (CT), section modulus (SM), buckling ratio (BR) at the narrow neck (NN), intertrochanter (IT), and femoral shaft (FS). Relationships of age, BMI, and years of menstruation with bone phenotypes were analyzed with the adjustment of height, age at menarche, total daily physical activity, education, smoking status, calcium tablet intake, etc. Age was associated with lower BMD, CSA, CT, SM, and higher BR (p < 0.05), which indicated a weaker bone strength at the proximal femur. BMI and years of menstruation had the positive relationships with proximal femur strength (p < 0.05). Further analyses showed that the ranges of absolute value of change slope per year, per BMI or per year of menstruation were 0.14%–1.34%, 0.20%–2.70%, and 0.16%–0.98%, respectively. These results supported that bone strength deteriorated with aging and enhanced with higher BMI and longer time of years of menstruation in Chinese postmenopausal women. PMID:26805871
Bone geometry profiles in women with and without SLE.
Alele, Jimmy D; Kamen, Diane L; Hunt, Kelly J; Ramsey-Goldman, Rosalind
2011-11-01
Recent studies have reported an increased risk of fracture among patients with systemic lupus erythematosus (SLE) in comparison with the general population. The aim of this study was to examine associations between SLE status and bone geometry in white and African-American women. We compared hip BMD and bone geometry parameters among SLE women and control individuals using hip structure analysis (HSA). One-hundred and fifty-three dual-energy X-ray absorptiometry (DXA) scans from the Study of Lupus Vascular and Bone Long Term Endpoints (68.7% white and 31.3% African American) and 4920 scans from the Third National Health and Nutrition Examination Survey (59.3% white and 40.7% African American) were analyzed. Linear regression was used to examine BMD and bone geometry differences by SLE status and by race/ethnicity after adjusting for age and BMI. Significant differences were detected between SLE and control women. Among white women, age-adjusted BMD (g/cm(2)), section modulus (cm(3)), and cross-sectional areas (cm(2)) were lower among SLE women than among control women at the narrow neck (0.88 versus 0.83 g/cm(2), 1.31 versus 1.11 cm(2), and 2.56 versus 2.40 cm(2), p < 0.001, p < 0.01, and p < 0.0001, respectively), whereas buckling ratio was increased (10.0 versus 10.6, p < 0.01). Likewise, BMD, section modulus, and cross-sectional areas were decreased among African-American SLE women at all subregions, whereas buckling ratios were increased. There were significant bone geometry differences between SLE and control women at all hip subregions. Bone geometry profiles among SLE women were suggestive of increased fragility. Copyright © 2011 American Society for Bone and Mineral Research.
Lukasse, Mirjam; Schroll, Anne-Mette; Karro, Helle; Schei, Berit; Steingrimsdottir, Thora; Van Parys, An-Sofie; Ryding, Elsa Lena; Tabor, Ann
2015-05-01
To assess the prevalence and current suffering of experienced abuse in healthcare, to present the socio-demographic background for women with a history of abuse in healthcare and to assess the association between abuse in healthcare and selected obstetric characteristics. Cross-sectional study. Routine antenatal care in six European countries. In total 6923 pregnant women. Cross-tabulation and Pearson's chi-square was used to study prevalence and characteristics for women reporting abuse in healthcare. Associations with selected obstetric factors were estimated using multiple logistic regression analysis. Abuse in healthcare, fear of childbirth and preference for birth by cesarean section. One in five pregnant women attending routine antenatal care reported some lifetime abuse in healthcare. Prevalence varied significantly between the countries. Characteristics for women reporting abuse in healthcare included a significantly higher prevalence of other forms of abuse, economic hardship and negative life events as well as a lack of social support, symptoms of post-traumatic stress and depression. Among nulliparous women, abuse in healthcare was associated with fear of childbirth, adjusted odds ratio 2.25 (95% CI 1.23-4.12) for severe abuse in healthcare. For multiparous women only severe current suffering from abuse in healthcare was significantly associated with fear of childbirth, adjusted odds ratio 4.04 (95% CI 2.08-7.83). Current severe suffering from abuse in healthcare was significantly associated with the wish for cesarean section, and counselling for fear of childbirth for both nulli- and multiparous women. Abuse in healthcare among women attending routine antenatal care is common and for women with severe current suffering from abuse in healthcare, this is associated with fear of childbirth and a wish for cesarean section. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.
Screw-Thread Inserts As Temporary Flow Restrictors
NASA Technical Reports Server (NTRS)
Trimarchi, Paul
1992-01-01
Coil-spring screw-thread inserts found useful as temporary flow restrictors. Inserts placed in holes through which flow restricted, effectively reducing cross sections available for flow. Friction alone holds inserts against moderate upstream pressures. Use of coil-spring thread inserts as flow restrictors conceived as inexpensive solution to problem of adjusting flow of oxygen through orifices in faceplate into hydrogen/oxygen combustion chamber. Installation and removal of threaded inserts gentle enough not to deform orifice tubes.
The Role of Dyadic Coping on the Marital and Emotional Adjustment of Couples With Infertility.
Chaves, Catarina; Canavarro, Maria Cristina; Moura-Ramos, Mariana
2018-04-30
Infertility is a challenging experience, affecting individual and couples' adjustment. However, the way the members of the couple support each other may affect the experience of infertility and their adjustment. This study aimed to investigate the role of dyadic coping by oneself and by the partner in the association between the impact of infertility and dyadic and emotional adjustment (anxiety and depression) to infertility. In this cross-sectional study, a total of 134 participants (67 couples with infertility) completed self-report questionnaires assessing infertility-related stress, dyadic coping, dyadic adjustment, and depression and anxiety symptoms. A path analysis examined the direct and indirect effects between the impact of infertility in one's life and dyadic and emotional adjustment. There is an indirect effect of the impact of infertility in one's life on dyadic adjustment through men's perceived dyadic coping efforts employed by the self (dyadic coping by oneself) and women's perceived dyadic coping efforts of the partner (dyadic coping by the partner). Regarding the emotional adjustment of infertile couples, infertility stress impact had an indirect effect only on depressive symptoms through men's dyadic coping by oneself. The results highlight the importance of men's dyadic coping strategies for the marital adjustment of couples as well as for men's emotional adjustment. Findings emphasize the importance of involving men in the fertility treatment process, reinforcing the dyadic nature of infertility processes. © 2018 Family Process Institute.
Lee, Dale Y.; Wetzsteon, Rachel J.; Zemel, Babette S.; Shults, Justine; Organ, Jason M.; Foster, Bethany J.; Herskovitz, Rita M.; Foerster, Debbie L.; Leonard, Mary B.
2015-01-01
Measures of muscle mass or size are often used as surrogates of forces acting on bone. However, chronic diseases may be associated with abnormal muscle force relative to muscle size. The muscle-bone unit was examined in 64 children and adolescents with new-onset Crohn’s disease (CD), 54 with chronic kidney disease (CKD), 51 treated with glucocorticoids for nephrotic syndrome (NS), and 264 healthy controls. Muscle torque was assessed by isometric ankle dynamometry. Calf muscle cross-sectional area (CSA) and tibia cortical section modulus (Zp) were assessed by quantitative CT. Log-linear regression was used to determine the relations among muscle CSA, muscle torque, and Zp, adjusted for tibia length, age, Tanner stage, sex, and race. Muscle CSA and muscle torque-relative-to-muscle CSA were significantly lower than controls in advanced CKD (CSA −8.7%, p = 0.01; torque −22.9%, p < 0.001) and moderate-to-severe CD (CSA −14.1%, p < 0.001; torque −7.6%, p = 0.05), but not in NS. Zp was 11.5% lower in advanced CKD (p = 0.005) compared to controls, and this deficit was attenuated to 6.7% (p = 0.05) with adjustment for muscle CSA. With additional adjustment for muscle torque and body weight, Zp was 5.9% lower and the difference with controls was no longer significant (p = 0.09). In participants with moderate-to-severe CD, Zp was 6.8% greater than predicted (p = 0.01) given muscle CSA and torque deficits (R2=0.92), likely due to acute muscle loss in newly diagnosed patients. Zp did not differ in NS, compared with controls. In conclusion, muscle torque relative to muscle CSA was significantly lower in CKD and CD, compared with controls, and was independently associated with Zp. Future studies are needed to determine if abnormal muscle strength contributes to progressive bone deficits in chronic disease, independent of muscle area. PMID:25264231
Valente, Denis Souto; Padoin, Alexandre Vontobel; Carvalho, Lauro Aita; Pereira Filho, Gustavo de Azambuja; Ribeiro, Vinicius Weissheimer; Zanella, Rafaela Koehler
2016-07-01
It has been speculated that the immediate decrease in body fat following liposuction may affect body composition by feedback mechanisms of body fat regain. Physical activity has both short- and long-term impacts on health. Although the lay public often associates higher levels of physical activity with body fat distribution changes, studies on the association between physical activity and body fat distribution present inconsistent results. The aim of this study was to investigate the cross-sectional and prospective associations between physical activity and body mass index following liposuction. This is a prospective, bidirectional, cross-sectional study, including 526 liposuction patients, who were followed up at a mean of 11.7 and 24.3 months after surgery. The sum of skinfolds at 11.7 months was highly correlated with skinfolds at 24.3 months (rho = 0.74, p < 0.001). More than 85 percent of participants remained in the same quintile or changed by not more than one quintile during the 13.6-month period. Tracking of physical activity was considerably lower but still significant; the correlation was 0.24 (p < 0.001), and 61.4 percent of the patients moved one or less quintiles. In fully adjusted models, no significant cross-sectional or longitudinal associations were found between physical activity and body mass index. The authors provide evidence of tracking of physical activity and particularly body mass index following liposuction. The authors' results do not support the hypothesis that physical activity and fatness are strongly related following liposuction.
Study of proton induced reactions on niobium targets up to 70 MeV
NASA Astrophysics Data System (ADS)
Ditrói, F.; Takács, S.; Tárkányi, F.; Baba, M.; Corniani, E.; Shubin, Yu. N.
2008-12-01
Niobium is a metal with important technological applications: use as alloying element to increase strength of super alloys, as thin layer for tribological applications, as superconductive material, in high temperature engineering systems, etc. In the frame of a systematic study of activation cross-sections of charged particle induced reactions on structural materials proton induced excitation functions on Nb targets were determined with the aim of applications in accelerator and reactor technology and for thin layer activation (TLA). The charged particle activation cross-sections on this element are also important for yield calculation of medical isotope production ( 88,89Zr, 86,87,88Y) and for dose estimation in PET targetry. As Niobium is a monoisotopic element it is an ideal target material to test nuclear reaction theories. We present here the integral excitation functions of 93Nb(p,x) 90,93mMo, 92m,91m,90Nb, 86,88,89Zr, 86,87mg,88Y and 85Sr in the energy range 30-70 MeV, some measured for the first time at this energy range. The results were compared with the theoretical cross-sections calculated by means of the code ALICE-IPPE and with the literature data. The calculations have been carried out without any parameter adjustment. The theory reproduces the shape of the measured results well and magnitude is also acceptable. Thick target yields calculated from our fitted cross-section give reliable estimations for production of medically relevant radioisotopes and for dose estimation in accelerator technology.
ERIC Educational Resources Information Center
Koo Moon, Hyoung; Kwon Choi, Byoung; Shik Jung, Jae
2012-01-01
Although various antecedents of expatriates' cross-cultural adjustment have been addressed, previous international experience, predeparture cross-cultural training, and cultural intelligence (CQ) have been most frequently examined. However, there are few attempts that explore the effects of these antecedents simultaneously or consider the possible…
Lahey, Benjamin B.; Zald, David H.; Hakes, Jahn K.; Krueger, Robert F.; Rathouz, Paul J.
2014-01-01
Importance Mental disorders predict future occurrences of both the same disorder (homotypic continuity) and other disorders (heterotypic continuity). Heterotypic continuity is inconsistent with a view of mental disorders as fixed entities. In contrast, hierarchical-dimensional conceptualizations of psychopathology, in which each form of psychopathology is hypothesized to have both unique and broadly shared etiologies and mechanisms, predict both homotypic and heterotypic continuity. Objective To test predictions derived from a hierarchical-dimensional model of psychopathology that (a) heterotypic continuity is widespread, even controlling for homotypic continuity, and (b) the relative magnitudes of heterotypic continuities recapitulate the relative magnitudes of cross-sectional correlations among diagnoses at baseline. Design Assess 10 prevalent diagnoses in the same persons 3 years apart. Setting Representative sample of adults in the United States. Participants The 28,958 participants in the National Epidemiologic Study of Alcohol and Related Condition aged 18–64 years who were assessed in both waves. Main Outcome Measure Diagnoses from reliable and valid structured interviews. Results Bivariate associations of all pairs of diagnoses from wave 1 to wave 2 exceeded chance levels for all homotypic (tetrachoric ρ = 0.41 – 0.79, median = 0.54) and for nearly all heterotypic continuities (tetrachoric ρ = 0.07 – 0.50, median = 0.28), adjusted for sex and age. Significant heterotypic continuity was widespread even when all other wave 1 diagnoses (including the same diagnosis) were simultaneous predictors of each wave 2 diagnosis. The rank correlation between age and sex adjusted tetrachoric ρs for cross-sectional associations among wave 1 diagnoses and heterotypic associations from wave 1 to wave 2 diagnoses was ρ = .86. Conclusions and Relevance For these prevalent mental disorders, heterotypic continuity was nearly universal and not an artifact of failure to control for homotypic continuity. Furthermore, the relative magnitudes of heterotypic continuity closely mirrored the relative magnitudes of cross-sectional associations among these disorders, consistent with the hypothesis that both sets of associations reflect the same factors. Mental disorders are not fixed and independent entities. Rather, each diagnosis is robustly related to other diagnoses in a correlational structure that is manifested both concurrently and in patterns of heterotypic continuity across time. PMID:24989054
Lahey, Benjamin B; Zald, David H; Hakes, Jahn K; Krueger, Robert F; Rathouz, Paul J
2014-09-01
Mental disorders predict future occurrences of both the same disorder (homotypic continuity) and other disorders (heterotypic continuity). Heterotypic continuity is inconsistent with a view of mental disorders as fixed entities. In contrast, hierarchical-dimensional conceptualizations of psychopathology, in which each form of psychopathology is hypothesized to have both unique and broadly shared etiologies and mechanisms, predict both homotypic and heterotypic continuity. To test predictions derived from a hierarchical-dimensional model of psychopathology that (1) heterotypic continuity is widespread, even controlling for homotypic continuity, and that (2) the relative magnitudes of heterotypic continuities recapitulate the relative magnitudes of cross-sectional correlations among diagnoses at baseline. Ten prevalent diagnoses were assessed in the same person twice (ie, in 2 waves separated by 3 years). We used a representative sample of adults in the United States (i.e., 28,958 participants 18-64 years of age in the National Epidemiologic Study of Alcohol and Related Conditions who were assessed in both waves). Diagnoses from reliable and valid structured interviews. Adjusting for sex and age, we found that bivariate associations of all pairs of diagnoses from wave 1 to wave 2 exceeded chance levels (P < .05) for all homotypic (median tetrachoric correlation of ρ = 0.54 [range, 0.41-0.79]) and for nearly all heterotypic continuities (median tetrachoric correlation of ρ = 0.28 [range, 0.07-0.50]). Significant heterotypic continuity was widespread even when all wave 1 diagnoses (including the same diagnosis) were simultaneous predictors of each wave 2 diagnosis. The rank correlation between age- and sex-adjusted tetrachoric correlation for cross-sectional associations among wave 1 diagnoses and for heterotypic associations from wave 1 to wave 2 diagnoses was ρ = 0.86 (P < .001). For these prevalent mental disorders, heterotypic continuity was nearly universal and not an artifact of failure to control for homotypic continuity. Furthermore, the relative magnitudes of heterotypic continuity closely mirrored the relative magnitudes of cross-sectional associations among these disorders, consistent with the hypothesis that both sets of associations reflect the same factors. Mental disorders are not fixed and independent entities. Rather, each diagnosis is robustly related to other diagnoses in a correlational structure that is manifested both concurrently and in patterns of heterotypic continuity across time.
Zhang, Yi; Zeng, Chao; Wei, Jie; Li, Hui; Yang, Tuo; Yang, Ye; Deng, Zhen-han; Ding, Xiang; Lei, Guanghua
2016-03-11
High-sensitivity C-reactive protein (hsCRP) is possibly related to osteoarthritis (OA) progression and a variety of OA-related symptoms. This study aimed to examine associations between cigarette smoking, betel quid chewing and alcohol consumption and hsCRP in early radiographic knee OA. Cross-sectional health examination survey. This primary study was conducted in a health examination centre in China. 936 (656 men and 280 women) patients with early radiographic knee OA were included in this cross-sectional study. Smoking status was classified into four levels based on daily smoking habit: 0/day, 1-10/day, 11-20/day and >20/day. Betel quid chewing and alcohol consumption status was divided into 'Yes' or 'No'. Early radiographic knee OA was defined as Kellgren Lawrence (K-L) grade 1 or 2 in at least one leg, and elevated hsCRP was assessed as ≥ 3.0 mg/L. After adjustment for a number of potential confounding factors, a significant positive association between cigarette smoking and hsCRP was observed in the multivariable model. The multivariable-adjusted ORs (95% CI) of elevated hsCRP (≥ 3.0 mg/L) in the second (1-10/day, n=133), third (11-20/day, n=59) and highest (>20/day, n=104) cigarette smoking categories were 1.54 (95% CI 0.91 to 2.61), 1.27 (95% CI 0.57 to 2.79) and 2.09 (95% CI 1.20 to 3.64), respectively, compared with the non-smoker category (n=640). In addition, there was a positive dose-response relationship between cigarette smoking and elevated hsCRP (p for trend=0.01). No significant associations between betel quid chewing and alcohol consumption and hsCRP were observed in the multivariable model. This study indicated that cigarette smoking was positively associated with serum hsCRP level in patients with early radiographic knee OA. However, in view of the nature of cross-sectional designs, the results need to be confirmed by further prospective studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Richter, Marlise; Chersich, Matthew F; Vearey, Jo; Sartorius, Benn; Temmerman, Marleen; Luchters, Stanley
2014-02-01
Intersections between migration and sex work are underexplored in southern Africa, a region with high internal and cross-border population mobility, and HIV prevalence. Sex work often constitutes an important livelihood activity for migrant women. In 2010, sex workers trained as interviewers conducted cross-sectional surveys with 1,653 female sex workers in Johannesburg (Hillbrow and Sandton), Rustenburg and Cape Town. Most (85.3%) sex workers were migrants (1396/1636): 39.0% (638/1636) internal and 46.3% (758/1636) cross-border. Cross-border migrants had higher education levels, predominately worked part-time, mainly at indoor venues, and earned more per client than other groups. They, however, had 41% lower health service contact (adjusted odds ratio = 0.59; 95% confidence interval = 0.40-0.86) and less frequent condom use than non-migrants. Police interaction was similar. Cross-border migrants appear more tenacious in certain aspects of sex work, but require increased health service contact. Migrant-sensitive, sex work-specific health care and health education are needed.
A New Scaling Law of Resonance in Total Scattering Cross Section in Gases
NASA Astrophysics Data System (ADS)
Raju, Gorur Govinda
2009-10-01
Electrical discharges in gases continue to be an active area of research because of industrial applications such as power systems, environmental clean up, laser technology, semiconductor fabrication etc. A fundamental knowledge of electron-gas neutral interaction is indispensable and, the total scattering cross section is one of the quantities that have been measured extensively. The energy dependence of the total cross sections shows peaks or resonance processes that are operative in the collision process. These peaks and the energies at which they occur are shown to satisfy a broad relationship involving the polarizability and the dipole moment of the target particle. Data on 62 target particles belonging to the following species are analyzed. (Eq 1) Rare gas atoms (Eq 2) Di-atomic molecules with combinations of polar, non-polar, attaching, and non-attaching properties Poly-atomic molecules with combinations of polar, non-polar, attaching, and non-attaching properties. Methods of improving the newly identified scaling law and possible application have been identified. 1 INTRODUCTION: Data on electron-neutral interactions are one of the most fundamental in the study of gaseous electronics and an immense literature, both experimental and theoretical, has become available since about the year 1920. [1-5]. In view of the central role which these data play in all facets of gas discharges and plasma science, it is felt that a critical review of available data is timely, mainly for the community of high voltage engineers and industries connected with plasma science in general. The electron-neutral interaction, often referred to as scattering in the scientific literature, is quantified by using the quantity called the total scattering cross section (QT, m^2). In the literature on cross section, total cross section and total scattering cross section are terms used synonymously and we follow the same practice. A definition may be found in reference [1]. This paper concerns scaling of total cross section of gases at resonance energy and the electron energy at which resonance occurs. The meaning of resonance is briefly explained in the following section. Here, we use the term scaling to relate the two quantities mentioned, namely, the resonance energy and the total cross section at that energy. Consistent with the definition of scaling, if the law proposed holds, one of the two quantities mentioned above may be calculated if the other is known. Such a method is very useful in gas discharge modeling and calculation of breakdown voltages, as more fully explained in the later section of the paper. 2 DESCRIPTION OF RESONANCE: A brief description of resonance phenomena in several types of target particles, viz., atomic, poly atomic, polar, non-polar phenomena are presented. 3 PREVIOUS SCALING LAWS: A common representation of a given characteristic with as few adjustable parameters as possible is generally known as the scaling law. The Paschen curve for breakdown voltage is such a familiar scaling law. With reference to cross sections several attempts have been made to obtain a scaling law, with varying degree of success. If the cross section-energy curve is qualitatively similar without having sharp peaks and oscillations, moderately successful scaling laws may be devised. For example, the ionization cross section- energy curves for most gases follow a general pattern. Several published scaling laws are discussed. 4 A NEW SCALING LAW AND DISCUSSION: In this work the author has compiled the resonance details for more than 60 gasest hat include the range from simple atoms to complex molecules that are polyatomic, dipolar, electron-attaching and isomers. The target particles exhibit a number of distinct features, as far as their total cross section variation with electron energy is concerned as already explained.
Mahner, Maria; Raus, Christina; Ludwig, Fabian; Weckmann, Gesine; Stracke, Sylvia; Chenot, Jean-François
2018-06-01
Many drugs require dose adjustment or are contraindicated in patients with chronic kidney disease (CKD) to avoid adverse events. The aims of this study were to assess if medication was appropriately dose adjusted in patients with CKD in primary care, to identify medications that were frequently prescribed inappropriately and to identify factors predicting mal-prescription. We conducted a cross-sectional observational study in 34 general practioners' offices, assessing the medication of patients with CKD stage ≥ 3 according to the corresponding pharmaceutical product information. Additional information was extracted from recommendations of scientific societies and regulatory authorities. Contraindicated and overdosed medications were identified. Predictive factors for inadequate prescribing were analyzed with multiple logistic regression. 589 patients (Ø 78 years, 63 % female) with CKD stage ≥ 3 were included. A total of 5102 medications were extracted from the medication sheets (94,6 % regular, 5,4 % "as needed"). 4,2 % were judged as being inadequate according to pharmaceutical information (2,1 % contraindicated, 2,1 % overdosed). 173 patients (29 %) had ≥ 1 inadequate prescription. The proportion of inadequate prescriptions fell to 3,5 % after adjustment for the most recent recommendations of scientific societies and regulatory authorities. Most frequent inappropriate prescriptions were ACE-inhibitors, diuretics, oral antidiabetic drugs, methotrexate and potassium supplements. Most important predictors for inadequate prescriptions were CKD stage ≥ 3b and number of medications. A quarter of all patients had a least one inadequate prescription. The overall proportion of inadequately prescribed drugs was low. Adjustment for recommendations by scientific societies and regulatory authorities further reduced the number of inadequate prescriptions. Valid data on the clinical relevance of inadequate prescriptions is scarce and further research is required. Because of the time and effort needed to assess all medications, future quality improvement projects should focus on CKD stage ≥ 3b, patients with polypharmacy and crucial medication. © Georg Thieme Verlag KG Stuttgart · New York.
Mustafa, Madihah; Abdul Rahman, Mohd Rizam; Yusof, Khairul Hazdi; Abd Aziz, Noor Azah
2016-01-01
Background and Purpose Mental health problems are common in old age, but frequently remain undetected and untreated. Mental health problems in the elderly are the result of a complex interaction of social, psychological and biological factors. The aim of this study is to determine the prevalence of mental health problems (depression, anxiety, and emotional stress) and their associated factors among the Malay elderly in a rural community of Perak, Malaysia. Methods It was a cross-sectional study. The Malay elderly aged 60 years and above were selected through convenient sampling to give a total of 230 respondents. The Depression, Anxiety, and Stress Scale (DASS-21) was used to assess the symptoms of depression, anxiety, and stress. Bivariate analyses were performed using chi-square tests and multiple logistic regression analyses were conducted to determine the association between the factors and each of the mental health statuses assessed. Results The results showed that the prevalence of depression, anxiety, and stress among the elderly respondents was 27.8%, 22.6%, and 8.7%, respectively. The significant factors for depression were single elderly (Adjusted OR = 3.27, 95%CI 1.66, 6.44), living with family (Adjusted OR = 4.98, 95%CI 2.05, 12.10), and poor general health status (Adjusted OR = 2.28, 95%CI 1.20, 4.36). Living with family was the only significant factor for anxiety (Adjusted OR = 2.68, 95%CI 1.09, 6.57). There was no significant factor for stress. Conclusions Depression and anxiety among the Malay elderly in the rural community were very worrying. More equity in health should be created or strengthened in order to intensify the opportunity to identify, diagnose, and treat those with mental health problems. Living arrangement in the rural community was an important factor that had influenced depression and anxiety. Therefore, further research is recommended for more comprehensive information, as a result of which appropriate intervention can be made. PMID:27280529
Shi, Hongying; Yang, Xinjun; Huang, Chenping; Zhou, Zumu; Zhou, Qiang; Chu, Maoping
2011-07-05
Injuries affect all age groups but have a particular impact on young people. To evaluate the incidence of non-fatal, unintentional, injuries among undergraduates in Wenzhou, China, assess the burden caused by these injuries, and explore the associated risk factors for unintentional injuries among these undergraduates, we conducted a college-based cross-sectional study. Participants were selected by a multi-stage random sampling method, and 2,287 students were asked whether they had had an injury in the last 12 months; the location, cause, and consequences of the event. The questionnaire included demographic and socioeconomic characteristics, lifestyle habits, and the scale of type A behaviour pattern (TABP). Multivariate logistic regression models were used; crude odds ratios (ORs), adjusted ORs and their 95% confidence intervals (CIs) were estimated, with students having no injuries as the reference group. The incidence of injuries among undergraduates in Wenzhou was 18.71 injuries per 100 person-years (95%CI: 17.12~20.31 injuries per 100 person-years). Falls were the leading cause of injury, followed by traffic injuries, and animal/insect bites. Male students were more likely to be injured than female students. Risk factors associated with unintentional injuries among undergraduates were: students majoring in non-medicine (adjusted OR: 1.53; 95% CI: 1.19-1.96); type A behaviour pattern (adjusted OR: 2.99; 95% CI: 1.45-6.14); liking sports (adjusted OR: 1.86; 95% CI: 1.41-2.45). Injuries have become a public health problem among undergraduates. Falls were the major cause of non-fatal injury. Therefore, individuals, families, schools and governments should promptly adopt preventive measures aimed at preventing and controlling morbidity due to non-fatal injury, especially among students identified to be at high-risk; such as male students with type A behaviour pattern who like sports.
Jeannot, Emilien; Mahler, Per; Elia, Nadia; Cerruti, Bernard; Chastonnay, P.
2015-01-01
Background: Obesity among children and adolescents is a growing public health problem. The purpose of this study is to assess the prevalence, socioeconomic and demographic determinants of overweight and obesity in schoolchildren from Geneva. Methods: A cross-sectional study was undertaken at the Public School of Geneva canton in Switzerland. A total of 8544 public school children were collected and analyzed: 2577 were in second grade, 2641 in fifth grade and 3326 in eighth grade. To identify overweight and obesity we used the definition issued by the International Obesity Task Force. Child characteristics included gender, age, socioeconomic status (SES) of father and mother, and school grade. The multivariate logistic regression model was used to examine potential predictors of overweight/obesity. Results: The prevalence of overweight or obese children was 14.4% in second grade, 17.3% in fifth grade and 18.6% in eighth grade. Multivariate logistic regression analyses reveal that children that have a low economic status or certain citizenships are more likely to be overweight or obese. Children of Kosovar origin, have a higher risk of OBO in second grade (adjusted odds ratio [OR] = 2.19; 95% confidence interval [CI]: 1.20–4.00), fifth grade (adjusted OR = 2.36 95% CI: 1.27–4.39) and in eighth grade (adjusted OR = 2.15 95% CI: 1.27–4.39). Association between SES and overweight was high with regards to the father's SES in fifth grade (adjusted OR = 4.21 95% CI: 2.83–6.25). Conclusions: Overweight and obesity is associated to socioeconomic and sociodemographic factors. The analyzes reveals that children with a low economic status and/or from certain countries are more likely to be overweight or obese than Swiss children. There is an urgent need for action to prevent further increase in overweight or obesity among children. PMID:26015862
Abdul Manaf, M Rizal; Mustafa, Madihah; Abdul Rahman, Mohd Rizam; Yusof, Khairul Hazdi; Abd Aziz, Noor Azah
2016-01-01
Mental health problems are common in old age, but frequently remain undetected and untreated. Mental health problems in the elderly are the result of a complex interaction of social, psychological and biological factors. The aim of this study is to determine the prevalence of mental health problems (depression, anxiety, and emotional stress) and their associated factors among the Malay elderly in a rural community of Perak, Malaysia. It was a cross-sectional study. The Malay elderly aged 60 years and above were selected through convenient sampling to give a total of 230 respondents. The Depression, Anxiety, and Stress Scale (DASS-21) was used to assess the symptoms of depression, anxiety, and stress. Bivariate analyses were performed using chi-square tests and multiple logistic regression analyses were conducted to determine the association between the factors and each of the mental health statuses assessed. The results showed that the prevalence of depression, anxiety, and stress among the elderly respondents was 27.8%, 22.6%, and 8.7%, respectively. The significant factors for depression were single elderly (Adjusted OR = 3.27, 95%CI 1.66, 6.44), living with family (Adjusted OR = 4.98, 95%CI 2.05, 12.10), and poor general health status (Adjusted OR = 2.28, 95%CI 1.20, 4.36). Living with family was the only significant factor for anxiety (Adjusted OR = 2.68, 95%CI 1.09, 6.57). There was no significant factor for stress. Depression and anxiety among the Malay elderly in the rural community were very worrying. More equity in health should be created or strengthened in order to intensify the opportunity to identify, diagnose, and treat those with mental health problems. Living arrangement in the rural community was an important factor that had influenced depression and anxiety. Therefore, further research is recommended for more comprehensive information, as a result of which appropriate intervention can be made.
Carthon, J Margo Brooks; Lasater, Karen B; Sloane, Douglas M; Kutney-Lee, Ann
2015-01-01
Introduction Threats to quality and patient safety may exist when necessary nursing care is omitted. Empirical research is needed to determine how missed nursing care is associated with patient outcomes. Aim The aim of this study was to examine the relationship between missed nursing care and hospital readmissions. Methods Cross-sectional examination, using three linked data sources—(1) nurse survey, (2) patient discharge data from three states (California, New Jersey and Pennsylvania) and (3) administrative hospital data— from 2005 to 2006. We explored the incidence of 30-day readmission for 160 930 patients with heart failure in 419 acute care hospitals in the USA. Logistic regression was used to assess the effect of missed care on the odds of readmission, adjusting for patient and hospital characteristics. Results The most frequently missed nursing care activities across all hospitals in our sample included talking to and comforting patients (42.0%), developing and updating care plans (35.8%) and educating patients and families (31.5%). For 4 of the 10 studied care activities, each 10 percentage-point increase in the number of nurses reporting having missed the activity was associated with an increase in the odds of readmission by 2–8% after adjusting for patient and hospital characteristics. However, missed nursing care was no longer a significant predictor of readmission once adjusting for the nurse work environment, except in the case of the delivery of treatments and procedures (OR 1.08, 95% CI 1.02 to 1.14). Conclusions Missed care is an independent predictor of heart failure readmissions. However, once adjusting for the quality of the nurse work environment, this relationship is attenuated. Improvements in nurses’ working conditions may be one strategy to reduce care omissions and improve patient outcomes. PMID:25672342
Wang, Fenglei; Liu, Huijuan; Wan, Yi; Li, Jing; Chen, Yu; Zheng, Jusheng; Huang, Tao; Li, Duo
2016-11-01
To examine the association between sleep duration and overweight/obesity in preschool-aged children. A total of 48,922 3-year old children enrolled in the Jiaxing Birth Cohort, who provided sleep information and anthropometric data, were included in the present study as baseline and were followed up to 5 years of age. Sleep duration was categorized as ≤ 10 hours, 11-12 hours, and ≥ 13 hours. Overweight and obesity were defined according to the cut point criteria in China. Prevalence ratios and risk ratios were used to assess the association between sleep duration and risk of overweight/obesity. In cross-sectional analyses at baseline, the adjusted prevalence ratios (95% confidence interval) of overweight (with 11-12 h of sleep being considered the reference group) for children sleeping ≤ 10 h and ≥ 13 h were 1.13 (1.06-1.20) and 1.16 (1.09-1.24), respectively, whereas the adjusted prevalence ratios (95% confidence interval) of obesity were 1.25 (1.11-1.40) and 1.25 (1.11-1.42). In longitudinal analyses, the adjusted risk ratios (95% confidence interval) of overweight for children sleeping ≤ 10 h and ≥ 13 h were 1.48 (1.26-1.74) and 1.13 (0.96-1.34), while adjusted risk ratios (95% confidence interval) of obesity were 1.77 (1.30-2.40) and 1.19 (0.85-1.66). Restricted cubic splines regression supported U-shaped curvilinear associations between sleep duration and overweight/obesity in both cross-sectional and longitudinal analyses. Both short and overlong sleep duration are associated with a higher risk of overweight/obesity in preschool-aged children. Optimizing sleep duration may be an important modifiable intervention for overweight and obesity. © 2016 Associated Professional Sleep Societies, LLC.
2011-01-01
Background Injuries affect all age groups but have a particular impact on young people. To evaluate the incidence of non-fatal, unintentional, injuries among undergraduates in Wenzhou, China, assess the burden caused by these injuries, and explore the associated risk factors for unintentional injuries among these undergraduates, we conducted a college-based cross-sectional study. Methods Participants were selected by a multi-stage random sampling method, and 2,287 students were asked whether they had had an injury in the last 12 months; the location, cause, and consequences of the event. The questionnaire included demographic and socioeconomic characteristics, lifestyle habits, and the scale of type A behaviour pattern (TABP). Multivariate logistic regression models were used; crude odds ratios (ORs), adjusted ORs and their 95% confidence intervals (CIs) were estimated, with students having no injuries as the reference group. Results The incidence of injuries among undergraduates in Wenzhou was 18.71 injuries per 100 person-years (95%CI: 17.12~20.31 injuries per 100 person-years). Falls were the leading cause of injury, followed by traffic injuries, and animal/insect bites. Male students were more likely to be injured than female students. Risk factors associated with unintentional injuries among undergraduates were: students majoring in non-medicine (adjusted OR: 1.53; 95% CI: 1.19-1.96); type A behaviour pattern (adjusted OR: 2.99; 95% CI: 1.45-6.14); liking sports (adjusted OR: 1.86; 95% CI: 1.41-2.45). Conclusions Injuries have become a public health problem among undergraduates. Falls were the major cause of non-fatal injury. Therefore, individuals, families, schools and governments should promptly adopt preventive measures aimed at preventing and controlling morbidity due to non-fatal injury, especially among students identified to be at high-risk; such as male students with type A behaviour pattern who like sports. PMID:21729294
2013-01-01
Background Among life-style factors affecting mental health, dietary habits are becoming a public health concern in their relation to psychological distress and social capital. We examined associations between interest in dietary pattern, social capital, and psychological distress with a population-based cross-sectional study in rural Japan. Methods A total of 16,996 residents of a rural town in northern Japan aged 30–79 years participated in this questionnaire survey. The questionnaire gathered data about socio-demographic variables, psychological distress, issues related to dietary habits, including interest in dietary pattern, and the social capital factors of reciprocity and sense of community belonging. Factors related to psychological distress were analyzed by using multiple logistic regression analysis. Results A high interest in dietary pattern was significantly associated with a high level of social capital. In addition, an association between interest in dietary pattern and frequencies of intake of vegetables and fruits was confirmed. The multiple logistic regression analyses showed significant associations between interest in dietary pattern, social capital, frequency of intake of vegetables, and psychological distress after adjusting for socio-demographic variables. Low interest in dietary pattern was positively associated with psychological distress after adjusting for socio-demographic variables (OR = 2.18; 95%CI: 1.69-2.81). Low levels of both reciprocity and sense of community belonging were associated with psychological distress after adjusting for socio-demographic variables (OR = 3.46 with 95%CI of 2.10–5.71 for reciprocity, and OR = 7.42 with 95%CI of 4.64–11.87 for sense of community belonging). Conclusion Low interest in dietary pattern, low frequency of intake of vegetables, and low levels of social capital were significantly associated with psychological distress after adjusting for socio-demographic variables. PMID:24099097
Laurent, M R; Cook, M J; Gielen, E; Ward, K A; Antonio, L; Adams, J E; Decallonne, B; Bartfai, G; Casanueva, F F; Forti, G; Giwercman, A; Huhtaniemi, I T; Kula, K; Lean, M E J; Lee, D M; Pendleton, N; Punab, M; Claessens, F; Wu, F C W; Vanderschueren, D; Pye, S R; O'Neill, T W
2016-11-01
We examined cross-sectional associations of metabolic syndrome and its components with male bone turnover, density and structure. Greater bone mass in men with metabolic syndrome was related to their greater body mass, whereas hyperglycaemia, hypertriglyceridaemia or impaired insulin sensitivity were associated with lower bone turnover and relative bone mass deficits. Metabolic syndrome (MetS) has been associated with lower bone turnover and relative bone mass or strength deficits (i.e. not proportionate to body mass index, BMI), but the relative contributions of MetS components related to insulin sensitivity or obesity to male bone health remain unclear. We determined cross-sectional associations of MetS, its components and insulin sensitivity (by homeostatic model assessment-insulin sensitivity (HOMA-S)) using linear regression models adjusted for age, centre, smoking, alcohol, and BMI. Bone turnover markers and heel broadband ultrasound attenuation (BUA) were measured in 3129 men aged 40-79. Two centres measured total hip, femoral neck, and lumbar spine areal bone mineral density ( a BMD, n = 527) and performed radius peripheral quantitative computed tomography (pQCT, n = 595). MetS was present in 975 men (31.2 %). Men with MetS had lower β C-terminal cross-linked telopeptide (β-CTX), N-terminal propeptide of type I procollagen (PINP) and osteocalcin (P < 0.0001) and higher total hip, femoral neck, and lumbar spine a BMD (P ≤ 0.03). Among MetS components, only hypertriglyceridaemia and hyperglycaemia were independently associated with PINP and β-CTX. Hyperglycaemia was negatively associated with BUA, hypertriglyceridaemia with hip a BMD and radius cross-sectional area (CSA) and stress-strain index. HOMA-S was similarly associated with PINP and β-CTX, BUA, and radius CSA in BMI-adjusted models. Men with MetS have higher a BMD in association with their greater body mass, while their lower bone turnover and relative deficits in heel BUA and radius CSA are mainly related to correlates of insulin sensitivity. Our findings support the hypothesis that underlying metabolic complications may be involved in the bone's failure to adapt to increasing bodily loads in men with MetS.
Redmayne, Mary; Smith, Euan; Abramson, Michael J
2013-10-22
The exposure of young people to radiofrequency electromagnetic fields (RF-EMFs) has increased rapidly in recent years with their increased use of cellphones and use of cordless phones and WiFi. We sought to ascertain associations between New Zealand early-adolescents' subjective well-being and self-reported use of, or exposure to, wireless telephone and internet technology. In this cross-sectional survey, participants completed questionnaires in class about their cellphone and cordless phone use, their self-reported well-being, and possible confounding information such as whether they had had influenza recently or had a television in the bedroom. Parental questionnaires provided data on whether they had WiFi at home and cordless phone ownership and model. Data were analysed with Ordinal Logistic Regression adjusting for common confounders. Odds ratios (OR) and 95% confidence intervals were calculated. The number and duration of cellphone and cordless phone calls were associated with increased risk of headaches (>6 cellphone calls over 10 minutes weekly, adjusted OR 2.4, CI 1.2-4.8; >15 minutes cordless use daily adjusted OR 1.74, CI 1.1-2.9)). Texting and extended use of wireless phones was related to having a painful 'texting' thumb). Using a wired cellphone headset was associated with tinnitus (adjusted OR 1.8, CI 1.0-3.3), while wireless headsets were associated with headache (adjusted OR 2.2, CI 1.1-4.5), feeling down/depressed (adjusted OR 2.0, CI 1.1-3.8), and waking in the night (adjusted OR 2.4, CI 1.2-4.8). Several cordless phone frequencies bands were related to tinnitus, feeling down/depressed and sleepiness at school, while the last of these was also related to modulation. Waking nightly was less likely for those with WiFi at home (adjusted OR 0.7, CI 0.4-0.99). Being woken at night by a cellphone was strongly related to tiredness at school (OR 3.49, CI 1.97-6.2). There were more statistically significant associations (36%) than could be expected by chance (5%). Several were dose-dependent relationships. To safeguard young people's well-being, we suggest limiting their use of cellphones and cordless phones to less than 15 minutes daily, and employing a speaker-phone device for longer daily use. We recommend parental measures are taken to prevent young people being woken by their cellphones.
2013-01-01
Background The exposure of young people to radiofrequency electromagnetic fields (RF-EMFs) has increased rapidly in recent years with their increased use of cellphones and use of cordless phones and WiFi. We sought to ascertain associations between New Zealand early-adolescents’ subjective well-being and self-reported use of, or exposure to, wireless telephone and internet technology. Methods In this cross-sectional survey, participants completed questionnaires in class about their cellphone and cordless phone use, their self-reported well-being, and possible confounding information such as whether they had had influenza recently or had a television in the bedroom. Parental questionnaires provided data on whether they had WiFi at home and cordless phone ownership and model. Data were analysed with Ordinal Logistic Regression adjusting for common confounders. Odds ratios (OR) and 95% confidence intervals were calculated. Results The number and duration of cellphone and cordless phone calls were associated with increased risk of headaches (>6 cellphone calls over 10 minutes weekly, adjusted OR 2.4, CI 1.2-4.8; >15 minutes cordless use daily adjusted OR 1.74, CI 1.1-2.9)). Texting and extended use of wireless phones was related to having a painful ‘texting’ thumb). Using a wired cellphone headset was associated with tinnitus (adjusted OR 1.8, CI 1.0-3.3), while wireless headsets were associated with headache (adjusted OR 2.2, CI 1.1-4.5), feeling down/depressed (adjusted OR 2.0, CI 1.1-3.8), and waking in the night (adjusted OR 2.4, CI 1.2-4.8). Several cordless phone frequencies bands were related to tinnitus, feeling down/depressed and sleepiness at school, while the last of these was also related to modulation. Waking nightly was less likely for those with WiFi at home (adjusted OR 0.7, CI 0.4-0.99). Being woken at night by a cellphone was strongly related to tiredness at school (OR 3.49, CI 1.97-6.2). Conclusions There were more statistically significant associations (36%) than could be expected by chance (5%). Several were dose-dependent relationships. To safeguard young people’s well-being, we suggest limiting their use of cellphones and cordless phones to less than 15 minutes daily, and employing a speaker-phone device for longer daily use. We recommend parental measures are taken to prevent young people being woken by their cellphones. PMID:24148357
Bustillos, Arnaldo Sanchez; Trigoso, Oswaldo Ortiz
2013-11-01
To examine access to health programs at workplace as a determinant of presenteeism among adults. Data source was a subsample of the 2009-2010 Canadian Community Health Survey. The outcome was self-reported reduced activities at work (presenteeism). The explanatory variable was self-reported access to a health program at workplace. Logistic regression was used to measure the association between outcome and explanatory variables adjusting for potential confounders. Adjusting for sex, age, education, income, work stress, and chronic conditions, presenteeism was not associated with having access to a health program at workplace (adjusted odds ratio, 1.23; 95% confidence interval, 0.91 to 1.65). The odds of presenteeism were higher in workers who reported high work stress and those with chronic medical conditions. This study found that access to health programs at workplace is not significantly associated with a decline in presenteeism.
Wang, Chao; Zhang, Qinglei; Shen, Shuiyun; Yan, Xiaohui; Zhu, Fengjuan; Cheng, Xiaojing; Zhang, Junliang
2017-01-01
The flow field configuration plays an important role on the performance of proton exchange membrane fuel cells (PEMFCs). For instance, channel/rib width and total channel cross-sectional area determine the under-rib convection and pressure drop respectively, both of which directly influence the water removal, in turn affecting the oxygen supply and cathodic oxygen reduction reaction. In this study, effects of under-rib convection and pressure drop on cell performance are investigated experimentally and numerically by adjusting the channel/rib width and channel cross-sectional area of flow fields. The results show that the performance differences with various flow field configurations mainly derive from the oxygen transport resistance which is determined by the water accumulation degree, and the cell performance would benefit from the narrower channels and smaller cross sections. It reveals that at low current densities when water starts to accumulate in GDL at under-rib regions, the under-rib convection plays a more important role in water removal than pressure drop does; in contrast, at high current densities when water starts to accumulate in channels, the pressure drop dominates the water removal to facilitate the oxygen transport to the catalyst layer. PMID:28251983
Jay, Kenneth; Friborg, Maria Kristine; Sjøgaard, Gisela; Jakobsen, Markus Due; Sundstrup, Emil; Brandt, Mikkel; Andersen, Lars Louis
2015-12-11
Musculoskeletal pain and stress-related disorders are leading causes of impaired work ability, sickness absences and disability pensions. However, knowledge about the combined detrimental effect of pain and stress on work ability is lacking. This study investigates the association between pain in the neck-shoulders, perceived stress, and work ability. In a cross-sectional survey at a large pharmaceutical company in Denmark 473 female laboratory technicians replied to questions about stress (Perceived Stress Scale), musculoskeletal pain intensity (scale 0-10) of the neck and shoulders, and work ability (Work Ability Index). General linear models tested the association between variables. In the multi-adjusted model, stress (p < 0.001) and pain (p < 0.001) had independent main effects on the work ability index score, and there was no significant stress by pain interaction (p = 0.32). Work ability decreased gradually with both increased stress and pain. Workers with low stress and low pain had the highest Work Ability Index score (44.6 (95% CI 43.9-45.3)) and workers with high stress and high pain had the lowest score (32.7 (95% CI 30.6-34.9)). This cross-sectional study indicates that increased stress and musculoskeletal pain are independently associated with lower work ability in female laboratory technicians.
Phillips, Jeffrey D.
2018-01-10
PDEPTH is an interactive, graphical computer program used to construct interpreted geological source models for observed potential-field geophysical profile data. The current version of PDEPTH has been adapted to the Windows platform from an earlier DOS-based version. The input total-field magnetic anomaly and vertical gravity anomaly profiles can be filtered to produce derivative products such as reduced-to-pole magnetic profiles, pseudogravity profiles, pseudomagnetic profiles, and upward-or-downward-continued profiles. A variety of source-location methods can be applied to the original and filtered profiles to estimate (and display on a cross section) the locations and physical properties of contacts, sheet edges, horizontal line sources, point sources, and interface surfaces. Two-and-a-half-dimensional source bodies having polygonal cross sections can be constructed using a mouse and keyboard. These bodies can then be adjusted until the calculated gravity and magnetic fields of the source bodies are close to the observed profiles. Auxiliary information such as the topographic surface, bathymetric surface, seismic basement, and geologic contact locations can be displayed on the cross section using optional input files. Test data files, used to demonstrate the source location methods in the report, and several utility programs are included.
Crangle, Cassandra J; Hart, Tae L
2017-11-01
Couples facing multiple sclerosis (MS) report significantly elevated rates of relationship distress, yet the effects of attachment have never been examined in this population. We examined whether hostile conflict mediated the dyadic effects of attachment on relationship adjustment in couples facing MS and whether these associations were moderated by gender or role. We also explored whether dyadic adjustment mediated the relationship between attachment and hostile conflict. The study was cross-sectional and included 103 couples in which one partner had been diagnosed with MS. Participants completed the Experiences in Close Relationships-Revised, Dyadic Adjustment Scale, and Aversive Interactions Scale, as well as demographic variables. We used the actor-partner interdependence model for data analysis. There were significant actor and partner effects of greater anxious attachment and worse dyadic adjustment. Actor and partner effects of anxious attachment were significantly mediated by greater hostile conflict. Gender significantly moderated the effects between avoidant attachment and dyadic adjustment. The actor effect was significant for males and females; the partner effect was only significant for females. The actor effect for females but not males was significantly mediated by greater hostile conflict. Role was not a significant moderator. Exploratory analyses also showed that dyadic adjustment mediated the relationship between anxious and avoidant attachment and hostile conflict. Findings highlight the important effects of attachment on relationship adjustment in MS couples. Both hostile conflict and dyadic adjustment appear to be mechanisms through which insecure attachment has a detrimental effect. Statement of contribution What is already known on this subject? Despite higher-than-normal rates of marital distress and separation/divorce, the effects of attachment on relationship adjustment among couples facing multiple sclerosis have never been examined. Prior studies within healthy populations have supported within-person and cross-dyadic associations between attachment and relationship adjustment; however, they have failed to use dyadic analyses. Hostile conflict has been associated with both insecure attachment and relationship adjustment and therefore may be an important mediator to help understand these relationships. What does this study add? Women were more negatively affected by their partner's avoidant attachment then men. Hostile conflict mediated the effects of anxious attachment on dyadic adjustment for individuals and across dyads. Hostile conflict accounted for the individual effect of avoidant attachment on dyadic adjustment for women. © 2017 The British Psychological Society.
Gaertner, Beate; Buttery, Amanda K; Finger, Jonas D; Wolfsgruber, Steffen; Wagner, Michael; Busch, Markus A
2018-05-01
To examine cross-sectional and longitudinal associations between physical exercise and cognitive function across different age groups in a nationwide population-based sample of adults aged 18-79 years in Germany. Cross-sectional/prospective. Cognitive function was assessed in the mental health module of the German Health Interview and Examination Survey for Adults (DEGS1-MH, 2009-2012, n=3535), using a comprehensive neuropsychological test battery. Cognitive domain scores for executive function and memory were derived from confirmatory factor analysis. Regular physical exercise in the last three months was assessed by self-report and defined as no exercise, <2 and ≥2h (hours) of exercise per week. A subgroup of DEGS1-MH participants who previously participated in the German National Health Interview and Examination Survey 1998 (GNHIES98, 1997-1999, n=1624) enabled longitudinal analyses with a mean follow-up of 12.4 years. Compared to no exercise, more weekly physical exercise was associated with better executive function in cross-sectional (<2h: β=0.12; ≥2h: β=0.17; all p<0.001) and longitudinal analyses (<2h: β=0.14, p<0.001; ≥2h: β=0.15, p=0.001) using linear regression models adjusted for age, sex, education, smoking, alcohol consumption, fruit and vegetable consumption and obesity. Slightly weaker associations were found for memory in cross-sectional (<2h: β=0.08, p=0.009; ≥2h: β=0.08, p=0.026) and longitudinal analysis (<2h: β=0.09, p=0.036; ≥2h: β=0.08, p=0.114). There was no evidence of interaction between physical exercise and age. Higher levels of physical exercise were associated with better executive function and memory in cross-sectional and longitudinal analyses with no evidence for differential effects by age. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Goswami, Neela D; Tsalik, Ephraim L; Naggie, Susanna; Miller, William C; Horton, John R; Pfeiffer, Christopher D; Hicks, Charles B
2014-01-22
The proportion of clinical research sponsored by industry will likely continue to expand as federal funds for academic research decreases, particularly in the fields of HIV/AIDS and hepatitis C (HCV). While HIV and HCV continue to burden the US population, insufficient data exists as to how industry sponsorship affects clinical trials involving these infectious diseases. Debate exists about whether pharmaceutical companies undertake more market-driven research practices to promote therapeutics, or instead conduct more rigorous trials than their non-industry counterparts because of increased resources and scrutiny. The ClinicalTrials.gov registry, which allows investigators to fulfill a federal mandate for public trial registration, provides an opportunity for critical evaluation of study designs for industry-sponsored trials, independent of publication status. As part of a large public policy effort, the Clinical Trials Transformation Initiative (CTTI) recently transformed the ClinicalTrials.gov registry into a searchable dataset to facilitate research on clinical trials themselves. We conducted a cross-sectional analysis of 477 HIV and HCV drug treatment trials, registered with ClinicalTrials.gov from 1 October 2007 to 27 September 2010, to study the relationship of study sponsorship with randomized study design. The likelihood of using randomization given industry (versus non-industry) sponsorship was reported with prevalence ratios (PR). PRs were estimated using crude and stratified tabular analysis and Poisson regression adjusting for presence of a data monitoring committee, enrollment size, study phase, number of study sites, inclusion of foreign study sites, exclusion of persons older than age 65, and disease condition. The crude PR was 1.17 (95% CI 0.94, 1.45). Adjusted Poisson models produced a PR of 1.13 (95% CI 0.82, 1.56). There was a trend toward mild effect measure modification by study phase, but this was not statistically significant. In stratified tabular analysis the adjusted PR was 1.14 (95% CI 0.78, 1.68) among phase 2/3 trials and 1.06 (95% CI 0.50, 2.22) among phase 4 trials. No significant relationship was found between industry sponsorship and use of randomization in trial design in this cross-sectional study. Prospective studies evaluating other aspects of trial design may shed further light on the relationship between industry sponsorship and appropriate trial methodology.
Millett, Christopher; Agrawal, Sutapa; Sullivan, Ruth; Vaz, Mario; Kurpad, Anura; Bharathi, A. V.; Prabhakaran, Dorairaj; Reddy, Kolli Srinath; Kinra, Sanjay; Smith, George Davey; Ebrahim, Shah
2013-01-01
Background Increasing active travel (walking, bicycling, and public transport) is promoted as a key strategy to increase physical activity and reduce the growing burden of noncommunicable diseases (NCDs) globally. Little is known about patterns of active travel or associated cardiovascular health benefits in low- and middle-income countries. This study examines mode and duration of travel to work in rural and urban India and associations between active travel and overweight, hypertension, and diabetes. Methods and Findings Cross-sectional study of 3,902 participants (1,366 rural, 2,536 urban) in the Indian Migration Study. Associations between mode and duration of active travel and cardiovascular risk factors were assessed using random-effect logistic regression models adjusting for age, sex, caste, standard of living, occupation, factory location, leisure time physical activity, daily fat intake, smoking status, and alcohol use. Rural dwellers were significantly more likely to bicycle (68.3% versus 15.9%; p<0.001) to work than urban dwellers. The prevalence of overweight or obesity was 50.0%, 37.6%, 24.2%, 24.9%; hypertension was 17.7%, 11.8%, 6.5%, 9.8%; and diabetes was 10.8%, 7.4%, 3.8%, 7.3% in participants who travelled to work by private transport, public transport, bicycling, and walking, respectively. In the adjusted analysis, those walking (adjusted risk ratio [ARR] 0.72; 95% CI 0.58–0.88) or bicycling to work (ARR 0.66; 95% CI 0.55–0.77) were significantly less likely to be overweight or obese than those travelling by private transport. Those bicycling to work were significantly less likely to have hypertension (ARR 0.51; 95% CI 0.36–0.71) or diabetes (ARR 0.65; 95% CI 0.44–0.95). There was evidence of a dose-response relationship between duration of bicycling to work and being overweight, having hypertension or diabetes. The main limitation of the study is the cross-sectional design, which limits causal inference for the associations found. Conclusions Walking and bicycling to work was associated with reduced cardiovascular risk in the Indian population. Efforts to increase active travel in urban areas and halt declines in rural areas should be integral to strategies to maintain healthy weight and prevent NCDs in India. Please see later in the article for the Editors' Summary PMID:23776412
2014-01-01
Background The proportion of clinical research sponsored by industry will likely continue to expand as federal funds for academic research decreases, particularly in the fields of HIV/AIDS and hepatitis C (HCV). While HIV and HCV continue to burden the US population, insufficient data exists as to how industry sponsorship affects clinical trials involving these infectious diseases. Debate exists about whether pharmaceutical companies undertake more market-driven research practices to promote therapeutics, or instead conduct more rigorous trials than their non-industry counterparts because of increased resources and scrutiny. The ClinicalTrials.gov registry, which allows investigators to fulfill a federal mandate for public trial registration, provides an opportunity for critical evaluation of study designs for industry-sponsored trials, independent of publication status. As part of a large public policy effort, the Clinical Trials Transformation Initiative (CTTI) recently transformed the ClinicalTrials.gov registry into a searchable dataset to facilitate research on clinical trials themselves. Methods We conducted a cross-sectional analysis of 477 HIV and HCV drug treatment trials, registered with ClinicalTrials.gov from 1 October 2007 to 27 September 2010, to study the relationship of study sponsorship with randomized study design. The likelihood of using randomization given industry (versus non-industry) sponsorship was reported with prevalence ratios (PR). PRs were estimated using crude and stratified tabular analysis and Poisson regression adjusting for presence of a data monitoring committee, enrollment size, study phase, number of study sites, inclusion of foreign study sites, exclusion of persons older than age 65, and disease condition. Results The crude PR was 1.17 (95% CI 0.94, 1.45). Adjusted Poisson models produced a PR of 1.13 (95% CI 0.82, 1.56). There was a trend toward mild effect measure modification by study phase, but this was not statistically significant. In stratified tabular analysis the adjusted PR was 1.14 (95% CI 0.78, 1.68) among phase 2/3 trials and 1.06 (95% CI 0.50, 2.22) among phase 4 trials. Conclusions No significant relationship was found between industry sponsorship and use of randomization in trial design in this cross-sectional study. Prospective studies evaluating other aspects of trial design may shed further light on the relationship between industry sponsorship and appropriate trial methodology. PMID:24450313
Millett, Christopher; Agrawal, Sutapa; Sullivan, Ruth; Vaz, Mario; Kurpad, Anura; Bharathi, A V; Prabhakaran, Dorairaj; Reddy, Kolli Srinath; Kinra, Sanjay; Smith, George Davey; Ebrahim, Shah
2013-01-01
Increasing active travel (walking, bicycling, and public transport) is promoted as a key strategy to increase physical activity and reduce the growing burden of noncommunicable diseases (NCDs) globally. Little is known about patterns of active travel or associated cardiovascular health benefits in low- and middle-income countries. This study examines mode and duration of travel to work in rural and urban India and associations between active travel and overweight, hypertension, and diabetes. Cross-sectional study of 3,902 participants (1,366 rural, 2,536 urban) in the Indian Migration Study. Associations between mode and duration of active travel and cardiovascular risk factors were assessed using random-effect logistic regression models adjusting for age, sex, caste, standard of living, occupation, factory location, leisure time physical activity, daily fat intake, smoking status, and alcohol use. Rural dwellers were significantly more likely to bicycle (68.3% versus 15.9%; p<0.001) to work than urban dwellers. The prevalence of overweight or obesity was 50.0%, 37.6%, 24.2%, 24.9%; hypertension was 17.7%, 11.8%, 6.5%, 9.8%; and diabetes was 10.8%, 7.4%, 3.8%, 7.3% in participants who travelled to work by private transport, public transport, bicycling, and walking, respectively. In the adjusted analysis, those walking (adjusted risk ratio [ARR] 0.72; 95% CI 0.58-0.88) or bicycling to work (ARR 0.66; 95% CI 0.55-0.77) were significantly less likely to be overweight or obese than those travelling by private transport. Those bicycling to work were significantly less likely to have hypertension (ARR 0.51; 95% CI 0.36-0.71) or diabetes (ARR 0.65; 95% CI 0.44-0.95). There was evidence of a dose-response relationship between duration of bicycling to work and being overweight, having hypertension or diabetes. The main limitation of the study is the cross-sectional design, which limits causal inference for the associations found. Walking and bicycling to work was associated with reduced cardiovascular risk in the Indian population. Efforts to increase active travel in urban areas and halt declines in rural areas should be integral to strategies to maintain healthy weight and prevent NCDs in India. Please see later in the article for the Editors' Summary.
A 40 Year Time Series of SBUV Observations: the Version 8.6 Processing
NASA Technical Reports Server (NTRS)
McPeters, Richard; Bhartia, P. K.; Flynn, L.
2012-01-01
Under a NASA program to produce long term data records from instruments on multiple satellites (MEaSUREs), data from a series of eight SBUV and SBUV 12 instruments have been reprocessed to create a 40 year long ozone time series. Data from the Nimbus 4 BUV, Nimbus 7 SBUV, and SBUV/2 instruments on NOAA 9, 11, 14, 16, 17, and 18 were used covering the period 1970 to 1972 and 1979 to the present. In past analyses an ozone time series was created from these instruments by adjusting ozone itself, instrument by instrument, for consistency during overlap periods. In the version 8.6 processing adjustments were made to the radiance calibration of each instrument to maintain a consistent calibration over the entire time series. Data for all eight instruments were then reprocessed using the adjusted radiances. Reprocessing is necessary to produce an accurate latitude dependence. Other improvements incorporated in version 8.6 included the use of the ozone cross sections of Brion, Daumont, and Malicet, and the use of a cloud height climatology derived from Aura OMI measurements. The new cross sections have a more accurate temperature dependence than the cross sections previously used. The OMI-based cloud heights account for the penetration of UV into the upper layers of clouds. The consistency of the version 8.6 time series was evaluated by intra-instrument comparisons during overlap periods, comparisons with ground-based instruments, and comparisons with measurements made by instruments on other satellites such as SAGE II and UARS MLS. These comparisons show that for the instruments on NOAA 16, 17 and 18, the instrument calibrations were remarkably stable and consistent from instrument to instrument. The data record from the Nimbus 7 SBUV was also very stable, and SAGE and ground-based comparisons show that the' calibration was consistent with measurements made years laterby the NOAA 16 instrument. The calibrations of the SBUV/2 instruments on NOAA 9, 11, and 14 were more of a problem. The rapidly drifting orbits of these satellites resulted in relative time and altitude dependent differences that are significant. Despite these problems, total column ozone appears to be consistent to better than 1% over the entire time series, while the ozone vertical distribution is consistent to approximately 5%.
Suri, Pradeep; Stolzmann, Kelly; Iverson, Katherine M; Williams, Rhonda; Meterko, Mark; Yan, Kun; Gormley, Katelyn; Pogoda, Terri K
2017-11-01
To determine whether traumatic brain injury (TBI) history is associated with worse headache severity outcomes. Prospective cohort study. Department of Veterans Affairs (VA) outpatient clinics. Veterans (N=2566) who completed a mail follow-up survey an average of 3 years after a comprehensive TBI evaluation (CTBIE). Not applicable. The presence or absence of TBI, and TBI severity were evaluated by a trained clinician and classified according to VA/Department of Defense clinical practice guidelines. Headache severity was evaluated at both the baseline CTBIE assessment and 3-year follow-up using a 5-level headache score ranging from 0 ("none") to 4 ("very severe") based on headache-associated activity interference in the past 30 days. We examined associations of mild and moderate/severe TBI history, as compared to no TBI history, with headache severity in cross-sectional and longitudinal analyses, with and without adjustment for potential confounders. Mean headache severity scores were 2.4 at baseline and 2.3 at 3-year follow-up. Mild TBI was associated with greater headache severity in multivariate-adjusted cross-sectional analyses (β [SE]=.61 [.07], P<.001), as compared with no TBI, but not in longitudinal analyses (β [SE]=.09 [.07], P=.20). Moderate/severe TBI was significantly associated with greater headache severity in both cross-sectional (β [SE]=.66 [.09], P<.001) and longitudinal analyses (β [SE]=.18 [.09], P=.04). Headache outcomes are poor in veterans who receive VA TBI evaluations, irrespective of past TBI exposure, but significantly worse in those with a history of moderate/severe TBI. No association was found between mild TBI and future headache severity in veterans. Veterans with headache presenting for TBI evaluations, and particularly those with moderate/severe TBI, may benefit from further evaluation and treatment of headache. Published by Elsevier Inc.
Viola-Saltzman, Mari; Watson, Nathaniel F.; Bogart, Andy; Goldberg, Jack; Buchwald, Dedra
2010-01-01
Study Objectives: To investigate the prevalence of restless legs syndrome (RLS) in fibromyalgia (FM) and determine the presence and amount of sleep disruption in FM patients with RLS. RLS and FM have been associated in uncontrolled studies using a variety of RLS definitions. We explored this relationship using a cross-sectional study design. Methods: FM cases that met the American College of Rheumatology diagnostic criteria were recruited through an academic referral clinic and advertising. Pain- and fatigue-free controls were recruited from the Seattle metropolitan area. We enrolled 172 FM patients (mean age 50 years, 93% female) and 63 pain- and fatigue-free controls (mean age 41 years, 56% female). RLS was ascertained by a self-administered validated diagnostic interview. Results: The age- and gender-adjusted prevalence of RLS was higher in the FM group than the control group (33.0%; 95% CI: 25.9, 40.1 vs. 3.1%; 95% CI: 0.0, 7.4; p = 0.001). Likewise, the FM group was more likely to report RLS (OR = 11.7; 95% CI: 2.6, 53.0), even after adjusting for age and gender. The mean Pittsburgh Sleep Quality Index score was higher among FM patients with RLS than those without (11.8 vs. 9.9; p = 0.01) but subjective limb pain measures did not differ between these 2 groups. Conclusions: There is a higher prevalence and odds of RLS in those with FM compared to controls. Clinicians should routinely query FM patients regarding RLS symptoms because treatment of RLS can potentially improve sleep and quality of life in these patients. Citation: Viola-Saltzman M; Watson NF; Bogart A; Goldberg J; Buchwald D. High prevalence of restless legs syndrome among patients with fibromyalgia: a controlled cross-sectional study. J Clin Sleep Med 2010;6(5):423-427. PMID:20957840
The Association of Ambient Air Pollution and Physical Inactivity in the United States
Roberts, Jennifer D.; Voss, Jameson D.; Knight, Brandon
2014-01-01
Background Physical inactivity, ambient air pollution and obesity are modifiable risk factors for non-communicable diseases, with the first accounting for 10% of premature deaths worldwide. Although community level interventions may target each simultaneously, research on the relationship between these risk factors is lacking. Objectives After comparing spatial interpolation methods to determine the best predictor for particulate matter (PM2.5; PM10) and ozone (O3) exposures throughout the U.S., we evaluated the cross-sectional association of ambient air pollution with leisure-time physical inactivity among adults. Methods In this cross-sectional study, we assessed leisure-time physical inactivity using individual self-reported survey data from the Centers for Disease Control and Prevention's 2011 Behavioral Risk Factor Surveillance System. These data were combined with county-level U.S. Environmental Protection Agency air pollution exposure estimates using two interpolation methods (Inverse Distance Weighting and Empirical Bayesian Kriging). Finally, we evaluated whether those exposed to higher levels of air pollution were less active by performing logistic regression, adjusting for demographic and behavioral risk factors, and after stratifying by body weight category. Results With Empirical Bayesian Kriging air pollution values, we estimated a statistically significant 16–35% relative increase in the odds of leisure-time physical inactivity per exposure class increase of PM2.5 in the fully adjusted model across the normal weight respondents (p-value<0.0001). Evidence suggested a relationship between the increasing dose of PM2.5 exposure and the increasing odds of physical inactivity. Conclusions In a nationally representative, cross-sectional sample, increased community level air pollution is associated with reduced leisure-time physical activity particularly among the normal weight. Although our design precludes a causal inference, these results provide additional evidence that air pollution should be investigated as an environmental determinant of inactivity. PMID:24598907
Best, Catherine; Haseen, Farhana; van der Sluijs, Winfried; Ozakinci, Gozde; Currie, Dorothy; Eadie, Douglas; Stead, Martine; MacKintosh, Anne Marie; Pearce, Jamie; Tisch, Catherine; MacGregor, Andy; Amos, Amanda; Frank, John; Haw, Sally
2016-04-14
There has been a rapid increase in the retail availability of e-cigarettes in the UK and elsewhere. It is known that exposure to cigarette point-of-sale (POS) displays influences smoking behaviour and intentions in young people. However, there is as yet no evidence regarding the relationship between e-cigarette POS display exposure and e-cigarette use in young people. This cross sectional survey was conducted in four high schools in Scotland. A response rate of 87 % and a total sample of 3808 was achieved. Analysis was by logistic regression on e-cigarette outcomes with standard errors adjusted for clustering within schools. The logistic regression models were adjusted for recall of other e-cigarette adverts, smoking status, and demographic variables. Multiple chained imputation was employed to assess the consistency of the findings across different methods of handling missing data. Adolescents who recalled seeing e-cigarettes in small shops were more likely to have tried an e-cigarette (OR 1.92 99 % CI 1.61 to 2.29). Adolescents who recalled seeing e-cigarettes for sale in small shops (OR 1.80 99 % CI 1.08 to 2.99) or supermarkets (OR 1.70 99 % CI 1.22 to 2.36) were more likely to intend to try them in the next 6 months. This study has found a cross-sectional association between self-reported recall of e-cigarette POS displays and use of, and intention to use, e-cigarettes. The magnitude of this association is comparable to that between tobacco point of sale recall and intention to use traditional cigarettes in the same sample. Further longitudinal data is required to confirm a causal relationship between e-cigarette point of sale exposure and their use and future use by young people.
Tillin, Therese; Hughes, Alun D; Wang, Qin; Würtz, Peter; Ala-Korpela, Mika; Sattar, Naveed; Forouhi, Nita G; Godsland, Ian F; Eastwood, Sophie V; McKeigue, Paul M; Chaturvedi, Nish
2015-05-01
South Asian individuals have an increased risk of diabetes compared with Europeans that is unexplained by obesity and traditional or established metabolic measures. Circulating amino acids (AAs) may provide additional explanatory insights. In a unique cohort of European and South Asian men, we compared cross-sectional associations between AAs, metabolic and obesity traits, and longitudinal associations with incident diabetes. Nuclear magnetic spectroscopy was used to measure the baseline (1988-1991) levels of nine AAs in serum samples from a British population-based cohort of 1,279 European and 1,007 South Asian non-diabetic men aged 40-69 years. Follow-up was complete for 19 years in 801 European and 643 South Asian participants. The serum concentrations of isoleucine, phenylalanine, tyrosine and alanine were significantly higher in South Asian men, while cross-sectional correlations of AAs with glycaemia and insulin resistance were similar in the two ethnic groups. However, most AAs were less strongly correlated with measures of obesity in the South Asian participants. Diabetes developed in 227 (35%) South Asian and 113 (14%) European men. Stronger adverse associations were observed between branched chain and aromatic AAs and incident diabetes in South Asian men. Tyrosine was a particularly strong predictor of incident diabetes in South Asian individuals, even after adjustment for metabolic risk factors, including obesity and insulin resistance (adjusted OR for a 1 SD increment, 1.47, 95% CI 1.17,1.85, p = 0.001) compared with Europeans (OR 1.10, 0.87, 1.39, p = 0.4; p = 0.045 for ethnicity × tyrosine interaction). Branched chain and aromatic AAs, particularly tyrosine, may be a focus for identifying novel aetiological mechanisms and potential treatment targets for diabetes in South Asian populations and may contribute to their excess risk of diabetes.
Shorter Lumbar Paraspinal Fascia Is Associated With High Intensity Low Back Pain and Disability.
Ranger, Tom A; Teichtahl, Andrew J; Cicuttini, Flavia M; Wang, Yuanyuan; Wluka, Anita E; OʼSullivan, Richard; Jones, Graeme; Urquhart, Donna M
2016-04-01
A cross-sectional, community-based study. The aim of this study was to investigate the relationship between structural features of the thoracolumbar fascia and low back pain and disability. The thoracolumbar fascia plays a role in stabilization of the spine by transmitting tension from the spinal and abdominal musculature to the vertebrae. It has been hypothesized that the fascia is associated with low back pain through the development of increased pressure in the paraspinal compartment, which leads to muscle ischemia. Seventy-two participants from a community-based study of musculoskeletal health underwent Magnetic Resonance Imaging from the T12 vertebral body to the sacrum. The length of the paraspinal fascia and cross-sectional area of the paraspinal compartment were quantitatively measured from axial images at the level of the transverse processes and the Chronic Pain Grade Scale was used to assess low back pain intensity and disability. A shorter length of fascia around the parapsinal compartment was significantly associated with high intensity low back pain and/or disability, after adjusting for age, gender, and body mass index [right odds ratio (OR) 1.9, 95% CI 0.99-3.8, P = 0.05; left OR 2.6, 95% CI 1.2 to 5.6, P = 0.01). Further adjustment for the cross-sectional area of the compartment strengthened the associations between fascial length and low back pain/or disability (right OR 8.9, 95% CI 1.9-40.9, P = 0.005; left OR 9.6, 95% CI 1.2-42.9, P = 0.003). This study has demonstrated that a shorter lumbar paraspinal fascia is associated with high intensity low back pain and/or disability among community-based adults. Although cohort studies are needed, these results suggest that structural features of the fascia may play a role in high levels of low back pain and disability. 3.
Modeling the evolution of channel shape: Balancing computational efficiency with hydraulic fidelity
Wobus, C.W.; Kean, J.W.; Tucker, G.E.; Anderson, R. Scott
2008-01-01
The cross-sectional shape of a natural river channel controls the capacity of the system to carry water off a landscape, to convey sediment derived from hillslopes, and to erode its bed and banks. Numerical models that describe the response of a landscape to changes in climate or tectonics therefore require formulations that can accommodate evolution of channel cross-sectional geometry. However, fully two-dimensional (2-D) flow models are too computationally expensive to implement in large-scale landscape evolution models, while available simple empirical relationships between width and discharge do not adequately capture the dynamics of channel adjustment. We have developed a simplified 2-D numerical model of channel evolution in a cohesive, detachment-limited substrate subject to steady, unidirectional flow. Erosion is assumed to be proportional to boundary shear stress, which is calculated using an approximation of the flow field in which log-velocity profiles are assumed to apply along vectors that are perpendicular to the local channel bed. Model predictions of the velocity structure, peak boundary shear stress, and equilibrium channel shape compare well with predictions of a more sophisticated but more computationally demanding ray-isovel model. For example, the mean velocities computed by the two models are consistent to within ???3%, and the predicted peak shear stress is consistent to within ???7%. Furthermore, the shear stress distributions predicted by our model compare favorably with available laboratory measurements for prescribed channel shapes. A modification to our simplified code in which the flow includes a high-velocity core allows the model to be extended to estimate shear stress distributions in channels with large width-to-depth ratios. Our model is efficient enough to incorporate into large-scale landscape evolution codes and can be used to examine how channels adjust both cross-sectional shape and slope in response to tectonic and climatic forcing. Copyright 2008 by the American Geophysical Union.
Milk Intakes Are Not Associated with Percent Body Fat in Children from Ages 10 to 13 Years12
Noel, Sabrina E.; Ness, Andrew R.; Northstone, Kate; Emmett, Pauline; Newby, P. K.
2011-01-01
Epidemiologic studies report conflicting results for the relationship between milk intake and adiposity in children. We examined prospective and cross-sectional associations between milk intake and percent body fat among 2245 children from the Avon Longitudinal Study of Parents and Children. Cross-sectional analyses were performed at age 13 y between total, full-fat, and reduced-fat milk intake assessed using 3-d dietary records and body fat from DXA. Prospective analyses were conducted between milk intakes at age 10 y and body fat at 11 and 13 y. Models were adjusted for age, sex, height, physical activity, pubertal status, maternal BMI, maternal education, and intakes of total fat, sugar-sweetened beverages, 100% fruit juice, and ready-to-eat cereals; baseline BMI was added to prospective models. Subset analyses were performed for those with plausible dietary intakes. Mean milk consumption at 10 and 13 y was (mean ± SD) 0.90 ± 0.73 and 0.85 ± 0.78 servings/d [1 serving = 8 oz of milk (244 g of plain and 250 g flavored milk)], respectively. Cross-sectional results indicated an inverse association between full-fat milk intake and body fat [β = −0.47 (95% CI = −0.76, −0.19); P = 0.001]. Milk intake at age 10 y was inversely associated with body fat at 11 y [β = −0.16 g/d (95%CI = −0.28, −0.04); P = 0.01], but not among those with plausible dietary intakes, suggesting that this association was influenced by dietary measurement errors. Milk intake was not associated with body fat at age 13 y after adjustment. Although our prospective results corroborate other findings of a null associations between milk intake and adiposity, our inconsistent findings across analyses suggest further investigation is needed to clarify the relation, and accounting for dietary reporting errors is an important consideration. PMID:21940511
Wennberg, David E; Sharp, Sandra M; Bevan, Gwyn; Skinner, Jonathan S; Gottlieb, Daniel J; Wennberg, John E
2014-04-10
To compare the performance of two new approaches to risk adjustment that are free of the influence of observational intensity with methods that depend on diagnoses listed in administrative databases. Administrative data from the US Medicare program for services provided in 2007 among 306 US hospital referral regions. Cross sectional analysis. 20% sample of fee for service Medicare beneficiaries residing in one of 306 hospital referral regions in the United States in 2007 (n = 5,153,877). The effect of health risk adjustment on age, sex, and race adjusted mortality and spending rates among hospital referral regions using four indices: the standard Centers for Medicare and Medicaid Services--Hierarchical Condition Categories (HCC) index used by the US Medicare program (calculated from diagnoses listed in Medicare's administrative database); a visit corrected HCC index (to reduce the effects of observational intensity on frequency of diagnoses); a poverty index (based on US census); and a population health index (calculated using data on incidence of hip fractures and strokes, and responses from a population based annual survey of health from the Centers for Disease Control and Prevention). Estimated variation in age, sex, and race adjusted mortality rates across hospital referral regions was reduced using the indices based on population health, poverty, and visit corrected HCC, but increased using the standard HCC index. Most of the residual variation in age, sex, and race adjusted mortality was explained (in terms of weighted R2) by the population health index: R2=0.65. The other indices explained less: R2=0.20 for the visit corrected HCC index; 0.19 for the poverty index, and 0.02 for the standard HCC index. The residual variation in age, sex, race, and price adjusted spending per capita across the 306 hospital referral regions explained by the indices (in terms of weighted R2) were 0.50 for the standard HCC index, 0.21 for the population health index, 0.12 for the poverty index, and 0.07 for the visit corrected HCC index, implying that only a modest amount of the variation in spending can be explained by factors most closely related to mortality. Further, once the HCC index is visit corrected it accounts for almost none of the residual variation in age, sex, and race adjusted spending. Health risk adjustment using either the poverty index or the population health index performed substantially better in terms of explaining actual mortality than the indices that relied on diagnoses from administrative databases; the population health index explained the majority of residual variation in age, sex, and race adjusted mortality. Owing to the influence of observational intensity on diagnoses from administrative databases, the standard HCC index over-adjusts for regional differences in spending. Research to improve health risk adjustment methods should focus on developing measures of risk that do not depend on observation influenced diagnoses recorded in administrative databases.
Ferreira, Maria Regina Sardinheiro do Céu Furtado; Martins, José Joaquim Penedos Amendoeira
2014-08-01
Testing the psychometric properties of the Portuguese version of the Practice Environment Scale of the Nursing Work Index. A descriptive, analytical and cross-sectional study, for the cross-cultural adaptation and validation of the psychometric properties of the scale. The study participants were 236 nurses from two hospitals in the regions of Lisbon and Vale do Tejo. The 0.92 Cronbach's alpha was obtained for overall reliability and support of a five-dimension structure. The excellent quality of adjustment of analysis confirms the validity of the adapted version to hospital care settings, although there was no total coincidence of items in the five dimensions
Modesti, Pietro A.; Calabrese, Maria; Perruolo, Eleonora; Bussotti, Alessandro; Malandrino, Danilo; Bamoshmoosh, Mohamed; Biggeri, Annibale; Zhao, Dong
2016-01-01
Abstract Migration flows from China are largely directed towards the South of Europe, Chinese being now the third largest overseas-born population in Italy. The aim of the study was to investigate hypertension burden and self-reported sleep disorders among 1608 first-generation Chinese migrants aged 16 to 59 years settled in Prato and recruited in a cross-sectional survey. Hypertension was defined as systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg or self-reported antihypertensive treatment; potential impact of sleep disorders was analyzed by logistic regression adjusted for age, sex, marital status, education, health insurance, current smoking, parental hypertension, alcohol drinking, overweight or obesity, central obesity, diabetes, high total cholesterol, and high triglycerides. Among the 1608 participants, 21.7% were hypertensive (age-standardized prevalence 19.2%; 95% Cl: 18.5–20.0); 54% of hypertensive subjects were aware of their condition; 70% of aware hypertensive subjects received drugs, and 39% of treated subjects had blood pressure controlled. Self-reported snoring increased the risk of hypertension; when compared with no snoring, the age- and sex-adjusted OR for hypertension of snoring 3 to 6 d/week was 2.11 (95% Cl: 1.48–3.01) and 2.48 (95% Cl: 1.79–3.46) of snoring every day. When compared with a sleep duration ≤5 hours, subjects with sleep duration of 7 hours had reduced risk of high triglycerides (adjusted OR: 0.66; 95% Cl: 0.43–0.95). Despite a high level of awareness, low treatment rates for hypertension were observed among Chinese participants, independently of health insurance. Sleep history is to be considered in screening and prevention programs. PMID:27057856
Associations of Blood and Urinary Mercury with Hypertension in U.S. Adults: the NHANES 2003–2006
Park, Sung Kyun; Lee, Sunghee; Basu, Niladri; Franzblau, Alfred
2013-01-01
Background Few studies have examined the association between hypertension and mercury exposure in the general population. We examined cross-sectional associations between blood (mainly methylmercury) or urinary mercury (mainly inorganic mercury) and hypertension in representative U.S. adults and effect modifications by dietary omega-3 fatty acids and serum selenium. Methods We examined 6,607 adults aged 20 years or older, using the National Health and Nutrition Examination Survey (NHANES) from 2003/2004 to 2005/2006 (2,201 adults were available for urinary mercury from NHANES 2003–2006; 2,117 available for serum selenium from NHANES 2003–2004 aged 40 years or older). The average of omega-3 fatty acids from two 24-hour recalls was calculated. Results The weighted prevalence of hypertension was 32.2%. The geometric means (95% confidence intervals) of blood total and urinary mercury were 1.03 (0.95, 1.11) µg/L and 0.51 (0.47, 0.54) µg/L, respectively. The adjusted odds ratios for a doubling increase in blood mercury and urinary mercury were 0.94 (0.87 to 1.01) and 0.87 (0.78 to 0.99), respectively, after adjusting for potential confounders. The associations remained similar, even after adjusting for either omega-3 fatty acids or selenium or both. No significant effect modification by either omega-3 fatty acids or selenium was observed. Conclusions In this cross-sectional study of the U.S. general population, we found no association of hypertension with blood mercury but a suggestive inverse association with urinary mercury. Future prospective studies are warranted to confirm these findings. PMID:23472608
Saggurti, Niranjan; Winter, Michael; Labonte, Alan; Decker, Michele R; Balaiah, Donta; Silverman, Jay G
2010-01-01
Objective To assess associations between maternal child marriage (marriage before age 18) and morbidity and mortality of infants and children under 5 in India. Design Cross-sectional analyses of nationally representative household sample. Generalised estimating equation models constructed to assess associations. Adjusted models included maternal and child demographics and maternal body mass index as covariates. Setting India. Population Women aged 15-49 years (n=124 385); data collected in 2005-6 through National Family Health Survey-3. Data about child morbidity and mortality reported by participants. Analyses restricted to births in past five years reported by ever married women aged 15-24 years (n=19 302 births to 13 396 mothers). Main outcome measures In under 5s: mortality related infectious diseases in the past two weeks (acute respiratory infection, diarrhoea); malnutrition (stunting, wasting, underweight); infant (age <1 year) and child (1-5 years) mortality; low birth weight (<2500 kg). Results The majority of births (73%; 13 042/19 302) were to mothers married as minors. Although bivariate analyses showed significant associations between maternal child marriage and infant and child diarrhoea, malnutrition (stunted, wasted, underweight), low birth weight, and mortality, only stunting (adjusted odds ratio 1.22, 95% CI 1.12 to 1.33) and underweight (1.24, 1.14 to 1.36) remained significant in adjusted analyses. We noted no effect of maternal child marriage on health of boys versus girls. Conclusions The risk of malnutrition is higher in young children born to mothers married as minors than in those born to women married at a majority age. Further research should examine how early marriage affects food distribution and access for children in India. PMID:20093277
Effect of seeing tobacco use in films on trying smoking among adolescents: cross sectional study.
Sargent, J D; Beach, M L; Dalton, M A; Mott, L A; Tickle, J J; Ahrens, M B; Heatherton, T F
2001-12-15
To test the hypothesis that greater exposure to smoking in films is associated with trying smoking among adolescents. Cross sectional survey of 4919 schoolchildren aged 9-15 years, and assessment of occurrence of smoking in 601 films. Randomly selected middle schools in Vermont and New Hampshire, USA. Number of schoolchildren who had ever tried smoking a cigarette. The films contained a median of 5 (interquartile range 1-12) occurrences of smoking. The typical adolescent had seen 17 of 50 films listed. Exposure to smoking in films varied widely: median 91 (49-152) occurrences. The prevalence of ever trying smoking increased with higher categories of exposure: 4.9% among students who saw 0-50 occurrences of smoking, 13.7% for 51-100 occurrences, 22.1% for 101-150, and 31.3% for >150. The association remained significant after adjustment for age; sex; school performance; school; parents' education; smoking by friend, sibling, or parent; and receptivity to tobacco promotions. The adjusted odds ratios of ever trying smoking for students in the higher categories of exposure, compared with students exposed to 0-50 occurrences of smoking in films, were 1.7 (95% confidence interval 1.2 to 2.4), 2.4 (1.7 to 3.4), and 2.7 (2.0 to 3.8). These odds ratios were not substantially affected by adjustment for parenting style or for personality traits of the adolescent. In this sample of adolescents there was a strong, direct, and independent association between seeing tobacco use in films and trying cigarettes, a finding that supports the hypothesis that smoking in films has a role in the initiation of smoking in adolescents.
Kalinina Ayuso, Viera; Scheerlinck, Laura M; de Boer, Joke H
2013-03-01
To assess the effect of Ahmed glaucoma valve implants on corneal endothelial cell density (ECD) in children with uveitic glaucoma. Cross-sectional study. setting: Institutional. patientpopulation: Eighty eyes from 42 patients diagnosed with uveitis before the age of 16. Twenty-eight eyes had an Ahmed glaucoma valve implant because of secondary glaucoma. Fifty-two eyes without an implant served as controls. intervention orobservationprocedure(s): Corneal ECD was examined cross-sectionally using a noncontact specular microscope. Univariate and multivariate generalized estimating equations analyses with correction for paired eyes were performed. mainoutcomemeasure(s): Correlation of ECD with the presence of an Ahmed glaucoma valve implant and with the time following implantation. ECD was significantly lower in the Ahmed glaucoma valve group than in controls (2359 and 3088 cells/mm(2), respectively; P < .001) following an average of 3.5 years after Ahmed glaucoma valve implantation. Presence of an Ahmed glaucoma valve implant, previous intraocular surgery, age, duration of uveitis, and history of corneal touch by the implant tube were all significantly associated with decreased ECD. Following a multivariate analysis, presence of an Ahmed glaucoma valve implant (B = -340; adjusted P < .011) and older age (B = -58; adjusted P = .005) remained independently associated with decreased ECD. Within the implant group, the age-adjusted time interval following Ahmed glaucoma valve implantation was highly correlated with decreased ECD (B = -558, P < .001). Ahmed glaucoma valve implants in children with uveitic glaucoma are independently associated with decreased ECD, and this effect is associated with the time interval following Ahmed glaucoma valve implantation. Copyright © 2013 Elsevier Inc. All rights reserved.
Perkins, Jessica M; Lee, Hwa-Young; James, K S; Oh, Juhwan; Krishna, Aditi; Heo, Jongho; Lee, Jong-Koo; Subramanian, S V
2016-09-30
Previous research has demonstrated health benefits of marriage and the potential for worse outcomes during widowhood in some populations. However, few studies have assessed the relevance of widowhood and widowhood duration to a variety of health-related outcomes and chronic diseases among older adults in India, and even fewer have examined these relationships stratified by gender. Using a cross-sectional representative sample of 9,615 adults aged 60 years or older from 7 states in diverse regions of India, we examine the relationship between widowhood and self-rated health, psychological distress, cognitive ability, and four chronic diseases before and after adjusting for demographic characteristics, socioeconomic status, living with children, and rural-urban location for men and women, separately. We then assess these associations when widowhood accounts for duration. Being widowed as opposed to married was associated with worse health outcomes for women after adjusting for other explanatory factors. Widowhood in general was not associated with any outcomes for men except for cognitive ability, though men who were widowed within 0-4 years were at greater risk for diabetes compared to married men. Moreover, recently widowed women and women who were widowed long-term were more likely to experience psychological distress, worse self-rated health, and hypertension, even after adjusting for other explanatory variables, whereas women widowed 5-9 years were not, compared to married women. Gender, the duration of widowhood, and type of outcome are each relevant pieces of information when assessing the potential for widowhood to negatively impact health. Future research should explore how the mechanisms linking widowhood to health vary over the course of widowhood. Incorporating information about marital relationships into the design of intervention programs may help better target potential beneficiaries among older adults in India.
Shidhaye, Pallavi; Shidhaye, Rahul; Phalke, Vaishali
2017-06-01
Maternal depression is a major public health problem in low- and middle-income countries including India. Very few studies have assessed association of various risk factors with antenatal depression in rural Indian women, especially the effect of marital conflict, gender disadvantage and gender preference on antenatal depression. This paper describes the prevalence of probable antenatal depression in rural Maharashtra, a state in the western part of India and specifically assesses the association of marital and gender disadvantage factors and gender preference for a male child with antenatal depression. Primary Health Centre-based cross-sectional survey of antenatal women in rural Maharashtra was carried out. The outcome of interest was a probable diagnosis of depression in antenatal women which was measured using the Edinburgh postnatal depression scale (EPDS). Data were analyzed using simple and multiple logistic regression. 302 women in their antenatal period were included in this study. The outcome of antenatal depression (EPDS > 12) was found in 51 women (16.9%, 95% CI 12.6-21.1%). Feeling pressurized to deliver a male child was strongly associated with the outcome of antenatal depression (adjusted odds ratio (OR): 3.0; 95% CI 1.4-6.5). Unsatisfactory reaction of in-laws to dowry (adjusted OR 11.2; 95% CI 2.4-52.9) and difficult relationship with in-laws (adjusted OR 5.3; 95% CI 2.4-11.6) were also significantly associated with antenatal depression. Our findings demonstrate that antenatal depression in rural women of Western Maharashtra is associated with gender disadvantage factors, especially related to preference for a male child. The agenda to improve maternal mental health should be ultimately linked to address the broader social development goals and gender empowerment.
Risk factors for eczema in infants born in Cuba: a population-based cross-sectional study
2014-01-01
Background There is a concern that allergic disease in childhood is higher than expected in Cuba. The aim of this study was to determine the risk factors for eczema of infants aged 12–15 months living in Havana. Methods We used a cross-sectional epidemiological study design. Data on eczema symptoms and a wide range of lifestyle factors were collected by researcher administered questionnaires. Results Data were collected on 1956 children (96% response rate), of whom 672 (34%) were reported as having had eczema. Independent risk factors for eczema included young maternal age (adjusted odds ratio (OR) 0.98 per additional year of age; 95% confidence interval (CI) 0.97-0.99), child’s weight (OR 1.13 per additional kg; 95% CI: 1.03-1.25), insect sting allergy (OR 2.11; 95% CI: 1.33-3.35), rodents in the home (OR 1.39; 95% CI: 1.10-1.76), attendance at childcare facilities (OR 1.34: 95% CI: 1.05-1.70) and self-reported mould in the home (OR 1.23; 95% CI: 1.07-1.41). Infant exposure to paracetamol was associated with an increased risk of eczema even after adjustment for wheeze (OR 1.22; 95% CI: 1.03-1.46). Conclusion Despite a very different culture and environment, the consistency of these findings with those from more economically developed countries suggests potential causal associations. The association with paracetamol, even after adjustment for wheeze, suggests that intervention studies are required in young infants, to ascertain if this commonly used anti-pyretic medication increases allergic disease. PMID:24666750
Levene, Louis S; Baker, Richard; Wilson, Andrew; Walker, Nicola; Boomla, Kambiz; Bankart, M John G
2017-01-01
Background NHS general practice payments in England include pay for performance elements and a weighted component designed to compensate for workload, but without measures of specific deprivation or ethnic groups. Aim To determine whether population factors related to health needs predicted variations in NHS payments to individual general practices in England. Design and setting Cross-sectional study of all practices in England, in financial years 2013–2014 and 2014–2015. Method Descriptive statistics, univariable analyses (examining correlations between payment and predictors), and multivariable analyses (undertaking multivariable linear regressions for each year, with logarithms of payments as the dependent variables, and with population, practice, and performance factors as independent variables) were undertaken. Results Several population variables predicted variations in adjusted total payments, but inconsistently. Higher payments were associated with increases in deprivation, patients of older age, African Caribbean ethnic group, and asthma prevalence. Lower payments were associated with an increase in smoking prevalence. Long-term health conditions, South Asian ethnic group, and diabetes prevalence were not predictive. The adjusted R2 values were 0.359 (2013–2014) and 0.374 (2014–2015). A slightly different set of variables predicted variations in the payment component designed to compensate for workload. Lower payments were associated with increases in deprivation, patients of older age, and diabetes prevalence. Smoking prevalence was not predictive. There was a geographical differential. Conclusion Population factors related to health needs were, overall, poor predictors of variations in adjusted total practice payments and in the payment component designed to compensate for workload. Revising the weighting formula and extending weighting to other payment components might better support practices to address these needs. PMID:27872085
O'Donovan, Gary; Chudasama, Yogini; Grocock, Samuel; Leigh, Roland; Dalton, Alice M; Gray, Laura J; Yates, Thomas; Edwardson, Charlotte; Hill, Sian; Henson, Joe; Webb, David; Khunti, Kamlesh; Davies, Melanie J; Jones, Andrew P; Bodicoat, Danielle H; Wells, Alan
2017-07-01
Observational evidence suggests there is an association between air pollution and type 2 diabetes; however, there is high risk of bias. To investigate the association between air pollution and type 2 diabetes, while reducing bias due to exposure assessment, outcome assessment, and confounder assessment. Data were collected from 10,443 participants in three diabetes screening studies in Leicestershire, UK. Exposure assessment included standard, prevailing estimates of outdoor nitrogen dioxide and particulate matter concentrations in a 1×1km area at the participant's home postcode. Three-year exposure was investigated in the primary analysis and one-year exposure in a sensitivity analysis. Outcome assessment included the oral glucose tolerance test for type 2 diabetes. Confounder assessment included demographic factors (age, sex, ethnicity, smoking, area social deprivation, urban or rural location), lifestyle factors (body mass index and physical activity), and neighbourhood green space. Nitrogen dioxide and particulate matter concentrations were associated with type 2 diabetes in unadjusted models. There was no statistically significant association between nitrogen dioxide concentration and type 2 diabetes after adjustment for demographic factors (odds: 1.08; 95% CI: 0.91, 1.29). The odds of type 2 diabetes was 1.10 (95% CI: 0.92, 1.32) after further adjustment for lifestyle factors and 0.91 (95% CI: 0.72, 1.16) after yet further adjustment for neighbourhood green space. The associations between particulate matter concentrations and type 2 diabetes were also explained away by demographic factors. There was no evidence of exposure definition bias. Demographic factors seemed to explain the association between air pollution and type 2 diabetes in this cross-sectional study. High-quality longitudinal studies are needed to improve our understanding of the association. Copyright © 2017 Elsevier Ltd. All rights reserved.
Van den Heede, Koen; Sermeus, Walter; Diya, Luwis; Clarke, Sean P; Lesaffre, Emmanuel; Vleugels, Arthur; Aiken, Linda H
2009-07-01
Studies have linked nurse staffing levels (number and skill mix) to several nurse-sensitive patient outcomes. However, evidence from European countries has been limited. This study examines the association between nurse staffing levels (i.e. acuity-adjusted Nursing Hours per Patient Day, the proportion of registered nurses with a Bachelor's degree) and 10 different patient outcomes potentially sensitive to nursing care. DESIGN-SETTING-PARTICIPANTS: Cross-sectional analyses of linked data from the Belgian Nursing Minimum Dataset (general acute care and intensive care nursing units: n=1403) and Belgian Hospital Discharge Dataset (general, orthopedic and vascular surgery patients: n=260,923) of the year 2003 from all acute hospitals (n=115). Logistic regression analyses, estimated by using a Generalized Estimation Equation Model, were used to study the association between nurse staffing and patient outcomes. The mean acuity-adjusted Nursing Hours per Patient Day in Belgian hospitals was 2.62 (S.D.=0.29). The variability in patient outcome rates between hospitals is considerable. The inter-quartile ranges for the 10 patient outcomes go from 0.35 for Deep Venous Thrombosis to 3.77 for failure-to-rescue. No significant association was found between the acuity-adjusted Nursing Hours per Patient Day, proportion of registered nurses with a Bachelor's degree and the selected patient outcomes. The absence of associations between hospital-level nurse staffing measures and patient outcomes should not be inferred as implying that nurse staffing does not have an impact on patient outcomes in Belgian hospitals. To better understand the dynamics of the nurse staffing and patient outcomes relationship in acute hospitals, further analyses (i.e. nursing unit level analyses) of these and other outcomes are recommended, in addition to inclusion of other study variables, including data about nursing practice environments in hospitals.
Mansouri, Masoume; Abasi, Roshanak; Nasiri, Morteza; Sharifi, Farshad; Vesaly, Sedyghe; Sadeghi, Omid; Rahimi, Nayere; Sharif, Nasrin Akbary
2018-05-01
We aimed to assess the association of vitamin D status with metabolic syndrome and its components among high educated Iranian adults. In this cross-sectional study, 352 faculty members with age of 35 years or more, belong to Tarbiat Modares University, Tehran, Islamic Republic of Iran, were recruited during 2016 and 2017. Fasting blood samples were obtained to quantify serum 25(OH)D concentrations, glycemic indicators and lipid profile. Metabolic syndrome was defined based on the guidelines of the National Cholesterol Education Program Adult Treatment Panel III (ATP III). Multivariate logistic regression adjusted for potential confounders was used to evaluate the association between vitamin D status and metabolic syndrome. Metabolic syndrome and vitamin D insufficiency were prevalent among 26% and 60.2% of subjects, respectively. There was no statistically significant difference in the prevalence of metabolic syndrome across quartiles of 25(OH)D levels either before or after adjusting for potential confounders (OR: 0.94, 95% CI: 0.43-1.95). In terms of metabolic syndrome components, subjects in the highest quartile of vitamin D levels had 59% decreased risk of abdominal obesity compared with those in the lowest quartile (OR: 0.41, 95% CI: 0.17-0.99), after adjusting for potential confounders. Such inverse relationship was also seen for elevated blood pressure (OR: 0.37, 95% CI: 0.14-0.99), and abnormal glucose homeostasis (OR: 0.40, 95% CI: 0.19-0.85). Serum levels of 25(OH)D was inversely associated with the risk of abdominal obesity, hypertension, and abnormal glucose homeostasis. However, no significant relationship was seen for metabolic syndrome. Copyright © 2018. Published by Elsevier Ltd.
Choi, Eunjoo; Choi, Kyung-Hyun; Park, Sang Min; Shin, Doosup; Joh, Hee-Kyung; Cho, Eunyoung
2016-01-01
Although the concern about coffee-associated health problems is increasing, the effect of coffee on osteoporosis is still conflicting. This study aimed to determine the relationship between coffee consumption and bone health in Korean postmenopausal women. A population-based, cross-sectional study was performed using a nationally representative sample of the Korean general population. All 4,066 postmenopausal women (mean age 62.6 years) from the fourth and fifth Korean National Health and Nutrition Examination Survey (2008-2011), who completed the questionnaire about coffee consumption and had data of dual-energy X-ray absorptiometry (DXA) examination. Bone mineral density (BMD) was measured using DXA at the femoral neck and lumbar spine and osteoporosis was defined by World Health Organization T-score criteria in addition to self-report of current anti-osteoporotic medication use. After adjusting for various demographic and lifestyle confounders (including hormonal factors), subjects in the highest quartile of coffee intake had 36% lower odds for osteoporosis compared to those in the lowest quartile (Adjusted odds ratio [aOR] = 0.64; 95% confidence interval [CI], 0.43-0.95; P for trend = 0.015). This trend was consistent in osteoporosis of lumbar spine and femoral neck (aOR = 0.65 and 0.55; P for trend = 0.026 and 0.003, respectively). In addition, age- and body mass index (BMI)-adjusted BMD of the femoral neck and lumbar spine increased with higher coffee intake (P for trend = 0.019 and 0.051, respectively). Coffee consumption may have protective benefits on bone health in Korean postmenopausal women in moderate amount. Further, prospective studies are required to confirm this association.
Park, Sang Min; Shin, Doosup; Joh, Hee-Kyung; Cho, Eunyoung
2016-01-01
Purpose Although the concern about coffee-associated health problems is increasing, the effect of coffee on osteoporosis is still conflicting. This study aimed to determine the relationship between coffee consumption and bone health in Korean postmenopausal women. Methods A population-based, cross-sectional study was performed using a nationally representative sample of the Korean general population. All 4,066 postmenopausal women (mean age 62.6 years) from the fourth and fifth Korean National Health and Nutrition Examination Survey (2008–2011), who completed the questionnaire about coffee consumption and had data of dual-energy X-ray absorptiometry (DXA) examination. Bone mineral density (BMD) was measured using DXA at the femoral neck and lumbar spine and osteoporosis was defined by World Health Organization T-score criteria in addition to self-report of current anti-osteoporotic medication use. Results After adjusting for various demographic and lifestyle confounders (including hormonal factors), subjects in the highest quartile of coffee intake had 36% lower odds for osteoporosis compared to those in the lowest quartile (Adjusted odds ratio [aOR] = 0.64; 95% confidence interval [CI], 0.43–0.95; P for trend = 0.015). This trend was consistent in osteoporosis of lumbar spine and femoral neck (aOR = 0.65 and 0.55; P for trend = 0.026 and 0.003, respectively). In addition, age- and body mass index (BMI)-adjusted BMD of the femoral neck and lumbar spine increased with higher coffee intake (P for trend = 0.019 and 0.051, respectively). Conclusions Coffee consumption may have protective benefits on bone health in Korean postmenopausal women in moderate amount. Further, prospective studies are required to confirm this association. PMID:26816211
The effect of change in body mass index on volumetric measures of mammographic density
Hart, Vicki; Reeves, Katherine W.; Sturgeon, Susan R.; Reich, Nicholas G.; Sievert, Lynnette Leidy; Kerlikowske, Karla; Ma, Lin; Shepherd, John; Tice, Jeffrey A.; Mahmoudzadeh, Amir Pasha; Malkov, Serghei; Sprague, Brian L.
2015-01-01
Background Understanding how changes in body mass index (BMI) relate to changes in mammographic density is necessary to evaluate adjustment for BMI gain/loss in studies of change in density and breast cancer risk. Increase in BMI has been associated with a decrease in percent density, but the effect on change in absolute dense area or volume is unclear. Methods We examined the association between change in BMI and change in volumetric breast density among 24,556 women in the San Francisco Mammography Registry from 2007-2013. Height and weight were self-reported at the time of mammography. Breast density was assessed using single x-ray absorptiometry measurements. Cross-sectional and longitudinal associations between BMI and dense volume (DV), non-dense volume (NDV) and percent dense volume (PDV) were assessed using multivariable linear regression models, adjusted for demographics, risk factors, and reproductive history. Results In cross-sectional analysis, BMI was positively associated with DV (β=2.95 cm3, 95% CI 2.69, 3.21) and inversely associated with PDV (β=-2.03%, 95% CI -2.09, -1.98). In contrast, increasing BMI was longitudinally associated with a decrease in both DV (β=-1.01 cm3, 95% CI -1.59, -0.42) and PDV (β=-1.17%, 95% CI -1.31, -1.04). These findings were consistent for both pre- and postmenopausal women. Conclusion Our findings support an inverse association between change in BMI and change in PDV. The association between increasing BMI and decreasing DV requires confirmation. Impact Longitudinal studies of PDV and breast cancer risk, or those using PDV as an indicator of breast cancer risk, should evaluate adjustment for change in BMI. PMID:26315554
Kern, Lisa M; Seirup, Joanna K; Casalino, Lawrence P; Safford, Monika M
2017-02-01
Fragmented ambulatory care has been associated with high rates of emergency department visits and hospitalizations, but effects on other types of utilization are unclear. To determine whether more fragmented care is associated with more radiology and other diagnostic tests, compared to less fragmented care. We conducted a cross-sectional study using claims from five commercial payers for 2010. The study took place in the Hudson Valley, a seven-county region in New York State. We included adult patients who were insured through the participating payers and were attributed to a primary care physician in the region. We restricted the cohort to those with ≥4 ambulatory visits, as measures of fragmentation are not reliable if based on ≤3 visits (N = 126,801). For each patient, we calculated fragmentation using a reversed Bice-Boxerman Index, which we divided into seven categories. We used negative binomial regression to determine the association between fragmentation category and rates of radiology and other diagnostic tests, stratified by number of chronic conditions and adjusting for patient age, gender, and number of visits. Patients with the most fragmented care had approximately twice as many radiology and other diagnostic tests as patients with the least fragmented care, across all groups stratified by number of chronic conditions (each adjusted p < 0.0001). For example, among patients with ≥5 chronic conditions, those with the least fragmented care had 258 tests per 100 patients, and those with the most fragmented care had 542 tests per 100 patients (+284 tests per 100 patients, or +110 %, adjusted p < 0.0001). More fragmented care was independently associated with higher rates of radiology and other diagnostic tests than less fragmented care.
Solis-Soto, María Teresa; Schön, Anabel; Solis-Soto, Angel; Parra, Manuel; Radon, Katja
2017-10-27
Musculoskeletal disorders (MSD) are important health problems in working populations. The study aimed to determine the prevalence of MSD among school teachers from urban and rural areas in Chuquisaca, Bolivia. A cross-sectional study was conducted in 60 randomly selected schools. In total, 1062 teachers were invited to participate (response 58%). The Spanish version of the Standardized Nordic questionnaire was used assessing the 12-months and 7-days prevalence of MSD as well as the 12-months prevalence of work limiting pain. Prevalence were calculated for the different parts of the body; as summary measures, MSD in any part of the body and in ≥3 parts of the body were assessed. Crude and adjusted odds ratios with 95% confidence intervals were calculated using logistic regression models adjusting for age, sex, teaching level and school type. Prevalence of MSD in any part of the body was 86% during the last 12 months, 63% during the last 7 days and 15% for work limiting pain. MSD was most common in the neck (12-months prevalence 47%) and least common in the wrist/hands (26%). In the adjusted model, teachers working in rural areas presented significantly higher odds than teachers from urban schools for work-limiting pain during the last 12-months considering any part of the body (aOR 2.2; 95% CI 1.1-4.1), and for ≥3 parts of the body (aOR 3.7; 95% CI 1.3-10.6). The prevalence of MSD is high in School teachers, even more in teachers working in rural areas. It is needed to identify risk factors for MSD in teachers in order to propose appropriate strategies to control and reduce it.
Levene, Louis S; Baker, Richard; Wilson, Andrew; Walker, Nicola; Boomla, Kambiz; Bankart, M John G
2017-01-01
NHS general practice payments in England include pay for performance elements and a weighted component designed to compensate for workload, but without measures of specific deprivation or ethnic groups. To determine whether population factors related to health needs predicted variations in NHS payments to individual general practices in England. Cross-sectional study of all practices in England, in financial years 2013-2014 and 2014-2015. Descriptive statistics, univariable analyses (examining correlations between payment and predictors), and multivariable analyses (undertaking multivariable linear regressions for each year, with logarithms of payments as the dependent variables, and with population, practice, and performance factors as independent variables) were undertaken. Several population variables predicted variations in adjusted total payments, but inconsistently. Higher payments were associated with increases in deprivation, patients of older age, African Caribbean ethnic group, and asthma prevalence. Lower payments were associated with an increase in smoking prevalence. Long-term health conditions, South Asian ethnic group, and diabetes prevalence were not predictive. The adjusted R 2 values were 0.359 (2013-2014) and 0.374 (2014-2015). A slightly different set of variables predicted variations in the payment component designed to compensate for workload. Lower payments were associated with increases in deprivation, patients of older age, and diabetes prevalence. Smoking prevalence was not predictive. There was a geographical differential. Population factors related to health needs were, overall, poor predictors of variations in adjusted total practice payments and in the payment component designed to compensate for workload. Revising the weighting formula and extending weighting to other payment components might better support practices to address these needs. © British Journal of General Practice 2017.
Lam, Matthew Chak Leung; Adams, Jean
2017-05-23
'Ultra-processed foods' (UPF) have been industrially processed and tend to be higher in saturated fat, sodium and sugar than other foods. There is some evidence that consumption of UPF is associated with overweight, obesity and related diseases. In developed countries more than half of dietary energy is attributed to UPF. One reason for reliance on UPF may be poor home food preparation skills or infrequent use of these. This relationship has been previously proposed but not tested. We examined the relationship between home food preparation skills and behaviour and consumption of UPF. We used data from adults in the UK National Diet & Nutrition Survey 2008-09. Home food preparation skills and behaviours of adults (n = 509) were assessed using questions on confidence using eight cooking techniques, confidence cooking 10 foods, ability to prepare a cake or biscuits without help, and whether or not participants prepared a main meal five or more days per week. Individuals' UPF consumption was determined from four-day estimated diet diaries. Associations were adjusted for age, gender, occupational social class and household composition. In fully adjusted models, individuals who were confident with all 10 foods (adjusted beta (95% CI) = -3.76 (-6.02 to -1.50)), able to bake cakes or biscuits without help (-3.87 (-6.62 to -1.12)), and cooked a main meal at least five days a week (-2.84 (-5.43 to -0.24)) consumed a lower percentage of dietary energy from UPF. In UK adults better home food preparation skills and more frequent use of these skills tended to be cross-sectionally associated with lower UPF consumption. Greater encouragement of these skills may help reduce reliance on UPF.
Verret, Catherine; Trichereau, Julie; Rondier, Jean-Philippe; Viance, Patrice; Migliani, René
2012-01-01
Objectives To investigate the associations between psychosocial risk factors and self-reported health, taking into account other occupational risk factors. Design Cross-sectional survey using a self-administered questionnaire. Setting The three military hospitals in Paris, France. Participants Surveys were distributed to 3173 employees (1807 military and 1336 civilian), a total of 1728 employees completed surveys. Missing data prohibited the use of 26 surveys. Primary and secondary outcome measures The authors used Karasek's model in order to identify psychosocial factors (psychological demands, decisional latitude, social support) in the workplace. The health indicator studied was self-reported health. Adjustments were made for covariates: age, gender, civil or military status, work injury, ergonomic score, physical and chemical exposures, and occupational profile. Occupational profile was defined by professional category, department, work schedule, supervisor status and service-related length in the hospital. Results Job strain (defined as high psychological demands and low decisional latitude) (adjusted OR 2.1, 95% CI 1.5 to 2.8, p<0.001) and iso-strain (job strain with low social support) were significantly associated with moderate or poor self-reported health. Among covariates, occupational profile (p<0.001) and an unsatisfactory ergonomic score (adjusted OR 2.3 95% CI 1.6 to 3.2, p<0.001) were also significantly associated with moderate or poor self-reported health. Conclusions The results support findings linking moderate or poor self-reported health to psychosocial risk factors. The results of this study suggest that workplace interventions that aim to reduce exposure to psychological demands as well as to increase decisional latitude and social support could help improve self-reported health. PMID:22855624
Patel, Sumaiya; Lawlor, Debbie A.; Ferreira, Diana L.S.; Hughes, Alun D.; Chaturvedi, Nish; Callaway, Mark; Day, Chris; Sattar, Naveed; Fraser, Abigail
2015-01-01
Objectives: We aimed to determine the association of nonalcoholic fatty liver disease (NAFLD) with central and peripheral blood pressure (BP), in a general adolescent population and to examine whether associations are independent of adiposity. Methods: Using cross-sectional data from a subsample (N = 1904) of a UK birth cohort, we assessed markers of NAFLD including ultrasound scan (USS) determined fatty liver, shear velocity (marker of liver fibrosis), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyltransferase (GGT) at a mean age of 17.8 years. These were related to BP [central and peripheral SBP and DBP and mean arterial pressure (MAP)]. Results: Fatty liver was positively associated with central and peripheral SBP, DBP and MAP in models adjusting for age, sex, social class, puberty and alcohol intake. These positive associations were attenuated to the null when fat mass was included. For example, in confounder-adjusted models, not including fat mass, mean central SBP was 3.74 mmHg [95% confidence interval (CI) 1.12 to 6.36] higher in adolescents with USS fatty liver than in those without; with additional adjustment for fat mass, the association attenuated to the null value (−0.37 mmHg; 95% CI –3.09 to 2.36). Similar patterns were found for associations of ALT and GGT with central and peripheral BP. There was no consistent evidence of associations of shear velocity or AST with BP measurements. Fatty liver was not consistently associated with central pulse pressure (PP), peripheral PP and Aix@75. Conclusion: NAFLD is not associated with higher central or peripheral BP in adolescents once confounding by adiposity is taken into account. PMID:25426570
Mannesse, Cyndie K; Jansen, Paul A F; Van Marum, Rob J; Sival, Rob C; Kok, Rob M; Haffmans, P M Judith; Egberts, Toine C G
2013-12-01
The aims of this study were to describe the characteristics of hyponatremia in elderly users of antidepressants, to determine the prevalence and risk factors for hyponatremia, and to identify the underlying mechanisms. Cross-sectional study (March 2007-April 2009) with prospectively collected data. Patients were older than 60 years, used antidepressants, and had a complete geriatric assessment. Serum sodium and antidiuretic hormone levels, serum osmolality, urine sodium level, and urine osmolality were measured. The prevalence of hyponatremia (serum sodium <135 mM) as an adverse reaction to an antidepressant (AR-AD), defined with Naranjo's algorithm, was calculated. Hyponatremic patients were compared to normonatremic patients with regard to gender, age, weight, history of hyponatremia, hyponatremia-associated medications and disorders, and type and duration of antidepressant use. Of 358 eligible patients, 345 were included. The prevalence of hyponatremia as an AR-AD was 9.3%. Risk factors were a history of hyponatremia (adjusted OR 11.17, 95%CI 2.56-40.41), weight<60 kg (adjusted OR 3.47, 95%CI 1.19-10.13), and psychosis (adjusted OR 3.62, 95%CI 1.12-11.73). Non-suppressed ADH was found in a minority of hyponatremic patients. In elderly patients, the prevalence of hyponatremia as adverse reaction to all types of antidepressants was 9%. Patients with previous hyponatremia, weight <60 kg, and psychosis were at risk. Beside SIADH, the nephrogenic syndrome of inappropriate antidiuresis, in which ADH secretion was normal, is postulated as an underlying mechanism. This has consequences for treatment of antidepressant-induced hyponatremia with vasopressin receptor antagonists. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Schluter, Philip J; Turner, Catherine; Benefer, Christine
2012-06-01
The relationship between long working hours and harmful alcohol consumption reported in the literature is equivocal. This study aimed to investigate this relationship in a methodologically rigorous fashion. A cross-sectional analysis of a large cohort study of Australian and New Zealand nurses and midwives was undertaken. Psychometrically robust standardised assessments of alcohol consumption and problems and other key variables were elicited using an electronic survey. Crude and adjusted logistic regression models using complete case and multistage multiple imputed data were employed. The study included 4419 participants, 3552 from Australia and 867 from New Zealand. Long working hours were common, with 33.2% working 40-49 h/week and 7.5% working ≥50 h/week. Overall, 13.9% engaged in harmful daily drinking. Significant associations between long working hours and harmful daily alcohol consumption was seen in crude and adjusted complete case and imputed logistic regression models. In the adjusted model with imputed data, the odds of harmful daily drinking increased by 1.17 (95% confidence interval: 1.01, 1.36) between <40 h/week and 40-49 h/week groups, and between 40-49 h/week and ≥50 h/week groups. Many nurses and midwives engaging in harmful daily drinking and work long hours. Since the late 1970s, the average hours worked by full-time employees in Australia has increased. Unless these long working hours can be curbed, workforce policies and programmes aimed at prevention, supportive and empathetic intervention, and recovery need to be instigated; both to protect patients and the nurses and midwives themselves. Copyright © 2012 Elsevier Ltd. All rights reserved.
Miyake, Yoshihiro; Tanaka, Keiko; Okubo, Hitomi; Sasaki, Satoshi; Furukawa, Shinya; Arakawa, Masashi
2017-03-15
One epidemiological study in Canada has addressed the association between zinc intake and depressive symptoms during pregnancy while another epidemiological study in Korea has examined the association between iron intake and depressive symptoms during pregnancy. The present cross-sectional study in Japan examined the association between intake of zinc, magnesium, iron, copper, and manganese and depressive symptoms during pregnancy. Study subjects were 1745 pregnant women. Dietary intake during the preceding month was assessed using a self-administered diet history questionnaire. Depressive symptoms were defined as a score ≥16 on the Center for Epidemiologic Studies Depression Scale. Adjustment was made for age, gestation, region of residence, number of children, family structure, history of depression, family history of depression, smoking, secondhand smoke exposure at home and at work, employment, household income, education, body mass index, and intake of saturated fatty acids, eicosapentaenoic acid plus docosahexaenoic acid, calcium, vitamin D, and isoflavones. In crude analysis, significant inverse associations were observed between intake levels of zinc, magnesium, iron, copper, and manganese and the prevalence of depressive symptoms during pregnancy. After adjustment for confounding factors, only manganese intake was independently inversely associated with depressive symptoms during pregnancy: the adjusted prevalence ratio between extreme quartiles was 0.74 (95% confidence interval:0.56-0.97, P for trend=0.046). Information was obtained between the 5th and 39th week of pregnancy. The current cross-sectional study of Japanese women demonstrated higher manganese intake to be independently associated with a lower prevalence of depressive symptoms during pregnancy. Copyright © 2017 Elsevier B.V. All rights reserved.
Quality of Life in Chinese Persons Living With an Ostomy: A Multisite Cross-sectional Study.
Geng, Zhaohui; Howell, Doris; Xu, Honglian; Yuan, Changrong
The aim of the study was to describe health-related quality of life (HRQOL) in persons with ostomies and to explore influencing factors. Secondary analysis of data from a cross-sectional survey. Eight hundred twenty-seven persons living with an ostomy were enrolled from 5 provinces and cities in China from October 2010 to November 2012; the final sample comprises 729 individuals who completed data collection. Their mean ± SD age was 62.59 ± 12.40 years (range 26-93 years). Health-related quality of life was assessed using the Chinese language version of the City of Hope-Quality of Life-Ostomy Questionnaire-Chinese Version. Sociodemographic data, clinical characteristics, self-efficacy, adjustment to an ostomy, social support, and psychological state of patients were measured by a general information questionnaire. We also administered the Stoma Self-Efficacy Scale, Ostomy Adjustment Inventory-Chinese Version, the Social Support Revalued Scale, and Hospital Anxiety Depression Scale. Of the 729 ostomy patients, the overall HRQOL in ostomy patients was in the moderate range (mean score 5.19 ± 1.29); scores of physical domain, psychological domain, social domain, and spiritual domains also in the moderate range (5.00 ± 1.73, 5.97 ± 1.59, 4.86 ± 2.31, and 4.93 ± 2.08 respectively). Multivariate analysis found that multiple factors influenced HRQOL in persons with an ostomy; they were gender, religious belief, and marital status, psychological factors depression and anxiety, and specific components related to social support, self-efficacy in ostomy care, and adjustment to an ostomy. Health-related quality of life among Chinese patients with fecal ostomies was less than optimal and influenced by multiple demographic and psychosocial factors. Additional research is needed to design strategies to improve HRQOL in this population.
Gibbs, Andrew; Corboz, Julienne; Jewkes, Rachel
2018-05-03
Intimate partner violence (IPV) is exceedingly common in conflict and post-conflict settings. We first seek to describe factors associated with past 12 month IPV amongst currently married women in Afghanistan, focused on the factors typically assumed to drive IPV. Second, to describe whether IPV is independently associated with a range of health outcomes. Cross-sectional analysis of currently married Afghan women, comprising the baseline study of a trial to prevent IPV. We use multinomial regression, reporting adjusted relative-risk ratios to model factors associated with the different forms of IPV, comparing no IPV, emotional IPV only, and physical IPV and emotional IPV. Second we assessed whether experience of emotional IPV, and physical IPV, were independently associated with health outcomes, reporting adjusted ß coefficients and adjusted odds ratios as appropriate. Nine hundred thirty five currently married women were recruited, 11.8% experienced only emotional IPV and 23.1% experienced physical and emotional IPV. Emotional IPV only was associated with attending a women's group, greater food insecurity, her husband having more than one wife, experiencing other forms of family violence, and more inequitable community gender norms. Experiencing both physical IPV and emotional IPV was associated with attending a women's group, more childhood trauma, husband cruelty, her husband having more than one wife, experiencing other forms of family violence, more inequitable community gender norms, and greater reported disability. Emotional IPV and physical IPV were independently associated with worse health outcomes. IPV remains common in Afghanistan. Economic interventions for women alone are unlikely to prevent IPV and potentially may increase IPV. Economic interventions need to also work with husbands and families, and work to transform community level gender norms. NCT03236948 . Registered 28 July 2017, retrospectively registered.
Yamamoto, Tatsuo; Kondo, Katsunori; Aida, Jun; Suzuki, Kayo; Misawa, Jimpei; Nakade, Miyo; Fuchida, Shinya; Hirata, Yukio
2014-06-03
Studies suggest that using a denture/bridge may prevent disability in older people. However, not all older people with few remaining teeth use a denture/bridge. This cross-sectional study aimed to examine the social determinants which promote denture/bridge use among older Japanese. A total of 54,388 (25,630 males and 28,758 females) community-dwelling individuals aged 65 or over, living independently, able to perform daily activities, and with 19 or fewer teeth. The dependent variable was denture/bridge use. Socio-demographics, number of teeth, present illness, social participation, social support, and social networks were used as individual-level independent variables. Data for social capital were aggregated and used as local district (n = 561 for males, n = 562 for females) -level independent variables. Number of dentists working in hospitals/clinics per population and population density were used as municipality (n = 28) -level independent variables. Three-level multilevel Poisson regression analysis was performed for each sex. High equivalent income, low number of teeth, present illness, and living in a municipality with high population density were significantly associated with denture/bridge use in both sexes in the fully adjusted models (p < 0.05). Denture/bridge use was significantly associated with high educational attainment in males and participating in social groups in females in the fully adjusted model (p < 0.05). No significant associations were observed between denture/bridge use and social capital. Denture/bridge use was significantly associated with high economic status and present illness in both sexes, high educational attainment in males, and participation in social groups in females among community-dwelling older Japanese after adjusting for possible confounders.
Agénor, Madina; Peitzmeier, Sarah; Gordon, Allegra R; Haneuse, Sebastien; Potter, Jennifer E; Austin, S Bryn
2015-07-21
Lesbians and bisexual women are at risk for human papillomavirus (HPV) infection from female and male sexual partners. To examine the association between sexual orientation identity and HPV vaccination among U.S. women and girls. Cross-sectional, using 2006-2010 National Survey of Family Growth data. U.S. civilian noninstitutionalized population. The 2006-2010 National Survey of Family Growth used stratified cluster sampling to establish a national probability sample of 12,279 U.S. women and girls aged 15 to 44 years. Analyses were restricted to 3253 women and girls aged 15 to 25 years who were asked about HPV vaccination. Multivariable logistic regression was used to obtain prevalence estimates of HPV vaccine awareness and initiation adjusted for sociodemographic and health care factors for each sexual orientation identity group. Among U.S. women and girls aged 15 to 25 years, 84.4% reported having heard of the HPV vaccine; of these, 28.5% had initiated HPV vaccination. The adjusted prevalence of vaccine awareness was similar among heterosexual, bisexual, and lesbian respondents. After adjustment for covariates, 8.5% (P = 0.007) of lesbians and 33.2% (P = 0.33) of bisexual women and girls who had heard of the vaccine had initiated vaccination compared with 28.4% of their heterosexual counterparts. Self-reported, cross-sectional data, and findings may not be generalizable to periods after 2006 to 2010 or all U.S. lesbians aged 15 to 25 years (because of the small sample size for this group). Adolescent and young adult lesbians may be less likely to initiate HPV vaccination than their heterosexual counterparts. Programs should facilitate access to HPV vaccination services among young lesbians. National Cancer Institute.
The Impact of Muscle Disuse on Muscle Atrophy in Severely Burned Rats
2010-12-01
Following muscle collection from the right hindlimb, muscle isometric force of PL and SL was measured simultaneously in the left hindlimb under...37.5°C by manually adjusting the temperature of cir culating water in the rat surgical bed. The isometric force of the PL and SL muscles was then...the physiologic cross sectional area (CSA) of PL and SL was calculated using the following formula: CSA= ( muscle mass) × cos θ ( muscle fiber
ERIC Educational Resources Information Center
Luebbe, Aaron M.; Bell, Debora J.
2009-01-01
Background: Caffeine, the only licit psychoactive drug available to minors, may have a harmful impact on students' health and adjustment, yet little is known about its use or effects on students, especially from a developmental perspective. Caffeine use in 5th- and 10th-grade students was examined in a cross-sectional design, and relations and…
All-Dielectric Multilayer Cylindrical Structures for Invisibility Cloaking
Mirzaei, Ali; Miroshnichenko, Andrey E.; Shadrivov, Ilya V.; Kivshar, Yuri S.
2015-01-01
We study optical response of all-dielectric multilayer structures and demonstrate that the total scattering of such structures can be suppressed leading to optimal invisibility cloaking. We use experimental material data and a genetic algorithm to reduce the total scattering by adjusting the material and thickness of various layers for several types of dielectric cores at telecommunication wavelengths. Our approach demonstrates 80-fold suppression of the total scattering cross-section by employing just a few dielectric layers. PMID:25858295
A new approach to flow through a region bounded by two ellipses of the same ellipticity
NASA Astrophysics Data System (ADS)
Lal, K.; Chorlton, F.
1981-05-01
A new approach is presented to calculate steady flow of a laminar viscous incompressible fluid through a channel whose cross section is bounded by two ellipses with the same ellipticity. The Milne-Thomas approach avoids the stream function and is similar to the Rayleigh-Ritz approximation process of the calculus of variations in its first satisfying boundary conditions and then adjusting constants or multiplying functions to fit the differential equation.
ERIC Educational Resources Information Center
Rotenberg, Ken J.; McDougall, Patricia; Boulton, Michael J.; Vaillancourt, Tracy; Fox, Claire; Hymel, Shelley
2004-01-01
Trustworthiness was examined in children and early adolescents from two countries. In Study 1,505 children in the fifth and sixth school years in the United Kingdom (mean age = 9 years 7 months) were tested across an 8-month period. In Study 2,350 sixth- through eighth-grade Canadian children and early adolescents (mean age = 12 years 11 months)…
Capillary Flow Experiment in Node 2
2013-06-15
Astronaut Karen Nyberg,Expedition 36 flight engineer,works on the Capillary Flow Experiment (CFE) Vane Gap-1 (VG-1) setup in the Node 2/Harmony. The CFE-2 vessel is used to observe fluid interface and critical wetting behavior in a cylindrical chamber with elliptic cross-section and an adjustable central perforated vane. The primary objective of the Vane Gap experiments is to determine equilibrium interface configurations and critical wetting conditions for interfaces between interior corners separated by a gap.
Kolarcik, Peter; Madarasova Geckova, Andrea; Reijneveld, Sijmen A; van Dijk, Jitse P
2016-02-01
Rates of aggression and delinquency are assumed to be higher among Roma and other minorities, but sound evidence of this is lacking. Our aim was to assess delinquent and aggressive behavior among Roma and non-Roma adolescents and the effects on ethnic differences of parental education and social desirability. We conducted a cross-sectional study among Roma from separated and segregated settlements in the eastern part of Slovakia (N = 330; Mage = 14.50; interview) and non-Roma adolescents (N = 722; Mage = 14.86; questionnaire). The effect of ethnicity on antisocial behaviors was analyzed using linear regression (crude) and adjusted for gender, parental education, and social desirability. Adjustment for social desirability diminished the ethnic differences in delinquency (B = 1.08; 95% confidence interval [CI] = [2.12, -0.04]), led to an increase in the differences in hostility (B = 2.43; 95% CI = [0.87, 3.99]), and led to the disappearance of differences in physical aggression (B = 0.45; 95% CI = [1.14, 2.07]). Parental education did not affect the associations in an important way. Our findings indicate that Roma are not that much different from non-Roma, in terms of antisocial behavior, which contradicts the general perception of Roma. Our findings should be confirmed in other settings. © The Author(s) 2014.
Junne, Florian; Ziser, Katrin; Giel, Katrin Elisabeth; Schag, Kathrin; Skoda, Eva; Mack, Isabelle; Niess, Andreas; Zipfel, Stephan; Teufel, Martin
2017-01-01
Objective Associations of specific types of stress with increased food intake and subsequent weight gain have been demonstrated in animal models as well as in experimental and epidemiological studies on humans. This study explores the research question of to what extent potentially obesity-related factors determine perceived stress in individuals with obesity. Methods N = 547 individuals with obesity participated in a cross-sectional study assessing perceived stress as the outcome variable and potential determinants of stress related to obesity. Based on the available evidence, a five factorial model of ‘obesity-related obesogenic stressors’ was hypothesized, including the dimensions, ‘drive for thinness’, ‘impulse regulation’, ‘ineffectiveness’, ‘social insecurity’, and ‘body dissatisfaction’. The model was tested using multiple linear regression analyses. Results The five factorial model of ‘potentially obesity-related stressors’ resulted in a total variance explanation of adjusted R² = 0.616 for males and adjusted R² = 0.595 for females for perceived stress. The relative variance contribution of the five included factors differed substantially for the two sexes. Conclusion The findings of this cross-sectional study support the hypothesized, potentially obesity-related factors: ‘drive for thinness’, ‘impulse regulation’, ‘ineffectiveness’, ‘social insecurity’, and ‘body dissatisfaction’ as relevant determinants of perceived stress in individuals with obesity. PMID:28433993
Fenta, Teferi Gedif; Assefa, Tamrat; Alemayehu, Bekele
2017-06-06
Warfarin is the most widely used anticoagulant in the world. The difficulty of managing warfarin contributes to great potential for patient harm, both from excessive anticoagulation and insufficient anticoagulation. This study assessed the International Normalized Ratio (INR) control outcome measures and warfarin dose adjustment practices at cardiology and hematology outpatient clinics at a teaching hospital in Addis Ababa, Ethiopia. The study was based on a cross - sectional study design involving 360 retrospective patients' chart review among outpatients who received warfarin for its various indications. The mean frequency of INR monitoring per patient was 62.9 days (17.2-143.7 days). Patients spent 52.2%, 29.0% and 18.8% of the time in sub-therapeutic, therapeutic and supra-therapeutic ranges, respectively. The daily warfarin dose was increased 50.9% and 36.9% and decreased in 52.8% and 60.9% of the time for occurrences of sub-therapeutic and supra-therapeutic INRs to achieve target ranges of 2.0-3.0 and 2.5-3.5, respectively. The quality of anticoagulation management with warfarin among outpatients in Tikur Anbessa Specialized Hospital was sub-optimal. This was reflected by low Time in Therapeutic Range (TTR), longer than recommended INR monitoring frequency, and minimal actions taken to adjust warfarin dose after occurrences of non-therapeutic INRs.
Relation Between Iliopsoas Cross-sectional Area and Kicked Ball Speed in Soccer Players.
Wakahara, Taku; Chiba, Manabu
2018-05-14
This study aimed to investigate the relationship between the maximal anatomical cross-sectional area (ACSA) of the iliopsoas muscle and ball speed in side-foot and instep kicks. The ACSA of the psoas major and iliacus was measured in 29 male collegiate soccer players by using magnetic resonance imaging. They performed maximal side-foot and instep kicks to a stationary ball. The kicked ball speed was measured with a high-speed camera. Ball speed in the side-foot and instep kicks was significantly correlated with body height (side-foot kick: r=0.650, P<0.001; instep kick: r=0.583, P<0.001). After adjustment for body height, the maximal ACSA of the psoas major was significantly correlated with ball speed in the side-foot kick (r=0.441, P=0.017), but not in the instep kick. The maximal ACSA of the iliacus was not correlated with ball speed in side-foot or instep kicks, even after adjustment for body height. Our results suggest that: 1) body height is a significant determinant of the ball speed in side-foot and instep kicks, and 2) for a given body height, the maximal ACSA of the dominant psoas major is a factor that affects the ball speed in side-foot kick. © Georg Thieme Verlag KG Stuttgart · New York.
Swahn, Monica H; Bossarte, Robert M
2007-08-01
To examine the cross-sectional associations between preteen alcohol use initiation and subsequent suicide ideation and attempts for boys and girls in a nationally representative sample of high school students. Analyses are computed using data from the 2005 national Youth Risk Behavior Survey, which includes a representative sample (n = 13,639) of high-school students in grades 9-12 in the United States. Cross-sectional logistic regression analyses were conducted to determine the associations between early alcohol use and reports of suicide ideation and suicide attempts for boys and girls while controlling for demographic characteristics, substance use, involvement in physical fights, weapon carrying, physical abuse by dating partner, sexual assault, and sadness. Among study participants, 25.4% reported drinking before age 13 years. Preteen alcohol use initiation was statistically significantly associated with suicidal ideation (adjusted OR = 1.89, 95% CI =1.46-2.44) and suicide attempts (adjusted OR = 2.71, 95% CI =1.82-4.02) relative to nondrinkers. Preteen alcohol use initiation was statistically significantly associated with suicidal ideation and attempts relative to nondrinkers for both boys and girls. Alcohol use among adolescents, particularly preteen alcohol use initiation, is an important risk factor for both suicide ideation and suicide attempts among boys and girls. Increased efforts to delay and reduce early alcohol use are needed, and may reduce suicide attempts.
Henchoz, Yves; Dupuis, Marc; Deline, Stéphane; Studer, Joseph; Baggio, Stéphanie; N'Goran, Alexandra Adjua; Daeppen, Jean-Bernard; Gmel, Gerhard
2014-07-01
This study aims to measure the associations of physical activity and one of its components, sport and exercise, with at-risk substance use in a population of young men. Baseline (2010-2012) and follow-up (2012-2013) data of 4748 young Swiss men from the Cohort Study on Substance Use Risk Factors (C-SURF) were used. Cross-sectional and prospective associations between at-risk substance use and both sport and exercise and physical activities were measured using Chi-squared tests and logistic regression models adjusting for covariates. At baseline, logistic regression indicated that sport and exercise is negatively associated with at-risk use of cigarettes and cannabis. A positive association was obtained between physical activity and at-risk alcohol use. At baseline, sport and exercise was negatively associated with at-risk use of cigarettes and cannabis at follow-up. Adjusted for sport and exercise, physical activity was positively associated with at-risk use of cigarettes and cannabis. Sport and exercise is cross-sectionally and longitudinally associated with a low prevalence of at-risk use of cigarettes and cannabis. This protective effect was not observed for physical activity broadly defined. Taking a substance use prevention perspective, the promotion of sport and exercise among young adults should be encouraged. Copyright © 2014 Elsevier Inc. All rights reserved.
Monitoring of Deformation in Ground Before and After Tunnel Excavation
NASA Astrophysics Data System (ADS)
Eren, Mehmet; Hilmi Erkoç, Muharrem
2017-04-01
As population increase in metropolitan city, we need transportation and transmission tunnel. In this context, the engineers and administors attach impotance to building and planning underground-tunnel. Moreover, we must at regular intervals monitoring to deformation in underground-tunnel for quality and safety. Firstly, a deformation monitoring network is designed as perpendicular to the tunnel main axis. Secondly, the prescribed number of deformation measurements must be made. Finally, the deformation analysis is evaluated and its results is interpreted. This study investigates how deformation in monitoring network during and after tunnel excavate change.For this purpose, a deformation monitoring network of 18 object point and 4 reference point was established. Object points networks was designed steeply to the tunnel main axis as 3 cross section. Each cross section consisted of 3 point left, 2 point right and 1 point at the flowing line. Initial conditional measurement was made before tunnel excavation. Then the deformation measurement was made 5 period (1 period measured after tunnel excavate). All data sets were adjusted according to free adjustment method. The results from the investigation considering the tunnel line, a symmetrical subsidence was observed. The following day of tunnel excavation, we were observed %68 per of the total deformation. At the end of the last period measurements, %99 per of the total deformation was detected. Keywords: Tunnel, Deformation, Subsidence, Excavation
Phobic Anxiety and Plasma Levels of Global Oxidative Stress in Women.
Hagan, Kaitlin A; Wu, Tianying; Rimm, Eric B; Eliassen, A Heather; Okereke, Olivia I
2015-01-01
Psychological distress has been hypothesized to be associated with adverse biologic states such as higher oxidative stress and inflammation. Yet, little is known about associations between a common form of distress - phobic anxiety - and global oxidative stress. Thus, we related phobic anxiety to plasma fluorescent oxidation products (FlOPs), a global oxidative stress marker. We conducted a cross-sectional analysis among 1,325 women (aged 43-70 years) from the Nurses' Health Study. Phobic anxiety was measured using the Crown-Crisp Index (CCI). Adjusted least-squares mean log-transformed FlOPs were calculated across phobic categories. Logistic regression models were used to calculate odds ratios (OR) comparing the highest CCI category (≥6 points) vs. lower scores, across FlOPs quartiles. No association was found between phobic anxiety categories and mean FlOP levels in multivariable adjusted linear models. Similarly, in multivariable logistic regression models there were no associations between FlOPs quartiles and likelihood of being in the highest phobic category. Comparing women in the highest vs. lowest FlOPs quartiles: FlOP_360: OR=0.68 (95% CI: 0.40-1.15); FlOP_320: OR=0.99 (95% CI: 0.61-1.61); FlOP_400: OR=0.92 (95% CI: 0.52, 1.63). No cross-sectional association was found between phobic anxiety and a plasma measure of global oxidative stress in this sample of middle-aged and older women.
Kelly, J Daniel; Richardson, Eugene T; Drasher, Michael; Barrie, M Bailor; Karku, Sahr; Kamara, Mohamed; Hann, Katrina; Dierberg, Kerry; Hubbard, Allan; Lindan, Christina P; Farmer, Paul E; Rutherford, George W; Weiser, Sheri D
2018-05-01
Studies have shown that people suffering from food insecurity are at higher risk for infectious and noncommunicable diseases and have poorer health outcomes. No study, however, has examined the association between food insecurity and outcomes related to Ebola virus disease (EVD). We conducted a cross-sectional study in two Ebola-affected communities in Kono district, Sierra Leone, from November 2015 to September 2016. We enrolled persons who were determined to have been exposed to Ebola virus. We assessed the association of food insecurity, using an adapted version of the Household Food Insecurity Access Scale, a nine-item scale well validated across Africa, with having been diagnosed with EVD and having died of EVD, using logistic regression models with cluster-adjusted standard errors. We interviewed 326 persons who were exposed to Ebola virus; 61 (19%) were diagnosed with EVD and 45/61 (74%) died. We found high levels (87%) of food insecurity, but there was no association between food insecurity and having been diagnosed with EVD. Among EVD cases, those who were food insecure had 18.3 times the adjusted odds of death than those who were food secure ( P = 0.03). This is the first study to demonstrate a potential relationship between food insecurity and having died of EVD, although larger prospective studies are needed to confirm these findings.
An evolutionary attractor model for sapwood cross section in relation to leaf area.
Westoby, Mark; Cornwell, William K; Falster, Daniel S
2012-06-21
Sapwood cross-sectional area per unit leaf area (SA:LA) is an influential trait that plants coordinate with physical environment and with other traits. We develop theory for SA:LA and also for root surface area per leaf area (RA:LA) on the premise that plants maximizing the surplus of revenue over costs should have competitive advantage. SA:LA is predicted to increase in water-relations environments that reduce photosynthetic revenue, including low soil water potential, high water vapor pressure deficit (VPD), and low atmospheric CO(2). Because sapwood has costs, SA:LA adjustment does not completely offset difficult water relations. Where sapwood costs are large, as in tall plants, optimal SA:LA may actually decline with (say) high VPD. Large soil-to-root resistance caps the benefits that can be obtained from increasing SA:LA. Where a plant can adjust water-absorbing surface area of root per leaf area (RA:LA) as well as SA:LA, optimal RA:SA is not affected by VPD, CO(2) or plant height. If selection favours increased height more so than increased revenue-minus-cost, then height is predicted to rise substantially under improved water-relations environments such as high-CO(2) atmospheres. Evolutionary-attractor theory for SA:LA and RA:LA complements models that take whole-plant conductivity per leaf area as a parameter. Copyright © 2012 Elsevier Ltd. All rights reserved.
Lerchbaum, E; Schwetz, V; Nauck, M; Völzke, H; Wallaschofski, H; Hannemann, A
2015-05-01
Accumulating evidence demonstrates an important interaction between bone and energy metabolism. We aimed to study the associations of three bone turnover markers (BTM: osteocalcin, beta-crosslaps, procollagen type 1 N-terminal propeptide) as well as of 25-hydroxyvitamin D and parathyroid hormone with metabolic syndrome (MetS) or type 2 diabetes mellitus (T2DM) in a large population-based cohort. This cross-sectional study comprised 2671 adult men and women participating in the first follow-up of the population-based Study of Health in Pomerania (SHIP-1). Multivariable logistic regression analyses were performed to assess sex-specific associations between the BTMs, 25-hydroxyvitamin D or parathyroid hormone and metabolic disease. All models were adjusted for age, body mass index, smoking status, physical activity, estimated glomerular filtration rate and month of blood sampling. The models for women were further adjusted for menopausal status. Higher BTM or 25-hydroxyvitamin D concentrations were associated with significantly lower odds for metabolic disease, while there was no association between parathyroid hormone and MetS or T2DM. Our results contribute to the accumulating evidence of a cross-sectional association between high BTM or 25-hydroxyvitamin D concentrations and a lower prevalence of MetS or T2DM. Further research is necessary to evaluate the mechanisms underlying these results. Copyright © 2015 Elsevier B.V. All rights reserved.
Joyce, Rachel; Webb, R; Peacock, Janet
2002-11-01
We performed a cross-sectional study of all Thames maternity units, 1994-96, including 540,834 live and stillbirths. In contrast to recent media speculation, no association of caesarean section rates with midwifery staffing levels was found after adjustment for confounders. The only association with staffing was with levels of junior obstetric staffing, which could be a reflection of less experienced management of labour. Caesarean section rates were also associated positively with the levels of delivery beds, which could be a reflection of the closer monitoring of labour that may result from increased bed availability. Both caesarean section and instrumental vaginal delivery rates were associated with epidural rates, which was expected from the literature. Variations in epidural rates were mainly associated with variations in demographic case-mix, due possibly to patient demand. Demographic case-mix was also associated with instrumental vaginal deliveries but not the caesarean section rate.
40 CFR 63.92 - Approval of State requirements that adjust a section 112 rule.
Code of Federal Regulations, 2010 CFR
2010-07-01
... adjust a section 112 rule. 63.92 Section 63.92 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... requirements that adjust a section 112 rule. Under this section a State may seek approval of State requirements that make pre-approved adjustments to a Federal section 112 rule, emission standard, or requirement...
Hospital care for mental health and substance abuse conditions in Parkinson's disease.
Willis, Allison W; Thibault, Dylan P; Schmidt, Peter N; Dorsey, E Ray; Weintraub, Daniel
2016-12-01
The objective of this study was to examine mental health conditions among hospitalized individuals with Parkinson's disease in the United States. This was a serial cross-sectional study of hospitalizations of individuals aged ≥60 identified in the Nationwide Inpatient Sample dataset from 2000 to 2010. We identified all hospitalizations with a diagnosis of PD, alcohol abuse, anxiety, bipolar disorder, depression, impulse control disorders, mania, psychosis, substance abuse, and attempted suicide/suicidal ideation. National estimates of each mental health condition were compared between hospitalized individuals with and without PD. Hierarchical logistic regression models determined which inpatient mental health diagnoses were associated with PD, adjusting for demographic, payer, geographic, and hospital characteristics. We identified 3,918,703 mental health and substance abuse hospitalizations. Of these, 2.8% (n = 104, 437) involved a person also diagnosed with PD. The majority of mental health and substance abuse patients were white (86.9% of PD vs 83.3% of non-PD). Women were more common than men in both groups (male:female prevalence ratio, PD: 0.78, 0.78-0.79, non-PD: 0.58, 0.57-0.58). Depression (adjusted odds ratio 1.32, 1.31-1.34), psychosis (adjusted odds ratio 1.25, 1.15-1.33), bipolar disorder (adjusted odds ratio 2.74, 2.69-2.79), impulse control disorders (adjusted odds ratio 1.51, 1.31-1.75), and mania (adjusted odds ratio 1.43, 1.18-1.74) were more likely among PD patients, alcohol abuse was less likely (adjusted odds ratio 0.26, 0.25-0.27). We found no PD-associated difference in suicide-related care. PD patients have unique patterns of acute care for mental health and substance abuse. Research is needed to guide PD treatment in individuals with pre-existing psychiatric illnesses, determine cross provider reliability of psychiatric diagnoses in PD patients, and inform efforts to improve psychiatric outcomes. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.
Clarke, Sally-Ann; Newell, Robert; Thompson, Andrew; Harcourt, Diana; Lindenmeyer, Antje
2014-01-01
Psychosocial difficulties have been reported in head and neck cancer (HNC) patients, yet only few studies have assessed the impact of altered appearance following HNC treatment using theoretically selected measures of appearance-related distress. This study investigated appearance-related adjustment following HNC, and demographic and socio-cognitive predictors of adjustment. HNC patients (n=49) completed baseline questionnaires and a nine-month postal follow-up (n=20). Participants showed considerable variation in appearance-related adjustment, with females reporting higher levels of appearance-related distress (derriford appearance scale [DAS-24]) than females in the general population and male HNC survivors. Depression scores on the hospital anxiety and depression scale were higher than UK norms whilst anxiety was similar to UK norms. There were no significant differences between baseline and follow-up data. Fear of negative evaluation (a central feature of social anxiety) was a significant predictor of appearance-related adjustment at baseline, whilst dispositional optimism was a significant predictor of appearance-related adjustment at baseline and follow-up. Qualitative responses showed themes of appearance and disability, and coping strategies. Findings suggest that appearance-related adjustment post-HNC varies considerably and psychosocial services working with HNC patients should consider this broad pattern of response. Future research to examine the role of socio-cognitive predictors of appearance-related adjustment could progress development of effective psychological interventions.
Adverse maternal and neonatal outcomes in women with preeclampsia in Iran.
Omani-Samani, Reza; Ranjbaran, Mehdi; Amini, Payam; Esmailzadeh, Arezoo; Sepidarkish, Mahdi; Almasi-Hashiani, Amir
2017-09-18
Preeclampsia is relatively a common complication in pregnancy and is characterized by high blood pressure and protein in urine during pregnancy. Consistent with the adverse outcomes followed by preeclampsia, this study designed to investigate the how preeclampsia is associated with preterm, low birth weight (LBW), cesarean section, and weigh gain during pregnancy. In this population-based cross-sectional study, 5166 deliveries from 103 hospitals in Tehran (Capital of Iran) were included in the analysis in 2015. The independent variable was preeclampsia during pregnancy and weight gain during pregnancy, preterm birth, cesarean section, and LBW were considered as interested outcomes. The data were analyzed by statistical Stata software (version 13, Stata Inc., College Station, TX). Adjusted results showed that the mean of weight gain in women with preeclampsia was significantly higher than women without preeclampsia (mean difference: 1.77 kg, 95%CI: 0.76-12.78, p = .001). The adjusted odds ratio for preterm birth, cesarean section, and LBW were 4.19 (95%CI: 2.71-6.48, p = .001), 1.92 (95%CI: 1.24-2.98, p = .003), and 1.19 (95%CI: 0.61-2.31, p = .599), respectively. Weight gain in women with preeclampsia was higher than women without preeclampsia and also the odds of preterm birth, cesarean section and LBW in women with preeclampsia was higher than women without preeclampsia.
Petersen, S R; Bagnall, K M; Wenger, H A; Reid, D C; Castor, W R; Quinney, H A
1989-01-01
This work was supported by Sport Canada end Hydra-Fitness Industries. In order to investigate the effects of velocity-specific resistance training, 30 healthy, male varsity athletes were assigned to either high (HVR) or low (LVR) velocity training or control (CG) groups. Subjects completed two 20-sec sets of maximal exercise at each of six hydraulic resistance stations for the lower limb. Resistances were adjusted as necessary to maintain consistent average angular velocities of approximately 1.05 and 3.14 rad/sec for the LVR and HVR groups, respectively. Subjects trained on alternate days for 6 weeks, completing either two (weeks 1 and 2) or three (weeks 3-6) circuits of the six stations each session. Peak knee extension torques were improved (p < 0.05) for the LVR group at all of seven angular velocities tested between 1.05 and 4.19 rad/sec. Improvements (p < 0.05) were also observed for the HVR group, but only at angular velocities of 2.62, 3.14, 3.66, and 4.19 rad/sec. Cross-sectional area of the quadriceps femoris muscle group obtained from serial computer tomography (CT) scans was increased (p < 0.05) for both training groups. No significant changes in either strength or cross-sectional area were observed for control subjects. These results indicate that while both of the training programs resulted in increased cross-sectional area of the knee extensors, the observed changes in strength performance are likely due to other factors which may be mediated by the different training velocities. J Orthop Sports Phys Ther 1989;10(11):456-462.
Skutnik, Steven E.
2016-09-22
154Eu is a nuclide of considerable importance to both non-destructive measurements of used nuclear fuel assembly burnup as well as for calculating the radiation source term for used fuel storage and transportation. But, recent evidence from code validation studies of spent fuel benchmarks have revealed evidence of a systemic bias in predicted 154Eu inventories when using ENDF/B-VII.0 and ENDF/B-VII.1 nuclear data libraries, wherein Eu-154 is consistently over-predicted on the order of 10% or more. Further, this bias is found to correlate with sample burnup, resulting in a larger departure from experimental measurements for higher sample burnups. Here, the bias in Eu-154 is characterized across eleven spent fuel destructive assay benchmarks from five different assemblies. Based on these studies, possible amendments to the ENDF/B-VII.0 and VII.1 evaluations of the 154Eu (n,γ) 155Eu are explored. By amending the location of the first resolved resonance for the 154Eu radiative capture cross-section (centered at 0.195 eV in ENDF/B-VII.0 and VII.1) to 0.188 eV and adjusting the neutron capture width proportional tomore » $$\\sqrt1/E$$, the amended cross-section evaluation was found to reduce the bias in predicted 154Eu inventories by approximately 5–7%. And while the amended capture cross-section still results in a residual over-prediction of 154Eu (ranging from 2% to 9%), the effect is substantially attenuated compared with the nominal ENDF/B-VII.0 and VII.1 evaluations.« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
Skutnik, Steven E.
154Eu is a nuclide of considerable importance to both non-destructive measurements of used nuclear fuel assembly burnup as well as for calculating the radiation source term for used fuel storage and transportation. But, recent evidence from code validation studies of spent fuel benchmarks have revealed evidence of a systemic bias in predicted 154Eu inventories when using ENDF/B-VII.0 and ENDF/B-VII.1 nuclear data libraries, wherein Eu-154 is consistently over-predicted on the order of 10% or more. Further, this bias is found to correlate with sample burnup, resulting in a larger departure from experimental measurements for higher sample burnups. Here, the bias in Eu-154 is characterized across eleven spent fuel destructive assay benchmarks from five different assemblies. Based on these studies, possible amendments to the ENDF/B-VII.0 and VII.1 evaluations of the 154Eu (n,γ) 155Eu are explored. By amending the location of the first resolved resonance for the 154Eu radiative capture cross-section (centered at 0.195 eV in ENDF/B-VII.0 and VII.1) to 0.188 eV and adjusting the neutron capture width proportional tomore » $$\\sqrt1/E$$, the amended cross-section evaluation was found to reduce the bias in predicted 154Eu inventories by approximately 5–7%. And while the amended capture cross-section still results in a residual over-prediction of 154Eu (ranging from 2% to 9%), the effect is substantially attenuated compared with the nominal ENDF/B-VII.0 and VII.1 evaluations.« less
Circulating linoleic acid and alpha-linolenic acid and glucose metabolism: the Hoorn Study.
Cabout, Mieke; Alssema, Marjan; Nijpels, Giel; Stehouwer, Coen D A; Zock, Peter L; Brouwer, Ingeborg A; Elshorbagy, Amany K; Refsum, Helga; Dekker, Jacqueline M
2017-09-01
Data on the relation between linoleic acid (LA) and alpha-linolenic acid (ALA) and type 2 diabetes mellitus (T2DM) risk are scarce and inconsistent. The aim of this study was to investigate the association of serum LA and ALA with fasting and 2 h post-load plasma glucose and glycated hemoglobin (HbA1c). This study included 667 participants from third examination (2000) of the population-based Hoorn study in which individuals with glucose intolerance were overrepresented. Fatty acid profiles in serum total lipids were measured at baseline, in 2000. Diabetes risk markers were measured at baseline and follow-up in 2008. Linear regression models were used in cross-sectional and prospective analyses. In cross-sectional analyses (n = 667), serum LA was inversely associated with plasma glucose, both in fasting conditions (B = -0.024 [-0.045, -0.002]) and 2 h after glucose tolerance test (B = -0.099 [-0.158, -0.039]), but not with HbA1c (B = 0.000 [-0.014, 0.013]), after adjustment for relevant factors. In prospective analyses (n = 257), serum LA was not associated with fasting (B = 0.003 [-0.019, 0.025]) or post-load glucose (B = -0.026 [-0.100, 0.049]). Furthermore, no significant associations were found between serum ALA and glucose metabolism in cross-sectional or prospective analyses. In this study, serum LA was inversely associated with fasting and post-load glucose in cross-sectional, but not in prospective analyses. Further studies are needed to elucidate the exact role of serum LA and ALA levels and dietary polyunsaturated fatty acids in glucose metabolism.
Metal poisons for criticality in waste streams
DOE Office of Scientific and Technical Information (OSTI.GOV)
Williamson, T.G.; Goslen, A.Q.
1996-12-31
Many of the wastes from processing fissile materials contain metals that may serve as neutron poisons. It would be advantageous to the criticality evaluation of these wastes to demonstrate that the poisons remain with the fissile materials and to demonstrate an always safe poison-to-fissile ratio. The first task, demonstrating that the materials stay together, is the job of the chemist; the second, calculating an always safe ratio, is an object of this paper. In an earlier study, the authors demonstrated safe ratios for iron, manganese, and chromium oxides to {sup 235}U. In these studies, the Hansen-Roach 16-group cross sections weremore » used with the Savannah River site code HRXN. Multiplication factors were computed, and safe ratios were defined such that the adjusted neutron multiplication factors (k values) were <0.95. These safe weight ratios were Fe:{sup 235}U - 77:1; Mn:{sup 235}U - 30:1; and Cr:{sup 235}U - 52:1. Palmer has shown that for certain mixtures of aluminum, iron, and zirconium with {sup 235}U, the computed infinite multiplication factors may differ by as much as 20% with different cross sections and processing systems. Parks et al. have further studied these mixtures and state, {open_quotes}...these metal/uranium mixtures are very sensitive to the metal cross-section data in the intermediate-energy range and the processing methods that are used.{close_quotes} They conclude with a call for more experimental data. The purpose of this study is to reexamine earlier work with cross sections and processing codes used at Westinghouse Savannah River Company today. This study will focus on {sup 235}U mixtures with iron, manganese and chromium. Sodium will be included in the list of poisons because it is abundant in many of the waste materials.« less
Hattori, Yuta; Naito, Mariko; Satoh, Masahiko; Nakatochi, Masahiro; Naito, Hisao; Kato, Masashi; Takagi, Sahoko; Matsunaga, Takashi; Seiki, Toshio; Sasakabe, Tae; Suma, Shino; Kawai, Sayo; Okada, Rieko; Hishida, Asahi; Hamajima, Nobuyuki; Wakai, Kenji
2016-01-01
Metallothioneins (MTs) are proteins that protect cells from toxic agents such as heavy metal ions or reactive oxygen species. MT2A A-5G is a single nucleotide polymorphism in the promoter region of the MT2A gene, and the minor G allele results in lower transcription efficiency. We aimed to elucidate associations between MT2A A-5G and risks of 2 diseases potentially related to lowered MT expression, chronic kidney disease (CKD), and diabetes mellitus (DM), in a community-dwelling population. Study subjects were Nagoya city residents participating in the Japan Multi-Institutional Collaborative Cohort Study (J-MICC) Daiko Study, comprised 749 men and 2,025 women, aged 39–75 years. CKD (>stage 3) and DM were defined by standard guidelines. Associations were evaluated using logistic regression models with adjustments for age, sex and potential confounders in a cross-sectional study, and verified in a 5-year longitudinal study. Odds ratios (OR [95% confidence interval]) were calculated relative to the AA genotype. Serum MT (I + II), Cd and zinc levels were also determined by genotype. The OR of the GG genotype for CKD risk was 3.98 (1.50, 10.58) in the cross-sectional study and 5.17 (1.39, 19.28) in the longitudinal study. The OR of the GA genotype for DM was 1.86 (1.26, 2.75) in the cross-sectional study and 2.03 (1.19, 3.46) in the longitudinal study. MT2A A-5G may be associated with CKD and DM risks. This polymorphism is a promising target for evaluations of CKD and DM risks with possible involvement of low-dose chronic exposure to environmental pollutants. PMID:27122239
Salas-Wright, Christopher P; Vaughn, Michael G; Perron, Brian E; Gonzalez, Jennifer M Reingle; Goings, Trenette Clark
2016-12-01
Prior research has often overlooked potential cohort differences in marijuana views and use across adolescence and young adulthood. To begin to address this gap, we conduct an exploratory examination of marijuana views and use among American youth using a panel of cross-sectional surveys. Findings are based on repeated, cross-sectional data collected annually from adolescents (ages 12-17; n=230,452) and young adults (ages 18-21; n=120,588) surveyed as part of the National Survey on Drug Use and Health between 2002 and 2014. For each of the birth years between 1986 and 1996, we combined a series of nationally representative cross-sections to provide multi-year data strings designed to approximate nationally representative cohorts. Compared to youth born in the mid-to-late 1980s, youth born in the mid-1990s reported significantly higher levels of marijuana disapproval during the early adolescent years (Age 14: 1988=64.7%, 1994=70.4%) but lower levels of disapproval during the young adult years (Age 19: 1988=32.0%, 1994=25.0%; Age 20: 1988=27.9%, 1994=19.7%). Moreover, the prevalence of marijuana use among youth born in 1994 was significantly lower-compared to youth born in 1988-at age 14 (1988: 11.39%, 1994: 8.19%) and significantly higher at age 18 (1988: 29.67%, 1994: 34.83%). This pattern held even when adjusting for potential confounding by demographic changes in the population across the study period. We see evidence of changes in the perceptions of marijuana use among youth born during the late twentieth century. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Kim, Ju Hee; Shin, Hye Sook; Yun, Eun Kyoung
2018-03-01
This study was conducted to examine the level of infertility stress, marital adjustment, depression, and quality of life in infertile couples and assess the actor and partner effects in these areas using the actor-partner interdependence model. Cross-sectional study. Participants were 121 infertile couples. After pilot study, data were collected from November 2012 to March 2013 using the following questionnaires: the Fertility Quality of Life, Fertility Problem Inventory, Revised Dyadic Adjustment Scale, and Beck Depression Inventory. There was a gender difference in infertility stress, depression, and quality of life. Infertility stress had actor and partner effects on the quality of life. Marital adjustment had an actor effect on the quality of life for the wives. Depression had actor and partner effects on quality of life for the wives, but only an actor effect for the husbands. This study found that there were actor and partner effects of infertility stress, marital adjustment, and depression on the quality of life in infertile couples. These findings may help nurses be aware of such effects and can be used as a baseline data in the development of nursing interventions for infertile couples.
Molecular quenching and relaxation in a plasmonic tunable system
NASA Astrophysics Data System (ADS)
Baffou, Guillaume; Girard, Christian; Dujardin, Erik; Colas Des Francs, Gérard; Martin, Olivier J. F.
2008-03-01
Molecular fluorescence decay is significantly modified when the emitting molecule is located near a plasmonic structure. When the lateral sizes of such structures are reduced to nanometer-scale cross sections, they can be used to accurately control and amplify the emission rate. In this Rapid Communication, we extend Green’s dyadic method to quantitatively investigate both radiative and nonradiative decay channels experienced by a single fluorescent molecule confined in an adjustable dielectric-metal nanogap. The technique produces data in excellent agreement with current experimental work.
Global alpha-particle optical potentials
NASA Astrophysics Data System (ADS)
Ferdous, N.
1991-12-01
A search for a global optical potential (for alpha-particles) is described. It was not possible to find a potential that was valid for a wide range of energies and nuclei, even treating the absorbing potential as an adjustable parameter for each nucleus. For practical purposes the best that can be done is to define an average potential, and such a potential is compared with a wide range of experimental data. Its energy variation is determined by fitting the total reaction cross-section.
NASA Astrophysics Data System (ADS)
Zroichikov, N. A.; Lyskov, M. G.; Prokhorov, V. B.; Morozova, E. A.
2007-06-01
We describe a proposed small-size cavitator having an adjustable flow cross-section, which allows the dispersion of water-fuel oil emulsion to be varied during the operation of large-capacity boilers. It is shown that the operating conditions of the boiler must be synchronized with those of the cavitator if we wish the problem of reducing the amount of harmful substances emitted into the atmosphere during the combustion of fuel oil to be solved in a comprehensive manner.
Flexible Endian Adjustment for Cross Architecture Binary Translation
NASA Astrophysics Data System (ADS)
Zhu, Tong; Liu, Bo; Guan, Haibing; Liang, Alei
Different architectures and/or ISA (Instruction Set Architecture) representations hold different data arranging formats in the memory. Therefore, the adjustment of byte packing order (endianness) is indispensable in cross- architecture binary translation if the source and target machines are of heterogeneous endianness, which may otherwise cause system failure. The issue is inconspicuous but may lead to significant performance bottleneck. This paper investigates the key aspects of endianness and finds several solutions to endian adjustment for cross-architecture binary translation. In particular, it considers the two principal methods of this field - byte swapping and address swizzling, and gives a comparison of them in our DBT (Dynamic Binary Translator) - CrossBit.
Culture, Cross-Role Consistency, and Adjustment: Testing Trait and Cultural Psychology Perspectives
Church, A. Timothy; Anderson-Harumi, Cheryl A.; del Prado, Alicia M.; Curtis, Guy J.; Tanaka-Matsumi, Junko; Valdez Medina, José L.; Mastor, Khairul A.; White, Fiona A.; Miramontes, Lilia A.; Katigbak, Marcia S.
2008-01-01
Trait and cultural psychology perspectives on cross-role consistency and its relation to adjustment were examined in two individualistic cultures, the United States (N = 231) and Australia (N = 195), and four collectivistic cultures, Mexico (N = 199), Philippines (N = 195), Malaysia (N = 217), and Japan (N = 180). Cross-role consistency in trait ratings was evident in all cultures, supporting trait perspectives. Cultural comparisons of mean consistency provided support for cultural psychology perspectives as applied to East Asian cultures (i.e., Japan), but not collectivistic cultures more generally. Some but not all of the hypothesized predictors of consistency were supported across cultures. Cross-role consistency predicted aspects of adjustment in all cultures, but prediction was most reliable in the American sample and weakest in the Japanese sample. Alternative constructs proposed by cultural psychologists—personality coherence, social appraisal, and relationship harmony—predicted adjustment in all cultures, but were not, as hypothesized, better predictors of adjustment in collectivistic cultures than in individualistic cultures. PMID:18729706
Culture, cross-role consistency, and adjustment: testing trait and cultural psychology perspectives.
Church, A Timothy; Anderson-Harumi, Cheryl A; del Prado, Alicia M; Curtis, Guy J; Tanaka-Matsumi, Junko; Valdez Medina, José L; Mastor, Khairul A; White, Fiona A; Miramontes, Lilia A; Katigbak, Marcia S
2008-09-01
Trait and cultural psychology perspectives on cross-role consistency and its relation to adjustment were examined in 2 individualistic cultures, the United States (N=231) and Australia (N=195), and 4 collectivistic cultures, Mexico (N=199), the Philippines (N=195), Malaysia (N=217), and Japan (N=180). Cross-role consistency in trait ratings was evident in all cultures, supporting trait perspectives. Cultural comparisons of mean consistency provided support for cultural psychology perspectives as applied to East Asian cultures (i.e., Japan) but not collectivistic cultures more generally. Some but not all of the hypothesized predictors of consistency were supported across cultures. Cross-role consistency predicted aspects of adjustment in all cultures, but prediction was most reliable in the U.S. sample and weakest in the Japanese sample. Alternative constructs proposed by cultural psychologists--personality coherence, social appraisal, and relationship harmony--predicted adjustment in all cultures but were not, as hypothesized, better predictors of adjustment in collectivistic cultures than in individualistic cultures.
Extremism, religion and psychiatric morbidity in a population-based sample of young men.
Coid, Jeremy W; Bhui, Kamaldeep; MacManus, Deirdre; Kallis, Constantinos; Bebbington, Paul; Ullrich, Simone
2016-12-01
There is growing risk from terrorism following radicalisation of young men. It is unclear whether psychopathology is associated. To investigate the population distribution of extremist views among UK men. Cross-sectional study of 3679 men, 18-34 years, in Great Britain. Multivariate analyses of attitudes, psychiatric morbidity, ethnicity and religion. Pro-British men were more likely to be White, UK born, not religious; anti-British were Muslim, religious, of Pakistani origin, from deprived areas. Pro- and anti-British views were linearly associated with violence (adjusted odds ratio (OR) = 1.51, 95% CI 1.38-1.64, P<0.001, adjusted OR = 1.33, 95% CI 1.13-1.58, P<0.001, respectively) and negatively with depression (adjusted OR = 0.72, 95% CI 0.61-0.85, P<0.001, adjusted OR = 0.64, 95% CI 0.48-0.86, P = 0.003, respectively). Men at risk of depression may experience protection from strong cultural or religious identity. Antisocial behaviour increases with extremism. Religion is protective but may determine targets of violence following radicalisation. © The Royal College of Psychiatrists 2016.
Trends in prevalence of patient case-mix adjusters used in the Medicare dialysis payment system.
Hollenbeak, Christopher S; Rubin, Robert J; Tzivelekis, Spiros; Stephens, J Mark
2015-06-01
The Medicare End-Stage Renal Disease Prospective Payment System (PPS) used data from 2006-08 to set weights for each case-mix adjuster that is part of the bundled payment formula. The details of the population case-mix were not made public, and little is known about consistency of case-mix over time. This study estimated the prevalence of case-mix adjusters during 2006-2008 and analyzed changes in case-mix prevalence from 2000-2008. Cross-sectional cohort study using United States Renal Data System data for Medicare dialysis patients. Three 3-year cohorts (2000-02, 2003-05, 2006-08) were analyzed for changes over time in case-mix prevalence. Double-digit trends were observed in many case-mix categories between 2000-02 and 2006-08. Large declines were observed in prevalence of patients with low BMI, pericarditis, new to dialysis, and ages 18-44. Large increases were observed in chronic co-morbidities, pneumonia and age cohort 80+. Substantial changes in case-mix adjuster prevalence suggest the PPS payment formula should be regularly updated.
Extremism, religion and psychiatric morbidity in a population-based sample of young men
Coid, Jeremy W.; Bhui, Kamaldeep; MacManus, Deirdre; Kallis, Constantinos; Bebbington, Paul; Ullrich, Simone
2016-01-01
Background There is growing risk from terrorism following radicalisation of young men. It is unclear whether psychopathology is associated. Aims To investigate the population distribution of extremist views among UK men. Method Cross-sectional study of 3679 men, 18–34 years, in Great Britain. Multivariate analyses of attitudes, psychiatric morbidity, ethnicity and religion. Results Pro-British men were more likely to be White, UK born, not religious; anti-British were Muslim, religious, of Pakistani origin, from deprived areas. Pro- and anti-British views were linearly associated with violence (adjusted odds ratio (OR) = 1.51, 95% CI 1.38–1.64, P<0.001, adjusted OR = 1.33, 95% CI 1.13–1.58, P<0.001, respectively) and negatively with depression (adjusted OR = 0.72, 95% CI 0.61–0.85, P<0.001, adjusted OR = 0.64, 95% CI 0.48–0.86, P = 0.003, respectively). Conclusions Men at risk of depression may experience protection from strong cultural or religious identity. Antisocial behaviour increases with extremism. Religion is protective but may determine targets of violence following radicalisation. PMID:27765774
ERIC Educational Resources Information Center
Townes, Brenda D.; And Others
1976-01-01
This study investigates differences in psychological sex, present and past adjustment, and parental influences among homosexual cross-dressers, homosexual non-cross-dressers, applicants for sex change surgery, and heterosexuals. Homosexual non-cross-dressers and heterosexual groups had the most masculine gender role, with the sex change group…
ERIC Educational Resources Information Center
Baba, Yoko; Hosoda, Megumi
2014-01-01
Numerous studies have examined international students' adjustment problems, yet, these studies have not explored the mechanisms through which social support operates in the context of stressful events in predicting cross-cultural adjustment among international students. Using Barrera's (1988) models of social support, the present study…
ERIC Educational Resources Information Center
Swagler, Michelle A.; Jome, LaRae M.
2005-01-01
As more North Americans sojourn abroad in the emerging global marketplace, it is important to understand the factors related to successful cross-cultural adjustment. This study explores how personality factors and acculturation influence the cross-cultural adjustment process of North Americans sojourning in Taiwan. The results reveal that greater…
Johansson, Gun; Hultin, Hanna; Möller, Jette; Hallqvist, Johan; Kjellberg, Katarina
2012-07-01
Adjustment latitude describes opportunities to change demands at work when ill and may affect work ability. The aim here is to study the association between adjustment latitude and self-assessed work ability among men and women and employees from different occupational sectors. This cross-sectional study used data from a questionnaire sent to 3020 employees in three occupational sectors in Sweden; 1430 responded. Subjects were divided into: full, moderately reduced, and greatly reduced work ability. Presence of nine adjustment opportunities was requested and subjects were divided into three groups. Each specific opportunity was also analyzed in relation to work ability. Multinomial logistic regression was used for analyses. Number of opportunities to adjust was associated with work ability among men and employees in health care. "Shortening the working day" was associated with work ability in most groups. For men and industrial employees, "postponing work", "going home and working later", and "working without disturbance" were associated with work ability. "To work from home" was associated with work ability among women and employees in insurance. The assumption that adjustment latitude affects work ability is supported. Associations differ with regard to gender and occupational sectors. Further studies with longitudinal design and alternative samples are needed.
Factors influencing rising caesarean section rates in China between 1988 and 2008.
Feng, Xing Lin; Xu, Ling; Guo, Yan; Ronsmans, Carine
2012-01-01
To identify factors driving the rapid increase in caesarean section in China between 1988 and 2008. Data from four national cross-sectional surveys (1993, 1998, 2003 and 2008) and modified Poisson regression were used to determine whether changes in household income, access to health insurance or women's education accounted for the rise in caesarean sections in urban and rural areas. In 2008, 64.1% of urban women and 11.3% of women in the poorest rural region reported giving birth by caesarean section. A fast rise was occurring in all socioeconomic groups. Between 1993 and 2008, the risk of caesarean section had increased more than threefold in urban areas (relative risk, RR: 3.63; 95% confidence interval, CI: 2.61-5.04) and more than 15-fold in rural areas (RR: 15.46; 95% CI: 10.46-22.86). After adjustment for improvements in income, education and access to health insurance over the study period, the RR dropped minimally in urban areas (RR: 3.07; 95% CI: 2.32-4.07), which suggests that these factors do not explain the rise; in rural areas, the adjusted RR dropped to 7.18 (95% CI: 4.82-10.69), which shows that socioeconomic change is only partly responsible for the rise. Socioeconomic region of residence was a more important driver of the caesarean section rate than individual socioeconomic status. The large variation in caesarean section rate by socioeconomic region--independent of individual income, health insurance or education--suggests that structural factors related to service supply have influenced the increasing rate more than a woman's ability to pay.
Uncertainty Quantification Techniques of SCALE/TSUNAMI
DOE Office of Scientific and Technical Information (OSTI.GOV)
Rearden, Bradley T; Mueller, Don
2011-01-01
The Standardized Computer Analysis for Licensing Evaluation (SCALE) code system developed at Oak Ridge National Laboratory (ORNL) includes Tools for Sensitivity and Uncertainty Analysis Methodology Implementation (TSUNAMI). The TSUNAMI code suite can quantify the predicted change in system responses, such as k{sub eff}, reactivity differences, or ratios of fluxes or reaction rates, due to changes in the energy-dependent, nuclide-reaction-specific cross-section data. Where uncertainties in the neutron cross-section data are available, the sensitivity of the system to the cross-section data can be applied to propagate the uncertainties in the cross-section data to an uncertainty in the system response. Uncertainty quantification ismore » useful for identifying potential sources of computational biases and highlighting parameters important to code validation. Traditional validation techniques often examine one or more average physical parameters to characterize a system and identify applicable benchmark experiments. However, with TSUNAMI correlation coefficients are developed by propagating the uncertainties in neutron cross-section data to uncertainties in the computed responses for experiments and safety applications through sensitivity coefficients. The bias in the experiments, as a function of their correlation coefficient with the intended application, is extrapolated to predict the bias and bias uncertainty in the application through trending analysis or generalized linear least squares techniques, often referred to as 'data adjustment.' Even with advanced tools to identify benchmark experiments, analysts occasionally find that the application models include some feature or material for which adequately similar benchmark experiments do not exist to support validation. For example, a criticality safety analyst may want to take credit for the presence of fission products in spent nuclear fuel. In such cases, analysts sometimes rely on 'expert judgment' to select an additional administrative margin to account for gap in the validation data or to conclude that the impact on the calculated bias and bias uncertainty is negligible. As a result of advances in computer programs and the evolution of cross-section covariance data, analysts can use the sensitivity and uncertainty analysis tools in the TSUNAMI codes to estimate the potential impact on the application-specific bias and bias uncertainty resulting from nuclides not represented in available benchmark experiments. This paper presents the application of methods described in a companion paper.« less
Fan, Z Joyce; Harris-Adamson, Carisa; Gerr, Fred; Eisen, Ellen A; Hegmann, Kurt T; Bao, Stephen; Silverstein, Barbara; Evanoff, Bradley; Dale, Ann Marie; Thiese, Matthew S; Garg, Arun; Kapellusch, Jay; Burt, Susan; Merlino, Linda; Rempel, David
2015-05-01
Few large epidemiologic studies have used rigorous case criteria, individual-level exposure measurements, and appropriate control for confounders to examine associations between workplace psychosocial and biomechanical factors and carpal tunnel syndrome (CTS). Pooling data from five independent research studies, we assessed associations between prevalent CTS and personal, work psychosocial, and biomechanical factors while adjusting for confounders using multivariable logistic regression. Prevalent CTS was associated with personal factors of older age, obesity, female sex, medical conditions, previous distal upper extremity disorders, workplace measures of peak forceful hand activity, a composite measure of force and repetition (ACGIH Threshold Limit Value for Hand Activity Level), and hand vibration. In this cross-sectional analysis of production and service workers, CTS prevalence was associated with workplace and biomechanical factors. The findings were similar to those from a prospective analysis of the same cohort with differences that may be due to recall bias and other factors. © 2015 Wiley Periodicals, Inc.
AFCI-2.0 Library of Neutron Cross Section Covariances
DOE Office of Scientific and Technical Information (OSTI.GOV)
Herman, M.; Herman,M.; Oblozinsky,P.
2011-06-26
Neutron cross section covariance library has been under development by BNL-LANL collaborative effort over the last three years. The primary purpose of the library is to provide covariances for the Advanced Fuel Cycle Initiative (AFCI) data adjustment project, which is focusing on the needs of fast advanced burner reactors. The covariances refer to central values given in the 2006 release of the U.S. neutron evaluated library ENDF/B-VII. The preliminary version (AFCI-2.0beta) has been completed in October 2010 and made available to the users for comments. In the final 2.0 release, covariances for a few materials were updated, in particular newmore » LANL evaluations for {sup 238,240}Pu and {sup 241}Am were adopted. BNL was responsible for covariances for structural materials and fission products, management of the library and coordination of the work, while LANL was in charge of covariances for light nuclei and for actinides.« less
Vazirian, Mohsen; Nassirimanesh, Bijan; Zamani, Saman; Ono-Kihara, Masako; Kihara, Masahiro; Mortazavi Ravari, Shahrzad; Gouya, Mohammad Mehdi
2005-01-01
HIV infection rates have reached epidemic proportions amongst injecting drug users (IDUs) in Iran. Although a number of community-based interventions have being implemented in the country, there is little information on the risk behaviors of IDU participants in these programs. This cross-sectional report aimed to compare the risk behaviors of injecting drug users with differential exposure rates to an HIV outreach program in Tehran, Iran. Results indicated that shared use of needle/syringe in the past month was significantly lower among IDUs who received estimated ≥ 7 syringes per week than those who did not [adjusted odds ratio (OR) = 14.36, 95% confidence interval (CI) 2.30–89.56]. While the effectiveness of this outreach program needs further evaluation through a longitudinal investigation, our preliminary findings suggest that the outreach program in Tehran may have been beneficial in reducing direct sharing among those who received more than several needles/syringes from the program. PMID:16212655
Light Like a Feather: A Fibrous Natural Composite with a Shape Changing from Round to Square.
Wang, Bin; Meyers, Marc André
2017-03-01
Only seldom are square/rectangular shapes found in nature. One notable exception is the bird feather rachis, which raises the question: why is the proximal base round but the distal end square? Herein, it is uncovered that, given the same area, square cross sections show higher bending rigidity and are superior in maintaining the original shape, whereas circular sections ovalize upon flexing. This circular-to-square shape change increases the ability of the flight feathers to resist flexure while minimizes the weight along the shaft length. The walls are themselves a heterogeneous composite with the fiber arrangements adjusted to the local stress requirements: the dorsal and ventral regions are composed of longitudinal and circumferential fibers, while lateral walls consist of crossed fibers. This natural avian design is ready to be reproduced, and it is anticipated that the knowledge gained from this work will inspire new materials and structures for, e.g., manned/unmanned aerial vehicles.
Velasquez-Melendez, Gustavo; Molina, Maria Del Carmen B; Benseñor, Isabela M; Cardoso, Leticia O; Fonseca, Maria de Jesus M; Moreira, Alexandra D; Pereira, Taísa Sabrina S; Barreto, Sandhi M
2017-02-01
To estimate the association between regular consumption of sweetened soft drinks, natural fruit juice, and coconut water with metabolic syndrome (MetS). This was a cross-sectional study including men and women aged 35-74 years from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) Study, excluding patients with type 2 diabetes. The main explanatory variables were beverage consumption and the outcome variable was metabolic syndrome (Adult Treatment Panel III). After adjustments, a daily intake of 250 ml of soft drink increased the chance of metabolic syndrome (odds ratio [OR] = 1.95; 95% confidence interval [CI], 1.60-2.38). There was no association between coconut water and MetS. Moderate consumption of fruit juices has low odds of MetS compared to no consumption. Our results add evidence to potential negative effects of sweetened soft drinks on cluster metabolic abnormalities in middle-income countries.
Job demands, job resources, and job performance in japanese workers: a cross-sectional study.
Nakagawa, Yuko; Inoue, Akiomi; Kawakami, Norito; Tsuno, Kanami; Tomioka, Kimiko; Nakanishi, Mayuko; Mafune, Kosuke; Hiro, Hisanori
2014-01-01
This study investigated the cross-sectional association of job demands (i.e., psychological demands) and job resources (i.e., decision latitude, supervisor support, co-worker support, and extrinsic reward) with job performance. A total of 1,198 workers (458 males and 740 females) from a manufacturing company in Japan completed a self-administered questionnaire that included the Job Content Questionnaire, Effort-Reward Imbalance Questionnaire, World Health Organization Health and Work Performance Questionnaire, and demographic survey. Hierarchical multiple regression analyses were conducted. After adjusting for demographic characteristics, decision latitude (β=0.107, p=0.001) and extrinsic reward (β=0.158, p<0.001) were positively and significantly associated with job performance while supervisor support (β=-0.102, p=0.002) was negatively and significantly associated with job performance. On the other hand, psychological demands or co-worker support was not significantly associated with job performance. These findings suggest that higher decision latitude and extrinsic reward enhance job performance among Japanese employees.
Job Demands, Job Resources, and Job Performance in Japanese Workers: A Cross-sectional Study
NAKAGAWA, Yuko; INOUE, Akiomi; KAWAKAMI, Norito; TSUNO, Kanami; TOMIOKA, Kimiko; NAKANISHI, Mayuko; MAFUNE, Kosuke; HIRO, Hisanori
2014-01-01
This study investigated the cross-sectional association of job demands (i.e., psychological demands) and job resources (i.e., decision latitude, supervisor support, co-worker support, and extrinsic reward) with job performance. A total of 1,198 workers (458 males and 740 females) from a manufacturing company in Japan completed a self-administered questionnaire that included the Job Content Questionnaire, Effort-Reward Imbalance Questionnaire, World Health Organization Health and Work Performance Questionnaire, and demographic survey. Hierarchical multiple regression analyses were conducted. After adjusting for demographic characteristics, decision latitude (β=0.107, p=0.001) and extrinsic reward (β=0.158, p<0.001) were positively and significantly associated with job performance while supervisor support (β=−0.102, p=0.002) was negatively and significantly associated with job performance. On the other hand, psychological demands or co-worker support was not significantly associated with job performance. These findings suggest that higher decision latitude and extrinsic reward enhance job performance among Japanese employees. PMID:25016948
Light Like a Feather: A Fibrous Natural Composite with a Shape Changing from Round to Square
Wang, Bin
2016-01-01
Only seldom are square/rectangular shapes found in nature. One notable exception is the bird feather rachis, which raises the question: why is the proximal base round but the distal end square? Herein, it is uncovered that, given the same area, square cross sections show higher bending rigidity and are superior in maintaining the original shape, whereas circular sections ovalize upon flexing. This circular‐to‐square shape change increases the ability of the flight feathers to resist flexure while minimizes the weight along the shaft length. The walls are themselves a heterogeneous composite with the fiber arrangements adjusted to the local stress requirements: the dorsal and ventral regions are composed of longitudinal and circumferential fibers, while lateral walls consist of crossed fibers. This natural avian design is ready to be reproduced, and it is anticipated that the knowledge gained from this work will inspire new materials and structures for, e.g., manned/unmanned aerial vehicles. PMID:28331789
Emotional Abilities and the Development of Cross Cultural Competence and Adjustment
2012-04-20
Emotional abilities and the development of cross-cultural competence and adjustment. An empirical study conducted by Patrice A. Reid, Ph.D. Defense...diverse organization, and to better understand the global environment in which we operate.” ~ Leon Panetta, Secretary of Defense Study Objectives • To...investigate the role of understanding emotions and managing emotions in the development of cross-cultural competence. • To examine the impact of cross
Fu, Chang; Li, Zhen; Mao, Zongfu
2018-01-30
Participation in social activities is one of important factors for older adults' health. The present study aims to examine the cross-sectional association between social activities and cognitive function among Chinese elderly. A total of 8966 individuals aged 60 and older from the 2015 China Health and Retirement Longitudinal Study were obtained for this study. Telephone interviews of cognitive status, episodic memory, and visuospatial abilities were assessed by questionnaire. We used the sum of all three of the above measures to represent the respondent's cognitive status as a whole. Types and frequencies of participation in social groups were used to measure social activities. Multiple linear regression analysis was used to explore the relationship between social activities and cognitive function. After adjustment for demographics, smoking, drinking, depression, hypertension, diabetes, basic activities of daily living, instrumental activities of daily living, and self-rated health, multiple linear regression analysis revealed that interaction with friends, participating in hobby groups, and sports groups were associated with better cognitive function among both men and women ( p < 0.05); doing volunteer work was associated with better cognitive function among women but not among men ( p < 0.05). These findings suggest that there is a cross-sectional association between participation in social activities and cognitive function among Chinese elderly. Longitudinal studies are needed to examine the effects of social activities on cognitive function.
Fu, Chang; Li, Zhen; Mao, Zongfu
2018-01-01
Participation in social activities is one of important factors for older adults’ health. The present study aims to examine the cross-sectional association between social activities and cognitive function among Chinese elderly. A total of 8966 individuals aged 60 and older from the 2015 China Health and Retirement Longitudinal Study were obtained for this study. Telephone interviews of cognitive status, episodic memory, and visuospatial abilities were assessed by questionnaire. We used the sum of all three of the above measures to represent the respondent’s cognitive status as a whole. Types and frequencies of participation in social groups were used to measure social activities. Multiple linear regression analysis was used to explore the relationship between social activities and cognitive function. After adjustment for demographics, smoking, drinking, depression, hypertension, diabetes, basic activities of daily living, instrumental activities of daily living, and self-rated health, multiple linear regression analysis revealed that interaction with friends, participating in hobby groups, and sports groups were associated with better cognitive function among both men and women (p < 0.05); doing volunteer work was associated with better cognitive function among women but not among men (p < 0.05). These findings suggest that there is a cross-sectional association between participation in social activities and cognitive function among Chinese elderly. Longitudinal studies are needed to examine the effects of social activities on cognitive function. PMID:29385773
NASA Astrophysics Data System (ADS)
García-Alvarez, J. A.; Fernández-Varea, J. M.; Vanin, V. R.; Santos, O. C. B.; Barros, S. F.; Malafronte, A. A.; Rodrigues, C. L.; Martins, M. N.; Koskinas, M. F.; Maidana, N. L.
2017-08-01
We have used the low-energy beam line of the São Paulo Microtron accelerator to study the maximum energy transfer point (tip) of electron-atom bremsstrahlung spectra for C, Al, Te, Ta and Au. Absolute cross sections differential in energy and angle of the emitted photon were measured for various electron kinetic energies between 20 and 100 keV, and photon emission angles of 35◦, 90◦ and 131◦. The bremsstrahlung spectra were collected with three HPGe detectors and their response functions were evaluated analytically. Rutherford backscattering spectrometry allowed us to obtain the thicknesses of the targets with good accuracy. We propose a simple model for the tip region of the bremsstrahlung spectrum emitted at a given angle, whose adjustable parameters are the mean energy of the incident beam and its spread as well as an amplitude. The model was fitted simultaneously to the pulse-height distributions recorded at the three angles, determining the doubly differential cross sections from the corresponding amplitudes. The measured values have uncertainties between 3% and 13%. The agreement of the experimental results with the theoretical partial-wave calculations of Pratt and co-workers depends on the analyzed element and angle but is generally satisfactory. In the case of Al and Au, the uncertainty attributed to the theory is probably overestimated.
Simmons, Rebecca K; Ko, Gary T; Chan, Juliana C; Cockram, Clive S; Nan, Jennifer H; Griffin, Simon J
2010-11-01
To examine the distribution of plasma glucose and related cardiovascular risk factors in two occupation-based cross-sectional surveys in a Chinese ethnic population. Two cross-sectional surveys in a Hong Kong working population. In 1990, 1496 participants aged 18-66 years underwent an OGTT, anthropometric, and other biochemical measures. Identical measures were collected from 534 participants aged 20-72 years in 2001-2003. Data were direct age-standardised to compare CVD risk factor prevalence. Linear regression modelling was used to examine the distribution of continuous CVD risk factors. Mean (SD) 2-h plasma glucose values were 5.6mmol/l (2.1) in 1990 and 6.5mmol/l (2.5) in 2001-2003, an apparent increase of 0.5mmol/l (95% CI 0.3 to 0.7, p<0.001) after age and sex adjustment. However, there was no significant difference in the age-standardised prevalence of glucose intolerance, overweight or obesity. There were significantly smaller proportions of women with hypertension and hyperlipidaemia and male smokers in the second compared to the first survey. We observed a relatively adverse glycaemia profile, which may have worsened over time, in two healthy populations of survey respondents, with comparatively low rates of most CVD risk factors. This has implications for the future burden of disease associated with hyperglycaemia in this population. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Immediate or deferred adjustment of drug regimens in multidose drug dispensing systems.
Mertens, Bram J; Kwint, Henk-Frans; van Marum, Rob J; Bouvy, Marcel L
2018-05-18
Multidose drug dispensing (MDD) is used to help patients take their medicines appropriately. Little is known about drug regimen changes within these MDD systems and how they are effectuated by the community pharmacist. Manual immediate adjustments of the MDD system could introduce dispensing errors. MDD guidelines therefore recommend to effectuate drug regimen changes at the start of a new MDD system. The aim of this study was to investigate the frequency, type, procedure followed, immediate necessity, and time taken to make MDD adjustments. This was a cross-sectional study in eight community pharmacies in the Netherlands. All adjustments to MDD systems were systematically documented for 3 weeks by the community pharmacist. Overall, 261 MDD adjustments involving 364 drug changes were documented for 250 patients: 127 (35%) drug changes involved the addition of a new drug, 124 (34%) a change in dosage, and 95 (26%) drug discontinuation. Of the MDD adjustments, 135 (52%) were effectuated immediately: 81 (31%) by adjusting the MDD system manually, 49 (19%) by temporarily dispensing the drug separately from the MDD system, and 5 (2%) by ordering a new MDD system. Pharmacists considered that 36 (27%) of the immediate MDD adjustments could have been deferred until the next MDD system was produced. Immediate adjustment took significantly longer than deferred adjustment (p < 0.001). This study shows that in patients using MDD systems, over half of the drug regimen changes are adjusted immediately. The necessity of these immediate changes should be critically evaluated. Copyright © 2018. Published by Elsevier Inc.
NASA Technical Reports Server (NTRS)
Panda, Jayatana; Martin, Fred W.; Sutliff, Daniel L.
2008-01-01
At the wake of the Columbia (STS-107) accident it was decided to remove the Protuberance Aerodynamic Load (PAL) Ramp that was originally intended to protect various protuberances outside of the Space Shuttle External Tank from high buffet load induced by cross-flows at transonic speed. In order to establish the buffet load without the PAL ramp, a wind tunnel test was conducted where segments of the protuberances were instrumented with dynamic pressure transducers; and power-spectra of sectional lift and drag forces at various span-wise locations between two adjacent support brackets were measured under different cross flow angles, Mach number and other conditions. Additionally, frequency-dependent spatial correlations between the sectional forces were also established. The sectional forces were then adjusted by the correlation length to establish span-averaged spectra of normal and lateral forces that can be suitably "added" to various other unsteady forces encountered by the protuberance. This paper describes the methodology used for calculating the correlation-adjusted power spectrum of the buffet load. A second part of the paper describes wind-tunnel results on the difference in the buffet load on the protuberances with and without the PAL ramp. In general when the ramp height is the same as that of the protuberance height, such as that found on the liquid Oxygen part of the tank, the ramp is found to cause significant reduction of the unsteady aerodynamic load. However, on the liquid Hydrogen part of the tank, where the Oxygen feed-line is far larger in diameter than the height of the PAL ramp, little protection is found to be available to all but the Cable Tray.
Total Homocysteine Is Associated With White Matter Hyperintensity Volume
Wright, Clinton B.; Paik, Myunghee C.; Brown, Truman R.; Stabler, Sally P.; Allen, Robert H.; Sacco, Ralph L.; DeCarli, Charles
2005-01-01
Background Total homocysteine (tHcy) has been implicated as a risk factor for stroke and dementia, but the mechanism is unclear. White matter hyperintensities may be a risk factor for both, but studies of the relationship between tHcy and quantitative measures of white matter hyperintensity volume (WMHV) are lacking, especially in minority populations. Methods A community-based sample of 259 subjects with baseline tHcy levels underwent pixel-based quantitative measurement of WMHV. We examined the relationship between tHcy and WMHV adjusting for age, sociodemographics, vascular risk factors, and B12 deficiency. Results Higher levels of tHcy were associated with WMHV adjusting for sociodemographics and vascular risk factors. Conclusions These cross-sectional data provide evidence that tHcy is a risk factor for white matter damage. PMID:15879345
Bekhet, Abir K; Zauszniewski, Jaclene A
2013-09-01
The population of older people in both the United States and Egypt is expected to double by the year 2030. With ageing, chronic illnesses increase and many older people need to relocate to retirement communities. Research has shown that positive cognitions and resourcefulness are positively correlated with adaptive functioning and better adjustment. The purpose of this study was to examine and compare relocation controllability, positive cognitions, resourcefulness and relocation adjustment between American and Egyptian older people living in retirement communities. The purpose of this cultural comparison is to gain insight into influencing factors in each culture that might lead to interventions to help relocated older adults in both cultures adjust to their new surroundings. A cross-sectional, descriptive design was used to compare relocation controllability, positive cognitions, resourcefulness and relocation adjustment of a convenience sample of American older people (n = 104) and a convenience sample of Egyptian older people (n = 94). The study was a secondary analysis of two studies of older people residing in six retirement communities in Northeast Ohio and in five retirement communities in Alexandria, Egypt. Examination of mean scores and standard deviations on the measure of positive cognitions using independent sample t-tests indicated that on average, the American older people reported more positive cognitions (t (131.16) = 11.29, P < 0.001), more relocation controllability (t (196) = -6.78, P < 0.001) and more relocation adjustment (t (196) = 9.42, P < 0.001) than the Egyptian older people. However, there was no significant difference between Egyptians and Americans in resourcefulness (t (174.16) = -0.97, P > 0.05). The results provide direction for the development of positive cognition interventions and engaging older people in the decision-making process to help them to adjust to relocation. Implications for practice. Positive thinking and resourcefulness training interventions can be used by nurses to help relocated older people to adjust to the stress of relocation to retirement communities. These interventions can be used on primary, secondary, and tertiary levels. Primary interventions can help to prevent the stress of relocation before happening by helping older people to use their positive thinking and their resources and work with them before relocating to retirement communities. Secondary prevention can be used by nurses to help older people who have already relocated to retirement communities and have already experienced stress of relocation to help them out by decreasing the stress that they are suffering. Tertiary prevention can be used to prevent further stress and deterioration for those who have suffered physical and psychological symptoms as a result of relocation. © 2012 Blackwell Publishing Ltd.
Sharp, Sandra M; Bevan, Gwyn; Skinner, Jonathan S; Gottlieb, Daniel J
2014-01-01
Objective To compare the performance of two new approaches to risk adjustment that are free of the influence of observational intensity with methods that depend on diagnoses listed in administrative databases. Setting Administrative data from the US Medicare program for services provided in 2007 among 306 US hospital referral regions. Design Cross sectional analysis. Participants 20% sample of fee for service Medicare beneficiaries residing in one of 306 hospital referral regions in the United States in 2007 (n=5 153 877). Main outcome measures The effect of health risk adjustment on age, sex, and race adjusted mortality and spending rates among hospital referral regions using four indices: the standard Centers for Medicare and Medicaid Services—Hierarchical Condition Categories (HCC) index used by the US Medicare program (calculated from diagnoses listed in Medicare’s administrative database); a visit corrected HCC index (to reduce the effects of observational intensity on frequency of diagnoses); a poverty index (based on US census); and a population health index (calculated using data on incidence of hip fractures and strokes, and responses from a population based annual survey of health from the Centers for Disease Control and Prevention). Results Estimated variation in age, sex, and race adjusted mortality rates across hospital referral regions was reduced using the indices based on population health, poverty, and visit corrected HCC, but increased using the standard HCC index. Most of the residual variation in age, sex, and race adjusted mortality was explained (in terms of weighted R2) by the population health index: R2=0.65. The other indices explained less: R2=0.20 for the visit corrected HCC index; 0.19 for the poverty index, and 0.02 for the standard HCC index. The residual variation in age, sex, race, and price adjusted spending per capita across the 306 hospital referral regions explained by the indices (in terms of weighted R2) were 0.50 for the standard HCC index, 0.21 for the population health index, 0.12 for the poverty index, and 0.07 for the visit corrected HCC index, implying that only a modest amount of the variation in spending can be explained by factors most closely related to mortality. Further, once the HCC index is visit corrected it accounts for almost none of the residual variation in age, sex, and race adjusted spending. Conclusion Health risk adjustment using either the poverty index or the population health index performed substantially better in terms of explaining actual mortality than the indices that relied on diagnoses from administrative databases; the population health index explained the majority of residual variation in age, sex, and race adjusted mortality. Owing to the influence of observational intensity on diagnoses from administrative databases, the standard HCC index over-adjusts for regional differences in spending. Research to improve health risk adjustment methods should focus on developing measures of risk that do not depend on observation influenced diagnoses recorded in administrative databases. PMID:24721838
Jamil, Hikmet; Fakhouri, Monty; Dallo, Florence; Templin, Thomas; Khoury, Radwan; Fakhouri, Haifa
2008-10-01
Diabetes mellitus is an important public health problem that disproportionately affects minorities. Using a cross sectional, convenience sample, we estimated the prevalence of self-reported diabetes for Whites (n = 212), Arabs (n = 1,303), Chaldeans (n = 828), and Blacks (n = 789) in southeast Michigan. In addition, using a logistic regression model, we estimated odds ratios and 95% confidence intervals for the association between ethnicity and diabetes before and after adjusting for demographic, socioeconomic status, health care, chronic conditions, and health behavior variables. The overall age- and sex-adjusted prevalence of diabetes was 7.0%. Estimates were highest for Blacks (8.0%) followed by Arabs and Whites (7.0% for each group) and Chaldeans (6.0%). In the fully adjusted model, the association between ethnicity and diabetes was not statistically significant. Future studies should collect more detailed socioeconomic status, acculturation and health behavior information, which are factors that may affect the relationship between race/ethnicity and diabetes.
Quality of workplace social relationships and perceived health.
Rydstedt, Leif W; Head, Jenny; Stansfeld, Stephen A; Woodley-Jones, Davina
2012-06-01
Associations between the quality of social relationships at work and mental and self-reported health were examined to assess whether these associations were independent of job strain. The study was based on cross-sectional survey data from 728 employees (response rate 58%) and included the Demand-Control-(Support) (DC-S) model, six items on the quality of social relationships at the workplace, the General Health Questionnaire (30), and an item on self-reported physical health. Logistic regression analyses were used. A first set of models were run with adjustment for age, sex, and socioeconomic group. A second set of models were run adjusted for the dimensions of the DC-S model. Positive associations were found between the quality of social relationships and mental health as well as self-rated physical health, and these associations remained significant even after adjustment for the dimensions. The findings add support to the Health and Safety Executive stress management standards on social relationships at the workplace.
Explaining large mortality differences between adjacent counties: a cross-sectional study.
Schootman, M; Chien, L; Yun, S; Pruitt, S L
2016-08-02
Extensive geographic variation in adverse health outcomes exists, but global measures ignore differences between adjacent geographic areas, which often have very different mortality rates. We describe a novel application of advanced spatial analysis to 1) examine the extent of differences in mortality rates between adjacent counties, 2) describe differences in risk factors between adjacent counties, and 3) determine if differences in risk factors account for the differences in mortality rates between adjacent counties. We conducted a cross-sectional study in Missouri, USA with 2005-2009 age-adjusted all-cause mortality rate as the outcome and county-level explanatory variables from a 2007 population-based survey. We used a multi-level Gaussian model and a full Bayesian approach to analyze the difference in risk factors relative to the difference in mortality rates between adjacent counties. The average mean difference in the age-adjusted mortality rate between any two adjacent counties was -3.27 (standard deviation = 95.5) per 100,000 population (maximum = 258.80). Six variables were associated with mortality differences: inability to obtain medical care because of cost (β = 2.6), hospital discharge rate (β = 1.03), prevalence of fair/poor health (β = 2.93), and hypertension (β = 4.75) and poverty prevalence (β = 6.08). Examining differences in mortality rates and associated risk factors between adjacent counties provides additional insight for future interventions to reduce geographic disparities.
Bexelius, Tomas S; Olsson, Caroline; Järnbert-Pettersson, Hans; Parmskog, Malin; Ponzer, Sari; Dahlin, Marie
2016-08-01
Medical students' choice of their future specialty is influenced by several factors, including working conditions and type of patient relations. The aim of this study was to investigate the association between the choice of specialty and personality traits. This is a cross-sectional questionnaire-based study of 399 alumni from Karolinska Institutet Medical School who were assumed to undergo specialty training at the time of the survey in 2013. The Big Five Inventory was used to assess the personality traits extraversion, agreeableness, conscientiousness, neuroticism and openness to experience. Medical specialties were categorised as primary care, psychiatry, internal medicine and surgical and hospital service specialties. Adjustments were made for demographic factors and the method of selection for medical school admission. The response rate was 72% (n=289, of which 262 were in training to become specialists). Among these, surgeons scored lower in agreeableness than physicians in primary care, internal medicine and hospital services. Psychiatrists and hospital service physicians showed lower conscientiousness compared with surgeons. We found distinctive differences in personality traits between medical specialties even after adjusting for other potential explanatory variables. Since there are differences between specialties, for example, surgeons and psychiatrists, this supports previous findings that personality may affect medical students' specialty choice also in a Swedish setting. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Racial disparity in blood pressure: is vitamin D a factor?
Fiscella, Kevin; Winters, Paul; Tancredi, Dan; Franks, Peter
2011-10-01
Higher prevalence of hypertension among African Americans is a key cause of racial disparity in cardiovascular morbidity and mortality. Explanations for the difference in prevalence are incomplete. Emerging data suggest that low vitamin D levels may contribute. To assess the contribution of vitamin D to racial disparity in blood pressure. Cross-sectional analysis. Adult non-Hispanic Black and White participants from the National Health and Nutrition Examination Survey 2001-2006. We assessed Black-White differences in systolic blood pressure (SBP) controlling for conventional risk factors, and then additionally, for vitamin D (serum 25[OH]D). The sample included 1984 and 5156 Black and White participants ages 20 years and older. The mean age-sex adjusted Black-White SBP difference was 5.2 mm Hg. This difference was reduced to 4.0 mm Hg with additional adjustment for socio-demographic characteristics, health status, health care, health behaviors, and biomarkers; adding 25(OH)D reduced the race difference by 26% (95% CI 7-46%) to 2.9 mm Hg. This effect increased to 39% (95% CI 14-65%) when those on antihypertensive medications were excluded. Supplementary analyses that controlled for cardiovascular fitness, percent body fat, physical activity monitoring, skin type and social support yielded consistent results. In cross-sectional analyses, 25(OH)D explains one quarter of the Black-White disparity in SBP. Randomized controlled trials are required to determine whether vitamin D supplementation could reduce racial disparity in BP.
Marcellin, Fabienne; Protopopescu, Camelia; Esterle, Laure; Wittkop, Linda; Piroth, Lionel; Aumaitre, Hugues; Bouchaud, Olivier; Goujard, Cécile; Vittecoq, Daniel; Dabis, François; Salmon-Ceron, Dominique; Spire, Bruno; Roux, Perrine; Carrieri, Maria P
2017-07-01
The aim of this study is to document the relationship between anger dimensions (state, trait, expression, and control) and quality of life (QoL) in patients co-infected with HIV and hepatitis C virus (HCV). This is a cross-sectional study nested in the ANRS CO13-HEPAVIH French national cohort. Anger and QoL were assessed using self-administered questionnaires in 536 HIV-HCV-co-infected patients. Correlations between anger scores (STAXI-2 scale) and QoL scores (WHOQOL-HIV BREF scale) were assessed using Spearman's coefficients. Multiple linear regression models were then used to test the relationship between the different dimensions of anger and QoL after adjustment for statistically significant psychosocial, sociobehavioral, and clinical characteristics. Patients with excessive alcohol use or history of injecting drug use had higher levels of anger. All dimensions of anger were significantly correlated with impaired QoL for all six dimensions of the WHOQOL-HIV BREF scale. Greater internal experience of anger and impaired anger control were confirmed as independent correlates of impaired QoL related to psychological health, social relationships, and patients' beliefs after adjustment for depressive symptoms, functional impact of fatigue, socioeconomic status, and HIV-related characteristics. Anger issues need close monitoring in HIV-HCV-co-infected patients, especially in patients with addictive behaviors. Screening for problems in anger management and implementing individualized psychotherapeutic strategies may help improve QoL in this population.
Phobic Anxiety and Plasma Levels of Global Oxidative Stress in Women
Hagan, Kaitlin A.; Wu, Tianying; Rimm, Eric B.; Eliassen, A. Heather; Okereke, Olivia I.
2015-01-01
Background and Objectives Psychological distress has been hypothesized to be associated with adverse biologic states such as higher oxidative stress and inflammation. Yet, little is known about associations between a common form of distress – phobic anxiety – and global oxidative stress. Thus, we related phobic anxiety to plasma fluorescent oxidation products (FlOPs), a global oxidative stress marker. Methods We conducted a cross-sectional analysis among 1,325 women (aged 43-70 years) from the Nurses’ Health Study. Phobic anxiety was measured using the Crown-Crisp Index (CCI). Adjusted least-squares mean log-transformed FlOPs were calculated across phobic categories. Logistic regression models were used to calculate odds ratios (OR) comparing the highest CCI category (≥6 points) vs. lower scores, across FlOPs quartiles. Results No association was found between phobic anxiety categories and mean FlOP levels in multivariable adjusted linear models. Similarly, in multivariable logistic regression models there were no associations between FlOPs quartiles and likelihood of being in the highest phobic category. Comparing women in the highest vs. lowest FlOPs quartiles: FlOP_360: OR=0.68 (95% CI: 0.40-1.15); FlOP_320: OR=0.99 (95% CI: 0.61-1.61); FlOP_400: OR=0.92 (95% CI: 0.52, 1.63). Conclusions No cross-sectional association was found between phobic anxiety and a plasma measure of global oxidative stress in this sample of middle-aged and older women. PMID:26635425
Catastrophic household expenditure on health in Nepal: a cross-sectional survey.
Saito, Eiko; Gilmour, Stuart; Rahman, Md Mizanur; Gautam, Ghan Shyam; Shrestha, Pradeep Krishna; Shibuya, Kenji
2014-10-01
To determine the incidence of - and illnesses commonly associated with - catastrophic household expenditure on health in Nepal. We did a cross-sectional population-based survey in five municipalities of Kathmandu Valley between November 2011 and January 2012. For each household surveyed, out-of-pocket spending on health in the previous 30 days that exceeded 10% of the household's total expenditure over the same period was considered to be catastrophic. We estimated the incidence and intensity of catastrophic health expenditure. We identified the illnesses most commonly associated with such expenditure using a Poisson regression model and assessed the distribution of expenditure by economic quintile of households using the concentration index. Overall, 284 of the 1997 households studied in Kathmandu, i.e. 13.8% after adjustment by sampling weight, reported catastrophic health expenditure in the 30 days before the survey. After adjusting for confounders, this expenditure was found to be associated with injuries, particularly those resulting from road traffic accidents. Catastrophic expenditure by households in the poorest quintile were associated with at least one episode of diabetes, asthma or heart disease. In an urban area of Nepal, catastrophic household expenditure on health was mostly associated with injuries and noncommunicable diseases such as diabetes and asthma. Throughout Nepal, interventions for the control and management of noncommunicable diseases and the prevention of road traffic accidents should be promoted. A phased introduction of health insurance should also reduce the incidence of catastrophic household expenditure.
Evidence for the healthy immigrant effect in older Chinese immigrants: a cross-sectional study
2014-01-01
Background Previous work has found that first-generation immigrants to developed nations tend to have better health than individuals born in the host country. We examined the evidence for the healthy immigrant effect and convergence of health status between Chinese immigrants (n = 147) and U.S. born whites (n = 167) participating in the cross-sectional Community Assessment of Freeway Exposure and Health study and residing in the same neighborhoods. Methods We used bivariate and multivariate models to compare disease prevalence and clinical biomarkers. Results Despite an older average age and lower socioeconomic status, Chinese immigrants were less likely to have asthma (OR = 0.20, 95% CI = 0.09–0.48) or cardiovascular disease (OR = 0.44, 95% CI = 0.20–0.94), had lower body mass index (BMI), lower inflammation biomarker levels, lower average sex-adjusted low-density lipoprotein (LDL) cholesterol, and higher average sex-adjusted high-density lipoprotein (HDL) cholesterol. However, there was no significant difference in the prevalence of diabetes or hypertension. Duration of time in the U.S. was related to cardiovascular disease and asthma but was not associated with diabetes, hypertension, BMI, HDL cholesterol, LDL cholesterol, socioeconomic status, or health behaviors. Conclusions The lower CVD and asthma prevalence among the Chinese immigrants may be partially attributed to healthier diets, more physical activity, lower BMI, and less exposure to cigarette smoke. First generation immigrant status may be protective even after about two decades. PMID:24928348
Twinamasiko, Bruce; Lukenge, Edward; Nabawanga, Stella; Nansalire, Winnie; Kobusingye, Lois; Ruzaaza, Gad; Bajunirwe, Francis
2018-01-01
Globally, cardiovascular diseases (CVDs) and diabetes constitute over 50% of the noncommunicable disease (NCD) burden and projections indicate Sub-Saharan Africa will experience a larger burden. Urbanization on the continent is contributing to the change in lifestyle such as diet and physical activity, which may increase the risk for CVDs. There is lack of sufficient data from the African continent on hypertension and its association with sedentary lifestyle. We conducted a cross sectional study in periurban Uganda among adults aged at least 35 years. We administered questions on diet, physical activity, and smoking. We took anthropometric measurements, blood pressure, and fasting blood glucose. Hypertension was defined as systolic BP > = 140 and/or diastolic BP > = 90 and/or history of hypertension medications. Logistic regression was used to determine the crude and adjusted odds ratios for the factors associated with hypertension. We enrolled 310 participants and 50% were female. The prevalence of systolic hypertension was 24.5%, diastolic hypertension was 31%, obesity was 46%, and diabetes was 9%. Of those with hypertension ( n = 76), 53 participants (69.7%) were not aware they had high BP. Sedentary lifestyle was significantly associated with hypertension even after adjusting for age and obesity. There is a high prevalence of obesity, hypertension, and diabetes and majority of participants with hypertension are not aware. Participants with a sedentary work style should be targeted for prevention and screening.
Smoking habits in French farmers: a cross-sectional study.
Roux, Pauline; Guillien, Alicia; Soumagne, Thibaud; Ritter, Ophélie; Laplante, Jean-Jacques; Travers, Cécile; Dalphin, Jean-Charles; Peiffer, Gérard; Laurent, Lucie; Degano, Bruno
2017-02-04
Farmers are exposed to multiple air contaminants that may interact with tobacco smoking in the development of respiratory diseases. Farmers are currently considered to smoke less than non-farmers, but precise data in different categories of age and farming activities are lacking. Smoking habits were studied in a cross-sectional study involving 4105 farmers and 996 non-farming controls aged 40-74 years in 9 French departments between October 2012 and May 2013. Three age groups were defined (40-54, 55-64 and 65-74years). Farmers were divided into four activity groups, namely cattle breeders, livestock farmers working in confined spaces, crop farmers and others. Smoking prevalence was compared between farmers and controls, and odds ratios (ORs) for smoking adjusted for age were calculated. The adjusted OR for ever-smoking was lower among farmers than among non-farmers in all age categories, but the ORs for current smoking were similar in farmers and controls. Smoking prevalence varied according to the type of farming activity, and was lower than in non-farming controls only among cattle breeders and confined livestock farmers. In farmers, the proportion of smokers was higher in the youngest age categories compared with the older age classes. Our results confirm that the prevalence of ever-smokers is lower in farmers than in non-farmers. Nevertheless, our data show that active smoking prevalence is similar in farmers and in non-farmers. This suggests that farmers, just like non-farmers, should be targeted by primary prevention campaigns against smoking.
Association between serum CA 19-9 and metabolic syndrome: A cross-sectional study.
Du, Rui; Cheng, Di; Lin, Lin; Sun, Jichao; Peng, Kui; Xu, Yu; Xu, Min; Chen, Yuhong; Bi, Yufang; Wang, Weiqing; Lu, Jieli; Ning, Guang
2017-11-01
Increasing evidence suggests that serum CA 19-9 is associated with abnormal glucose metabolism. However, data on the association between CA 19-9 and metabolic syndrome is limited. The aim of the present study was to investigate the association between serum CA 19-9 and metabolic syndrome. A cross-sectional study was conducted on 3641 participants aged ≥40 years from the Songnan Community, Baoshan District in Shanghai, China. Logistic regression analysis was used to evaluate the association between serum CA 19-9 and metabolic syndrome. Multivariate logistic regression analysis showed that compared with participants in the first tertile of serum CA 19-9, those in the second and third tertiles had increased odds ratios (OR) for prevalent metabolic syndrome (multivariate adjusted OR 1.46 [95% confidence interval {CI} 1.11-1.92] and 1.51 [95% CI 1.14-1.98]; P trend = 0.005). In addition, participants with elevated serum CA 19-9 (≥37 U/mL) had an increased risk of prevalent metabolic syndrome compared with those with serum CA 19-9 < 37 U/mL (multivariate adjusted OR 2.10; 95% CI 1.21-3.65). Serum CA 19-9 is associated with an increased risk of prevalent metabolic syndrome. In order to confirm this association and identify potential mechanisms, prospective cohort and mechanic studies should be performed. © 2017 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.
Herrera-Anaya, Elizabeth; Angarita-Fonseca, Adriana; Herrera-Galindo, Víctor M; Martínez-Marín, Rocío D P; Rodríguez-Bayona, Cindy N
2016-09-01
To determine the association between gross motor function and nutritional status in children with cerebral palsy (CP) residing in an urban area in a developing country. We conducted a cross-sectional study in 177 children (ages 2-12y, 59.3% male) with a diagnosis of CP who were attending rehabilitation centres in Bucaramanga, Colombia (2012-2013). A physiotherapist evaluated patients using the Gross Motor Function Classification System (GMFCS, levels I to V). Nutritional status was evaluated by nutritionists and classified according to the World Health Organization growth charts. We used linear and multinomial logistic regression methods to determine the associations. There were 39.5%, 6.8%, 5.6%, 16.4%, and 31.6% patients classified in levels I to V respectively. The mean adjusted differences for weight-for-age, height-for-age, BMI-for-age, and height-for-weight z-scores were significantly larger for children classified in levels II to V compared with those in level I. The children classified in levels IV and V were more likely to have malnutrition (adjusted odds ratio [OR] 5.64; 95% confidence interval [CI] 2.27-14.0) and stunting (OR 8.42; 95% CI 2.90-24.4) than those classified in GMFCS levels I to III. Stunting and malnutrition are prevalent conditions among paediatric patients with CP, and both are directly associated with higher levels of gross motor dysfunction. © 2016 Mac Keith Press.
Ceresini, Graziano; Lauretani, Fulvio; Maggio, Marcello; Ceda, Gian Paolo; Morganti, Simonetta; Usberti, Elisa; Chezzi, Carlo; Valcavi, Rita; Bandinelli, Stefania; Guralnik, Jack M; Cappola, Anne R; Valenti, Giorgio; Ferrucci, Luigi
2009-01-01
To investigate thyroid function testing abnormalities in older persons and to explore the relationship between thyroid dysfunction and cognition. Cross-sectional. Community-based. One thousand one hundred seventy-one men and women aged 23 to 102. Thyroid function was evaluated by measuring plasma concentrations of thyrotropin (TSH), free thyroxine (FT4), and free triiodothyronine (FT3). Cognition was evaluated using the Mini-Mental State Examination (MMSE). Prevalence of overt and subclinical thyroid dysfunction was evaluated in different age groups (<65 vs > or =65). Age trends in TSH, FT4, and FT3 were examined in euthyroid participants. The cross-sectional association between thyroid dysfunction and MMSE score was evaluated adjusting for confounders. Subclinical hypothyroidism and subclinical hyperthyroidism were more prevalent in older than in younger participants (subclinical hypothyroidism, 3.5% vs 0.4%, P<.03; subclinical hyperthyroidism, 7.8% vs 1.9%, P<.002). In euthyroid participants, TSH and FT3 declined with age, whereas FT4 increased. Older participants with subclinical hyperthyroidism had lower MMSE scores than euthyroid subjects (22.61+/-6.88 vs 24.72+/-4.52, P<.03). In adjusted analyses, participants with subclinical hyperthyroidism were significantly more likely to have cognitive dysfunction (hazard rate=2.26, P=.003). Subtle age-related changes in FT3, FT4, and TSH occur in individuals who remain euthyroid. Subclinical hyperthyroidism is the most prevalent thyroid dysfunction in Italian older persons and is associated with cognitive impairment.
Otaki, N; Obayashi, K; Saeki, K; Kitagawa, M; Tone, N; Kurumatani, N
2017-01-01
Breakfast skipping is reported to be associated with obesity in children and younger populations; however, few studies report the association among elderly. The purpose of this study was to investigate the relationships between breakfast skipping and obesity prevalence among elderly. Cross-sectional study. Community-dwelling elderly in Nara, Japan. 1052 elderly participants (mean age: 71.6 years). Obesity and breakfast skipping were defined as body mass index of ≥25 kg/m2 and skipping breakfast one or more times per week, respectively. Two hundred and seventy-two participants (25.9%) were classified as obese and forty-one (3.9%) were as breakfast skippers. Obesity prevalence was significantly higher in breakfast skippers than in breakfast eaters (43.9% vs. 25.1%, P = 0.007). In multivariable logistic regression analysis adjusted for potential confounders (age, sex and alcohol consumption), breakfast skippers showed significantly higher odds ratio (OR) for obesity than breakfast eaters (OR, 2.23; 95% confidence interval, 1.17-4.27; P = 0.015), which continued to be significant after further adjustment for socioeconomic status. In addition, breakfast skippers showed significantly lower daily potassium (P <0.001) and dietary fibre intakes (P = 0.001) and lower subjective physical activity (P = 0.035) than breakfast eaters. Breakfast skipping was significantly associated with obesity among elderly. Poor diet quality and physical inactivity may be potential intermediators underlying the association between breakfast skipping and obesity.
Psoriasis and cardiometabolic traits: modest association but distinct genetic architectures
Koch, Manja; Baurecht, Hansjörg; Ried, Janina S.; Rodriguez, Elke; Schlesinger, Sabrina; Volks, Natalie; Gieger, Christian; Rückert, Ina-Maria; Heinrich, Luise; Willenborg, Christina; Smith, Catherine; Peters, Annette; Thorand, Barbara; Koenig, Wolfgang; Lamina, Claudia; Jansen, Henning; Kronenberg, Florian; Seissler, Jochen; Thiery, Joachim; Rathmann, Wolfgang; Schunkert, Heribert; Erdmann, Jeanette; Barker, Jonathan; Nair, Rajan P; Tsoi, Lam C; Elder, James T; Mrowietz, Ulrich; Weichenthal, Michael; Mucha, Sören; Schreiber, Stefan; Franke, Andre; Schmitt, Jochen; Lieb, Wolfgang; Weidinger, Stephan
2015-01-01
Psoriasis has been linked to cardiometabolic diseases, but epidemiological findings are inconsistent. We investigated the association between psoriasis and cardiometabolic outcomes in a German cross-sectional study (n=4.185) and a prospective cohort of German Health Insurance beneficiaries (n=1.811.098). A potential genetic overlap was explored using genome-wide data from >22.000 coronary artery disease (CAD) and >4.000 psoriasis cases, and with a dense genotyping study of cardiometabolic risk loci on 927 psoriasis cases and 3.717 controls. Controlling for major confounders, in the cross-sectional analysis psoriasis was significantly associated with type 2 diabetes (T2D, adjusted odd’s ratio OR=2.36; 95% confidence interval CI=1.26–4.41) and myocardial infarction (MI, OR=2.26, 95% CI=1.03–4.96). In the longitudinal study, psoriasis slightly increased the risk for incident T2D (adjusted relative risk RR=1.11; 95%CI=1.08–1.14) and MI (RR=1.14; 95%CI=1.06–1.22), with highest risk increments in systemically treated psoriasis, which accounted for 11 and 17 excess cases of T2D and MI per 10,000 person-years. Except for weak signals from within the MHC, there was no evidence for genetic risk loci shared between psoriasis and cardiometabolic traits. Our findings suggest that psoriasis, in particular severe psoriasis, increases risk for T2D and MI, and that the genetic architecture of psoriasis and cardiometabolic traits is largely distinct. PMID:25599394
Pitman, Alexandra; Rantell, Khadija; Marston, Louise; King, Michael; Osborn, David
2017-03-09
The sudden death of a friend or relative, particularly by suicide, is a risk factor for suicide. People who experience sudden bereavement report feeling highly stigmatised by the loss, potentially influencing access to support. We assessed whether perceived stigma following sudden bereavement is associated with suicidal thoughts and suicide attempt. We analysed cross-sectional survey data on 3387 young adults bereaved by the sudden death of a close contact. We tested the association of high versus low perceived stigma (on the stigma sub-scale of the Grief Experience Questionnaire) with post-bereavement suicidal ideation and suicide attempt, using random effects logistic regression, adjusting for socio-demographic factors, pre-bereavement psychopathology, and mode of sudden bereavement (natural causes/unnatural causes/suicide). Subjects with high perceived stigma scores were significantly more likely to report post-bereavement suicidal thoughts (adjusted odds ratio (AOR) = 2.74; 95% confidence interval (CI) = 1.93-3.89) and suicide attempt (AOR = 2.73; 95% CI = 2.33-3.18) than those with low stigma scores. People who feel highly stigmatised by a sudden bereavement are at increased risk of suicidal thoughts and suicide attempt, even taking into account prior suicidal behaviour. General practitioners, bereavement counsellors, and others who support people bereaved suddenly, should consider inquiring about perceived stigma, mental wellbeing, and suicidal thoughts, and directing them to appropriate sources of support.
Pérez-Zepeda, Mario Ulises; Cesari, Matteo; Carrillo-Vega, María Fernanda; Salinas-Escudero, Guillermo; Tella-Vega, Pamela; García-Peña, Carmen
2017-01-01
Objectives. To construct a frailty index from next-of-kin information of the last year of life of community-dwelling 50 years old or older adults and test its association with health services utilization. Methods. Cross-sectional analysis from next-of-kin data available from the last wave of the Mexican Health and Aging Study (MHAS). Measurements. Along with descriptive statistics, the frailty index (FI) was tested in regression models to assess its association with adverse outcomes previous to death: number of hospitalized days in the previous year and number of visits to a physician in the previous year, in unadjusted and adjusted models. Results. From a total of 2,649 individuals the mean of age was 74.8 (±11.4) and 56.3% ( n = 1,183) were women. The mean of the FI was of 0.279 (±SD 0.131, R = 0.0-0.738) and distribution was biased to the right. There was a significant association ( p < 0.001) between the FI and number of hospitalized days ( β = 45.7, 95% CI 36.1-55.4, p < 0.001) and for the number of visits to a physician ( β = 25.93, 95% CI 19.27-32.6, p < 0.001) both models adjusted for age and sex. Conclusion. The FI constructed with next-of-kin data showed similar characteristics to similar indexes of older adults. It was independently associated with health care use.
Chronic kidney disease in Chinese postmenopausal women: A cross-sectional survey.
Pei, F; Zhou, Z; Li, Y; Ren, Y; Yang, X; Liu, G; Xia, Q; Hu, Z; Zhang, L; Zhao, M; Wang, H
2017-02-01
Despite advances in the management of chronic kidney disease (CKD), there is ongoing uncertainty regarding the prevalence of CKD in postmenopausal women. This study was designed to investigate both CKD prevalence and related risk factors in a cohort of postmenopausal Chinese women. A cross-sectional survey was administered to a nationally representative sample of female Chinese participants, including a total of 47,204 subjects, among whom were 8573 self-reported postmenopausal women. CKD was defined as either an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2 body surface area or else the presence of albuminuria. All subjects completed a questionnaire that included items related to their lifestyles and medical histories. Data were collected on blood pressure, serum creatinine, urinary albumin, and urinary creatinine. Risk factors correlated with the presence of CKD were analyzed using logistic regression analysis. Results showed that the adjusted prevalence of an eGFR of < 60 mL/min/1.73 m2 among this postmenopausal survey cohort was 5.3% (95% confidence interval: 4.7-6.1) and of albuminuria, 12.4% (11.7-13.1). The overall prevalence of CKD in this postmenopausal cohort was 16.6% (15.8-17.4). Factors associated with kidney pathology included nephrotoxic drug use, history of cardiovascular disease, hyperuricemia, hypertension, and diabetes (the lower limit of multivariable adjusted odds ratios > 1). The current study revealed a high prevalence of CKD in Chinese postmenopausal women. These results provide baseline data for disease prevention and treatment.
Marginal bone level in two Danish cross-sectional population samples in 1997-1998 and 2007-2008.
Bahrami, Golnosh; Vaeth, Michael; Wenzel, Ann; Isidor, Flemming
2018-04-12
The aim of this study was to compare the marginal bone level of two randomly selected population samples from 1997/1998 and 2007/2008, with special emphasis on the role of smoking habits and gender. Two cross-sectional randomly selected population samples [1997/1998 (N = 616) and 2007/2008 (N = 396)] were analysed with respect to the marginal bone level. The marginal bone level was measured in full-mouth intraoral radiographs. Information on smoking was gathered using questionnaires. Multiple regression analysis was used in order to adjust for correlating factors (gender, age, smoking habits and number of teeth). After adjusting for confounding factors, the population sample from 2007/2008 had on average a slightly, but statistically significantly, more reduced average marginal bone level (0.15 mm) than the population sample from 1997/1998. Men had more reduced marginal bone level than women (0.12 mm). Smokers in both population samples had more reduced marginal bone level than non-smokers (0.39 mm and 0.12 mm for 1997/1998; 0.65 mm and 0.16 mm for 2007/2008). In these populations, sampled 10 years apart, the 2007/2008 population sample had a slightly more reduced marginal bone level than the 1997/1998 population sample. Men had more reduced marginal bone level than women, and smoking is considered a major risk factor for a reduced marginal bone level.
Yuan, Zhongshang; Zhao, Meng; Zhang, Bingchang; Zhang, Haiqing; Zhang, Xu; Guan, Qingbo; Ning, Guang; Gao, Ling; Xue, Fuzhong; Zhao, Jiajun
2015-01-01
Hypothyroidism was confirmed to be associated with both dyslipidemia and renal dysfunction. However, the impact of thyroid function on the relationship between serum lipid levels and renal function has never been given sufficient attention. In this large-scale multicenter cross-sectional study, the ratio of triglyceride to high-density lipoprotein cholesterol (TG/HDL) and the prevalence of hypothyroidism in CKD subjects were significantly higher than those in non-CKD ones (P < 0.001). After adjustment for potential confounding factors, TG/HDL was shown to be significantly associated with serum Cr levels (β = 0.551; 95%CI, 0.394–0.708), and eGFR (β = −0.481; 95%CI, −0.731–−0.230). The risk for CKD was significantly increased as TG/HDL ratio was elevated (adjusted odds ratio = 1.20; 95%CI, 1.11–1.27). These significant associations were found among subjects with euthyroidism and hypothyroidism rather than hyperthyroidism. Furthermore, the associations between TG/HDL and Cr or CKD status were significantly greater in hypothyroidism than those in euthyroidism (P < 0.05). These results suggested that elevated TG/HDL ratio was associated with renal dysfunction; it exhibited a significantly stronger association with Cr and CKD in hypothyroidism than in euthyroidism. Therefore, more attention should be paid on lipid profile to prevent or delay the occurrence and progression of renal dysfunction, especially for those with hypothyroidism. PMID:26179571
Yuan, Zhongshang; Zhao, Meng; Zhang, Bingchang; Zhang, Haiqing; Zhang, Xu; Guan, Qingbo; Ning, Guang; Gao, Ling; Xue, Fuzhong; Zhao, Jiajun
2015-07-16
Hypothyroidism was confirmed to be associated with both dyslipidemia and renal dysfunction. However, the impact of thyroid function on the relationship between serum lipid levels and renal function has never been given sufficient attention. In this large-scale multicenter cross-sectional study, the ratio of triglyceride to high-density lipoprotein cholesterol (TG/HDL) and the prevalence of hypothyroidism in CKD subjects were significantly higher than those in non-CKD ones (P < 0.001). After adjustment for potential confounding factors, TG/HDL was shown to be significantly associated with serum Cr levels (β = 0.551; 95%CI, 0.394-0.708), and eGFR (β = -0.481; 95%CI, -0.731--0.230). The risk for CKD was significantly increased as TG/HDL ratio was elevated (adjusted odds ratio = 1.20; 95%CI, 1.11-1.27). These significant associations were found among subjects with euthyroidism and hypothyroidism rather than hyperthyroidism. Furthermore, the associations between TG/HDL and Cr or CKD status were significantly greater in hypothyroidism than those in euthyroidism (P < 0.05). These results suggested that elevated TG/HDL ratio was associated with renal dysfunction; it exhibited a significantly stronger association with Cr and CKD in hypothyroidism than in euthyroidism. Therefore, more attention should be paid on lipid profile to prevent or delay the occurrence and progression of renal dysfunction, especially for those with hypothyroidism.
Benseñor, Isabela M; Nunes, Maria Angélica; Sander Diniz, Maria de Fátima; Santos, Itamar S; Brunoni, André R; Lotufo, Paulo A
2016-02-01
To evaluate the association between subclinical thyroid dysfunction and psychiatric disorders using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Cross-sectional study. The study included 12 437 participants from the ELSA-Brasil with normal thyroid function (92·8%), 193 (1·4%) with subclinical hyperthyroidism and 784 (5·8%) with subclinical hypothyroidism, totalling 13 414 participants (50·6% of women). The mental health diagnoses of participants were assessed by trained raters using the Clinical Interview Schedule - Revised (CIS-R) and grouped according to the International Classification of Diseases 10 (ICD-10). Thyroid dysfunction was assessed using TSH and FT4 as well as routine use of thyroid hormones or antithyroid medications. Logistic models were presented using psychiatric disorders as the dependent variable and subclinical thyroid disorders as the independent variable. All logistic models were corrected for multiple comparisons using Bonferroni correction. After multivariate adjustment for possible confounders, we found a direct association between subclinical hyperthyroidism and panic disorder odds ratio [OR], 2·55; 95% confidence Interval (95% CI), 1·09-5·94; and an inverse association between subclinical hypothyroidism and generalized anxiety disorder (OR, 0·75; 95% CI, 0·59-0·96). However, both lost significance after correction for multiple comparisons. Subclinical hyperthyroidism was positively associated with panic disorder and negatively associated with anxiety disorder, although not significant after adjustment for multiple comparisons. © 2015 John Wiley & Sons Ltd.
Vitamin B12 Deficiency and the Role of Gender: A Cross-Sectional Study of a Large Cohort.
Margalit, Ili; Cohen, Eytan; Goldberg, Elad; Krause, Ilan
2018-01-01
Vitamin B12 deficiency is associated with hematological, neurological, and cardiovascular consequences. Epidemiologic data on these related illnesses indicate gender differences. A cross-sectional study was designed to examine gender differences in vitamin B12 deficiency among a healthy population. Data from healthy individuals aged 18-65, who were provided with a routine medical evaluation during 2000-2014, were retrieved from the medical charts. Individuals with background illnesses and those who had used medications or nutritional supplements were excluded. Vitamin B12 deficiency was defined by 2 cutoff values (206 and 140 pmol/L). The multivariate analysis was adjusted for age, body mass index, estimated glomerular filtration rate, hyperhomocysteinemia, folate deficiency, albumin, and transferrin saturation. Sensitivity analyses were implemented by excluding individuals with anemia, hyperhomocysteinemia, or folate deficiency and by age stratification. In all, 7,963 individuals met the inclusion criteria. Serum vitamin B12 mean levels were 312.36 and 284.31 pmol/L for women and men respectively (p < 0.001). Deficiency prevalence was greater for men (25.5%) in comparison with women (18.9%; p < 0.001). Men were strongly associated with severe deficiency (adjusted OR 2.26; 95% CI 1.43-3.56). Among the healthy population, men are susceptible to vitamin B12 deficiency. This can be explained by neither diet habits nor estrogen effects. Genetic variations are therefore hypothesized to play a role. © 2018 S. Karger AG, Basel.
Gavrieli, Anna; Farr, Olivia M; Davis, Cynthia R; Crowell, Judith A; Mantzoros, Christos S.
2015-01-01
Background Early life adversity (ELA) and post-traumatic stress disorder (PTSD) are associated with poorer psychological and physical health. Potential underlying mechanisms and mediators remain to be elucidated, and the lifestyle habits and characteristics of individuals with ELA and/or PTSD have not been fully explored. We investigated whether the presence of ELA and/or PTSD are associated with nutrition, physical activity, resting and sleeping and smoking. Methods A cross-sectional sample of 151 males and females (age: 45.6±3.5 y, BMI: 30.0±7.1kg/m2) underwent anthropometric measurements, as well as detailed questionnaires for dietary assessment, physical activity, resting and sleeping, smoking habits and psychosocial assessments. A prospective follow-up visit of 49 individuals was performed 2.5 years later and the same outcomes were assessed. ELA and PTSD were evaluated as predictors, in addition to a variable assessing the combined presence/severity of ELA–PTSD. Data were analyzed using analysis of covariance after adjusting for several socioeconomic, psychosocial and anthropometric characteristics. Results Individuals with higher ELA or PTSD severity were found to have a poorer diet quality (DASH score: p=0.006 and p=0.003, respectively; aHEI-2010 score: ELA p=0.009), including further consumption of trans fatty acids (ELA p=0.003); the differences were significantly attenuated null after adjusting mainly for education or income and/or race. Further, individuals with higher ELA severity reported less hours of resting and sleeping (p=0.043) compared to those with zero/lower ELA severity, and the difference remained significant in the fully adjusted model indicating independence from potential confounders. When ELA and PTSD were combined, an additive effect was observed on resting and sleeping (p=0.001); results remained significant in the fully adjusted model. They also consumed more energy from trans fatty acids (p=0.017) tended to smoke more (p=0.008), and have less physical activity (PTSD p=0.024) compared to those with no or lower ELA and PTSD severity. Adjustments for sociodemographic factors and/or BMI rendered results of the above life style parameters non-significant. The analysis of the prospective data showed similar trends to the cross-sectional analysis, further supporting the conclusions, although statistical significance of results was lower due to the lower number of participants. Conclusion Fewer hours of resting and sleeping and poorer diet quality are linked to ELA and/or PTSD, indicating that these pathways might underlie the development of several metabolic abnormalities in individuals with ELA and/or PTSD. Differences in terms of diet quality are significantly attenuated by race and/or education and/or income, whereas differences in other lifestyle habits of individuals with and without ELA and/or PTSD, such as physical activity, are mostly explained by confounding sociodemographic variables and/or body mass index. PMID:26404481
Gavrieli, Anna; Farr, Olivia M; Davis, Cynthia R; Crowell, Judith A; Mantzoros, Christos S
2015-11-01
Early life adversity (ELA) and post-traumatic stress disorder (PTSD) are associated with poorer psychological and physical health. Potential underlying mechanisms and mediators remain to be elucidated, and the lifestyle habits and characteristics of individuals with ELA and/or PTSD have not been fully explored. We investigated whether the presence of ELA and/or PTSD are associated with nutrition, physical activity, resting and sleeping and smoking. A cross-sectional sample of 151 males and females (age: 45.6±3.5 years, BMI: 30.0±7.1 kg/m(2)) underwent anthropometric measurements, as well as detailed questionnaires for dietary assessment, physical activity, resting and sleeping, smoking habits and psychosocial assessments. A prospective follow-up visit of 49 individuals was performed 2.5 years later and the same outcomes were assessed. ELA and PTSD were evaluated as predictors, in addition to a variable assessing the combined presence/severity of ELA-PTSD. Data were analyzed using analysis of covariance after adjusting for several socioeconomic, psychosocial and anthropometric characteristics. Individuals with higher ELA or PTSD severity were found to have a poorer diet quality (DASH score: p=0.006 and p=0.003, respectively; aHEI-2010 score: ELA p=0.009), including further consumption of trans fatty acids (ELA p=0.003); the differences were significantly attenuated null after adjusting mainly for education or income and/or race. Further, individuals with higher ELA severity reported less hours of resting and sleeping (p=0.043) compared to those with zero/lower ELA severity, and the difference remained significant in the fully adjusted model indicating independence from potential confounders. When ELA and PTSD were combined, an additive effect was observed on resting and sleeping (p=0.001); results remained significant in the fully adjusted model. They also consumed more energy from trans fatty acids (p=0.017) tended to smoke more (p=0.008), and have less physical activity (PTSD p=0.024) compared to those with no or lower ELA and PTSD severity. Adjustments for sociodemographic factors and/or BMI rendered results of the above lifestyle parameters non-significant. The analysis of the prospective data showed similar trends to the cross-sectional analysis, further supporting the conclusions, although statistical significance of results was lower due to the lower number of participants. Fewer hours of resting and sleeping and poorer diet quality are linked to ELA and/or PTSD, indicating that these pathways might underlie the development of several metabolic abnormalities in individuals with ELA and/or PTSD. Differences in terms of diet quality are significantly attenuated by race and/or education and/or income, whereas differences in other lifestyle habits of individuals with and without ELA and/or PTSD, such as physical activity, are mostly explained by confounding sociodemographic variables and/or body mass index. Copyright © 2015 Elsevier Inc. All rights reserved.
HIV, HCV, HBV, and syphilis among transgender women from Brazil
Bastos, Francisco I.; Bastos, Leonardo Soares; Coutinho, Carolina; Toledo, Lidiane; Mota, Jurema Corrêa; Velasco-de-Castro, Carlos Augusto; Sperandei, Sandro; Brignol, Sandra; Travassos, Tamiris Severino; dos Santos, Camila Mattos; Malta, Monica Siqueira
2018-01-01
Abstract Different sampling strategies, analytic alternatives, and estimators have been proposed to better assess the characteristics of different hard-to-reach populations and their respective infection rates (as well as their sociodemographic characteristics, associated harms, and needs) in the context of studies based on respondent-driven sampling (RDS). Despite several methodological advances and hundreds of empirical studies implemented worldwide, some inchoate findings and methodological challenges remain. The in-depth assessment of the local structure of networks and the performance of the available estimators are particularly relevant when the target populations are sparse and highly stigmatized. In such populations, bottlenecks as well as other sources of biases (for instance, due to homophily and/or too sparse or fragmented groups of individuals) may be frequent, affecting the estimates. In the present study, data were derived from a cross-sectional, multicity RDS study, carried out in 12 Brazilian cities with transgender women (TGW). Overall, infection rates for HIV and syphilis were very high, with some variation between different cities. Notwithstanding, findings are of great concern, considering the fact that female TGW are not only very hard-to-reach but also face deeply-entrenched prejudice and have been out of the reach of most therapeutic and preventive programs and projects. We cross-compared findings adjusted using 2 estimators (the classic estimator usually known as estimator II, originally proposed by Volz and Heckathorn) and a brand new strategy to adjust data generated by RDS, partially based on Bayesian statistics, called for the sake of this paper, the RDS-B estimator. Adjusted prevalence was cross-compared with estimates generated by non-weighted analyses, using what has been called by us a naïve estimator or rough estimates. PMID:29794601
Mi, Wei; Wang, Nan; Lian, Wu; Yi, Weijie; Shi, Tala; Han, Wenting
2016-01-01
To explore the cross-sectional association between the incidence of diabetes and obesity among the elderly of different genders, which intends to provide the scientific basis for undertaking glycemia interventions in the early stage to be conducive to the old folks' health status in Yantai City. A total of 986 old people (≥ 60 years old) were recruited from 4 districts in Laishan District Yantai City, Penglai City, Qixia City, Haiyang City by stratified cluster of random sampling and surveyed using questionnaires, while the physical examinations and blood glucose tests were conducted. The logistic regression model was used to analyze the cross-sectional association between the incidence of diabetes and obesity among the elderly of different genders in Yantai City. The rates of obesity and abdominal obesity were 10.04% and 60.85% among the old people in Yantai, respectively. The morbidity rate of diabetes was 10.85%. The influencing factors such as age, cultural standard, monthly income, past job category, smoking, drinking were adjusted, the fat old people had 3.121 times as much chance of suffering from obesity as the normal weight ones (OR = 3.121, 95% CI 1.978 - 5.119). And there was a gender difference between diabetes and obesity. The cross-sectional association between the incidence of diabetes and masculine obesity was of statistical significance alone (OR = 3.924, 95% CI 1.561 - 7.174). The elderly with the abdominal obesity 2.398 times as likely to suffer from diabetes as the elderly with the non-abdominal obesity (OR = 2.398, 95% CI 2.123 - 4.412). There was a gender difference between diabetes and abdominal obesity. The cross-sectional association between the incidence of diabetes and masculine abdominal obesity was of statistical significance alone (OR = 2.917, 95% CI 1.249 - 4.019). There are gender difference in the relationship between obesity, abdominal obesity and diabetes in the elderly in Yantai. BMI and waist circumference can be used as the predictive indexes of masculine diabetes.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Spector, June T., E-mail: spectj@uw.edu; Department of Medicine, School of Medicine, University of Washington, Seattle, WA; De Roos, Anneclaire J., E-mail: ajd335@drexel.edu
Background: Polychlorinated biphenyl (PCB) exposure has been associated with non-Hodgkin lymphoma in several studies, and the immune system is a potential mediator. Objectives: We analyzed associations of plasma PCBs with immune function measures. We hypothesized that higher plasma PCB concentrations are associated with lower immune function cross-sectionally, and that increases in PCB concentrations over a one year period are associated with decreases in immune function. Methods: Plasma PCB concentrations and immune function [natural killer (NK) cell cytotoxicity and PHA-induced T-lymphocyte proliferation (PHA-TLP)] were measured at baseline and one year in 109 postmenopausal overweight women participating in an exercise intervention studymore » in the Seattle, Washington (USA) area. Mixed models, with adjustment for body mass index and other potential confounders, were used to estimate associations of PCBs with immune function cross-sectionally and longitudinally. Results: Associations of PCBs with immune function measures differed across groups of PCBs (e.g., medium- and high-chlorinated and dioxin-like [mono-ortho-substituted]) and by the time frame for the comparison (cross-sectional vs. longitudinal). Higher concentrations of medium- and high-chlorinated PCBs were associated with higher PHA-TLP cross-sectionally but not longitudinally. The mean decrease in 0.5 µg/mL PHA-TLP/50.0 pmol/g-lipid increase in dioxin-like PCBs over one year was 51.6 (95% confidence interval 2.7, 100.5; P=0.039). There was no association between plasma PCBs and NK cytotoxicity. Conclusions: These results do not provide strong evidence of impaired cellular immunity from PCB exposure. Larger longitudinal studies with greater variability in PCB exposures are needed to further examine temporal associations of PCBs with immune function. - Highlights: • Plasma PCBs and immune function were measured in 109 women at baseline and one year. • Immune measures included T lymphocyte proliferation (TLP) and NK cell cytotoxicity. • Higher-chlorinated PCBs were positively associated with TLP in cross-section. • An increase in dioxin-like PCBs was associated with a decrease in TLP over one year. • We did not find strong evidence of impaired cellular immunity from PCB exposure.« less
Kolokotroni, Ourania; Middleton, Nicos; Gavatha, Marina; Lamnisos, Demetris; Priftis, Kostas N; Yiallouros, Panayiotis K
2012-11-16
Studies on the association of birth by caesarean section (C/S) and allergies have produced conflicting findings. Furthermore, evidence on whether this association may differ in those at risk of atopy is limited. This study aims to investigate the association of mode of delivery with asthma and atopic sensitization and the extent to which any effect is modified by family history of allergies. Asthma outcomes were assessed cross-sectionally in 2216 children at age 8 on the basis of parents' responses to the ISAAC questionnaire whilst skin prick tests to eleven aeroallergens were also performed in a subgroup of 746 children. Adjusted odds ratios of asthma and atopy by mode of delivery were estimated in multivariable logistic models while evidence of effect modification was examined by introducing interaction terms in the models. After adjusting for potential confounders, children born by C/S appeared significantly more likely than those born vaginally to report ever wheezing (OR 1.36, 95% CI 1.07-1.71), asthma diagnosis (OR 1.41, 95% CI 1.09-1.83) and be atopic (OR 1.67, 95% CI 1.08-2.60). There was modest evidence that family history of allergies may modify the effect of C/S delivery on atopy (p for effect modification=0.06) but this was not the case for the asthma outcomes. Specifically, while more than a two-fold increase in the odds of being a topic was observed in children with a family history of allergies if born by C/S (OR 2.62, 95% CI 1.38-5.00), no association was observed in children without a family history of allergies (OR 1.16, 95% CI 0.64-2.11). Birth by C/S is associated with asthma and atopic sensitization in childhood. The association of C/S and atopy appears more pronounced in children with family history of allergies.
Case-Mix Adjustment of the Bereaved Family Survey.
Kutney-Lee, Ann; Carpenter, Joan; Smith, Dawn; Thorpe, Joshua; Tudose, Alina; Ersek, Mary
2018-01-01
Surveys of bereaved family members are increasingly being used to evaluate end-of-life (EOL) care and to measure organizational performance in EOL care quality. The Bereaved Family Survey (BFS) is used to monitor EOL care quality and benchmark performance in the Veterans Affairs (VA) health-care system. The objective of this study was to develop a case-mix adjustment model for the BFS and to examine changes in facility-level scores following adjustment, in order to provide fair comparisons across facilities. We conducted a cross-sectional secondary analysis of medical record and survey data from veterans and their family members across 146 VA medical centers. Following adjustment using model-based propensity weighting, the mean change in the BFS-Performance Measure score across facilities was -0.6 with a range of -2.6 to 0.6. Fifty-five (38%) facilities changed within ±0.5 percentage points of their unadjusted score. On average, facilities that benefited most from adjustment cared for patients with greater comorbidity burden and were located in urban areas in the Northwest and Midwestern regions of the country. Case-mix adjustment results in minor changes to facility-level BFS scores but allows for fairer comparisons of EOL care quality. Case-mix adjustment of the BFS positions this National Quality Forum-endorsed measure for use in public reporting and internal quality dashboards for VA leadership and may inform the development and refinement of case-mix adjustment models for other surveys of bereaved family members.
[Factors associated with cross-nursing].
von Seehausen, Mariana Pujól; Oliveira, Maria Inês Couto de; Boccolini, Cristiano Siqueira
2017-05-01
This article aims to estimate the prevalence and analyze the factors associated with cross-nursing. A cross-sectional study was conducted in 2013 with interviews with a representative sample of mothers of infants less than one-year-old (n' = 695) attended in nine primary health units in Rio de Janeiro, Brazil. Sociodemographic characteristics were studied; pregnancy, childbirth and primary care assistance; maternal habits and baby features. Adjusted prevalence ratios (PR) were obtained by Poisson Regression, retaining variables associated with the outcome in the final model (p ≤ 0.05). Cross-nursing was practiced by 29.4% of the mothers. Most practitioner mothers were relatives or friends. The following variables were directly associated with cross-nursing: being an adolescent mother (PR' = 1.595), smoking (PR' = 1.396), alcohol consumption (PR' = 1.613), inappropriate baby feeding habits (PR' = 1.371) and infant's age in months (PR' = 1.066). Maternal formal employment was inversely associated with the practice (PR' = 0.579). Cross-nursing has a relevant prevalence among mothers assisted by primary health care units in Rio de Janeiro City. This issue should be addressed, especially among the most vulnerable groups, due to the association with adolescence and with unhealthy habits.
Casillas, Alejandra; Paroz, Sophie; Green, Alexander R; Wolff, Hans; Weber, Orest; Faucherre, Florence; Ninane, Françoise; Bodenmann, Patrick
2014-01-30
As the diversity of the European population evolves, measuring providers' skillfulness in cross-cultural care and understanding what contextual factors may influence this is increasingly necessary. Given limited information about differences in cultural competency by provider role, we compared cross-cultural skillfulness between physicians and nurses working at a Swiss university hospital. A survey on cross-cultural care was mailed in November 2010 to front-line providers in Lausanne, Switzerland. This questionnaire included some questions from the previously validated Cross-Cultural Care Survey. We compared physicians' and nurses' mean composite scores and proportion of "3-good/4-very good" responses, for nine perceived skillfulness items (4-point Likert-scale) using the validated tool. We used linear regression to examine how provider role (physician vs. nurse) was associated with composite skillfulness scores, adjusting for demographics (gender, non-French dominant language), workplace (time at institution, work-unit "sensitized" to cultural-care), reported cultural-competence training, and cross-cultural care problem-awareness. Of 885 questionnaires, 368 (41.2%) returned the survey: 124 (33.6%) physicians and 244 (66.4%) nurses, reflecting institutional distribution of providers. Physicians had better mean composite scores for perceived skillfulness than nurses (2.7 vs. 2.5, p < 0.005), and significantly higher proportion of "good/very good" responses for 4/9 items. After adjusting for explanatory variables, physicians remained more likely to have higher skillfulness (β = 0.13, p = 0.05). Among all, higher skillfulness was associated with perception/awareness of problems in the following areas: inadequate cross-cultural training (β = 0.14, p = 0.01) and lack of practical experience caring for diverse populations (β = 0.11, p = 0.04). In stratified analyses among physicians alone, having French as a dominant language (β = -0.34, p < 0.005) was negatively correlated with skillfulness. Overall, there is much room for cultural competency improvement among providers. These results support the need for cross-cultural skills training with an inter-professional focus on nurses, education that attunes provider awareness to the local issues in cross-cultural care, and increased diversity efforts in the work force, particularly among physicians.
Liu, Chunqin; Zhao, Yuanyuan; Tian, Xiaohong; Zou, Guiyuan; Li, Ping
2015-06-01
Adjustment difficulties of college students are common and their school adjustment has gained wide concern in recent years. Negative life events and psychological capital (PsyCap) have been associated with school adjustment. However, the potential impact of negative life events on PsyCap, and whether PsyCap mediates the relationship between negative life events and school adjustment among nursing students have not been studied. To investigate the relationship among negative life events, PsyCap, and school adjustment among five-year vocational high school nursing students in China and the mediating role of PsyCap between negative life events and school adjustment. A cross-sectional survey design was conducted. 643 five-year vocational high school nursing students were recruited from three public high vocational colleges in Shandong of China. Adolescent Self-Rating Life Event Checklist (ASLEC), the Psychological Capital Questionnaire for Adolescent Students scale (PCQAS), and the Chinese College Student Adjustment Scale (CCSAS) were used in this study. Hierarchical linear regression analyses were performed to explore the mediating role of PsyCap. Negative life events were negatively associated with the dimensions of school adjustment (interpersonal relationship adaptation, learning adaptation, campus life adaptation, career adaptation, emotional adaptation, self-adaptation, and degree of satisfaction). PsyCap was positively associated with the dimensions of school adjustment and negatively associated with negative life events. PsyCap partially mediated the relationship between negative life events and school adjustment. Negative life events may increase the risk of school maladjustment in individuals with low PsyCap. Interventions designed to increase nursing students' PsyCap might buffer the stress of adverse life events, and thereby, enhance students' positive adjustment to school. Copyright © 2015 Elsevier Ltd. All rights reserved.
A SURVEY OF DEATH ADJUSTMENT IN THE INDIAN SUBCONTINENT.
Hossain, Mohammad Samir; Irfan, Muhammad; Balhara, Yatan Pal Singh; Giasuddin, Noor Ahmed; Sultana, Syeda Naheed
2015-01-01
The Death Adjustment Hypothesis (DAH) postulates two key themes. Its first part postulates that death should not be considered the end of existence and the second part emphasizes that the belief in immortal pattern of human existence can only be adopted in a morally rich life with the attitude towards morality and materialism balanced mutually. We wanted to explore Death Adjustment in the Indian subcontinent and the differences among, Indians, Pakistanis and Bangladeshis. We also wanted to find the relationship between death adjustment (i.e., adaptation to death), materialistic thoughts and death adjustment thoughts. This was a cross-sectional study, conducted from May 2010 to June 2013. Using a purposive sampling strategy, a sample of 296 participants from the Indian subcontinent [Pakistan (n=100), Bangladesh (n=98) and India (n=98)] was selected. Multidimensional Fear of Death Scale (MFODS) was used to measure death adjustment. The rest of the variables were measured using lists of respective thoughts, described in elaborated DAH. Analyses were carried out using SPSSv13. The mean death adjustment score for Pakistani, Indian and Bangaldeshi population were 115.26 +/- 26.4, 125.87 +/- 24.3 and 114.91 +/- 21.2, respectively. Death adjustment was better with older age (r=0.20) and with lower scores on materialistic thoughts (r = -0.26). However, this was a weak relation. The three nationalities were compared with each other by using Analysis of variance. Death adjustment thoughts and death adjustment were significantly different when Indians were compared with Bangladeshis (p=0.00) and Pakistanis (p=0.006) but comparison between Bangladeshis and Pakistanis showed no significant difference. Subjects with lesser materialistic thoughts showed better death adjustment. There are differences between Muslims and non-Muslims in adjusting to death.
2014-01-01
Background Chronic pain is a major public health problem. The impact of stages of chronic pain adjusted for disease load on societal burden has not been assessed in population surveys. Methods A cross-sectional survey with 4360 people aged ≥ 14 years representative of the German population was conducted. Measures obtained included demographic variables, presence of chronic pain (based on the definition of the International Association for the Study of Pain), chronic pain stages (by chronic pain grade questionnaire), disease load (by self-reported comorbidity questionnaire) and societal burden (by self-reported number of doctor visits, nights spent in hospital and days of sick leave/disability in the previous 12 months, and by current unemployment). Associations between chronic pain stages with societal burden, adjusted for demographic variables and disease load, were tested by Poisson and logistic regression analyses. Results 2508 responses were received. 19.4% (95% CI 16.8% to 22.0%) of participants met the criteria of chronic non-disabling non-malignant pain. 7.4% (95% CI 5.0% to 9.9%) met criteria for chronic disabling non-malignant pain. Compared with no chronic pain, the rate ratio (RR) of days with sick leave/disability was 1.6 for non-disabling pain and 6.4 for disabling pain. After adjusting for age and disease load, the RRs increased to 1.8 and 6.8. The RR of doctor visits was 2.5 for non-disabling pain and 4.5 for disabling pain if compared with no chronic pain. After adjusting for age and disease load, the RR fell to 1.7 and 2.6. The RR of days in hospital was 2.7 for non-disabling pain and 11.7 for disabling pain if compared with no chronic pain. After adjusting for age and disease load, the RR fell to 1.5 and 4.0. Unemployment was predicted by lower educational level (Odds Ratio OR 3.27 [95% CI 1.70-6.29]), disabling pain (OR 3.30 [95% CI 1.76-6.21]) and disease load (OR 1.70 [95% CI 1.41-2.05]). Conclusion Chronic pain stages, but also disease load and societal inequalities contributed to societal burden. Pain measurements in epidemiology research of chronic pain should include chronic pain grades and disease load. PMID:24725286
Claus, Matthias; Kimbel, Renate; Spahn, Daniel; Dudenhöffer, Sarah; Rose, Dirk-Matthias; Letzel, Stephan
2014-02-25
In Germany, about 70,000 teachers and educational staff were teaching at more than 3,000 special schools during the school year 2010/2011. Nursing services like lifting pupils form a substantial part of the work content of the staff at special schools. Since nursing care often involves carrying and lifting pupils, there is a reason to assume an adverse effect on the musculoskeletal health of teachers and other professionals. With the present study we aimed to describe the prevalence and risk factors of chronic back pain among employees at this type of school. The cross-sectional survey was carried out between August 2010 and August 2012 at 13 special schools focusing on motoric and/or holistic development of handicapped children in Rhineland-Palatinate (Germany). Teachers and educational staff were interviewed using a questionnaire. We applied multivariable logistic regression analyses to identify influencing factors of chronic back pain. Altogether 395 persons (response rate: 59.7%) participated in our study. Respondents were mostly female (86.8%) with a mean age of 45 years. The prevalence of chronic back pain was 38.7%. More than 40% reported frequently carrying and lifting heavy loads (>20 kg). Age [adjusted OR = 1.03 (95%-CI 1.00-1.05) for 1-year increase in age], current smoking [adjusted OR = 2.31 (95%-CI 1.27-4.23)], depression/depressive mood [adjusted OR = 1.85 (95%-CI 1.12-3.06)], frequently carrying and lifting heavy loads [adjusted OR = 2.69 (95%-CI 1.53-4.75)], and frequent exposure to environmental impacts [adjusted OR = 2.18 (95%-CI 1.26-3.76)] were influencing factors of chronic back pain in the final multivariable regression model. A large proportion of teachers and educational staff suffered from chronic back pain in our study, indicating a high need for treatment in this professional group. Increasing age, current smoking, a diagnosed depression/depressive mood, carrying and lifting heavy loads, and exposure to environmental impacts were associated with chronic back pain. Due to the sparse literature on the topic, further studies using a longitudinal design are necessary for a better understanding of the risk factors of chronic back pain.
Boulos, David; Fikretoglu, Deniz
2018-01-01
Objective The primary objective was to explore differences in mental health problems (MHP) between serving Canadian Armed Forces (CAF) components (Regular Force (RegF); Reserve Force (ResF)) with an Afghanistan deployment and to assess the contribution of both component and deployment experiences to MHP using covariate-adjusted prevalence difference estimates. Additionally, mental health services use (MHSU) was descriptively assessed among those with a mental disorder. Design Data came from the 2013 CAF Mental Health Survey, a cross-sectional survey of serving personnel (n=72 629). Analyses were limited to those with an Afghanistan deployment (population n=35 311; sampled n=4854). Logistic regression compared MHP between RegF and ResF members. Covariate-adjusted prevalence differences were computed. Primary outcome measure The primary outcomes were MHP, past-year mental disorders, identified using the WHO’s Composite International Diagnostic Interview, and past-year suicide ideation. Results ResF personnel were less likely to be identified with a past-year anxiety disorder (adjusted OR (AOR)=0.72 (95% CI 0.58 to 0.90)), specifically both generalised anxiety disorder and panic disorder, but more likely to be identified with a past-year alcohol abuse disorder (AOR=1.63 (95% CI 1.04 to 2.58)). The magnitude of the covariate-adjusted disorder prevalence differences for component was highest for the any anxiety disorder outcome, 2.8% (95% CI 1.0 to 4.6); lower for ResF. All but one deployment-related experience variable had some association with MHP. The ‘ever felt responsible for the death of a Canadian or ally personnel’ experience had the strongest association with MHP; its estimated covariate-adjusted disorder prevalence difference was highest for the any (of the six measured) mental disorder outcome (11.2% (95% CI 6.6 to 15.9)). Additionally, ResF reported less past-year MHSU and more past-year civilian MHSU. Conclusions Past-year MHP differences were identified between components. Our findings suggest that although deployment-related experiences were highly associated with MHP, these only partially accounted for MHP differences between components. Additional research is needed to further investigate MHSU differences between components. PMID:29530906
Lee, Yu-Mi; Kim, Rock Bum; Lee, Hey Jean; Kim, Keonyeop; Shin, Min-Ho; Park, Hyeung-Keun; Ahn, Soon-Ki; Kim, So Young; Lee, Young-Hoon; Kim, Byoung-Gwon; Lee, Heeyoung; Lee, Won Kyung; Lee, Kun Sei; Kim, Mi-Ji; Park, Ki-Soo
2018-05-22
The healthy adherer effect is a phenomenon in which patients who adhere to medical therapies tend to pursue health-seeking behaviors. Although the healthy adherer effect is supposed to affect health outcomes in patients with coronary artery disease, evaluation of its presence and extent is not easy. This study aimed to assess the relationship between medication adherence and lifestyle modifications and health-related quality of life among post-acute myocardial infarction (AMI) patients. A cross-sectional study was conducted in 417 post-AMI patients who underwent percutaneous coronary intervention (PCI). Patients were recruited from 11 university hospitals from December 2015 to March 2016 in South Korea. Details regarding socio-demographic factors, six health behaviors (low-salt intake, low-fat diet and/or weight-loss diet, regular exercise, stress reduction in daily life, drinking in moderation, and smoking cessation), medication adherence using the Modified Morisky Scale (MMS), and HRQoL using the Coronary Revascularization Outcome Questionnaire (CROQ) were surveyed in a one-on-one interview. In the univariate logistic analysis, sex (female), age (≥70 years), MMS score (≥5), and CROQ score were associated with adherence to lifestyle modification. In the multiple logistic analysis, a high MMS score (≥5) was associated with adherence to lifestyle modification after adjusting for sex, age, marital status, education, and family income (adjusted odds ratio [OR] = 11.7, 95% confidence interval [CI] = 1.5-91.3). After further adjusting for the CROQ score, the association between high MMS score and adherence to lifestyle modification was significant (adjusted OR = 11.5, 95% CI = 1.4-93.3). Adherence to medication was associated with adherence to lifestyle modification, suggesting the possible presence of the healthy adherer effect in post-AMI patients. After further adjusting for HRQoL, the association remained. To improve health outcome in post-AMI patients, early detection of patients with poor adherence to medication and lifestyle modification and motivational education programs to improve adherence are important. In addition, the healthy adherer effect should be considered in clinical research, in particular, in studies evaluating the effects of therapies on health outcomes.
Low Bone Density and Bisphosphonate Use and the Risk of Kidney Stones.
Prochaska, Megan; Taylor, Eric; Vaidya, Anand; Curhan, Gary
2017-08-07
Previous studies have demonstrated lower bone density in patients with kidney stones, but no longitudinal studies have evaluated kidney stone risk in individuals with low bone density. Small studies with short follow-up reported reduced 24-hour urine calcium excretion with bisphosphonate use. We examined history of low bone density and bisphosphonate use and the risk of incident kidney stone as well as the association with 24-hour calcium excretion. We conducted a prospective analysis of 96,092 women in the Nurses' Health Study II. We used Cox proportional hazards models to adjust for age, body mass index, thiazide use, fluid intake, supplemental calcium use, and dietary factors. We also conducted a cross-sectional analysis of 2294 participants using multivariable linear regression to compare 24-hour urinary calcium excretion between participants with and without a history of low bone density, and among 458 participants with low bone density, with and without bisphosphonate use. We identified 2564 incident stones during 1,179,860 person-years of follow-up. The multivariable adjusted relative risk for an incident kidney stone for participants with history of low bone density compared with participants without was 1.39 (95% confidence interval [95% CI], 1.20 to 1.62). Among participants with low bone density, the multivariable adjusted relative risk for an incident kidney stone for bisphosphonate users was 0.68 (95% CI, 0.48 to 0.98). In the cross-sectional analysis of 24-hour urine calcium excretion, the multivariable adjusted mean difference in 24-hour calcium was 10 mg/d (95% CI, 1 to 19) higher for participants with history of low bone density. However, among participants with history of low bone density, there was no association between bisphosphonate use and 24-hour calcium with multivariable adjusted mean difference in 24-hour calcium of -2 mg/d (95% CI, -25 to 20). Low bone density is an independent risk factor for incident kidney stone and is associated with higher 24-hour urine calcium excretion. Among participants with low bone density, bisphosphonate use was associated with lower risk of incident kidney stone but was not independently associated with 24-hour urine calcium excretion. Copyright © 2017 by the American Society of Nephrology.
Fone, David L; Dunstan, Frank; Christie, Stephen; Jones, Andrew; West, Jonathan; Webber, Margaret; Lester, Nathan; Watkins, John
2006-05-02
Council tax valuation bands (CTVBs) are a categorisation of household property value in Great Britain. The aim of the study was to assess the CTVB as a measure of socio-economic status by comparing the strength of the associations between selected health and lifestyle outcomes and CTVBs with two measures of socio-economic status: the National Statistics Socio-Economic Classification (NS-SEC) and the 2001 UK census-based Townsend deprivation index. Cross-sectional analysis of data on 12,092 respondents (adjusted response 62.7%) to the Caerphilly Health and Social Needs Study, a postal questionnaire survey undertaken in Caerphilly county borough, south-east Wales, UK. The CTVB was assigned to each individual by matching the sampling frame to the local authority council tax register. Crude and age-gender adjusted odds ratios for each category of CTVB, NS-SEC and fifth of the ward distribution of Townsend scores were estimated for smoking, poor diet, obesity, and limiting long-term illness using logistic regression. Mean mental (MCS) and physical (PCS) component summary scores of the Short-Form SF-36 health status questionnaire were estimated in general linear models. There were significant trends in odds ratios across the CTVB categories for all outcomes, most marked for smoking and mental and physical health status. The adjusted odds ratio for being a smoker in the lowest versus highest CTVB category was 3.80 (95% CI: 3.06, 4.71), compared to 3.00 (95% CI: 2.30, 3.90) for the NS-SEC 'never worked and long-term unemployed' versus 'higher managerial and professional' categories, and 1.61 (95% CI: 1.42, 1.83) for the most deprived versus the least deprived Townsend fifth. The difference in adjusted mean MCS scores was 5.9 points on the scale for CTVB, 9.2 for NS-SEC and 3.2 for the Townsend score. The values for the adjusted mean PCS scores were 6.3 points for CTVB, 11.3 for NS-SEC, and 2.5 for the Townsend score. CTVBs assigned to individuals were strongly associated with the health and lifestyle outcomes modelled in this study. CTVBs are readily available for all residential properties and deserve further consideration as a proxy for socio-economic status in epidemiological studies in Great Britain.
Fone, David L; Dunstan, Frank; Christie, Stephen; Jones, Andrew; West, Jonathan; Webber, Margaret; Lester, Nathan; Watkins, John
2006-01-01
Council tax valuation bands (CTVBs) are a categorisation of household property value in Great Britain. The aim of the study was to assess the CTVB as a measure of socio-economic status by comparing the strength of the associations between selected health and lifestyle outcomes and CTVBs with two measures of socio-economic status: the National Statistics Socio-Economic Classification (NS-SEC) and the 2001 UK census-based Townsend deprivation index. Methods Cross-sectional analysis of data on 12,092 respondents (adjusted response 62.7%) to the Caerphilly Health and Social Needs Study, a postal questionnaire survey undertaken in Caerphilly county borough, south-east Wales, UK. The CTVB was assigned to each individual by matching the sampling frame to the local authority council tax register. Crude and age-gender adjusted odds ratios for each category of CTVB, NS-SEC and fifth of the ward distribution of Townsend scores were estimated for smoking, poor diet, obesity, and limiting long-term illness using logistic regression. Mean mental (MCS) and physical (PCS) component summary scores of the Short-Form SF-36 health status questionnaire were estimated in general linear models. Results There were significant trends in odds ratios across the CTVB categories for all outcomes, most marked for smoking and mental and physical health status. The adjusted odds ratio for being a smoker in the lowest versus highest CTVB category was 3.80 (95% CI: 3.06, 4.71), compared to 3.00 (95% CI: 2.30, 3.90) for the NS-SEC 'never worked and long-term unemployed' versus 'higher managerial and professional' categories, and 1.61 (95% CI: 1.42, 1.83) for the most deprived versus the least deprived Townsend fifth. The difference in adjusted mean MCS scores was 5.9 points on the scale for CTVB, 9.2 for NS-SEC and 3.2 for the Townsend score. The values for the adjusted mean PCS scores were 6.3 points for CTVB, 11.3 for NS-SEC, and 2.5 for the Townsend score. Conclusion CTVBs assigned to individuals were strongly associated with the health and lifestyle outcomes modelled in this study. CTVBs are readily available for all residential properties and deserve further consideration as a proxy for socio-economic status in epidemiological studies in Great Britain. PMID:16669998
Boulos, David; Fikretoglu, Deniz
2018-03-12
The primary objective was to explore differences in mental health problems (MHP) between serving Canadian Armed Forces (CAF) components (Regular Force (RegF); Reserve Force (ResF)) with an Afghanistan deployment and to assess the contribution of both component and deployment experiences to MHP using covariate-adjusted prevalence difference estimates. Additionally, mental health services use (MHSU) was descriptively assessed among those with a mental disorder. Data came from the 2013 CAF Mental Health Survey, a cross-sectional survey of serving personnel (n=72 629). Analyses were limited to those with an Afghanistan deployment (population n=35 311; sampled n=4854). Logistic regression compared MHP between RegF and ResF members. Covariate-adjusted prevalence differences were computed. The primary outcomes were MHP, past-year mental disorders, identified using the WHO's Composite International Diagnostic Interview, and past-year suicide ideation. ResF personnel were less likely to be identified with a past-year anxiety disorder (adjusted OR (AOR)=0.72 (95% CI 0.58 to 0.90)), specifically both generalised anxiety disorder and panic disorder, but more likely to be identified with a past-year alcohol abuse disorder (AOR=1.63 (95% CI 1.04 to 2.58)). The magnitude of the covariate-adjusted disorder prevalence differences for component was highest for the any anxiety disorder outcome, 2.8% (95% CI 1.0 to 4.6); lower for ResF. All but one deployment-related experience variable had some association with MHP. The 'ever felt responsible for the death of a Canadian or ally personnel' experience had the strongest association with MHP; its estimated covariate-adjusted disorder prevalence difference was highest for the any (of the six measured) mental disorder outcome (11.2% (95% CI 6.6 to 15.9)). Additionally, ResF reported less past-year MHSU and more past-year civilian MHSU. Past-year MHP differences were identified between components. Our findings suggest that although deployment-related experiences were highly associated with MHP, these only partially accounted for MHP differences between components. Additional research is needed to further investigate MHSU differences between components. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
El-Serag, H B; Satia, J A; Rabeneck, L
2005-01-01
Background: Although diet has been associated with gastro-oesophageal reflux disease (GORD), the role of dietary components (total energy, macro and micronutrients) is unknown. We examined associations of GORD symptoms with intakes of specific dietary components. Methods: We conducted a cross sectional study in a sample of employees (non-patients) at the Houston VAMC. The Gastro Esophageal Reflux Questionnaire was used to identify the onset, frequency, and severity of GORD symptoms. Dietary intake (usual frequency of consumption of various foods and portion sizes) over the preceding year was assessed using the Block 98 food frequency questionnaire. Upper endoscopy was offered to all participants and oesophageal erosions recorded according to the LA classification. We compared the dietary intake (macronutrients, micronutrients, food groups) of participants with or without GORD symptoms, or erosive oesophagitis. Stepwise multiple logistic regression analyses were used to examine associations between nutrients and GORD symptoms or oesophageal erosions, adjusting for demographic characteristics, body mass index (BMI), and total energy intake. Results: A total of 371 of 915 respondents (41%) had complete and interpretable answers to both heartburn and regurgitation questions and met validity criteria for the Block 98 FFQ. Mean age was 43 years, 260 (70%) were women, and 103 (28%) reported at least weekly occurrences of heartburn or regurgitation. Of the 164 respondents on whom endoscopies were performed, erosive oesophagitis was detected in 40 (24%). Compared to participants without GORD symptoms, daily intakes of total fat, saturated fat, cholesterol, percentage of energy from dietary fat, and average fat servings were significantly higher in participants with GORD symptoms. In addition, there was a dose-response relationship between GORD and saturated fat and cholesterol. The effect of dietary fat became non-significant when adjusted for BMI. However, high saturated fat, cholesterol, or fat servings were associated with GORD symptoms only in participants with a BMI >25 kg/m2 (effect modification). Fibre intake remained inversely associated with the risk of GORD symptoms in adjusted full models. Participants with erosive oesophagitis had significantly higher daily intakes of total fat and protein than those without it (p<0.05). Conclusions: In this cross sectional study, high dietary fat intake was associated with an increased risk of GORD symptoms and erosive oesophagitis while high fibre intake correlated with a reduced risk of GORD symptoms. It is unclear if the effects of dietary fat are independent of obesity. PMID:15591498
Productivity cost due to postpartum ill health: A cross-sectional study in Sri Lanka
Horton, Jennifer; Darshika, Ishani; Galgamuwa, Kaushila Dinithi; Ranasinghe, Wasantha Pradeep; Agampodi, Thilini Chanchala; Agampodi, Suneth Buddhika
2017-01-01
Objective Even though postpartum morbidity continues to cause high disease burden in maternal morbidity and mortality across the globe, the literature pertaining to resultant productivity loss is scarce. Hence, the present study aimed at determining the productivity loss and associated cost of episodes of postpartum ill health. Methods A cross sectional study was conducted in two Medical Officer of Heath areas in the Anuradhapura district, Sri Lanka in 2011, among 407 women residing in Anuradhapura district with an infant aged between 8 to 24 weeks. Validated interviewer administered questionnaires, including the IMMPACT productivity cost tool, were used to collect data on self-reported episodes of postpartum ill health. The productivity loss was calculated as the sum of days lost due to partial and total incapacitation. The adjusted productivity loss for coping strategies was calculated. Productivity cost, both total and adjusted, were calculated based on the mean daily per capita income of the study sample. Results Of the 407 participants, 161(39.6%) reported at least one episode of postpartum illness. Hospitalisations were reported by 27 (16.8%) of all symptomatic postpartum women. Common symptoms of postpartum ill health were pain/infection at either episiotomy or surgical site (n = 44, 27.3%), lower abdominal pain (n = 40, 24.8%) and backache (n = 27, 16.8%). The mean productivity loss per episode of ill health was 15 days (SD = 7.8 days) and the mean productivity loss per episode after adjusting for coping strategies was 7.9 days (SD = 4.4 days). The mean productivity cost per an episode was US$ 34.2(95%CI US$ 26.7–41.6) and the mean productivity cost per an episode after adjusting for coping strategies was US$ 18.0 (95%CI US$ 14.1–22.0) Conclusions The prevalence of self-reported postpartum ill health, associated productivity loss and cost were high in the study sample and the main contributors were preventable conditions including pain and infection. Thus, effective pain management and proper infection prevention and control measures are important in reducing the burden of postpartum illness and resultant productivity cost. PMID:29020101
Hirani, Vasant; Naganathan, Vasi; Blyth, Fiona; Le Couteur, David G; Seibel, Markus J; Waite, Louise M; Handelsman, David J; Hsu, Ben; Cumming, Robert G
2016-12-01
The objective of this study is to examine associations between Hb levels and sarcopenia, low muscle strength, functional measures, and activities of daily living (ADL) and instrumental ADL (IADL) disabilities in older Australian men. Men aged 70 years and older (2005-2007) from the Concord Health and Ageing in Men Project were assessed at baseline (n = 1,705), 2 years (n = 1,367), and 5 years (n = 958). The main outcome measurements were walking speed, muscle strength, ADL and IADL disabilities, and sarcopenia using the Foundation for the National Institutes of Health criteria (low appendicular lean mass adjusted for body mass index < 0.789 and poor grip strength < 26kg). Analysis was performed using Hb levels as a continuous measure, unadjusted and adjusted by age, income, body mass index, measures of health, estimated glomerular function, inflammatory markers, and medication use. Receiver operating characteristic curve analysis was performed to determine a threshold of Hb for each outcome. In cross-sectional and longitudinal analysis, for every 1g/dL increase in Hb, there was a significant reduction in risk of sarcopenia, slow walking speed, poor grip strength, inability to perform chair stands, and ADL and IADL disabilities in unadjusted, age-adjusted, and multivariate-adjusted analysis. The highest value of the Youden Index for Hb was 14.2g/dL for sarcopenia and grip strength, 14.5g/dL for walking speed, and 14.4g/dL for all other outcomes. Declines in Hb levels over time are associated with poor functional outcomes. The risks and benefits of interventions to increase Hb among older men warrant further investigation to differentiate whether this is an active contributor to age-related debility or a passive biomarker of it. © 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.
Pierre, Pernilla Videhult; Fridberger, Anders; Wikman, Anders; Alexanderson, Kristina
2012-10-15
Hearing difficulties constitute the most common cause of disability globally. Yet, studies on people with hearing difficulties regarding socio-economic status (SES), work, long-term unemployment, sickness absence, and disability pension are scarce. The aim of the present study was to investigate the main income sources of men and women of working ages with and without self-reported hearing difficulties and associations with gender, age, SES, type of living area, and country of birth. A cross-sectional population-based study, using information on self-reported hearing difficulties and SES of 19 045 subjects aged 20-64 years participating in Statistics Sweden's annual Living Conditions Surveys in any of the years 2004 through 2008. The information was linked to a nationwide database containing data on demographics and income sources. Odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated, using binary logistic regression analysis. Hearing difficulties increased with age and were more common in men (age-adjusted OR: 1.42 (95% CI: 1.30-1.56)) with an overall prevalence of 13.1% in men and 9.8% in women. Using working men as reference, the OR of having hearing difficulties was 1.23 (0.94-1.60) in men with unemployment benefits and 1.36 (1.13-1.65) in men with sickness benefits or disability pension, when adjusting for age and SES. The corresponding figures in women were 1.59 (1.17-2.16) and 1.73 (1.46-2.06). The OR of having sickness benefits or disability pension in subjects with hearing difficulties was 1.36 (1.12-1.64) in men and 1.70 (1.43-2.01) in women, when adjusting for age and SES and using men and women with no hearing difficulties as reference. Hearing difficulties were more prevalent in men. After adjustment with age and SES as well as with type of living area and country of birth, a significant association with unemployment benefits was found only in women, and the associations with long-term sickness absence and disability pension tended to be stronger in women.
Mahler, E A M; Zweers, M C; van Lent, P L; Blom, A B; van den Hoogen, F H; van den Berg, W B; Roth, J; Vogl, T; Bijlsma, J W J; van den Ende, C H M; den Broeder, A A
2015-01-01
To explore the association between S100A8/A9 serum levels with clinical and structural characteristics of patients with established knee, hip, or hand osteoarthritis (OA). A cross-sectional exploratory study was conducted with 162 OA patients. Measures for pain, stiffness, and function included the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) questionnaire or the Australian Canadian Osteoarthritis Hand (AUSCAN) Index and for structural abnormalities, osteophytes and joint space narrowing grades. The association between S100A8/A9 and clinical or structural characteristics was analysed using linear regression or logistic regression where appropriate. The mean age of the OA patients was 56 years, 71% were female, and 61% had a Kellgren and Lawrence (K&L) score ≥ 2. The serum S100A8/A9 level did not differ between knee, hip, and hand OA patients and no association was found between serum S100A8/A9 and clinical characteristics. The serum S100A8/A9 level was negatively associated with the sum score of osteophytes after adjusting for sex and body mass index (BMI) [adjusted β -0.015, 95% confidence interval (CI) -0.030 to 0.001, p = 0.062] and positively associated with erythrocyte sedimentation rate (ESR) > 12 mm/h (adjusted OR 1.002, 95% CI 1.000-1.004 p = 0.049) for each increase in S100A8/A9 of 1 ng/mL. For hand OA patients, a negative association of S100A8/A9 with sum score of joint space narrowing was found (adjusted β -0.007, 95% CI -0.016 to 0.001, p = 0.099). The results from this cross-sectional exploratory study do not support an important role for serum S100A8/A9 levels as a biomarker for clinical and structural characteristics in established knee, hip, and hand OA patients. The inverse association with structural abnormalities and the positive association with ESR may reflect inflammatory synovial processes in patients with OA before structural abnormalities occur.
2011-01-01
Background Three different burnout types have been described: The "frenetic" type describes involved and ambitious subjects who sacrifice their health and personal lives for their jobs; the "underchallenged" type describes indifferent and bored workers who fail to find personal development in their jobs and the "worn-out" in type describes neglectful subjects who feel they have little control over results and whose efforts go unacknowledged. The study aimed to describe the possible associations between burnout types and general sociodemographic and occupational characteristics. Methods A cross-sectional study was carried out on a multi-occupational sample of randomly selected university employees (n = 409). The presence of burnout types was assessed by means of the "Burnout Clinical Subtype Questionnaire (BCSQ-36)", and the degree of association between variables was assessed using an adjusted odds ratio (OR) obtained from multivariate logistic regression models. Results Individuals working more than 40 hours per week presented with the greatest risk for "frenetic" burnout compared to those working fewer than 35 hours (adjusted OR = 5.69; 95% CI = 2.52-12.82; p < 0.001). Administration and service personnel presented the greatest risk of "underchallenged" burnout compared to teaching and research staff (adjusted OR = 2.85; 95% CI = 1.16-7.01; p = 0.023). Employees with more than sixteen years of service in the organisation presented the greatest risk of "worn-out" burnout compared to those with less than four years of service (adjusted OR = 4.56; 95% CI = 1.47-14.16; p = 0.009). Conclusions This study is the first to our knowledge that suggests the existence of associations between the different burnout subtypes (classified according to the degree of dedication to work) and the different sociodemographic and occupational characteristics that are congruent with the definition of each of the subtypes. These results are consistent with the clinical profile definitions of burnout syndrome. In addition, they assist the recognition of distinct profiles and reinforce the idea of differential characterisation of the syndrome for more effective treatment. PMID:21447169
2014-01-01
Background Several studies have reported that individualized residential place-based discrimination (PBD) affects residents’ health. However, studies exploring the association between institutionalized PBD and health are scarce, especially in Asian countries including Japan. Methods A cross-sectional study was conducted with random two-stage sampling of 6191 adults aged 25–64 years in 100 census tracts across Osaka city in 2011. Of 3244 respondents (response rate 52.4%), 2963 were analyzed using multilevel logistic regression to examine the association of both individualized and institutionalized PBD with self-rated health (SRH) after adjustment for individual-level factors such as socioeconomic status (SES). An area-level PBD indicator was created by aggregating individual-level PBD responses in each tract, representing a proxy for institutionalized PBD, i.e., the concept that living in a stigmatized neighborhood affects neighborhood health. 100 tracts were divided into quartiles in order. The health impact of area-level PBD was compared with that of area-level SES indicators (quartile) such as deprivation. Results After adjustment for individual-level PBD, the highest and third area-level PBD quartiles showed odds ratio (OR) 1.57 (95% credible interval: 1.13-2.18) and 1.38 (0.99-1.92), respectively, for poor SRH compared with the lowest area-level PBD quartile. In a further SES-adjusted model, ORs of area-level PBD (highest and third quartile) were attenuated to 1.32 and 1.31, respectively, but remained marginally significant, although those of the highest area-level not-home-owner (census-based indicator) and deprivation index quartiles were attenuated to 1.26 and 1.21, respectively, and not significant. Individual-level PBD showed significant OR 1.89 (1.33-2.81) for poor SRH in an age, sex, PBD and SES-adjusted model. Conclusion Institutionalized PBD may be a more important environmental determinant of SRH than other area-level SES indicators such as deprivation. Although it may have a smaller health impact than individualized PBD, attention should be paid to invisible and unconscious aspects of institutionalized PBD to improve residents’ health. PMID:24885239
Productivity cost due to postpartum ill health: A cross-sectional study in Sri Lanka.
Wickramasinghe, Nuwan Darshana; Horton, Jennifer; Darshika, Ishani; Galgamuwa, Kaushila Dinithi; Ranasinghe, Wasantha Pradeep; Agampodi, Thilini Chanchala; Agampodi, Suneth Buddhika
2017-01-01
Even though postpartum morbidity continues to cause high disease burden in maternal morbidity and mortality across the globe, the literature pertaining to resultant productivity loss is scarce. Hence, the present study aimed at determining the productivity loss and associated cost of episodes of postpartum ill health. A cross sectional study was conducted in two Medical Officer of Heath areas in the Anuradhapura district, Sri Lanka in 2011, among 407 women residing in Anuradhapura district with an infant aged between 8 to 24 weeks. Validated interviewer administered questionnaires, including the IMMPACT productivity cost tool, were used to collect data on self-reported episodes of postpartum ill health. The productivity loss was calculated as the sum of days lost due to partial and total incapacitation. The adjusted productivity loss for coping strategies was calculated. Productivity cost, both total and adjusted, were calculated based on the mean daily per capita income of the study sample. Of the 407 participants, 161(39.6%) reported at least one episode of postpartum illness. Hospitalisations were reported by 27 (16.8%) of all symptomatic postpartum women. Common symptoms of postpartum ill health were pain/infection at either episiotomy or surgical site (n = 44, 27.3%), lower abdominal pain (n = 40, 24.8%) and backache (n = 27, 16.8%). The mean productivity loss per episode of ill health was 15 days (SD = 7.8 days) and the mean productivity loss per episode after adjusting for coping strategies was 7.9 days (SD = 4.4 days). The mean productivity cost per an episode was US$ 34.2(95%CI US$ 26.7-41.6) and the mean productivity cost per an episode after adjusting for coping strategies was US$ 18.0 (95%CI US$ 14.1-22.0). The prevalence of self-reported postpartum ill health, associated productivity loss and cost were high in the study sample and the main contributors were preventable conditions including pain and infection. Thus, effective pain management and proper infection prevention and control measures are important in reducing the burden of postpartum illness and resultant productivity cost.
McKay, Ailsa J; Laverty, Anthony A; Shridhar, Krithiga; Alam, Dewan; Dias, Amit; Williams, Joseph; Millett, Christopher; Ebrahim, Shah; Dhillon, Preet K
2015-10-24
Data on use and health benefits of active travel in rural low- and middle- income country settings are sparse. We aimed to examine correlates of active travel, and its association with adiposity, in rural India and Bangladesh. Cross sectional study of 2,122 adults (≥18 years) sampled in 2011-13 from two rural sites in India (Goa and Chennai) and one in Bangladesh (Matlab). Logistic regression was used to examine whether ≥150 min/week of active travel was associated with socio-demographic indices, smoking, oil/butter consumption, and additional physical activity. Adjusting for these same factors, associations between active travel and BMI, waist circumference and waist-to-hip ratio were examined using linear and logistic regression. Forty-six percent of the sample achieved recommended levels of physical activity (≥150 min/week) through active travel alone (range: 33.1 % in Matlab to 54.8 % in Goa). This was more frequent among smokers (adjusted odds ratio 1.36, 95 % confidence interval 1.07-1.72; p = 0.011) and those that spent ≥150 min/week in work-based physical activity (OR 1.71, 1.35-2.16; p < 0.001), but less frequent among females than males (OR 0.25, 0.20-0.31; p < 0.001). In fully adjusted analyses, ≥150 min/week of active travel was associated with lower BMI (adjusted coefficient -0.39 kg/m(2), -0.77 to -0.02; p = 0.037) and a lower likelihood of high waist circumference (OR 0.77, 0.63-0.96; p = 0.018) and high waist-to-hip ratio (OR 0.72, 0.58-0.89; p = 0.002). Use of active travel for ≥150 min/week was associated with being male, smoking, and higher levels of work-based physical activity. It was associated with lower BMI, and lower risk of a high waist circumference or high waist-to-hip ratio. Promotion of active travel is an important component of strategies to address the growing prevalence of overweight in rural low- and middle- income country settings.
2012-01-01
Background Hearing difficulties constitute the most common cause of disability globally. Yet, studies on people with hearing difficulties regarding socio-economic status (SES), work, long-term unemployment, sickness absence, and disability pension are scarce. The aim of the present study was to investigate the main income sources of men and women of working ages with and without self-reported hearing difficulties and associations with gender, age, SES, type of living area, and country of birth. Methods A cross-sectional population-based study, using information on self-reported hearing difficulties and SES of 19 045 subjects aged 20–64 years participating in Statistics Sweden’s annual Living Conditions Surveys in any of the years 2004 through 2008. The information was linked to a nationwide database containing data on demographics and income sources. Odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated, using binary logistic regression analysis. Results Hearing difficulties increased with age and were more common in men (age-adjusted OR: 1.42 (95% CI: 1.30-1.56)) with an overall prevalence of 13.1% in men and 9.8% in women. Using working men as reference, the OR of having hearing difficulties was 1.23 (0.94-1.60) in men with unemployment benefits and 1.36 (1.13-1.65) in men with sickness benefits or disability pension, when adjusting for age and SES. The corresponding figures in women were 1.59 (1.17-2.16) and 1.73 (1.46-2.06). The OR of having sickness benefits or disability pension in subjects with hearing difficulties was 1.36 (1.12-1.64) in men and 1.70 (1.43-2.01) in women, when adjusting for age and SES and using men and women with no hearing difficulties as reference. Conclusions Hearing difficulties were more prevalent in men. After adjustment with age and SES as well as with type of living area and country of birth, a significant association with unemployment benefits was found only in women, and the associations with long-term sickness absence and disability pension tended to be stronger in women. PMID:23067045
Wang, Fenglei; Liu, Huijuan; Wan, Yi; Li, Jing; Chen, Yu; Zheng, Jusheng; Huang, Tao; Li, Duo
2016-01-01
Study Objectives: To examine the association between sleep duration and overweight/obesity in preschool-aged children. Methods: A total of 48,922 3-year old children enrolled in the Jiaxing Birth Cohort, who provided sleep information and anthropometric data, were included in the present study as baseline and were followed up to 5 years of age. Sleep duration was categorized as ≤ 10 hours, 11–12 hours, and ≥ 13 hours. Overweight and obesity were defined according to the cut point criteria in China. Prevalence ratios and risk ratios were used to assess the association between sleep duration and risk of overweight/obesity. Results: In cross-sectional analyses at baseline, the adjusted prevalence ratios (95% confidence interval) of overweight (with 11–12 h of sleep being considered the reference group) for children sleeping ≤ 10 h and ≥ 13 h were 1.13 (1.06–1.20) and 1.16 (1.09–1.24), respectively, whereas the adjusted prevalence ratios (95% confidence interval) of obesity were 1.25 (1.11–1.40) and 1.25 (1.11–1.42). In longitudinal analyses, the adjusted risk ratios (95% confidence interval) of overweight for children sleeping ≤ 10 h and ≥ 13 h were 1.48 (1.26–1.74) and 1.13 (0.96–1.34), while adjusted risk ratios (95% confidence interval) of obesity were 1.77 (1.30–2.40) and 1.19 (0.85–1.66). Restricted cubic splines regression supported U-shaped curvilinear associations between sleep duration and overweight/obesity in both cross-sectional and longitudinal analyses. Conclusions: Both short and overlong sleep duration are associated with a higher risk of overweight/obesity in preschool-aged children. Optimizing sleep duration may be an important modifiable intervention for overweight and obesity. Citation: Wang F, Liu H, Wan Y, Li J, Chen Y, Zheng J, Huang T, Li D. Sleep duration and overweight/obesity in preschool-aged children: a prospective study of up to 48,922 children of the Jiaxing birth cohort. SLEEP 2016;39(11):2013–2019. PMID:27568808
Dong, Bin; Wang, Zhiqiang; Song, Yi; Wang, Hai-Jun; Ma, Jun
2015-09-11
Understanding trends in blood pressure (BP) in childhood is crucial to addressing and reducing the burden of adulthood hypertension and associated mortality in the future. In view of growing obesity in Chinese children, we sought to investigate the trends in BP and the influence of body mass index (BMI) on them. We included 1,010,153 children aged 8-17 years, with completed records from a large national successive cross-sectional survey, the Chinese National Survey on Students' Constitution and Health, between 1985 and 2010. BP was measured according to the recommendation of the National High Blood Pressure Education Program Working Group, and the elevated BP was based on sex-, age- and height-specific 95th centile of the recommendation. The adjusted mean systolic BP in boys and girls decreased by 3.9 and 5.6 mm Hg between 1985 and 2005, and increased by 1.3 and 1.0 mm Hg between 2005 and 2010, respectively. Corresponding adjusted prevalence of elevated systolic BP in boys and girls declined from 5.1% and 5.5% to 3.5% and 2.5% between 1985 and 2005, and increased to 4.9% and 3.5% in 2010, respectively. Adjusted mean BMI of boys and girls in 2010 was 2.0 and 1.2 kg/m(2) higher than those in 1985, respectively. The prevalence of obesity rose from 0% to 3.4% in boys and 0.9% in girls. Further adjusting for BMI did not change these trends in systolic BP. A similar pattern was also observed in diastolic BP. After declining for 20 years, BP levels in Chinese children started to climb upwards. These trends in BP cannot be fully explained by BMI. The investigation of other determinants of BP may provide additional opportunity to curb the current upward BP trend in Chinese children. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Ganju, Deepika; Ramesh, Sowmya; Saggurti, Niranjan
2016-06-21
Although targeted interventions in India require all high-risk groups, including injecting drug users (IDUs), to test for HIV every 6 months, testing uptake among IDUs remains far from universal. Our study estimates the proportion of IDUs who have taken an HIV test and identifies the factors associated with HIV testing uptake in Nagaland and Manipur, two high HIV prevalence states in India where the epidemic is driven by injecting drug use. Data are drawn from the cross-sectional Integrated Behavioural and Biological Assessment (2009) of 1650 male IDUs from two districts each of Manipur and Nagaland. Participants were recruited using respondent-driven sampling (RDS). Descriptive data were analysed using RDSAT 7.1. Multivariate logistic regression analysis was undertaken using STATA 11 to examine the association between HIV testing and socio-demographic, behavioural and programme exposure variables. One third of IDUs reported prior HIV testing, of whom 8 % had tested HIV-positive. Among those without prior testing, 6.2 % tested HIV-positive in the current survey. IDUs aged 25-34 years (adjusted odds ratio (OR) = 1.41; 95 % confidence interval (CI) = 1.03-1.93), married (Adjusted OR = 1.56; 95 % CI = 1.15-2.12), had a paid sexual partner (Adjusted OR = 1.64; 95 % CI = 1.24-2.18), injected drugs for more than 36 months (Adjusted OR = 1.38; 95 % CI = 1.06-1.81), injected frequently (Adjusted OR = 1.49; 95 % CI = 1.12-1.98) and had high-risk perception (Adjusted OR = 1.68; 95 % CI = 1.32-2.14) were more likely than others to test for HIV. Compared to those with no programme exposure, IDUs who received counselling, or counselling and needle/syringe services, were more likely to test for HIV. HIV testing uptake among IDUs is low in Manipur and Nagaland, and a critical group of HIV-positive IDUs who have never tested for HIV are being missed by current programmes. This study identifies key sub-groups-including early initiators, short duration and less frequent injectors, perceived to be at low risk-for promoting HIV testing. Providing needles/syringes alone is not adequate to increase HIV testing; additionally, interventions must provide counselling services to inform all IDUs about HIV testing benefits, facilitate visits to testing centres and link those testing positive to timely treatment and care.
NASA Astrophysics Data System (ADS)
McDowell, P. F.
2016-12-01
The Middle Fork John Day River at Oxbow Conservation Area, northeastern Oregon, experienced heavy cattle grazing for a number of decades and was dredge mined for gold in the 1930s-50s. As a result of dredging, flow was divided between the original meandering channel on the southern part of the floodplain and a straight dredged channel on the northern part of the floodplain. The Confederated Tribes of the Warm Springs acquired this property and began planning floodplain and instream restoration focused primarily on anadromous and resident salmonids. In 2000, cattle grazing in the riparian zone was eliminated, resulting in expansion of sedges and other plants on banks, bars and the channel bed. In 2003, riparian planting of woody vegetation began. In 2011, log structures were constructed in the south channel. The overarching goals of the log structure project were: 1) to add bank protection and roughness to accommodate the planned increase in discharge, and 2) to provide fish cover, pools, and channel complexity. In 2013, the north channel was closed and all flow was put in the south channel. This paper examines channel morphological response to these multiple actions. Channel adjustment was monitored through repeated channel cross-section surveys, longitudinal profile surveys, and analysis of planform change using high-resolution aerial imagery. I hypothesized that channel adjustment would be greatest where banks were less protected, and where bed materials were more mobile due to smaller size or local hydraulic factors such as bend curvature. The results indicate that there has been significant reorganization of riffle-pool structure in the longitudinal profile, but less change in cross-sections and planform. Cross-sections, both at log structures and not at structures, show limited bar aggradation and bank erosion. Some modest erosion occurred on banks protected by log structures. There is no increase in pool depth. The hypothesized relationship between channel change and hydraulic factors is not supported. With healthy riparian vegetation and log structures, this reach is relatively resistant to change, yet it continues to have an active and mobile gravel-cobble bed, even in years with modest floods.
Finne, Emily; Bucksch, Jens; Lampert, Thomas; Kolip, Petra
2013-01-01
Purpose : Although it is widely accepted that physical activity (PA) positively, and screen-based media use (SBM) negatively, affects well-being, there is a lack of studies relating PA and SBM to health-related quality of life (HRQoL) in adolescents. We examined these associations in German adolescents for different HRQoL subdomains and explored the role of body satisfaction as a possible mediator. Methods : The 11-17-year-old subsample of the German Health Interview and Examination Survey (2003-2006) was analysed ( N = 6813; 51.3% male). Cross-sectional associations of self-reported PA frequency and amount of daily SBM with HRQoL subscale scores (according to KINDL-R) were examined by hierarchical linear regression models, adjusting for the clustering of the sample and for a variety of possible confounders. The size and significance of indirect effects via body (dis)satisfaction (BDS) were examined by mediation analyses. Results : Higher PA frequency was significantly associated with higher HRQoL on nearly all subscales and dose-response-relationships were observable. Variations were greatest in terms of social well-being in boys (effect size d = 0.59) and physical well-being in girls ( d = 0.43). Higher SBM was related to lower HRQoL on all subscales in girls and on some subscales in boys, with the largest effects for school functioning in both genders ( d = 0.31 and 0.37, respectively). The mediated effects for PA and SBM were significant in both genders, but the sizes and the proportions of total effects mediated by body satisfaction were rather small. Conclusions : Higher PA frequency was associated with higher self-reported HRQoL, and higher SBM was associated with lower self-reported HRQoL in both genders, even after adjusting for relevant covariates. The results support the assumption of independent health impacts of both behaviours, although no causal relationship can be confirmed with these cross-sectional data. Mechanisms other than body satisfaction must largely account for the effects of PA and SBM on well-being.
Okubo, Hitomi; Inagaki, Hiroki; Gondo, Yasuyuki; Kamide, Kei; Ikebe, Kazunori; Masui, Yukie; Arai, Yasumichi; Ishizaki, Tatsuro; Sasaki, Satoshi; Nakagawa, Takeshi; Kabayama, Mai; Sugimoto, Ken; Rakugi, Hiromi; Maeda, Yoshinobu
2017-09-11
An increasing number of studies in Western countries have shown that healthy dietary patterns may have a protective effect against cognitive decline and dementia. However, information on this relationship among non-Western populations with different cultural settings is extremely limited. We aim to examine the relationship between dietary patterns and cognitive function among older Japanese people. This cross-sectional study included 635 community-dwelling people aged 69-71 years who participated in the prospective cohort study titled Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians (SONIC). Diet was assessed over a one-month period with a validated, brief-type, self-administered diet history questionnaire. Dietary patterns from thirty-three predefined food groups [energy-adjusted food (g/d)] were extracted by factor analysis. Cognitive function was assessed using the Japanese version of the Montreal Cognitive Assessment (MoCA-J). Multivariate regression analysis was performed to examine the relationship between dietary patterns and cognitive function. Three dietary patterns were identified: the 'Plant foods and fish', 'Rice and miso soup', and 'Animal food' patterns. The 'Plant foods and fish' pattern, characterized by high intakes of green and other vegetables, soy products, seaweeds, mushrooms, potatoes, fruit, fish, and green tea, was significantly associated with a higher MoCA-J score [MoCA-J score per one-quartile increase in dietary pattern: β = 0.56 (95% CI: 0.33, 0.79), P for trend <0.001]. This association was still evident after adjustment for potential confounding factors [β = 0.41 (95% CI: 0.17, 0.65), P for trend <0.001]. In contrast, neither the 'Rice and miso soup' nor the 'Animal food' pattern was related to cognitive function. To confirm the possibility of reverse causation we also conducted a sensitivity analysis excluding 186 subjects who reported substantial changes in their diet for any reason, but the results did not change materially. This preliminary cross-sectional study suggests that a diet with high intakes of vegetables, soy products, fruit, and fish may have a beneficial effect on cognitive function in older Japanese people. Further prospective studies are needed to confirm this finding.
Helanterä, Ilkka; Haapio, Mikko; Koskinen, Petri; Grönhagen-Riska, Carola; Finne, Patrik
2012-05-01
Associations between mode of renal replacement therapy and employment rate have not been well characterized. Cross-sectional registry analysis. The employment status of all prevalent 15- to 64-year-old dialysis and kidney transplant patients in Finland at the end of 2007 (N = 2,637) was analyzed by combining data from the Finnish Registry for Kidney Diseases with individual-level employment statistics of the Finnish government. Prevalence rate ratios (PRRs) of employment according to treatment modality with adjustment for age, sex, cause of end-stage renal disease (ESRD), duration of ESRD, and comorbid conditions were estimated using Cox regression with a constant time at risk. Employment status of patients on dialysis therapy or after transplant. Clinical data were collected from the Finnish Registry for Kidney Diseases, and employment data were acquired from Statistics Finland. 19% of hemodialysis patients, 31% of peritoneal dialysis patients, and 40% of patients with a functioning transplant were employed; the overall employment rate for the Finnish population aged 15-64 years is 67%. Home hemodialysis patients and those treated with automated peritoneal dialysis had employment rates of 39% and 44%, respectively. In adjusted analysis, patients on home hemodialysis therapy (PRR, 1.87), on automated peritoneal dialysis therapy (PRR, 2.14), or with a kidney transplant (PRR, 2.30) had higher probabilities of employment than in-center hemodialysis patients. Patients with type 1 or 2 diabetes as the cause of ESRD had the lowest probability of employment (PRR, 0.48-0.60 compared with glomerulonephritis). Patients aged 25-54 years more frequently were employed than those younger than 25 or older than 54 years. Sex did not predict employment. For transplant recipients, longer time since transplant was associated with higher employment in addition to the mentioned factors. Cross-sectional design. Employment rate of home dialysis patients was similar to that of transplant recipients and higher than that of in-center hemodialysis patients. Patients with diabetes were less likely to be employed. Copyright © 2012 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Low osteocalcin level is a risk factor for impaired glucose metabolism in a Chinese male population.
Liang, Yaojie; Tan, Aihua; Liang, Danyan; Yang, Xiaobo; Liao, Ming; Gao, Yong; Jiang, Yonghua; Yao, Ziting; Lin, Xinggu; Lu, Zheng; Wu, Chunlei; Zhang, Shijun; Hu, Yanlin; Qin, Xue; Mo, Zengnan; Li, Hong; Zhang, Haiying
2016-07-01
This study was to assess the association between serum osteocalcin level and glucose metabolism in a Chinese male population. We carried out a cross-sectional study with a cohort of participants from the Fangchenggang Area Male Health and Examination Survey. The cross-sectional study was carried out among 2,353 men, including 2,139 participants with normal glucose tolerance, 148 with impaired fasting glucose and 66 with type 2 diabetes. A subsample of 1,109 men with measurement of osteocalcin was observed in the cohort. After a 4-year follow-up period, 1,049 non-diabetic and 983 participants with normal glucose tolerance who submitted the available information were enrolled in the cohort. Participants were divided into group-H (≥23.33 ng/mL) and group-L (<23.33 ng/mL) by osteocalcin level. In the cross-sectional study, osteocalcin levels were highest in participants with normal glucose tolerance, followed by those with impaired fasting glucose and type 2 diabetes (P < 0.001). In partial correlation analysis adjusted for age, serum osteocalcin level was related to glucose level (r = -0.082, P < 0.001), insulin level (r = -0.079, P < 0.001) and insulin resistance (r = -0.065, P = 0.002). Compared with group-H, group-L was associated with an increased risk of type 2 diabetes (odds ratio 2.107, 95% confidence interval 1.123-3.955), impaired fasting glucose (odds ratio 2.106; 95% CI 1.528-2.902), and insulin resistance (odds ratio 1.359, 95% confidence interval 1.080-1.710) adjusted for age, education levels, cigarette smoking and lipid profiles. In the cohort study, the increased risk of impaired fasting glucose was significant in group-L vs group-H (3.3% vs 1.2%, P = 0.026). Low serum osteocalcin level was a risk factor for impaired glucose metabolism and subsequent type 2 diabetes. © 2015 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.
Christensen, Jeppe Schultz; Raaschou-Nielsen, Ole; Tjønneland, Anne; Overvad, Kim; Nordsborg, Rikke B.; Ketzel, Matthias; Sørensen, Thorkild IA; Sørensen, Mette
2015-01-01
Background Traffic noise has been associated with cardiovascular and metabolic disorders. Potential modes of action are through stress and sleep disturbance, which may lead to endocrine dysregulation and overweight. Objectives We aimed to investigate the relationship between residential traffic and railway noise and adiposity. Methods In this cross-sectional study of 57,053 middle-aged people, height, weight, waist circumference, and bioelectrical impedance were measured at enrollment (1993–1997). Body mass index (BMI), body fat mass index (BFMI), and lean body mass index (LBMI) were calculated. Residential exposure to road and railway traffic noise exposure was calculated using the Nordic prediction method. Associations between traffic noise and anthropometric measures at enrollment were analyzed using general linear models and logistic regression adjusted for demographic and lifestyle factors. Results Linear regression models adjusted for age, sex, and socioeconomic factors showed that 5-year mean road traffic noise exposure preceding enrollment was associated with a 0.35-cm wider waist circumference (95% CI: 0.21, 0.50) and a 0.18-point higher BMI (95% CI: 0.12, 0.23) per 10 dB. Small, significant increases were also found for BFMI and LBMI. All associations followed linear exposure–response relationships. Exposure to railway noise was not linearly associated with adiposity measures. However, exposure > 60 dB was associated with a 0.71-cm wider waist circumference (95% CI: 0.23, 1.19) and a 0.19-point higher BMI (95% CI: 0.0072, 0.37) compared with unexposed participants (0–20 dB). Conclusions The present study finds positive associations between residential exposure to road traffic and railway noise and adiposity. Citation Christensen JS, Raaschou-Nielsen O, Tjønneland A, Overvad K, Nordsborg RB, Ketzel M, Sørensen TI, Sørensen M. 2016. Road traffic and railway noise exposures and adiposity in adults: a cross-sectional analysis of the Danish Diet, Cancer, and Health cohort. Environ Health Perspect 124:329–335; http://dx.doi.org/10.1289/ehp.1409052 PMID:26241990
Feinberg, Termeh; Sambamoorthi, Usha; Lilly, Christa; Innes, Kim Karen
2017-07-07
Fibromyalgia, a potentially debilitating chronic pain syndrome of unknown etiology, may be characterized by inflammation. In this study, we investigated the relation of FMS to serum C-reactive protein (CRP) in a large population of adults (18+) and investigated the influence of other factors on this relationship, including BMI, comorbidities, as well as mood and sleep disturbance. Participants were 52,535 Ohio Valley residents (Fibromyalgia n = 1125). All participants completed a comprehensive health survey (2005-2006) part of the C8 Health Project; serum levels of CRP were obtained, as was history of Fibromyalgia physician diagnosis. Logistic and linear regressions were used for this cross-sectional analysis. Mean CRP was higher among participants reporting Fibromyalgia than those without (5.54 ± 9.8 vs.3.75 ± 7.2 mg/L, p < .0001)). CRP level showed a strong, positive association with FMS (unadjusted odds ratio (OR) for highest vs. lowest quartile = 2.5 (CI 2.1,3.0;p for trend < .0001)); adjustment for demographic and lifestyle factors attenuated but did not eliminate this association (AOR for highest vs. lowest quartile = 1.4 (CI 1.1,1.6;p for trend < .0001)). Further addition of body mass index (BMI) and comorbidities to the model markedly weakened this relationship (AORs, respectively, for highest vs lowest CRP quartile = 1.2 (CI 1.0,1.4) and 1.1 (CI 0.9,1.3). In contrast, inclusion of mood and sleep impairment only modestly reduced the adjusted risk estimate (AORs for highest vs. lowest quartile = 1.3 (CI 1.1,1.5) for each)). Findings from this large cross-sectional study indicate a significant positive cross-sectional association of Fibromyalgia to serum C-reactive protein may be explained, in part, by BMI and comorbidity. Prospective research is needed to confirm this, and clarify the potential mediating influence of obesity and comorbid conditions on this relationship.
Method and apparatus for analog pulse pile-up rejection
De Geronimo, Gianluigi
2013-12-31
A method and apparatus for pulse pile-up rejection are disclosed. The apparatus comprises a delay value application constituent configured to receive a threshold-crossing time value, and provide an adjustable value according to a delay value and the threshold-crossing time value; and a comparison constituent configured to receive a peak-occurrence time value and the adjustable value, compare the peak-occurrence time value with the adjustable value, indicate pulse acceptance if the peak-occurrence time value is less than or equal to the adjustable value, and indicate pulse rejection if the peak-occurrence time value is greater than the adjustable value.
Method and apparatus for analog pulse pile-up rejection
De Geronimo, Gianluigi
2014-11-18
A method and apparatus for pulse pile-up rejection are disclosed. The apparatus comprises a delay value application constituent configured to receive a threshold-crossing time value, and provide an adjustable value according to a delay value and the threshold-crossing time value; and a comparison constituent configured to receive a peak-occurrence time value and the adjustable value, compare the peak-occurrence time value with the adjustable value, indicate pulse acceptance if the peak-occurrence time value is less than or equal to the adjustable value, and indicate pulse rejection if the peak-occurrence time value is greater than the adjustable value.
Pollmanns, Johannes; Romano, Patrick S; Weyermann, Maria; Geraedts, Max; Drösler, Saskia E
2018-04-01
To explore effects of disease prevalence adjustment on ambulatory care-sensitive hospitalization (ACSH) rates used for quality comparisons. County-level hospital administrative data on adults discharged from German hospitals in 2011 and prevalence estimates based on administrative ambulatory diagnosis data were used. A retrospective cross-sectional study using in- and outpatient secondary data was performed. Hospitalization data for hypertension, diabetes, heart failure, chronic obstructive pulmonary disease, and asthma were obtained from the German Diagnosis Related Groups (DRG) database. Prevalence estimates were obtained from the German Central Research Institute of Ambulatory Health Care. Crude hospitalization rates varied substantially across counties (coefficients of variation [CV] 28-37 percent across conditions); this variation was reduced by prevalence adjustment (CV 21-28 percent). Prevalence explained 40-50 percent of the observed variation (r = 0.65-0.70) in ACSH rates for all conditions except asthma (r = 0.07). Between 30 percent and 38 percent of areas moved into or outside condition-specific control limits with prevalence adjustment. Unadjusted ACSH rates should be used with caution for high-stakes public reporting as differences in prevalence may have a marked impact. Prevalence adjustment should be considered in models analyzing ACSH. © Health Research and Educational Trust.
The association between smoking and blood pressure in men: a cross-sectional study.
Li, Guoju; Wang, Hailing; Wang, Ke; Wang, Wenrui; Dong, Fen; Qian, Yonggang; Gong, Haiying; Hui, Chunxia; Xu, Guodong; Li, Yanlong; Pan, Li; Zhang, Biao; Shan, Guangliang
2017-10-10
Cigarette smoking is a known risk factor for cardiovascular disease (CVD), but the association between smoking and blood pressure is unclear. Thus, the current study examined the association between cigarette smoking and blood pressure in men. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure (PP) were examined using digital blood pressure measuring device, and smoking status was determined with China National Health Survey. The ANCOVA showed that the adjusted DBP and MAP were lower in current smokers versus nonsmokers and the adjusted SBP was lower in current smokers versus former smokers (P < 0.05). Additionally, the adjusted PP tend to be decreased steadily as the pack·years increased in current smokers. In a fully adjusted logistic regression model, former smokers had increased ORs (95% CI) of 1.48 (1.01, 2.18) of hypertension and current smokers had not increased ORs (95% CI) of 0.83 (0.61, 1.12), compared with never smokers. The findings revealed that the adjusted blood pressure were lower in current smokers versus nonsmokers and former smokers. No significant dose-dependent effect of current smoking on blood pressure indices except PP was observed. Smoking cessation was significantly associated with an increased risk of hypertension. However, current smoking was not a risk factor of hypertension.
Association between oral health behavior and periodontal disease among Korean adults
Han, Kyungdo; Park, Jun-Beom
2017-01-01
Abstract This study was performed to assess the association between oral health behavior and periodontal disease using nationally representative data. This study involved a cross-sectional analysis and multivariable logistic regression analysis models using the data from the Korean National Health and Nutrition Examination Survey. A community periodontal index greater than or equal to code 3 was used to define periodontal disease. Adjusted odds ratios and their 95% confidence intervals of periodontitis for the toothbrushing after lunch group and the toothbrushing before bedtime group were 0.842 (0.758, 0.936) and 0.814 (0.728, 0.911), respectively, after adjustments for age, sex, body mass index, drinking, exercise, education, income, white blood cell count, and metabolic syndrome. Adjusted odds ratios and their 95% confidence intervals of periodontitis for the floss group and the powered toothbrush group after adjustment were 0.678 (0.588, 0.781) and 0.771 (0.610, 0.974), respectively. The association between oral health behavior and periodontitis was proven by multiple logistic regression analyses after adjusting for confounding factors among Korean adults. Brushing after lunch and before bedtime as well as the use of floss and a powered toothbrush may be considered independent risk indicators of periodontal disease among Korean adults. PMID:28207558
Transition From Ideal To Viscous Mach Cones In A Partonic Transport Model
NASA Astrophysics Data System (ADS)
Bouras, I.; El, A.; Fochler, O.; Niemi, H.; Xu, Z.; Greiner, C.
2013-09-01
Using a partonic transport model we investigate the evolution of conical structures in ultrarelativistic matter. Using two different source terms and varying the transport properties of the matter we study the formation of Mach Cones. Furthermore, in an additional study we extract the two-particle correlations from the numerical calculations and compare them to an analytical approximation. The influence of the viscosity to the shape of Mach Cones and the corresponding two-particle correlations is studied by adjusting the cross section of the medium.
Acoustic rhinometry of the Indian and Anglo-Saxon nose.
Gurr, P; Diver, J; Morgan, N; MacGregor, F; Lund, V
1996-09-01
The internal and external geometry of the nose has previously been shown to differ between Anglo-Saxon, Chinese, and Negro noses. It is therefore important to define the normal geometric nasal parameters of a given race, so as to detect the abnormal nose. We present acoustic rhinometric data, with height-adjusted figures, examining the nasal minimum cross-sectional area (MCA), the distance to the nostril from the MCA, and the MCA between 0-6 cm. These data show no significant differences between Indian and Anglo-Saxon noses.
Horgan, Aine; Sweeney, John; Behan, Laura; McCarthy, Geraldine
2016-12-01
This study aimed to identify levels of depressive symptoms, social and personal college adjustment and peer support among nursing and midwifery students. Student mental health is of international concern, particularly among students who are undertaking professional qualifications in health care. Cross-sectional design. Data were collected in 2013 using the Centre for Epidemiology Depressive Symptoms Scale, two subscales of the Student Adaptation to College Questionnaire; and a subscale of the Peer Support Evaluation Inventory with 417 students in Ireland. Findings indicated that 34% of participants experienced depressive symptoms, 20% were poorly personally adjusted and 9% poorly socially adjusted. Most students had good levels of peer support. Statistically significant relationships were found between all key variables. Students in their second year of study had significantly higher rates of depressive symptoms. Participants who reported having poor relationships with their fathers were at higher risk and had more difficulties personally and socially adjusting to university life and study. The alcohol consumption of participants had a statistically significant relationship with depressive symptoms with higher consumption rates having a positive impact on symptoms. The mental health of undergraduates undertaking professional healthcare studies needs to be a key research, educational and clinical priority. High rates of adjustment and mental health difficulties, particularly in the second year of the programme need to be examined and more effective interventions developed. © 2016 John Wiley & Sons Ltd.
NASA Technical Reports Server (NTRS)
Bard, Steven (Inventor); Wu, Jiunn-Jeng (Inventor); Trimble, Curtis A. (Inventor)
1992-01-01
A Joule-Thomson cryogenic refrigeration system capable of achieving high temperature stabilities in the presence of varying temperature, atmospheric pressure, and heat load is provided. The Joule-Thomson cryogenic refrigeration system includes a demand flow Joule-Thomson expansion valve disposed in a cryostat of the refrigeration system. The expansion valve has an adjustable orifice that controls the flow of compressed gas therethrough and induces cooling and partial liquefaction of the gas. A recuperative heat exchanger is disposed in the cryostat and coupled to the expansion valve. A thermostatically self-regulating mechanism is disposed in the cryostat and coupled to the J-T expansion valve. The thermostatically self-regulating mechanism automatically adjusts the cross sectional area of the adjustable valve orifice in response to environmental temperature changes and changes in power dissipated at a cold head. A temperature sensing and adjusting mechanism is coupled to a cold head for adjusting the temperature of the cold head in response to the change in heat flow in the cold head. The temperature sensing and adjusting mechanism comprises a temperature sensitive diode, a wound wire heater, and an electrical feedback control circuit coupling the diode to the heater. An absolute pressure relief valve is interposed between the output of the cryostat and an exhaust port for maintaining a constant exhaust temperature in the refrigerating system, independent of the changes in atmospheric pressure.
NASA Astrophysics Data System (ADS)
Bard, Steven; Wu, Jiunn-Jeng; Trimble, Curtis A.
1992-06-01
A Joule-Thomson cryogenic refrigeration system capable of achieving high temperature stabilities in the presence of varying temperature, atmospheric pressure, and heat load is provided. The Joule-Thomson cryogenic refrigeration system includes a demand flow Joule-Thomson expansion valve disposed in a cryostat of the refrigeration system. The expansion valve has an adjustable orifice that controls the flow of compressed gas therethrough and induces cooling and partial liquefaction of the gas. A recuperative heat exchanger is disposed in the cryostat and coupled to the expansion valve. A thermostatically self-regulating mechanism is disposed in the cryostat and coupled to the J-T expansion valve. The thermostatically self-regulating mechanism automatically adjusts the cross sectional area of the adjustable valve orifice in response to environmental temperature changes and changes in power dissipated at a cold head. A temperature sensing and adjusting mechanism is coupled to a cold head for adjusting the temperature of the cold head in response to the change in heat flow in the cold head. The temperature sensing and adjusting mechanism comprises a temperature sensitive diode, a wound wire heater, and an electrical feedback control circuit coupling the diode to the heater. An absolute pressure relief valve is interposed between the output of the cryostat and an exhaust port for maintaining a constant exhaust temperature in the refrigerating system, independent of the changes in atmospheric pressure.
[Factors associated with cross-nursing in two cities in Southeast Brazil].
Seehausen, Mariana Pujól von; Oliveira, Maria Inês Couto de; Boccolini, Cristiano Siqueira; Leal, Maria do Carmo
2017-06-01
The objective was to estimate the prevalence of cross-nursing in two Brazilian cities and analyze factors associated with the practice. This was a cross-sectional study nested in a cohort of pregnant women recruited at public health services that offered prenatal care in two medium-sized cities in the State of Rio de Janeiro: one in Greater Metropolitan Rio and the other in the Mountainous Region, conducted from 2008 to 2010. The current study included women interviewed when their infants were six months old. Adjusted prevalence ratios were obtained with a Poisson regression model, and exposure variables that reached p ≤ 0.05 comprised the final model. Cross-nursing was practiced by 43.4% of the mothers in Greater Metropolitan Rio de Janeiro and 34.5% in Mountainous Region. Low socioeconomic status was associated with cross-nursing in both cities. In addition, in Mountainous Region the outcome was directly associated with adolescent motherhood, maternal schooling less than or equal to complete primary, and fewer than six prenatal visits. In Greater Metropolitan Rio de Janeiro, in addition to socioeconomic status, only multiparity was associated (inversely) with cross-nursing. Cross-nursing, although contraindicated by the Brazilian Ministry of Health, showed high prevalence among the mothers in the sample and was more frequent among the more vulnerable population groups.
Impact of HMO mergers and acquisitions on financial performance.
Weech-Maldonado, Robert
2002-01-01
This study examines the effect of health maintenance organization (HMO) mergers and acquisitions on financial performance, as indicated by cash flow returns, profitability ratios, and efficiency indicators. Pooled, cross-sectional files of financial performance data were created for HMO mergers occurring in the period of 1988 to 1994. The study uses a time-series design involving the analysis of pre- and post-acquisition financial performance measured over a period of four years. Change scores for the industry-adjusted financial performance measures were calculated and then evaluated using t-tests. The study showed that HMO mergers had a positive effect on financial performance and efficiency. This effect disappeared, however, after adjusting for HMO industry returns. Potential synergies arising from HMO mergers have been largely illusory. Mergers may have been a result of non-value enhancing motives or management overconfidence.
Townes, B D; Ferguson, W D; Gillam, S
1976-01-01
The present study investigated differences in psychological sex, present and past adjustment, and parental influences among homosexual cross-dressers, homosexual non-cross-dressers, applicants for sex change surgery, and heterosexuals. The homosexual non-cross dresser and heterosexual groups were found to have the most masculine gender role, with the sex change group having the most feminine gender identity. The two homosexual groups were most accepting of homosexuality, with the sex change group having the least acceptance of homosexuality. Support was not found for the prediction that the sex change group would have the worst present and past adjustment followed by the homosexual cross-dressers with the poorest past adjustment. As predicted, however, fathers were perceived as more nurturant in the heterosexual group than among the remaining three groups. These findings suggest that variations in sexual-life-style can be understood as manifestations of different combinations of the components of psychological sex and that a nurturant father is important in the development of a heterosexual life-style.
CT of Patients With Hip Fracture: Muscle Size and Attenuation Help Predict Mortality
Boutin, Robert D.; Bamrungchart, Sara; Bateni, Cyrus P.; Beavers, Daniel P.; Beavers, Kristen M.; Meehan, John P.; Lenchik, Leon
2018-01-01
OBJECTIVE Our objective was to determine the association between muscle cross-sectional area and attenuation, as measured on routine CT scans, and mortality in older patients with hip fracture. MATERIALS AND METHODS A retrospective 10-year study of patients with hip fracture was conducted with the following inclusion criteria: age 65 years or older, first-time hip fracture treated with surgery, and CT of the chest, abdomen, or pelvis. This yielded 274 patients (70.4% women; mean [± SD] age, 81.3 ± 8.3 years). On each CT scan, two readers independently measured the size (cross-sectional area, indexed for patient height) and attenuation of the paravertebral muscle at T12 and the psoas muscle at L4. We then determined the association between overall mortality and the muscle size and muscle attenuation, while adjusting for demographic variables (age, sex, ethnicity, and body mass index), American Society of Anesthesiologists (ASA) classification, and Charlson comorbidity index (CCI). RESULTS The overall mortality rate increased from 28.3% at 1 year to 79.5% at 5 years. Mortality was associated with decreased thoracic muscle size (odds ratio [OR], 0.66; 95% CI, 0.49–0.87). This association persisted after adjusting for demographic variables (OR, 0.69; 95% CI, 0.50–0.95), the ASA classification (OR, 0.70; CI, 0.51–0.97), and the CCI (OR, 0.72; 95% CI, 0.52–1.00). Similarly, decreased survival was associated with decreased thoracic muscle attenuation after adjusting for all of these combinations of covariates (OR, 0.67–0.72; 95% CI, 0.49–0.99). Decreased lumbar muscle size and attenuation trended with decreased survival but did not reach statistical significance. CONCLUSION In older adults with hip fractures, CT findings of decreased thoracic paravertebral muscle size and attenuation are associated with decreased overall survival. PMID:28267356
Wei, Jie; Lei, Guang-hua; Fu, Lei; Zeng, Chao; Yang, Tuo; Peng, Shi-fang
2016-01-01
Background Non-alcoholic fatty liver disease (NAFLD) has become one of the most prevalent chronic liver disease all over the world. The objective of this study was to evaluate the association between dietary vitamin C intake and NAFLD. Method Subjects were diagnosed with NAFLD by abdominal ultrasound examination and the consumption of alcohol was less than 40g/day for men or less than 20g/day for women. Vitamin C intake was classified into four categories according to the quartile distribution in the study population: ≤74.80 mg/day, 74.81–110.15 mg/day, 110.16–146.06 mg/day, and ≥146.07 mg/day. The energy and multi-variable adjusted odds ratio (OR), as well as their corresponding 95% confidence interval (CI), were used to determine the relationship between dietary vitamin C intake and NAFLD through logistic regression. Result The present cross-sectional study included 3471 subjects. A significant inverse association between dietary vitamin C intake and NAFLD was observed in the energy-adjusted and the multivariable model. The multivariable adjusted ORs (95%CI) for NAFLD were 0.69 (95%CI: 0.54–0.89), 0.93 (95%CI: 0.72–1.20), and 0.71 (95%CI: 0.53–0.95) in the second, third and fourth dietary vitamin C intake quartiles, respectively, compared with the lowest (first) quartile. The relative odds of NAFLD was decreased by 0.71 times in the fourth quartile of dietary vitamin C intake compared with the lowest quartile. After stratifying data by sex or the status of obesity, the inverse association remained valid in the male population or non-obesity population, but not in the female population or obesity population. Conclusion There might be a moderate inverse association between dietary vitamin C intake and NAFLD in middle-aged and older adults, especially for the male population and non-obesity population. PMID:26824361
Patterson, Sophie; Kaida, Angela; Nguyen, Paul; Dobrer, Sabina; Ogilvie, Gina; Hogg, Robert; Kerr, Thomas; Montaner, Julio; Wood, Evan; Milloy, M.-J.
2016-01-01
Background: In October 2012, the Canadian Supreme Court ruled that people living with HIV must disclose their HIV status before sex that poses a "realistic possibility" of HIV transmission, clarifying that in circumstances where condom-protected penile-vaginal intercourse occurred with a low viral load (< 1500 copies/mL), the realistic possibility of transmission would be negated. We estimated the proportion of people living with HIV who use injection drugs who would face a legal obligation to disclose under these circumstances. Methods: : We used cross-sectional survey data from a cohort of people living with HIV who inject drugs. Participants interviewed since October 2012 who self-reported recent penile-vaginal intercourse were included. Participants self-reporting 100% condom use with a viral load consistently < 1500 copies/mL were assumed to have no legal obligation to disclose. Logistic regression identified factors associated with facing a legal obligation to disclose. Results: We included 176 participants, 44% of whom were women: 94% had a low viral load, and 60% self-reported 100% condom use. If condom use and low viral load were required to negate the realistic possibility of transmission, 44% would face a legal obligation to disclose. Factors associated with facing a legal obligation to disclose were female sex (adjusted odds ratio [OR] 2.19, 95% confidence interval [CI] 1.13-4.24), having 1 recent sexual partner (v. > 1) (adjusted OR 2.68, 95% CI 1.24-5.78) and self-reporting a stable relationship (adjusted OR 2.00, 95% CI 1.03-3.91). Interpretation: Almost half the participants in our analytic sample would face a legal obligation to disclose to sexual partners under these circumstances (with an increased burden among women), adding further risk of criminalization within this marginalized and vulnerable community. PMID:27398360
Takeuchi, Kenji; Izumi, Maya; Furuta, Michiko; Takeshita, Toru; Shibata, Yukie; Kageyama, Shinya; Ganaha, Seijun; Yamashita, Yoshihisa
2015-01-01
Early detection and subsequent reduction of modifiable risk factors for cognitive decline is important for extending healthy life expectancy in the currently aging society. Although a recent increase in studies on the state or number of the teeth and cognitive function, few studies have focused on the association between posterior teeth occlusion necessary to maintain chewing function and cognitive function among older adults. This study examined the association between posterior teeth occlusion and cognitive function in nursing home older residents. In this cross-sectional study, 279 residents aged ≥60 years from eight nursing homes in Aso City, Japan participated in cognitive function and dental status assessments and completed a comprehensive questionnaire survey in 2014. Cognitive function was measured using a Mini-Mental State Examination (MMSE). Posterior teeth occlusion was assessed using a total number of functional tooth units (total-FTUs), depending on the number and location of the remaining natural and artificial teeth on implant-supported, fixed, and removable prostheses. Linear regression models were used to assess univariate and multivariate associations between total-FTUs and MMSE scores. Models were sequentially adjusted for demographic characteristics, number of natural teeth, socioeconomic status, health behaviors, comorbidities, physical function, and nutritional status. Among the 200 residents included in our analysis, mean MMSE scores and total-FTUs were 11.0 ± 8.6 and 9.3 ± 4.6, respectively. Higher total-FTUs were significantly associated with higher MMSE scores after adjustment for demographics and teeth number (B = 0.48, 95% confidence interval [CI] = 0.22–0.74). The association remained significant even after adjustment for all covariates (B = 0.25, 95% CI = 0.01–0.49). The current findings demonstrated that loss of posterior teeth occlusion was independently associated with cognitive decline in nursing home older residents in Japan. Maintenance and restoration of posterior teeth occlusion may be a preventive factor against cognitive decline in aged populations. PMID:26512900
Upson, Kristen; Harmon, Quaker E.; Baird, Donna D.
2016-01-01
Objective To examine the association between serum 25-hydroxyvitamin D (25(OH)D) and menstrual cycle length and regularity. Design Community-based, cross-sectional study of serum 25(OH)D (adjusted for seasonal differences in timing of blood draw) and menstrual cycle length. Women ages 23-34 reported their gynecologic history. Menstrual cycles were described with four independent categories (normal, short, long, irregular). We used polytomous logistic regression to estimate the association between a doubling of seasonally-adjusted 25(OH)D and the odds of each cycle category. Setting Women from the Detroit, Michigan area attended a study clinic visit. Participants 1102 African-American women ages 23-34. Intervention None Main Outcome Measure Self-reported menstrual cycle length over the previous 12 months excluding women who were using cycle-regulating medications over the entire year. Women who reported that their cycles were “too irregular to estimate” were classified as having irregular cycles. A typical cycle length of <27 days was considered “short,” >34 days was “long,” and 27-34 days was “normal”. Results The median 25(OH)D level was 14.7 ng/ml (interquartile range: 10.9, 19.6). A doubling of 25(OH)D was associated with half the odds of having long menstrual cycles (adjusted odds ratio (aOR) (95% Confidence interval (CI): 0.54 (0.32, 0.89)). 25(OH)D was not associated with the occurrence of short (aOR(CI): 1.03 (0.82, 1.29)) or irregular (aOR(CI): 1.46 (0.88, 2.41) menstrual cycles. Results were robust to several sensitivity analyses. Conclusions These findings suggest that vitamin D status may influence the menstrual cycle and play a role in ovarian function. Further investigation of 25(OH)D and ovarian hormones, and prospective studies of 25(OH)D and cycle length, are needed. PMID:26997249
Underage alcohol drinking and medical services use in Hong Kong: a cross-sectional study
Wang, Man Ping; Ho, Sai Yin; Lam, Tai Hing
2013-01-01
Objectives To investigate the association of underage alcohol drinking with medical consultation and hospitalisation in Hong Kong. Design Cross-sectional study. Setting Secondary schools in Hong Kong. Participants A total of 33 300 secondary 1 (US grade 7) to secondary 5 students (47.6% boys; mean age 14.6 years, SD 1.6) in 85 randomly selected schools. Outcome measures An anonymous questionnaire was used to obtain information about medical consultation in the past 14 days, hospitalisation in the past 12 months, drinking alcohol, smoking, illicit drug use, physical activity, secondhand smoke exposure, feeling depressed, feeling anxious and sociodemographic characteristics. Drinking alcohol was categorised as non-drinking (reference), <1, 1–2 and 3–7 days/week. Logistic regression yielded adjusted ORs (AORs) of medical consultation and hospitalisation for drinking, adjusting for different potential confounders. Subgroup analysis was conducted among adolescents who did not report feeling anxious or depressed. Results More than one-fourth (27.6%) of adolescents drank alcohol, 15.9% had medical consultation and 5.1% had been hospitalised. In the fully adjusted model, the AORs (95% CI) for medical consultation were 1.14 (1.06 to 1.23) for <1 day/week, 1.30 (1.13 to 1.50) for 1–2 days/week and 1.70 (1.41 to 2.06) for 3–7 days/week of drinking compared with non-drinking (p for trend <0.001). The corresponding AORs (95% CI) for hospitalisation were 1.14 (1.02 to 1.28), 1.68 (1.32 to 2.14) and 2.38 (1.90 to 2.98) (p for trend <0.001). Similar associations were observed among students who did not feel anxious or depressed. Conclusions Alcohol consumption was associated with medical services use in Chinese adolescents. More rigorous alcohol control policies and health promotion programmes are needed to reduce alcohol drinking and related harms in adolescents. PMID:23793697
Bao, X; Xia, Y; Zhang, Q; Wu, H M; Du, H M; Liu, L; Wang, C J; Shi, H B; Guo, X Y; Liu, X; Li, C L; Su, Q; Meng, G; Yu, B; Sun, S M; Wang, X; Zhou, M; Jia, Q Y; Song, K; Niu, K J
2016-04-01
To investigate whether serum complement C3 is related to the prevalence and incidence of prediabetes in an adult population. A cross-sectional (n = 10 206) and prospective cohort study (n = 3333), with a mean (range; 95% CI) follow-up of 2.63 (1-6; 2.58-2.68) years, was conducted in people recruited from the Health Management Centre of Tianjin Medical University General Hospital in Tianjin, China. Measurement of serum C3 concentration, blood fasting glucose, oral glucose tolerance, HbA1c and other potential confounding factors was performed at baseline and each year during the follow-up. Prediabetes was defined according to the criteria of the American Diabetes Association. Adjusted logistic and Cox proportional hazards regression models were used to assess the relationships between C3 quintiles and prediabetes. The prevalence and incidence of prediabetes were 38.5% and 119 per 1000 person-years, respectively. In cross-sectional analysis, after adjustment for potential confounders, the odds ratios of prediabetes for increasing quintiles of C3 were 1.00 (reference), 1.32 (95% CI 1.14-1.53), 1.37 (95% CI 1.18-1.59), 1.75 (95% CI 1.51-2.03), 2.25 (95% CI 1.93-2.62; P for trend < 0.0001). In the cohort analysis, the multiple-adjusted hazard ratio of prediabetes in the highest quintile of baseline C3 was 1.43 (95% CI 1.15, 1.78; P for trend < 0.001), when compared with the lowest quintile. These findings indicate that elevated serum C3 levels are significantly related to an increased risk of developing prediabetes in an adult population, suggesting that C3 can be used as a biomarker in high-risk individuals to improve primary prevention of prediabetes and diabetes. © 2015 Diabetes UK.
da Costa, Liliane Peralta; Dias, Sónia Ferreira; Martins, Maria do Rosário Oliveira
2017-04-13
Despite the importance of immigrant population in Portugal few studies have analyzed the patterns of overweight/obesity in this subpopulation. The aims of this study are: (i) describe and compare the prevalence of overweight between immigrants and natives in Portugal; (ii) analyze the association between length of residence and overweight among adult immigrants in Portugal. A cross-sectional study (2005-2006) in a representative sample of the Portuguese population from national territory, including the Autonomous Regions of Azores and Madeira. The final sample comprised 31,685 adult participants (≥19 years old), of whom 4.6% were immigrants. Country of birth was used to determine immigrant condition. Logistic regressions were conducted to investigate the association between overweight (dependent variable) and length of residence (exposure), adjusting for all covariates in the study. A 5% confidence level and 95% CI were considered. The percentage of immigrants that are overweight [44.9% (95% CI: 42.3; 47.5)] was lower than for natives [52.8% (95% CI: 52.2; 53.4)]. The migrant condition, after adjusted for sociodemographic variables, was not associated with overweight [OR 1.004 (95% CI: 0.998; 1.010)]. Among immigrants, being women [OR 0.585 (95% CI: 0.583; 0.587)], not married [OR 0.784 (95% CI: 0.781; 0.787)] and with a higher education [OR 0.481 (95% CI: 0.478; 0.483)], are probably protective factors of being overweight. Adjusting for other factors, the odds of being overweight for a long-term immigrant (≥15 years) was 1.3 times higher [OR 1.274 (95% CI: 1.250; 1.299)] than for the newcomers (<4 years). The prevalence of overweight was higher for natives than immigrants. Length of residence (≥15 years) was positively associated with prevalence of overweight, among adult immigrant population. In the future, understanding dietary patterns and acculturation process may be important for health immigrant studies.
Jukic, Anne Marie Z; Upson, Kristen; Harmon, Quaker E; Baird, Donna D
2016-07-01
To examine the association between serum 25-hydroxyvitamin D [25(OH)D] and menstrual cycle length and regularity. Community-based, cross-sectional study of serum 25(OH)D (adjusted for seasonal differences in timing of blood draw) and menstrual cycle length. Women aged 23-34 years reported their gynecologic history. Menstrual cycles were described with four independent categories (normal, short, long, irregular). We used polytomous logistic regression to estimate the association between a doubling of seasonally adjusted 25(OH)D and the odds of each cycle category. Not applicable. A total of 1,102 African American women. Not applicable. Self-reported menstrual cycle length over the previous 12 months, excluding women who were using cycle-regulating medications over the entire year. Women who reported that their cycles were "too irregular to estimate" were classified as having irregular cycles. A typical cycle length of <27 days was considered "short," >34 days was "long," and 27-34 days was "normal." The median 25(OH)D level was 14.7 ng/mL (interquartile range, 10.9-19.6 ng/mL). A doubling of 25(OH)D was associated with half the odds of having long menstrual cycles: adjusted odds ratio (aOR) 0.54, 95% confidence interval (CI) 0.32-0.89. 25-Hydroxyvitamin D was not associated with the occurrence of short (aOR 1.03, 95% CI 0.82-1.29) or irregular (aOR 1.46, 95% CI 0.88-2.41) menstrual cycles. Results were robust to several sensitivity analyses. These findings suggest that vitamin D status may influence the menstrual cycle and play a role in ovarian function. Further investigation of 25(OH)D and ovarian hormones, and prospective studies of 25(OH)D and cycle length, are needed. Copyright © 2016 American Society for Reproductive Medicine. All rights reserved.
Emerson, E; Krnjacki, L; Llewellyn, G; Vaughan, C; Kavanagh, A
2016-06-01
To examine perceptions of safety and exposure to violence in public places among working age adults with and without disabilities in the UK and to assess the extent to which any between-group differences may be moderated by gender and socio-economic situation. Cross-sectional study. Secondary analysis of data collected in Wave 3 (2011-13) of Understanding Society. Data were extracted on a subsample of 5069 respondents aged 16 to 64 years (28% of whom had a disability/long-term health condition) who were administered a questionnaire module addressing experiences of harassment. Between-group comparisons were made on four self-reported indicators of safety. Respondents with disabilities/long-term health conditions were significantly more likely to have been attacked (adjusted OR 2.30, 95%CI 1.17-4.50, P < 0.05), insulted (adjusted OR 1.48, 95%CI 1.16-1.90, P < 0.01) and to feel unsafe in public places (adjusted OR 1.32, 95%CI 1.16-1.56, P < 0.01) over the previous 12 months. There were no statistically significant differences between groups with regard to self-reported avoidance of public places. These associations were moderated by both gender and poverty status, with the increased risk of exposure to violence among people with disabilities being greater for both women and people living in poverty. The data add further support to the growing evidence base suggesting that people with a disability/long-term health condition are at significantly increased risk of exposure to interpersonal violence, particularly if they are living in poverty or are women. As such, there is a clear need to develop interventions that are targeted to the particular circumstances and needs of these high risk groups. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Schumann, Barbara; Seidler, Andreas; Kluttig, Alexander; Werdan, Karl; Haerting, Johannes; Greiser, Karin Halina
2011-04-01
Hypertension is one of the most relevant risk factors for cardiovascular disease; however, little is known about differences in hypertension by occupation. The aim of this study was to explore the association between occupational group and prevalent hypertension. Cross-sectional data of the CARLA study were used, a representative sample of an East German population aged 45-83. Job titles of the current or last held occupation of 967 men and 808 women were coded using the German classification of occupation. Hypertension was defined as blood pressure of ≥140 mmHg (systolic), ≥90 mmHg (diastolic) or use of antihypertensives. Sex-stratified, age-adjusted prevalence risk ratios (PR) with 95% confidence intervals (CI) were calculated for 31 occupational groups. Hypertension was prevalent in 79% of the population. In men, highest age-adjusted prevalence ratios were observed in metal-processing workers, carpenters/painters, and electricians with PRs of 1.31 (CI 1.04-1.65), 1.28 (CI 1.00-1.64), and 1.21 (0.95-1.53), respectively, compared to office clerks. In women, highest PRs were found in technicians/forewomen, scrutinisers/storekeepers, and food-processing occupations with PR 1.28 (1.09-1.49), 1.23 (0.99-1.51), and 1.22 (1.01-1.48), respectively. Adjustment for education, smoking, body mass index, and current work hours did not fully explain occupational differences. Excluding currently non-working subjects lead to decreased PRs in men and to increased PR in women. Differences in the prevalences of hypertension by occupational group were only partly explained by conventional risk factors and may require workplace interventions targeted at high-risk occupations. Longitudinal data with large cohorts and work-related exposure assessment are needed to confirm a temporal relationship between occupation and incident hypertension.
Liljas, Ann E M; Carvalho, Livia A; Papachristou, Efstathios; De Oliveira, Cesar; Wannamethee, S Goya; Ramsay, Sheena E; Walters, Kate R
2017-11-01
Little is known about vision impairment and frailty in older age. We investigated the relationship of poor vision and incident prefrailty and frailty. Cross-sectional and longitudinal analyses with 4-year follow-up of 2836 English community-dwellers aged ≥60 years. Vision impairment was defined as poor self-reported vision. A score of 0 out of the 5 Fried phenotype components was defined as non-frail, 1-2 prefrail and ≥3 as frail. Participants non-frail at baseline were followed-up for incident prefrailty and frailty. Participants prefrail at baseline were followed-up for incident frailty. 49% of participants (n=1396) were non-frail, 42% (n=1178) prefrail and 9% (n=262) frail. At follow-up, there were 367 new cases of prefrailty and frailty among those non-frail at baseline, and 133 new cases of frailty among those prefrail at baseline. In cross-sectional analysis, vision impairment was associated with frailty (age-adjustedandsex-adjusted OR 2.53, 95% CI 1.95 to 3.30). The association remained after further adjustment for wealth, education, cardiovascular disease, diabetes, falls, cognition and depression. In longitudinal analysis, compared with non-frail participants with no vision impairment, non-frail participants with vision impairment had twofold increased risks of prefrailty or frailty at follow-up (OR 2.07, 95% CI 1.32 to 3.24). The association remained after further adjustment. Prefrail participants with vision impairment did not have greater risks of becoming frail at follow-up. Non-frail older adults who experience poor vision have increased risks of becoming prefrail and frail over 4 years. This is of public health importance as both vision impairment and frailty affect a large number of older adults. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Shaikh, Wasif; Nugawela, Manjula D; Szatkowski, Lisa
2015-06-19
Adolescent smoking is a worldwide public health concern. Whilst various support measures are available to help young smokers quit, their utilization of cessation support remains unknown. A cross-sectional study was conducted using data from the 2012 Smoking, Drinking and Drug Use among Young People survey to quantify the use of seven different types of cessation support by adolescents aged 11-16 in England who reported current smoking and having tried to quit, or ex-smoking. Logistic regression was used to calculate odds ratios and 95% confidence intervals for the associations between participant characteristics and reported use of cessation support. Amongst 617 current and ex-smokers, 67.3% (95% CI 63.0-71.2) reported use of at least one cessation support measure. Not spending time with friends who smoke was the most commonly-used measure, reported by 45.4% of participants (95% CI 41.1-49.8), followed by seeking smoking cessation advice from family or friends (27.4%, 95% CI 23.7-31.5) and using nicotine products (15.4%, 95% CI 12.6-18.7). Support services provided by the National Health Service (NHS) were infrequently utilized. Having received lessons on smoking was significantly associated with reported use of cessation support (adjusted OR 1.55, 95% CI 1.02-2.34) and not spending time with friends who smoked (adjusted OR 1.98, 95% CI 1.33-2.95). Students with family members who smoked were more likely to report asking family or friends for help to quit (adjusted OR 1.74, 95% CI 1.07-2.81). Respondents who smoked fewer cigarettes per week were generally less likely to report use of cessation support measures. The majority of young smokers reported supported attempts to quit, though the support they used tended to be informal rather than formal. Evidence is needed to quantify the effectiveness of cessation support mechanisms which are acceptable to and used by young smokers.
Does COPD risk vary by ethnicity? A retrospective cross-sectional study
Gilkes, Alexander; Ashworth, Mark; Schofield, Peter; Harries, Timothy H; Durbaba, Stevo; Weston, Charlotte; White, Patrick
2016-01-01
Background Lower risk of COPD has been reported in black and Asian people, raising questions of poorer recognition or reduced susceptibility. We assessed prevalence and severity of COPD in ethnic groups, controlling for smoking. Method A retrospective cross-sectional study using routinely collected primary care data in London. COPD prevalence, severity (% predicted forced expiratory volume in 1 second [FEV1]), smoking status, and treatment were compared between ethnic groups, adjusting for age, sex, smoking, deprivation, and practice clustering. Results Among 358,614 patients in 47 general practices, 47.6% were white, 20% black, and 5% Asian. Prevalence of COPD was 1.01% overall, 1.55% in whites, 0.58% in blacks, and 0.78% in Asians. COPD was less likely in blacks (adjusted odds ratio [OR], 0.44; 95% confidence interval [CI] 0.39–0.51) and Asians (0.82; CI, 0.68–0.98) than whites. Black COPD patients were less likely to be current smokers (OR, 0.56; CI, 0.44–0.71) and more likely to be never-smokers (OR, 4.9; CI, 3.4–7.1). Treatment of patients with similar disease severity was similar irrespective of ethnic origin, except that long-acting muscarinic antagonists were prescribed less in black COPD patients (OR, 0.53; CI, 0.42–0.68). Black ethnicity was a predictor of poorer lung function (% predicted FEV1: B coefficient, −7.6; P<0.0001), an effect not seen when ethnic-specific predicted FEV1 values were used. Conclusion Black people in London were half as likely as whites to have COPD after adjusting for lower smoking rates in blacks. It seems likely that the differences observed were due either to ethnic differences in the way cigarettes were smoked or to ethnic differences in susceptibility to COPD. PMID:27103797
2013-01-01
Background Although a number of studies have found an association between aircraft noise and hypertension, there is a lack of evidence on associations with other cardiovascular disease. For road traffic noise, more studies are available but the extent of possible confounding by air pollution has not been established. Methods This study used data from the Hypertension and Environmental Noise near Airports (HYENA) study. Cross-sectional associations between self-reported ‘heart disease and stroke’ and aircraft noise and road traffic noise were examined using data collected between 2004 and 2006 on 4712 participants (276 cases), who lived near airports in six European countries (UK, Germany, Netherlands, Sweden, Greece, Italy). Data were available to assess potential confounding by NO2 air pollution in a subsample of three countries (UK, Netherlands, Sweden). Results An association between night-time average aircraft noise and ‘heart disease and stroke’ was found after adjustment for socio-demographic confounders for participants who had lived in the same place for ≥ 20 years (odds ratio (OR): 1.25 (95% confidence interval (CI) 1.03, 1.51) per 10 dB (A)); this association was robust to adjustment for exposure to air pollution in the subsample. 24 hour average road traffic noise exposure was associated with ‘heart disease and stroke’ (OR: 1.19 (95% CI 1.00, 1.41), but adjustment for air pollution in the subsample suggested this may have been due to confounding by air pollution. Statistical assessment (correlations and variance inflation factor) suggested only modest collinearity between noise and NO2 exposures. Conclusions Exposure to aircraft noise over many years may increase risks of heart disease and stroke, although more studies are needed to establish how much the risks associated with road traffic noise may be explained by air pollution. PMID:24131577
Camden, Andi; Levy, Jennifer; Bassil, Kate; Vanderlinden, Loren; Barnett, Olanna White; Minaker, Leia M; Mulligan, Kate; Campbell, Monica
2018-06-01
Assess the consumer nutrition environment in midsize to large supermarkets by supermarket type and area-level socioeconomic variables. Cross-sectional census of 257 supermarkets using the Toronto Nutrition Environment Measures Survey in Stores. Toronto, Canada. Availability; price and linear shelf space of fruits and vegetables vs energy-dense snack foods by supermarket type; after-tax, low-income measure; and neighborhood improvement area. Multivariate linear regression. There was a high availability of fruits (7.7 of 8) and vegetables (9.5 of 11). There was similar linear shelf space for fruits and vegetables vs energy-dense snack foods (ratio, 1.1 m). Adjusted fruit prices were lowest in quintiles 1 (β = -$1.30; P = .008), 2 (β = -$1.41; P = .005), and 3 (β = -$1.89; P < .001) vs quintile 5 (lowest percentage of people living with low income) and in ethnic (β = -$3.47; P < .001) and discount stores (β = -$5.64; P < .001) vs conventional. Adjusted vegetable prices were lowest in quintiles 2 (β = -$1.87; P = .04), 3 (β = -$1.78; P = .03), and 4 (β = -$2.65; P = .001) vs quintile 5 and in ethnic (β = -$7.10; P < .001) and discount (β = -$5.49; P < .001) stores. They were highest in other (β = + $3.08; P = .003) vs conventional stores. Adjusted soda and chips prices were lower in discount (β = -$1.16; P < .001) and higher in other stores (β = + $0.67; P < .001) vs conventional. Findings do not indicate inequities in shelf space, availability, or price across diverse neighborhoods. Practitioners can use findings to help consumers navigate supermarkets to make healthy choices. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Kristunas, Caroline A; Smith, Karen L; Gray, Laura J
2017-03-07
The current methodology for sample size calculations for stepped-wedge cluster randomised trials (SW-CRTs) is based on the assumption of equal cluster sizes. However, as is often the case in cluster randomised trials (CRTs), the clusters in SW-CRTs are likely to vary in size, which in other designs of CRT leads to a reduction in power. The effect of an imbalance in cluster size on the power of SW-CRTs has not previously been reported, nor what an appropriate adjustment to the sample size calculation should be to allow for any imbalance. We aimed to assess the impact of an imbalance in cluster size on the power of a cross-sectional SW-CRT and recommend a method for calculating the sample size of a SW-CRT when there is an imbalance in cluster size. The effect of varying degrees of imbalance in cluster size on the power of SW-CRTs was investigated using simulations. The sample size was calculated using both the standard method and two proposed adjusted design effects (DEs), based on those suggested for CRTs with unequal cluster sizes. The data were analysed using generalised estimating equations with an exchangeable correlation matrix and robust standard errors. An imbalance in cluster size was not found to have a notable effect on the power of SW-CRTs. The two proposed adjusted DEs resulted in trials that were generally considerably over-powered. We recommend that the standard method of sample size calculation for SW-CRTs be used, provided that the assumptions of the method hold. However, it would be beneficial to investigate, through simulation, what effect the maximum likely amount of inequality in cluster sizes would be on the power of the trial and whether any inflation of the sample size would be required.
Deger, Leylâ; Plante, Céline; Jacques, Louis; Goudreau, Sophie; Perron, Stéphane; Hicks, John; Kosatsky, Tom; Smargiassi, Audrey
2012-01-01
BACKGROUND: Little attention has been devoted to the effects on children’s respiratory health of exposure to sulphur dioxide (SO2) in ambient air from local industrial emissions. Most studies on the effects of SO2 have assessed its impact as part of the regional ambient air pollutant mix. OBJECTIVE: To examine the association between exposure to stack emissions of SO2 from petroleum refineries located in Montreal’s (Quebec) east-end industrial complex and the prevalence of active asthma and poor asthma control among children living nearby. METHODS: The present cross-sectional study used data from a respiratory health survey of Montreal children six months to 12 years of age conducted in 2006. Of 7964 eligible households that completed the survey, 842 children between six months and 12 years of age lived in an area impacted by refinery emissions. Ambient SO2 exposure levels were estimated using dispersion modelling. Log-binomial regression models were used to estimate crude and adjusted prevalence ratios (PRs) and 95% CIs for the association between yearly school and residential SO2 exposure estimates and asthma outcomes. Adjustments were made for child’s age, sex, parental history of atopy and tobacco smoke exposure at home. RESULTS: The adjusted PR for the association between active asthma and SO2 levels was 1.14 (95% CI 0.94 to 1.39) per interquartile range increase in modelled annual SO2. The effect on poor asthma control was greater (PR=1.39 per interquartile range increase in modelled SO2 [95% CI 1.00 to 1.94]). CONCLUSIONS: Results of the present study suggest a relationship between exposure to refinery stack emissions of SO2 and the prevalence of active and poor asthma control in children who live and attend school in proximity to refineries. PMID:22536578
Wei, Jie; Lei, Guang-Hua; Fu, Lei; Zeng, Chao; Yang, Tuo; Peng, Shi-Fang
2016-01-01
Non-alcoholic fatty liver disease (NAFLD) has become one of the most prevalent chronic liver disease all over the world. The objective of this study was to evaluate the association between dietary vitamin C intake and NAFLD. Subjects were diagnosed with NAFLD by abdominal ultrasound examination and the consumption of alcohol was less than 40g/day for men or less than 20g/day for women. Vitamin C intake was classified into four categories according to the quartile distribution in the study population: ≤74.80 mg/day, 74.81-110.15 mg/day, 110.16-146.06 mg/day, and ≥146.07 mg/day. The energy and multi-variable adjusted odds ratio (OR), as well as their corresponding 95% confidence interval (CI), were used to determine the relationship between dietary vitamin C intake and NAFLD through logistic regression. The present cross-sectional study included 3471 subjects. A significant inverse association between dietary vitamin C intake and NAFLD was observed in the energy-adjusted and the multivariable model. The multivariable adjusted ORs (95%CI) for NAFLD were 0.69 (95%CI: 0.54-0.89), 0.93 (95%CI: 0.72-1.20), and 0.71 (95%CI: 0.53-0.95) in the second, third and fourth dietary vitamin C intake quartiles, respectively, compared with the lowest (first) quartile. The relative odds of NAFLD was decreased by 0.71 times in the fourth quartile of dietary vitamin C intake compared with the lowest quartile. After stratifying data by sex or the status of obesity, the inverse association remained valid in the male population or non-obesity population, but not in the female population or obesity population. There might be a moderate inverse association between dietary vitamin C intake and NAFLD in middle-aged and older adults, especially for the male population and non-obesity population.
Jasuja, Guneet K; Bhasin, Shalender; Reisman, Joel I; Hanlon, Joseph T; Miller, Donald R; Morreale, Anthony P; Pogach, Leonard M; Cunningham, Francesca E; Park, Angela; Berlowitz, Dan R; Rose, Adam J
2017-03-01
There has been concern about the growing off-label use of testosterone. Understanding the context within which testosterone is prescribed may contribute to interventions to improve prescribing. To evaluate patient characteristics associated with receipt of testosterone. Cross-sectional. A national cohort of male patients, who had received at least one outpatient prescription within the Veterans Affairs (VA) system during Fiscal Year 2008- Fiscal Year 2012. The study sample consisted of 682,915 non-HIV male patients, of whom 132,764 had received testosterone and a random 10% sample, 550,151, had not. Conditions and medications associated with testosterone prescription. Only 6.3% of men who received testosterone from the VA during the study period had a disorder of the testis, pituitary or hypothalamus associated with male hypogonadism. Among patients without a diagnosed disorder of hypogonadism, the use of opioids and obesity were the strongest predictors of testosterone prescription. Patients receiving >100 mg/equivalents of oral morphine daily (adjusted odds ratio = 5.75, p < 0.001) and those with body mass index (BMI) >40 kg/m 2 (adjusted odds ratio = 3.01, p < 0.001) were more likely to receive testosterone than non-opioid users and men with BMI <25 kg/m 2 . Certain demographics (age 40-54, White race), comorbid conditions (sleep apnea, depression, and diabetes), and medications (antidepressants, systemic corticosteroids) also predicted a higher likelihood of testosterone receipt, all with an adjusted odds ratio less than 2 (p < 0.001). In the VA, 93.7% of men receiving testosterone did not have a diagnosed condition of the testes, pituitary, or hypothalamus. The strongest predictors of testosterone receipt (e.g., obesity, receipt of opioids), which though are associated with unapproved, off-label use, may be valid reasons for therapy. Interventions should aim to increase the proportion of testosterone recipients who have a valid indication.
The Variation of Statin Use Among Nursing Home Residents and Physicians: A Cross-Sectional Analysis.
Campitelli, Michael A; Maxwell, Colleen J; Giannakeas, Vasily; Bell, Chaim M; Daneman, Nick; Jeffs, Lianne; Morris, Andrew M; Austin, Peter C; Hogan, David B; Ko, Dennis T; Lapane, Kate L; Maclagan, Laura C; Seitz, Dallas P; Bronskill, Susan E
2017-09-01
To examine the variability of statin use among nursing home residents and prescribing physicians, and to assess statin use by resident frailty. Population-based, cross-sectional analysis. All nursing home facilities (N = 631) in Ontario, Canada between April 1, 2013 and March 31, 2014. All adults aged 66 years and older who received a full clinical assessment while residing in a nursing home facility and their assigned, most responsible, physician. Statin use on date of clinical assessment. Resident- and physician-level characteristics ascertained through clinical assessment and health administrative data. Resident frailty was derived using a previously validated index. Among 76,226 nursing home residents assigned to 1,919 physicians, 25,648 (33.6%) were statin users. There were 13,331 (30.1%) statin users among the 44,290 residents categorized as frail. In an adjusted mixed-effects logistic regression model, frail residents (adjusted odds ratio = 0.62, 95% confidence interval 0.58-0.65) were significantly less likely to be statin users compared with non-frail residents. After adjustment for resident characteristics, the intraclass correlation coefficient indicated that between-physician variability accounted for 9.1% of the residual unexplained variation in statin use (P < .001). Among the 894 physicians assigned 20 or more residents, funnel plots confirmed there were more low-outlying (17.4%) and high-outlying (12.0%) prescribers of statins than expected by chance. Physicians who were high-outlying prescribers had higher historical rates of statin prescribing. Statin prescribing was substantial within nursing homes, even among frail residents. After controlling for resident characteristics, the likelihood of statin prescribing varied significantly across physicians. Further studies are required to evaluate the risks and benefits of statin use, and discontinuation, among nursing home residents to better inform clinical practice in this setting. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.
Feng, Rui Mei; Hu, Shang Ying; Zhao, Fang Hui; Zhang, Rong; Zhang, Xun; Wallach, Asya Izraelit; Qiao, You Lin
2017-09-01
We performed a pooled analysis to examine cigarette smoking and household passive smoke exposure in relation to the risk of human papillomavirus (HPV) infection and cervical intraepithelial neoplasia grade 2+ (CIN2+). Data were pooled from 12 cross-sectional studies for cervical cancer screenings from 10 provinces of China in 1999-2007. A total of 16,422 women were analyzed, along with 2,392 high-risk-HPV (hr-HPV) positive women and 381 CIN2+ cases. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression models controlling for sexual and non-sexual confounding factors. There was an excess risk between active smoking and hr-HPV infection and CIN2+. Adjusted OR for ever smokers vs. never smokers was 1.45 (95% CI=1.10-1.91), for hr-HPV infection and 1.89 (95% CI=1.03-3.44), for CIN2+. Passive smoking had a slightly increased risk on the hr-HPV infection with adjusted OR 1.11 (1.00-1.24), but no statistical association was observed between passive smoke exposure and CIN2+. Compared with the neither active nor passive smokers, both active and passive smokers had a 1.57-fold (95% CI=1.14-2.15) increased risk of HPV infection and a 1.99-fold (95% CI=1.02-3.88) risk of CIN2+. Our large multi-center cross-sectional study found active smoking could increase the risk of overall hr-HPV infection and CIN2+ adjusted by passive smoking and other factors. Passive smoking mildly increased the risk of HPV infection but not the CIN2+. An interaction existed between passive tobacco exposure and active smoking for hr-HPV infection and the CIN2+. Copyright © 2017. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology
Fabbri, Alice; Gregoraci, Giorgia; Tedesco, Dario; Ferretti, Filippo; Gilardi, Francesco; Iemmi, Diego; Lisi, Cosima; Lorusso, Angelo; Natali, Francesca; Shahi, Edit; Rinaldi, Alessandro
2016-01-01
Objective To describe how Italian medical societies interact with pharmaceutical and medical device industries through an analysis of the information available on their websites. Design Cross sectional study. Setting Italy. Participants 154 medical societies registered with the Italian Federation of Medical-Scientific Societies. Main outcome measures Indicators of industry sponsorship (presence of industry sponsorship in the programme of the last medical societies’ annual conference; presence of manufacturers’ logos on the homepage; presence of industry sponsorship of satellite symposia during the last annual conference). Results 131 Italian medical societies were considered. Of these, 4.6% had an ethical code covering relationships with industry on their websites, while 45.6% had a statute that mentioned the issue of conflict of interest and 6.1% published the annual financial report. With regard to industry sponsorship, 64.9% received private sponsorship for their last conference, 29.0% had manufacturers’ logos on their webpage, while 35.9% had industry-sponsored satellite symposia at their last conference. The presence of an ethical code on the societies’ websites was associated with both an increased risk of industry sponsorship of the last conference (relative risk (RR) 1.22, 95% CIs 1.01 to 1.48 after adjustment) and of conferences and/or satellite symposia (RR 1.22, 95% CIs 1.02 to 1.48 after adjustment) but not with the presence of manufacturers’ logos on the websites (RR 1.79, 95% CIs 0.66 to 4.82 after adjustment). No association was observed with the other indicators of governance and transparency. Conclusions This survey shows that industry sponsorship of Italian medical societies’ conferences is common, while the presence of a structured regulatory system is not. Disclosure of the amount of industry funding to medical societies is scarce. The level of transparency therefore needs to be improved and the whole relationship between medical societies and industry should be further disciplined in order to avoid any potential for conflict of interest. PMID:27251686
Quicke, Jonathan G; Foster, Nadine E; Ogollah, Reuben O; Croft, Peter R; Holden, Melanie A
2017-08-01
To investigate how attitudes and beliefs about exercise relate to physical activity behavior in older adults with knee pain attributable to osteoarthritis (OA). We conducted secondary data analyses of a randomized controlled trial of exercise interventions (ISRCTN: 93634563). Participants were adults ≥45 years old with knee pain attributable to OA (n = 514). Crude and adjusted cross-sectional and longitudinal associations between baseline Self-Efficacy for Exercise (SEE), Positive Outcome Expectations for Exercise (POEE), Negative Outcome Expectations for Exercise scores, and physical activity level, at baseline, 3 months, and 6 months (measured by self-report using the Physical Activity Scale for the Elderly [PASE]), and important increases in physical activity level (from baseline to 6-month followup) were investigated using multiple linear and logistic regression. Cross-sectional associations were found between SEE and PASE scores (β = 4.14 [95% confidence interval (95% CI) 0.26, 8.03]) and POEE and PASE scores (β = 16.71 [95% CI 1.87, 31.55]), adjusted for sociodemographic and clinical covariates. Longitudinal associations were found between baseline SEE and PASE scores at 3 months (β = 4.95 [95% CI 1.02, 8.87]) and 6 months β = 3.71 (0.26, 7.16), and baseline POEE and PASE at 3 months (β = 34.55 [95% CI 20.13, 48.97]) and 6 months (β = 25.74 [95% CI 11.99, 39.49]), adjusted for baseline PASE score and intervention arm. However, no significant associations with important increases in physical activity level were found. Greater exercise self-efficacy and more positive exercise outcome expectations were associated with higher current and future physical activity levels. These may be targets for interventions aimed at increasing physical activity. © 2017 The Authors. Arthritis Care & Research published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology.
Waylen, Andrea E; Leary, Sam D; Ness, Andrew R; Tanski, Susanne E; Sargent, James D
2012-01-01
Objective To assess associations between exposure to smoking depictions in films and adolescent tobacco use in a British population cohort. Methods Data on exposure to smoking in films and smoking behaviour were collected from 5166 15-year-old adolescents in the UK. Main outcome measures were smoking initiation (ever tried a cigarette) and current smoking status. Social, family and behavioural factors were adjusted for, together with alcohol use and peer smoking as potential mediators. Data from all existing cross-sectional studies examining the effects of exposure to smoking in films were summarised in a meta-analysis. Results Higher exposure to smoking in films was associated with a dose-response increase in the risk of smoking initiation even after adjusting for confounders. Adolescents in the highest exposure quartile were 1.73 (95% CI 1.55 to 1.93) times (RR) more likely to initiate smoking than those in the lowest quartile. They were more likely to report current smoking after adjusting for social and familial factors (RR 1.47 (95% CI 1.07 to 2.02)), but the association attenuated after including behavioural factors (RR 1.34 (95% CI 0.95 to 1.87)). The meta-analysis shows that, after aggregation of all relevant data, viewing smoking in films increases the risk of smoking onset by over 100% (combined RR 2.13 (95% CI 1.76 to 2.57)) and the risk of current or established smoking behaviour by 68% (combined RR 1.68 (95% CI 0.40 to 2.01)). Conclusions This study provides evidence that adolescents in the UK and elsewhere who are exposed to smoking depictions in films are more likely to initiate smoking. Given the association between smoking and poor health outcomes, these data justify a review of film ratings. PMID:21933947
Costa de Oliveira Forkert, E; de Moraes, A C F; Carvalho, H B; Kafatos, A; Manios, Y; Sjöström, M; González-Gross, M; Gottrand, F; Beghin, L; Censi, L; Kersting, M; Moreno, L A
2017-04-01
Socioeconomic status has been associated with obesity in children and adolescents. This association may be dependent according with where adolescents lives. The aim of this study was to evaluate the association between different socioeconomic indicators such as parental education and occupation and socioeconomic status with abdominal obesity in adolescents from two observational studies: the Healthy Lifestyle in Europe by Nutrition in Adolescence cross-sectional study (HELENA-CSS) and the Brazilian Cardiovascular Adolescent Health (BRACAH) study. European (n = 3192, aged 12.5-17.5 years, with 53.1% girls from HELENA-CSS) and Brazilian (n = 991, aged 14-18 years, with 54.5% girls from BRACAH study) adolescents from two cross-sectional studies were included in this analysis. Complete data on waist circumference (WC), height, socioeconomic status indicators and several confounders were collected. Socioeconomic indicators were measured using a self-reported questionnaire in order to assess the family social status of the adolescents. Multilevel linear regression models were used to examine associations, and results were adjusted for potential confounders. Adjusted results showed inverse associations between mother's and father's education levels (p < 0.001) and father's occupation level (p < 0.001) with waist-to-height ratio (WHtR) and WC in HELENA-CSS girls. Similarly in European girls, socioeconomic indicators by socioeconomic status and maternal occupation level were associated with WHtR. In HELENA-CSS boys, the same significant association was found between WHtR and WC with maternal occupation level. Moreover, in European boys WHtR was also associated with parental education. In Brazilian adolescents, both indicators of abdominal obesity did not remain associated with the independents variables, after adjustment for potential confounders. Abdominal obesity was associated with socioeconomic indicators in higher-income countries, but this association was not observed in a lower-middle-income country. © 2016 World Obesity Federation.
Geohelminth Infections among Pregnant Women in Rural Western Kenya; a Cross-Sectional Study
van Eijk, Anna M.; Lindblade, Kim A.; Odhiambo, Frank; Peterson, Elizabeth; Rosen, Daniel H.; Karanja, Diana; Ayisi, John G.; Shi, Ya Ping; Adazu, Kubaje; Slutsker, Laurence
2009-01-01
Background Geohelminth infections are common in rural western Kenya, but risk factors and effects among pregnant women are not clear. Methodology During a community-based cross-sectional survey, pregnant women were interviewed and asked to provide a blood sample and a single fecal sample. Hemoglobin was measured and a blood slide examined for malaria. Geohelminth infections were identified using the concentration and Kato-Katz method. Results Among 390 participants who provided a stool sample, 76.2% were infected with at least one geohelminth: 52.3% with Ascaris lumbricoides, 39.5% with hookworm, and 29.0% with Trichuris trichiura. Infection with at least one geohelminth species was associated with the use of an unprotected water source (adjusted odds ratio [AOR] 1.8, 95% confidence interval [CI] 1.1–3.0) and the lack of treatment of drinking water (AOR 1.8, 95% CI 1.1–3.1). Geohelminth infections were not associated with clinical symptoms, or low body mass index. A hookworm infection was associated with a lower mid upper arm circumference (adjusted mean decrease 0.7 cm, 95% CI 0.3–1.2 cm). Hookworm infections with an egg count ≥1000/gram feces (11 women) were associated with lower hemoglobin (adjusted mean decrease 1.5 g/dl, 95% CI 0.3–2.7). Among gravidae 2 and 3, women with A. lumbricoides were less likely to have malaria parasitemia (OR 0.4, 95% CI 0.2–0.8) compared to women without A. lumbricoides, unlike other gravidity groups. Conclusion Geohelminth infections are common in this pregnant population; however, there were few observed detrimental effects. Routine provision of antihelminth treatment during an antenatal clinic visit is recommended, but in this area an evaluation of the impact on pregnancy, malaria, and birth outcome is useful. PMID:19172184
Chiu, Maria; Rahman, Farah; Kurdyak, Paul; Cairney, John; Jembere, Nathaniel; Vigod, Simone
2017-05-01
Lone parenthood is associated with poorer health; however, the vast majority of previous studies have examined lone mothers and only a few have focused on lone fathers. We aimed to examine the self-rated health and mental health status among a large population-based cross-sectional sample of Canadian lone fathers compared with both partnered fathers and lone mothers. We investigated differences in self-rated health and mental health among 1058 lone fathers compared with 20 692 partnered fathers and 5725 lone mothers using the Ontario component of the Canadian Community Health Survey (2001-2013). Multivariable logistic regression was used to compare the odds of poor/fair self-rated health and mental health between the study groups while adjusting for a comprehensive list of sociodemographic factors, stressors and lifestyle factors. Lone fathers and lone mothers showed similar prevalence of poor/fair self-rated health (11.6% and 12.5%, respectively) and mental health (6.2% and 8.4%, respectively); the odds were similar even after multivariable adjustment. Lone fathers showed higher odds of poor/fair self-rated health (OR 1.53, 95% CI 1.07 to 2.17) and mental health (OR 2.09, 95% CI 1.26 to 3.46) than partnered fathers after adjustment for sociodemographic factors; however, these differences were no longer significant after accounting for stressors, including low income and unemployment. In this large population-based study, lone fathers had worse self-rated health and mental health than partnered fathers and similarly poor self-rated health and mental health as lone mothers. Interventions, supports and social policies designed for single parents should also recognise the needs of lone fathers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Adams, Marc A; Bruening, Meg; Ohri-Vachaspati, Punam; Hurley, Jane C
2016-03-01
The school lunch environment is a prime target for increasing a child's consumption of fresh fruits and vegetables (F/V). Salad bars are heavily encouraged in schools; however, more research is needed to examine the contexts in which salad bars promote consumption of F/V among students. To compare the amount of fresh F/V self-served, consumed, and wasted by students during lunch at schools with differing salad bar placement: inside or outside of the serving line. Cross-sectional plate waste study in which salad bar placement differed between schools. A random sample of middle school students (N=533) from six schools (three schools per district). Amount of fresh F/V taken, consumed, and wasted. Negative binomial multivariable regression examined placement of salad bars, adjusting for sex, grade, race/ethnicity, free/reduced status, day of the week, and nesting of students within schools. Almost all students (98.6%) in the schools with salad bars inside serving lines self-served F/V compared with only 22.6% of students in the schools with salad bars outside lines (adjusted prevalence ratio=5.38; 95% CI 4.04 to 7.17). Similarly, students at schools with salad bars inside the line had greater prevalence of consuming any F/V compared with students in schools with salad bars outside the line (adjusted prevalence ratio=4.83; 95% CI 3.40 to 6.81). On average, students with the salad bar outside the line wasted less F/V compared with those with salad bars inside the line (30% vs 48%, respectively). Few students visited salad bars located outside the lunch line. Salad bars inside the lunch line resulted in significantly greater fresh F/V taken, consumed, and wasted. When possible, schools should try to include salad bars inside the line to increase students' exposure to F/V. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Costa, Andrea Lorenada; Sophia, Eglacy C; Sanches, Cíntia; Tavares, Hermano; Zilberman, Monica L
2015-03-15
The aim of this study was to identify romantic relationship characteristics, emotional and personality aspects and social adjustment in subjects with pathological jealousy (PJ) and to compare them to control group. The participants, 32 individuals with PJ and 31 healthy volunteers completed measures of jealousy intensity, attachment type, love and relationship styles, personality, impulsivity, aggressiveness and social adjustment. Socio-demographic profiles were also obtained. Participants with PJ were significantly older than the control group, but no other important socio-demographic differences were observed. Participants with PJ were significantly more jealous and were predominately categorized with anxious-ambivalent attachment type, and Mania love style. They presented with elevated novelty seeking and harm avoidance, low self-directedness and cooperativeness, high levels of impulsivity and trait anxiety, and poor social adjustment. Multivariate analysis showed that jealousy intensity and trait anxiety were the variables that best distinguished participants with PJ from the control group. This study was limited by the cross-sectional design and relatively small sample size. PJ presents a particular pattern of attachment, love style, and personality structure, and deserves further attention as a specific potential disorder of the romantic bonding. Copyright © 2014 Elsevier B.V. All rights reserved.
Garfield, Victoria; Llewellyn, Clare H; Steptoe, Andrew; Kumari, Meena
2017-01-09
Cross-sectional analyses of adiposity and sleep duration in younger adults suggest that increased adiposity is associated with shorter sleep. Prospective studies have yielded mixed findings, and the direction of this association in older adults is unclear. We examined the cross-sectional and potential bi-directional, prospective associations between adiposity and sleep duration (covariates included demographics, health behaviours, and health problems) in 5,015 respondents from the English Longitudinal Study of Ageing (ELSA), at baseline and follow-up. Following adjustment for covariates, we observed no significant cross-sectional relationship between body mass index (BMI) and sleep duration [(unstandardized) B = -0.28 minutes, (95% Confidence Intervals (CI) = -0.012; 0.002), p = 0.190], or waist circumference (WC) and sleep duration [(unstandardized) B = -0.10 minutes, (95% CI = -0.004; 0.001), p = 0.270]. Prospectively, both baseline BMI [B = -0.42 minutes, (95% CI = -0.013; -0.002), p = 0.013] and WC [B = -0.18 minutes, (95% CI = -0.005; -0.000), p = 0.016] were associated with decreased sleep duration at follow-up, independently of covariates. There was, however, no association between baseline sleep duration and change in BMI or WC (p > 0.05). In older adults, our findings suggested that greater adiposity is associated with decreases in sleep duration over time; however the effect was very small.
Three-dimensional modeling of the cochlea by use of an arc fitting approach.
Schurzig, Daniel; Lexow, G Jakob; Majdani, Omid; Lenarz, Thomas; Rau, Thomas S
2016-12-01
A cochlea modeling approach is presented allowing for a user defined degree of geometry simplification which automatically adjusts to the patient specific anatomy. Model generation can be performed in a straightforward manner due to error estimation prior to the actual generation, thus minimizing modeling time. Therefore, the presented technique is well suited for a wide range of applications including finite element analyses where geometrical simplifications are often inevitable. The method is presented for n=5 cochleae which were segmented using a custom software for increased accuracy. The linear basilar membrane cross sections are expanded to areas while the scalae contours are reconstructed by a predefined number of arc segments. Prior to model generation, geometrical errors are evaluated locally for each cross section as well as globally for the resulting models and their basal turn profiles. The final combination of all reconditioned features to a 3D volume is performed in Autodesk Inventor using the loft feature. Due to the volume generation based on cubic splines, low errors could be achieved even for low numbers of arc segments and provided cross sections, both of which correspond to a strong degree of model simplification. Model generation could be performed in a time efficient manner. The proposed simplification method was proven to be well suited for the helical cochlea geometry. The generated output data can be imported into commercial software tools for various analyses representing a time efficient way to create cochlea models optimally suited for the desired task.
Perry, Rebecca A; Mallan, Kimberley M; Koo, Jasly; Mauch, Chelsea E; Daniels, Lynne A; Magarey, Anthea M
2015-02-13
Food neophobia, the rejection of unknown or novel foods, may result in poor dietary patterns. This study investigates the cross-sectional relationship between neophobia in children aged 24 months and variety of fruit and vegetable consumption, intake of discretionary foods and weight. Secondary analysis of data from 330 parents of children enrolled in the NOURISH RCT (control group only) and SAIDI studies was performed using data collected at child age 24 months. Neophobia was measured at 24 months using the Child Food Neophobia Scale (CFNS). The cross-sectional associations between total CFNS score and fruit and vegetable variety, discretionary food intake and BMI (Body Mass Index) Z-score were examined via multiple regression models; adjusting for significant covariates. At 24 months, more neophobic children were found to have lower variety of fruits (β = -0.16, p = 0.003) and vegetables (β = -0.29, p < 0.001) but have a greater proportion of daily energy from discretionary foods (β = 0.11, p = 0.04). There was no significant association between BMI Z-score and CFNS score. Neophobia is associated with poorer dietary quality. Results highlight the need for interventions to (1) begin early to expose children to a wide variety of nutritious foods before neophobia peaks and (2) enable health professionals to educate parents on strategies to overcome neophobia.
Weber, Alisa; Herr, Caroline; Hendrowarsito, Lana; Meyer, Nicole; Nennstiel-Ratzel, Uta; von Mutius, Erika; Bolte, Gabriele; Colon, Diana; Kolb, Stefanie
2016-07-01
After three decades of an increase in the prevalence of asthma and allergies, new findings show a plateau in the prevalence of industrialized nations. The objective of this study was to determine whether there was a change in the parent reported prevalence of asthma and allergies among Bavarian preschool children since 2004. A parent questionnaire was administered as part of the Bavarian school entrance examination in three cross-sectional studies from 2004/2005, 2006/2007 and 2012/2013. The questionnaire included items on allergy testing history, identified allergens, symptoms (e.g. wheezing, itchy eyes, rash), medically diagnosed asthma, hay fever and atopic dermatitis. Logistic regression was performed to observe time patterns and adjust for risk factors. Data were available for 6350 (2004/2005), 6483 (2006/2007) and 5052 (2012/2013) individuals. Symptoms and diseases were more frequent in boys, except for allergies which affect the skin. From 2004 to 2012 the parent reported prevalence of asthma (2.6% to 2.8%), hay fever (4.7% to 4.0%) and atopic dermatitis (12.4% to 11.1%) either remained quite stable or decreased not significantly. Results from these three cross-sectional surveys of parent reports suggest that the parent reported prevalences of asthma and allergies are quite stable with small fluctuations since 2004 for Bavarian preschool children. Future research is needed to determine if this trend will continue. Copyright © 2016 Elsevier GmbH. All rights reserved.
Söderberg, Mia; Rosengren, Annika; Hillström, Jenny; Lissner, Lauren; Torén, Kjell
2012-12-21
This cross-sectional study explored relationships between psychosocial work environment, captured by job demand-control (JDC) and effort-reward imbalance (ERI), and seven cardiovascular heart disease (CHD) risk factors in a general population. The sampled consists of randomly-selected men and women from Gothenburg, Sweden and the city's surrounding metropolitan areas. Associations between psychosocial variables and biomarkers were analysed with multiple linear regression adjusted for age, smoking, education and occupational status. The study included 638 men and 668 women aged 24-71. Analysis between JDC and CHD risk factors illustrated that, for men, JDC was associated with impaired scores in several biomarkers, especially among those in high strain jobs. For women, there were no relationships between JDC and biomarkers. In the analysis of links between ERI and CHD risk factors, most associations tested null. The only findings were raised triglycerides and BMI among men in the fourth quartile of the ERI-ratio distribution, and lowered LDL-cholesterol for women. An complementary ERI analysis, combining high/low effort and reward into categories, illustrated lowered triglycerides and elevated HDL-cholesterol values among women reporting high efforts and high rewards, compared to women experiencing low effort and high reward. There were some associations between psychosocial stressors and CHD risk factors. The cross-sectional design did not allow conclusions about causality but some results indicated gender differences regarding sensitivity to work stressors and also how the models might capture different psychosocial dimensions.
NASA Astrophysics Data System (ADS)
TANASA, C.; MUNTEAN, S.; CIOCAN, T.; SUSAN-RESIGA, R. F.
2016-11-01
The hydraulic turbines operated at partial discharge (especially hydraulic turbines with fixed blades, i.e. Francis turbine), developing a swirling flow in the conical diffuser of draft tube. As a result, the helical vortex breakdown, also known in the literature as “precessing vortex rope” is developed. A passive method to mitigate the pressure pulsations associated to the vortex rope in the draft tube cone of hydraulic turbines is presented in this paper. The method involves the development of a progressive and controlled throttling (shutter), of the flow cross section at the bottom of the conical diffuser. The adjustable cross section is made on the basis of the shutter-opening of circular diaphragms, while maintaining in all positions the circular cross-sectional shape, centred on the axis of the turbine. The stagnant region and the pressure pulsations associated to the vortex rope are mitigated when it is controlled with the turbine operating regime. Consequently, the severe flow deceleration and corresponding central stagnant are diminished with an efficient mitigation of the precessing helical vortex. Four cases (one without diaphragm and three with diaphragm), are numerically and experimentally investigated, respectively. The present paper focuses on a 3D turbulent swirling flow simulation in order to evaluate the control method. Numerical results are compared against measured pressure recovery coefficient and Fourier spectra. The results prove the vortex rope mitigation and its associated pressure pulsations when employing the diaphragm.
Correlates and predictors of colorectal cancer screening among male automotive workers.
McQueen, Amy; Vernon, Sally W; Myers, Ronald E; Watts, Beatty G; Lee, Eun Sul; Tilley, Barbara C
2007-03-01
Most studies examining factors associated with colorectal cancer (CRC) screening (CRCS) are cross-sectional and thus temporal relationships cannot be determined. Furthermore, less attention has been paid to psychosocial predictors of CRCS. We examined both cross-sectional correlates of prior CRCS and predictors of prospective CRCS initiation and maintenance during The Next Step Trial, a 2-year worksite behavioral intervention to promote regular CRCS and dietary change. The sample included 2,693 White male automotive workers at increased occupational risk for, but no history of, CRC who completed a baseline survey. Stratified analyses were conducted for three dependent variables (prior CRCS, CRCS initiation, and CRCS maintenance). We also assessed prior CRCS as a moderator in prospective analyses. Multivariable logistic regression analyses with generalized linear mixed models were used to adjust for cluster sampling. Except for education, cross-sectional correlates of prior CRCS including older age, family history of CRC or polyps, personal history of polyps, self-efficacy, family support, and intention were also significant prospective predictors of increased CRCS during the trial. Despite differences in the patterns of association for CRCS initiation and maintenance in stratified analyses, the only associations with prospective CRCS that were significantly moderated by prior CRCS were family history and CRCS availability. Correlates of prior CRCS that also were prospective predictors of CRCS may be suitable targets for intervention. Additionally, intervention messages addressing psychosocial constructs may be relevant for both CRCS initiation and maintenance. However, studies with more diverse samples are needed to replicate the results reported here.
Vibha, Pandey; Saddichha, Sahoo; Khan, Nawab; Akhtar, Sayeed
2013-04-01
People with mental disorders experience impaired quality of life (QOL). In India, spouses form the most important caregiver for the patient and therefore impact the patients' QOL. However, relatively little is known about marital adjustment, which can definitely influence QOL of patients with mental illness. This study intended to explore marital adjustment and QOL among remitted patients with schizophrenia (SC), depression, and bipolar disorders (BPADs) and to study differences, if any, between the groups. Using a cross-sectional design, consecutive patients (N = 150) with an ICD-10-Diagnostic Criteria for Research diagnosis of SC, depression (recurrent depressive disorder [RDD]), or BPAD, who were currently in remission, were taken up for the study and administered the WHOQOL-BREF for assessing QOL and the Marital Adjustment Inventory for assessing marital adjustment, separately for the husband and the wife. The patients with SC reported poor QOL, whereas a better QOL was seen in those with BPAD and RDD, with significant differences noted between all three groups (p < 0.001). Marital adjustment was perceived to be poor by the patients but not so by the spouses. The greatest marital dissatisfaction was reported by the patients with SC (96%). A positive correlation was observed between the patients' perception of marital adjustment and QOL (p < 0.05). Provision of mental health care should take into consideration patients' possible perception of marital maladjustment and factor these into treatment strategies.